RESUMO
Resumen: El virus del Zika fue el responsable en Colombia de la segunda epidemia más grande del continente después de Brasil durante el período 2015-2017. Con 100.000 casos reportados, 19.963 gestantes infectadas y 248 casos de niños nacidos con microcefalia, la epidemia fue declarada como finalizada en el país en 2016. Es el causal del Síndrome Congénito por Zika (SCZ), sospechado por primera vez en Río de Janeiro donde se estableció la relación entre la infección por Zika en gestantes y el aumento en la incidencia de microcefalias. Posteriormente se plantearía toda una serie de alteraciones congénitas en el feto a nivel neurológico, sensorial y osteomuscular confirmando así el efecto teratogénico del virus. Se presenta el caso de un paciente de cuatro meses y veinte días de edad que procede del área rural de Ibagué y que acude al programa madre canguro de la Unidad Materno Infantil del Tolima (UMIT); presenta diagnóstico de microcefalia asociada a neuroinfección congénita por Zika con prueba confirmatoria RT-PCR de la madre por parte del Instituto Nacional de Salud. Presenta hallazgos imagenológicos, físicos y clínicos como un perímetro cefálico que persiste por debajo de -3SD, trastorno del tono y un Retardo en el Desarrollo Psicomotor (RDPM) severo con una edad neurológica de tres meses persistente en todos los controles. Atrofia cortical, microcalcificaciones periventriculares y gangliobasales, y ventriculomegalia. Se trata del primero de veintiún pacientes con sospecha clínica y confirmación con hallazgos similares a los presentados en la literatura. La importancia de la detección de estos casos radica en el riesgo neurológico que se presenta por el compromiso motor, cognitivo y sensorial. También en la diferenciación con las secuelas neurológicas por TORCH y de alteraciones cromosómicas.
Abstract: The Zika virus was responsible in Colombia for the second largest epidemic on the continent after Brazil during the 2015-2017 period. With 100,000 reported cases, 19,963 infected pregnant women and 248 cases of children born with microcephaly, the epidemic was declared to have ended in the country in 2016. It is the cause of the Congenital Zika Syndrome (CZS), suspected for the first time in Rio de Janeiro where the relationship between Zika infection in pregnant women and the increase in the incidence of microcephaly was established. Subsequently, a whole series of congenital disorders in the fetus would be considered at the neurological, sensory, and musculoskeletal levels, thus confirming the teratogenic effect of the virus. The case of a four-month and twenty-day old patient coming from the rural area of Ibagué and attending the kangaroo mother program of the Maternal and Child Unit of Tolima (UMIT) is presented. The child was diagnosed with microcephaly associated with congenital Zika neuroinfection confirmed by RT-PCR test to the mother by the National Institute of Health. It presents imaging, physical, and clinical findings such as a head circumference persistently below -3SD, tone disorder, and a severe Psychomotor Development Retardation (PDR) with a persistent neurological age of three months in all controls. Cortical atrophy, periventricular and basal ganglia micro-calcification, and ventriculomegaly. This is the first of twenty-one patients with clinical suspicion and confirmation with findings similar to those presented in the literature. The importance of detecting these cases lies in the neurological risk presented by motor, cognitive and sensory involvement and also in the differentiation with TORCH neurological sequelae and chromosomal abnormalities.
Resumo: O vírus do Zika foi o responsável na Colômbia pela segunda maior epidemia do continente depois do Brasil entre 2015 e 2017. Com 100.000 casos relatados, 19.963 gestantes infectadas e 248 casos de recém-nascidos com microcefalia, a epidemia foi declarada como finalizada no país em 2016. É a causa da síndrome congênita pelo vírus Zika, suspeita pela primeira vez no Rio de Janeiro, Brasil, onde foi estabelecida a relação entre a infecção pelo vírus Zika em gestantes e o aumento da incidência de mi-crocefalias. Em seguida, são apresentadas alterações congénitas no feto em nível neurológico, sensorial e osteomuscular, o que confirma o efeito teratogênico do vírus. É apresentado o caso de um paciente de quatro meses e vinte dias de idade que procede da área rural de Ibagué, Colômbia, e que recorre ao programa "mãe canguru" da Unidade Materno-Infantil de Tolima; apresenta diagnóstico de microcefalia associada à neuroinfecção congênita pelo vírus Zika com teste confirmatório RT-PCR da mãe, realizado pelo Instituto Nacional de Saúde da Colômbia. Apresenta achados imagenológicos, físicos e clínicos como um perímetro cefálico que persiste abaixo de -3SD, transtorno do tom e um atraso no desenvolvimento psicomotor agudo com uma rede neurológica de três meses persistente em todas as revisões. Atrofia cortical, microcalcificações periventriculares e dos gânglios da base, e ventriculomegalia. Trata-se do primeiro de 21 pacientes com suspeita clínica e confirmação com achados semelhantes aos apresentados na literatura. A importância da detecção desses casos está no risco neurológico apresentado pelo comprometimento motor, cognitivo e sensorial. Também na diferenciação com as sequelas neurológicas por TORCH e alterações cromossômicas.
Assuntos
Humanos , Gravidez , Lactente , Microcefalia , Anormalidades Congênitas , Zika virus , Infecção por Zika virusRESUMO
Los productos fluorados son utilizados principalmente por su efecto anticariogénico en el esmalte dental. Objetivo: El propósito de este estudio fue determinar la eficiencia de tres compuestos fluorados en el tratamiento del esmalte desmineralizado. Método: Una superficie desmineralizada fue producida por exposición en solución desmineralizante en el esmalte de 120 terceros molares permanentes durante 96 horas. Se dividieron aleatoriamente en cuatro grupos para recibir tratamiento tópico con los siguientes productos fluorados: 1) fluoruro de plata amoniacal, 2) difluorsilano, 3) flúor fosfato acidulado y 4) un grupo control. Las muestras fueron inmersas en un sistema de pH cíclico (pH 4.4 a 7.0) y recuperadas a 5, 10 y 15 días para ser observadas bajo luz polarizada con solución de Tholuet en un fotomicroscopio y determinar la remineralización de acuerdo con la birrefringencia que mostraron. Resultados: El grupo tratado con fluoruro de plata amoniacal mostró una diferencia significativa con los otros grupos a 5 y 10 días. Por otra parte, los resultados a los 10 días para el flúor fosfato acidulado se mantuvieron iguales a los 15 días. Conclusiones: El grupo tratado con fluoruro de plata amoniacal presentó mayores cambios que los grupos tratados con flúor fosfato acidulado, difluorsilano y control.
Fluoride-containing products are mainly used due to their anti-cariogenic effect upon dental enamel. Objective: The aim of the present study was to determine the efficiency of three fluorinated compounds when used on demineralized enamel. Method: A de-mineralized surface was obtained by means of exposing the enamel of 120 permanent third molars to a demineralizing solution for 96 hours. Molars were randomly divided into four groups in order to receive topical treatment with the following fluorinated compounds: 1) silver ammonium fluoride, 2) difluorsilane, 3) acidulated phosphate fluoride and 4) a control group. All samples were immersed in a cyclic pH system (pH 4.4 to 7.0) and retrieved after 5, 10 and 15 days in order to be observed. Samples were examined under polarized light and Tholuet solution in a photomicroscope (Zeiss, Germany) in order to determine remineralization according to exhibited birefringence. Results: After 5 and 10 days, the group treated with silver ammonium fluoride showed significant difference with respect to other groups. Nevertheless, acidulated phosphate fluoride 10-day results remained equally unaltered at 15 days. Conclusions: The group treated with silver ammonium fluoride presented more significant changes than groups treated with silver ammonium fluoride, difluorsilane as well as the control group.
RESUMO
Valproate, a widely used anti-epileptic drug also employed in the treatment of neurological diseases such as bipolar disorder and migraine, regulates the glutamatergic and GABAergic systems, although its effects in cell physiology have not been thoroughly characterized. High concentrations of glutamate reached during abnormal neurotransmission if not removed properly, become neurotoxic. Glutamate clearance is carried out by high affinity Na(+)-dependent glutamate transporter systems. The glutamate/aspartate transporter GLAST/EAAT1 plays the major role in glutamate removal and is regulated at different levels: transcription, post-translational modifications and cytoplasmic trafficking. The aim of this work was to gain insight into a plausible effect of valproate in GLAST function. Using cultured Bergmann glia cells from chick cerebellum we demonstrate here that valproate exposure elicits a dual regulatory effect on GLAST. In the short-term, valproate increases its Na(+)-dependent [(3)H]-d-aspartate uptake activity in a cytochalasin B-sensitive manner. Interestingly, a synergism between valproate and a histone deacetylase inhibitor was observed. Long-term valproate treatment up-regulates chglast promoter activity, GLAST mRNA levels, GLAST molecules at the plasma membrane and its uptake activity. Furthermore, valproate induces histone 3 lysine 14 acetylation and regulates Ying-Yang 1 (YY1) transcriptional repression on the chglast promoter. These results suggest that valproate elicits its effect through its histone deacetylase inhibitor properties.