Fatores que influenciam nas complicações das tireoidectomias

O resultado pós-operatório das tireoidectomias é imputado a fatores relativos ao paciente, à tireopatia e ao cirurgião. OBJETIVO: Analisar a experiência de um serviço quanto a complicações com a tireoidectomia. Desenho do estudo: coorte histórica com corte transversal. MATERIAL E MÉTODO: Foram avaliados os prontuários de 228 pacientes submetidos à tireoidectomia, entre 1991 e 2004. Foram estudadas as complicações transitórias, definitivas e totais, persistência e recidiva da tireopatia de base, em relação a fatores clínico-laboratoriais. RESULTADOS: Ocorreram 34,65% de complicações totais, 18,86% de complicações transitórias (9,21% hipocalcemia, 0,44% paralisia de cordas vocais, 4,82% outras), associadas aos primeiros anos de cirurgia no serviço e queixas compressivas, e 17,98% de complicações definitivas (8,77% hipoparatireoidismo, 1,75% paralisia de cordas vocais, 0,44% rouquidão), associadas à malignidade e cirurgias mais radicais. Houve persistência da doença de base em 17,98% dos casos, associada à idade, e recidiva em 10,96%, associada aos primeiros anos de cirurgia, benignidade e cirurgias menos radicais. CONCLUSÃO: Complicações pós-operatórias se associaram a queixas compressivas, história curta, malignidade e cirurgias mais radicais. A recidiva se associou aos primeiros anos de cirurgia no serviço, tireopatias benignas e cirurgias menos radicais. A persistência da doença se associou à maior idade.

Neurocisticercose e síndrome de lennox-gastaut: relato de caso

Relata-se o caso de uma menina que, aos 2 anos de idade, apresentou a forma epiléptica, hidrocefálica e encefalítica da neurocisticercose, diagnosticada por exame do líquido cefalorraqueano e tomografia computadorizada de crânio, evolução com crises polimórficas, episódios de descompensação da hipertensão intracraniana por obstrução do sistema de derivação ventriculoperitoneal, retardo no desenvolvimento neuropsicomotor e cegueira até que, aos 10 anos de idade, foi diagnosticada síndrome de Lennox-Gastaut. Atualmente, a paciente tem 16 anos, apresenta sequelas neurológicas e crises parciais complexas com automatismos, parcialmente controladas com o uso de clobazan e oxcarbazepina. A primeira associação de neurocisticercose e síndrome de Lennox-Gastaut foi descrita em 1973, por Frochtengarten & Scarante, em uma menina com quadro clínico semelhante ao do caso relatado.

Lesões sequelares na laringe em pacientes com paracoccidiodomicose

A Paracoccidioidomicose (PCM) é uma doença sistêmica que em sua forma sequelar se caracteriza por manifestações clínicas relacionadas às alterações anatômicas ou funcionais de órgãos e sistemas comprometidos no período de estado. OBJETIVO: Descrever as alterações anatômicas e funcionais laríngeas sequelares em pacientes com paracoccidioidomicose. MATERIAL E MÉTODOS: Estudo retrospectivo, sendo avaliados 49 pacientes do sexo masculino, na faixa etária de 30 a 60 anos, entre 1999 a 2004, com diagnóstico de PCM em acompanhamento pela disciplina de Moléstias Infecciosas e Parasitárias, confirmado pela demonstração do fungo em escarro, exame citológico ou histopatológico. RESULTADOS: As pregas vocais foram a estrutura laríngea mais afetada, em 67% dos pacientes verificaram-se alterações. A epiglote estava acometida em 55% dos casos. As pregas ariepiglóticas tinham modificações em 53% dos pacientes. As pregas vestibulares estavam alteradas em 46% dos casos. em 40% dos casos verificaram-se alterações em aritenoides. Na fonação, 28% tinham limitação ao movimento das cordas vocais, paresia unilateral ocorreu em 4% casos. em 24% havia restrição da luz supraglótica e 4% tinham estenose glótica, sendo que 2% precisaram de traqueotomia. CONCLUSÃO: As lesões sequelares na laringe devido à infecção pelo P. brasilienses são extensas e causam restrições funcionais na maioria dos casos.

Doença vestibular periférica decorrente de osteoartropatia temporoioídea em um eqüino

Um eqüino com 22 anos de idade apresentou síndrome vestibular periférica associada à paralisia de nervo facial esquerdo devido à osteoartropatia temporoioídea. O exame endoscópico das bolsas guturais mostrou alteração de contorno da bula timpânica esquerda e aumento de volume da extremidade proximal do osso estiloióide do mesmo lado.

Canine rabies epidemiology in Araçatuba and neighborhood, Northwestern São Paulo State - Brazil

São apresentadas algumas características epidemiológicas da raiva canina na região de Araçatuba, no período de 1993 a 1997. Dentre 1.984 cães submetidos ao diagnóstico de raiva, 351 foram positivos sendo que 89% dos casos (312/351) ocorreram na zona urbana e destes, 85% (266/312) eram de animais com proprietário. As informações sobre sexo estavam presentes em 83% das fichas e destas 61% eram de machos. A média de idade dos cães positivos foi de 34 meses. A agressividade foi um dos sintomas mais comumente observado (77%), seguido por incoordenação motora e/ou paralisia (42%) e 48% dos cães positivos haviam agredido pessoas ou outros animais. Das 182 fichas epidemiológicas que possuíam dados de vacinação, 51% (92/182) dos cães não eram vacinados. Aponta-se como possíveis razões para o aparecimento da epidemia no município de Araçatuba a baixa cobertura vacinal demonstrada pelo índice de cães não vacinados que adquiriram a doença aliado à elevada relação cão/homem (1:3,5) revelada em estudo anterior.

Type C botulism in swine fed on restaurant waste

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Antagonism of myotoxic and paralyzing activities of bothropstoxin-I by surarnin

Polyanionic substances are known to inhibit the myotoxic effects of some crotalide snake venoms. Bothropstoxin-I (BthTX-I), a basic Lys49 phospholipase (PLA(2)) homologue from Bothrops jararacussu venom, besides inducing muscle damage, also promotes the blockade of both directly and indirectly evoked contractions in mouse neuromuscular preparation. In this work, we evaluated the ability of suramin, a polysulfonated naphtylurea derivative, to antagonize the myotoxic and the paralyzing activities of BthTX-I on mice neuromuscular junction in vitro. Myotoxicity was assessed by light and electronic microscopic analysis of extensor digitorum longus (EDL) muscles; paralyzing activity was evaluated through the recording of both directly and indirectly evoked contractions of phrenic-diaphragm (PD) preparations. BthTX-I (1 muM) alone, or pre-incubated with suramin (10 muM) at 37degreesC for 15 min was added to the preparations for 120 min. BthTX-I induced histological alterations typical of myonecrosis in 14.6 +/- 1.0% of EDL muscle fibers. In addition, BthTX-I blocked 50% of both directly and indirectly evoked contractions in PD preparations in 72.1 +/- 9.1 and 21.1 +/- 2.0 min, respectively. Pre-incubation with suramin abolished both the muscle-damaging and muscle-paralyzing activities of BthTX-I. Since suramin is a polyanionic substance, we suggested that its effects result from the formation of inactive acid-base complexes with BthTX-I. (C) 2003 Elsevier Ltd. All rights reserved.

Co-60 gamma irradiation prevents Bothrops jararacussu venom neurotoxicity and myotoxicity in isolated mouse neuromuscular junction

The ability of gamma radiation from Co-60 (2000 Gy) to attenuate the toxic effects of Bothrops jararacussu venom was investigated on mouse neuromuscular preparations in vitro. A comparative study between the effects of native and irradiated venoms was performed on both phrenic-diaphragm (PD) and extensor digitorum longus (EDL) preparations by means of myographic, biochemical and morphological techniques. Native venom (10 and 20 mug/ml) induced a concentration-dependent paralysis of both directly and indirectly evoked contractions on PD preparations. At 20 mug/ml, it also caused a pronounced myotoxic effect on the EDL muscle preparation that was characterized by an increase of creatine kinase release and by several morphological changes of this preparation. By contrast, irradiated venom, even at concentrations as high as 40 mug/ml, induced neither paralyzing nor myotoxic effects. It was concluded that Co-60 gamma radiation is able to abolish both the paralyzing and the myotoxic effects of B. jararacussu venom on the mouse neuromuscular junction. These findings support the hypothesis that gamma radiation could be an important toot to improve antisera production by reducing toxicity while preserving immunogenicity. (C) 2002 Elsevier B.V. Ltd. All rights reserved.

Insect Venom Peptides

The insects of the order Hymenoptera ( bees, wasps, and ants) are classified in two groups, based on their life history: social and solitary. The venoms of the social Hymenoptera evolved to be used as defensive tools to protect the colonies of these insects from the attacks of predators. Generally they do not cause lethal effects but cause mainly inflammatory and/or immunological reactions in the victims of their stings. However, sometimes it is also possible to observe the occurrence of systemic effects like respiratory and/or kidney failure. Meanwhile, the venoms of solitary Hymenoptera evolved mainly to cause paralysis of the preys in order to permit egg laying on/within the prey's body; thus, some components of these venoms cause permanent/transient paralysis in the preys, while other components seem to act preventing infections of the food and future progenies. The peptide components of venoms from Hymenoptera are spread over the molar mass range of 1400 to 7000 da and together comprise up to 70% of the weight of freeze-dried venoms. Most of these toxins are linear polycationic amphipatic peptides with a high content of alpha-helices in their secondary structures. These peptides generally account for cell lysis, hemolysis, antibiosis, and sometimes promote the delivery of cellular activators/mediators through interaction with the G-protein receptor, and perhaps some of them are even immunogenic components. In addition to these peptides, the Hymenopteran venoms also may contain a few neurotoxins that target Na+ and/or Ca+2 channels or even the nicotinic ACh receptor. This review summarizes current knowledge of the biologically active Hymenoptera venoms.

Structure determination of hydroxytrypargine: A new tetrahydro-beta-carboline toxin from the venom of the spider Parawixia bistriata

A new, highly active tetrahydro-p-carboline toxin from the spider Parawixia bistriata, the most-common species of social spider occurring in Brazil, was isolated. The new toxin was identified as 1,2,3,4-tetrahydro-6-hydroxy-beta-carboline (= N-[3-(2,3,4,9-tetrahydro-6-hydroxy-1H-pyrido[3,4-b]indol-1-yl)propyl]guanidine; 3). This type of alkaloid, not common among spider toxins, was found to be the most-potent constituent of the spider's chemical weaponry to kill prey. When P bistriata catch arthropods in their web, they apparently attack their prey in groups of many individuals injecting their venoms. In vivo toxicity assays with 3 demonstrated a potent lethal effect to honeybees, giving rise to clear neurotoxic effects (paralysis) before death. The compound's toxicity (LD50 value) was determined to be ca. 8 ng/g of honeybee. The investigation of the pharmacological properties and neurotoxic actions of 3 may be used in the future for the development of new drugs to be applied for pest control in agriculture.

Monoamine oxidase inhibitory activities of indolylalkaloid toxins from the venom of the colonial spider Parawixia bistriata: Functional characterization of PwTX-I

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The chelation of metal ions by the acylpolyamine toxins from the web-spider Nephilengys cruentata: effects in the intoxication/detoxification of preys

Orb-web-spiders present a series of different strategies for prey capture, involving the use of different types of silk for web building, the use of adhesive traps in the webs, the secretion of toxic compounds to the spider's preys in the adhesive coating of the capture web and the biosynthesis of a wide range of structurally related acylpolyamine toxins in their venoms. The polyamine toxins usually block neuromuscular junctions and/or the central nervous system (CNS) of Arthropods, targeting specially the ionotropic glutamate receptors; this way these toxins are used are as chemical weapons to kill / paralyze the spider's prey. Polyamine toxins contain many azamethylene groups involved with the chelation of metal ions, which in turn can interact with the glutamate receptors, affecting the toxicity of these toxins. It was demonstrated that the chelation of Ni+2, Fe+2, Pb+2, Ca+2 and Mg+2 ions by the desalted crude venom of Nephilengys cruentata and by the synthetic toxin JSTX-3, did not cause any significant change in the toxicity of the acylpolyamine toxins to the model-prey insect (honeybees). However, it was also reported that the chelation of Zn+2 ions by the acylpolyamines potentiated the lethal / paralytic action of these toxins to the honeybees, while the chelation of Cu+2 ions caused the inverse effect. Atomic absorption spectrometry and Plasma-ICP analysis both of N.cruentata venom and honeybee's hemolymph revealed that the spider's venom concentrates Zn+2 ions, while the honeybee's hemolymph concentrates Cu+2 ions. These results are suggesting that the natural accumulation of Zn+2 ions in N. cruentata venom favors the prey catching and/or its maintenance in the web, while the natural accumulation of Cu+2 ions in prey's hemolymph minimizes the efficiency of the acylpolyamine toxins as killing/paralyzing tool.

Controle de movimentos voluntários no membro superior não plégico de portadores de paralisia cerebral hemiplégica espástica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Crystal Structure of Bucain, a Three-Fingered Toxin from the Venom of the Malayan Krait (Bungarus candidus)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Clinical and hematological alterations in dogs during experimental envenomation with Crotalus durissus terrificus venom and treated with antiophidic serum

The present work aimed to evaluate the clinical and hematological aspects during experimental envenomation by Crotalus durissus terrificus in dogs treated with different antiophidic serum doses. Sixteen dogs were divided into two groups of eight animals each. Group I received 1mg/kg venom subcutaneously and 30mg antiophidic serum intravenously; Group II received 1mg/kg venom subcutaneously and 60mg antiophidic serum intravenously. In the clinical evaluation, we observed ataxia, moderate sedation, dilated pupils, sialorrhea, flaccid paralysis of mandibular muscles, and discreet edema at the site of venom inoculation. Evaluating red and white blood cells, we observed a decrease of hemoglobins, globular volume and erythrocytes, and an increase of plasmatic proteins, leukocytes, neutrophils, monocytes and lymphocytes. Clotting time increased and there was blood incoagulability with return to normal clotting time six hours after antiophidic serum administration. Animals treated with six antiophidic serum flasks had a faster recovery than the animals that received three serum flasks.