Assuntos
Fármacos Antiobesidade/toxicidade , Doenças Desmielinizantes/induzido quimicamente , Leucoencefalopatias/induzido quimicamente , Doenças Desmielinizantes/epidemiologia , Contaminação de Medicamentos , Humanos , Inseticidas/toxicidade , Leucoencefalopatias/epidemiologia , México/epidemiologia , Proteínas do Tecido Nervoso/antagonistas & inibidores , Nitrilas/toxicidade , Resíduos de Praguicidas/toxicidade , Disponibilidade de Medicamentos Via Internet , Inibidores de Proteínas Quinases/toxicidade , Proteínas Tirosina Quinases/antagonistas & inibidores , Espanha/epidemiologia , Texas/epidemiologia , Desacopladores/toxicidadeRESUMO
The prevalence of drug-associated toxic encephalopathy is unknown, but it is an uncommon condition. Toxic leukoencephalopathy was described associated with heroin consumption, it has been less commonly described with the use of cocaine and there are no reports of its association with consumption pasta base of cocaine (PBC). We report two females aged 31 years and a male aged 19 years, consumers of PBC who developed a fatal toxic leukoencephalopathy. They initiated their disease with severe and persistent headache, sequential focal neurologic deficits and a progressive impairment of consciousness that culminated with their death. Laboratory parameters such as blood count, cerebrospinal fluid analyses or infectious biological indices were normal. MRI showed multifocal lesions in brain white matter of both hemispheres confirming the leukoencephalopathy. There was no response to the use of methylprednisolone.
Assuntos
Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Cocaína/efeitos adversos , Leucoencefalopatias/induzido quimicamente , Transtornos da Consciência/etiologia , Evolução Fatal , Cefaleia/etiologia , Leucoencefalopatias/complicações , Leucoencefalopatias/diagnóstico , Imageamento por Ressonância Magnética , Síndromes Neurotóxicas/complicações , Síndromes Neurotóxicas/diagnósticoRESUMO
The prevalence of drug-associated toxic encephalopathy is unknown, but it is an uncommon condition. Toxic leukoencephalopathy was described associated with heroin consumption, it has been less commonly described with the use of cocaine and there are no reports of its association with consumption pasta base of cocaine (PBC). We report two females aged 31 years and a male aged 19 years, consumers of PBC who developed a fatal toxic leukoencephalopathy. They initiated their disease with severe and persistent headache, sequential focal neurologic deficits and a progressive impairment of consciousness that culminated with their death. Laboratory parameters such as blood count, cerebrospinal fluid analyses or infectious biological indices were normal. MRI showed multifocal lesions in brain white matter of both hemispheres confirming the leukoencephalopathy. There was no response to the use of methylprednisolone.
Assuntos
Cocaína/efeitos adversos , Leucoencefalopatias/induzido quimicamente , Adulto , Transtornos da Consciência/etiologia , Evolução Fatal , Feminino , Cefaleia/etiologia , Humanos , Leucoencefalopatias/complicações , Leucoencefalopatias/diagnóstico , Imageamento por Ressonância Magnética , Masculino , Síndromes Neurotóxicas/complicações , Síndromes Neurotóxicas/diagnóstico , Adulto JovemRESUMO
Air pollution exposures are linked to neuroinflammation and neuropathology in young urbanites. Forty percent of exposed children and young adults exhibit frontal tau hyperphosphorylation and 51% have amyloid-ß diffuse plaques compared to 0% in low pollution controls. In older adults, white matter hyperintensities (WMH) are associated with cognitive deficits while inflammatory markers correlate with greater atrophy than expected for age. We investigated patterns of WMH, magnetic resonance imaging (MRI) volume growth, blood inflammatory mediators, and cognition in matched children from two urban cohorts: one severely and one minimally exposed to air pollution. Baseline and one year follow-up measurements of cognitive abilities, brain MRI volumes, and blood were collected in 20 Mexico City (MC) children (10 with WMH+, and 10 without WMH-) and 10 matched controls (WMH-). MC WMH- children display the profile of classical pro-inflammatory defensive responses: high interleukin 12, production of powerful pro-inflammatory cytokines, and low concentrations of key cytokines and chemokines associated with neuroprotection. MC WMH+ children exhibit a response involved in resolution of inflammation, immunoregulation, and tissue remodeling. The MC WMH+ group responded to the air pollution-associated brain volumetric alterations with white and grey matter volume increases in temporal, parietal, and frontal regions and better cognitive performance compared to MC WMH-. We conclude that complex modulation of cytokines and chemokines influences children's central nervous system structural and volumetric responses and cognitive correlates resulting from environmental pollution exposures. Identification of biomarkers associating systemic inflammation to brain growth is critical for detecting children at higher risk for cognitive deficits and neurodegeneration, thereby warranting early implementation of neuroprotective measures.
Assuntos
Poluição do Ar/efeitos adversos , Encéfalo/patologia , Transtornos Cognitivos/induzido quimicamente , Deficiências do Desenvolvimento/induzido quimicamente , Inflamação/induzido quimicamente , Leucoencefalopatias/induzido quimicamente , Mapeamento Encefálico , Criança , Transtornos Cognitivos/patologia , Citocinas/metabolismo , Feminino , Seguimentos , Humanos , Imageamento Tridimensional , Inflamação/patologia , Contagem de Leucócitos , Leucoencefalopatias/patologia , Imageamento por Ressonância Magnética , Masculino , Testes NeuropsicológicosRESUMO
Fumonisins are mycotoxins that contaminate maize, disrupt the folate and sphingolipid metabolism, are associated with neural tube defects, and are considered by the International Agency for Research on Cancer (IARC) as possible human carcinogens. Since maize-based foods are significant components of the Mexican diet and there is a high prevalence of genetic susceptibility for folate deficiency among Mexicans, this essay presents international and national evidence of fumonisin exposure and the relevance that such exposure represents for Mexico.
Assuntos
Ácido Fólico/metabolismo , Contaminação de Alimentos , Fumonisinas/efeitos adversos , Defeitos do Tubo Neural/etiologia , Adolescente , Adulto , Animais , Carcinógenos Ambientais/efeitos adversos , Neoplasias do Sistema Digestório/induzido quimicamente , Neoplasias do Sistema Digestório/epidemiologia , Equidae , Feminino , Receptor 2 de Folato/antagonistas & inibidores , Fumonisinas/química , Fumonisinas/farmacocinética , Fumonisinas/toxicidade , Homocistinúria/epidemiologia , Homocistinúria/genética , Humanos , Necrose Tubular Aguda/induzido quimicamente , Leucoencefalopatias/induzido quimicamente , Leucoencefalopatias/veterinária , Masculino , Proteínas de Membrana Transportadoras/metabolismo , Metilenotetra-Hidrofolato Redutase (NADPH2)/deficiência , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , México , Camundongos , Espasticidade Muscular/epidemiologia , Espasticidade Muscular/genética , Defeitos do Tubo Neural/induzido quimicamente , Defeitos do Tubo Neural/epidemiologia , Defeitos do Tubo Neural/genética , Gravidez , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/genética , Ratos , Esfingolipídeos/química , Esfingolipídeos/metabolismo , Suínos , Teratogênicos/toxicidade , Adulto Jovem , Zea mays/microbiologiaRESUMO
Las fumonisinas son una familia de micotoxinas que contaminan al maíz, alteran el metabolismo de los esfingolípidos y del folato, se asocian con defectos del tubo neural y están catalogadas por la Agencia Internacional de Investigación en Cáncer (IARC por sus siglas en inglés) como posibles carcinógenos humanos. Debido a que en México los derivados de maíz constituyen una parte importante de la dieta y existe alta prevalencia de población genéticamente susceptible a la deficiencia de folato, en este ensayo se presentan las evidencias mundiales y nacionales de la exposición a fumonisinas y la relevancia que para México representa la evaluación de esta exposición.
Fumonisins are mycotoxins that contaminate maize, disrupt the folate and sphingolipid metabolism, are associated with neural tube defects, and are considered by the International Agency for Research on Cancer (IARC) as possible human carcinogens. Since maize-based foods are significant components of the Mexican diet and there is a high prevalence of genetic susceptibility for folate deficiency among Mexicans, this essay presents international and national evidence of fumonisin exposure and the relevance that such exposure represents for Mexico.