RESUMO
Components from animal venoms may vary according to the snake's age, gender and region of origin. Recently, we performed a proteomic analysis of Bothrops jararaca venom from southern (BjSv) and southeastern (BjSEv) Brazil, showing differences in the venom composition, as well as its biological activity. To continue the study, we report in this short communication the different effects induced by the BjSEv and BjSv on isolated kidney and MDCK renal cells. BjSEv decreased perfusion pressure (PP) and renal vascular resistance (RVR) and increased urinary flow (UF) and glomerular filtration rate (GFR), while BjSv did not alter PP and RVR and reduced UF and GFR. Both types of venom, more expressively BjSEv, reduced %TNa+, %TK+ and %Cl-. In MDCK cells, the two types of venom showed cytotoxicity with IC50 of 1.22 µg/mL for BjSv and 1.18 µg/mL for BjSEv and caused different profiles of cell death, with BjSv being more necrotic. In conclusion, we suggest that BjSv is more nephrotoxic than BjSEv.
Assuntos
Bothrops , Venenos de Crotalídeos/toxicidade , Rim/efeitos dos fármacos , Animais , Apoptose/efeitos dos fármacos , Venenos de Crotalídeos/química , Cães , Técnicas In Vitro , Rim/patologia , Células Madin Darby de Rim Canino , Masculino , Ratos WistarRESUMO
Malignant hypertension is a rare consequence of contraceptive use. We report here on two young women with malignant hypertension secondary to contraceptive use whose main symptomatology was neurological. Both patients had renal failure, severe left ventricle hypertrophy, and hemorrhagic stroke, all reversible after control of blood pressure and discontinuation of the contraceptive pill.
PIP: Although an association between oral contraceptives (OCs) and arterial hypertension has been well-documented, most studies have found only mild or moderate hypertension with reversal to normal levels 3 months after OC discontinuation. This paper presents two cases in which young women developed severe left ventricular hypertrophy and renal failure due to OC-induced malignization of hypertension. The first patient, a 23-year-old, was admitted to the hospital with a 3-day history of headache, mental confusion, and aggressiveness. 6 months before presentation, severe arterial hypertension had been diagnosed. At that time, she was advised to discontinue OCs (30 mcg of ethinyl estradiol and 150 mcg of levonorgestrel), which she had been taking for a year; she did not comply with this directive. The second patient, 21 years old, was admitted with accelerating hypertension. She had initiated OC use (30 mg of ethinyl estradiol and 150 mcg of levonorgestrel) 6 months earlier. 3 months after starting OC use, she developed headache and fatigue. Both women had a hemorrhagic cerebral accident as a complication of malignant hypertension. All neurologic, renal, and cardiovascular complications were reversible after OC discontinuation. OC-related malignant hypertension can be averted through effective control of blood pressure in OC users.
Assuntos
Injúria Renal Aguda/etiologia , Hemorragia Cerebral/etiologia , Etinilestradiol/efeitos adversos , Hipertensão Maligna/induzido quimicamente , Hipertrofia Ventricular Esquerda/etiologia , Levanogestrel/efeitos adversos , Adulto , Anti-Hipertensivos/uso terapêutico , Dexametasona/uso terapêutico , Feminino , Cefaleia/etiologia , Hemianopsia/etiologia , Humanos , Hipertensão Maligna/complicações , Convulsões/etiologiaRESUMO
PIP: The provincial ministry of health has taken over a dialysis center in La Plata, Argentina, following the discovery that at least 20 of the clinic's 34 regular patients have been infected with the human immunodeficiency virus (HIV). Catheters of the clinic's dialysis machines were found to be contaminated with HIV. The 5 physicians associated with the Centro Modelo de Dialisis have been discharged for negligence. 20 of the regular patients also contracted hepatitis C. Argentinian law stipulates that filters for the same patient must be changed after 4 times and prohibits the use of the same vessel to administer medication to more than 1 patient. Testimony from nurses at the La Plata clinic revealed that filters were reused for several patients and basic sanitary procedures were not followed. In 1990, 33 kidney disease patients at a dialysis center in Cordoba became infected with HIV and it was discovered that filters had been used up to 8 times for different patients. The 5 La Plata physicians stand accused of "the culpable propagation of dangerous diseases."^ieng