Urticaria induced by caffeine

Caffeine has rarely been reported as the cause of allergic reactions. We describe a 10-year-old child who developed urticaria after the intake of coffee and cola beverages. The prick test and the oral challenge test with caffeine were both positive. Nevertheless, the oral challenge test with theophylline, another methylxanthine, was negative.

[Pathogenic potential of vibrio cholerae 01 isolated from the Mapocho river and Aguada ditch]

The pathogenic potential of 20 strains of Vibrio Cholerae 01 isolated from the Mapocho river and Aguada ditch in Santiago, Chile was studied using a rabbit intestinal loop biological model. The presence of cholera toxin (CT) was previously found by the detection of CT gene, ELISA and passive reserve agglutination in only one of these strains. After 24 h of intestinal loop inoculation, the 20 strains showed enterotoxic activity. In four of these strains the secretory reaction was particularly intense. In these same four strains, the presence of cholera toxin was detected after the passage through the animal model. Thus, the number of cholera toxin producing strains increased after the inoculation in intestinal loops. These results suggest that the enterotoxic activity of strains that do not produce CT is given by the new cholera toxin (NCT). It is concluded that most of the strains of Vibrio Cholerae isolated from Mapocho river and its affluents are producers of NCT toxin, that some strains recover the capacity to produce CT after colonization of intestinal loops of living organisms and that the additive effects of CT and NCT may explain the intense enterotoxic activity of the strains that produce CT.

Dual genitotropic human papillomavirus infections in genital warts

BACKGROUND AND METHODS

We have carried out a prospective study of dual genitotropic human papillomavirus (HPV) infections by means of two different DNA detection methods in biopsy specimens obtained from patients who were examined for genital warts at the STD clinic of the School of Medicine in Seville, between January 1990 and December 1991.

RESULTS

100 patients with a clinical diagnosis of condilomata acuminata were seen during the study period. DNA of the genitotropic HPV 6/11, 16/18 and 31/33/35 was detected by an in situ hybridisation method in 75 (77%) of the 98 evaluable samples; one of the genotypes tested in 59 (61%) samples, and two or more genotypes tested in the remaining 16 (15%) samples. In 21 (98%) of the 23 negative samples by in situ hybridisation, we were able to detect DNA of genital HPV using a polymerase chain reaction amplification method (PCR). Among the 34 samples where PCR was applied we confirmed the presence of two different HPV genotypes in eight samples.

CONCLUSIONS

The frequency of dual infections with human genitotropic papillomavirus in genital warts was 8%, although we believe that this rate should be higher as we have not used the PCR method in all of the samples.

Enterohemorrhagic Escherichia coli associated with hemolytic-uremic syndrome in Chilean children

A clinicoepidemiological study was undertaken to determine if enterohemorrhagic Escherichia coli (EHEC) was associated with hemolytic-uremic syndrome (HUS) in children in Santiago, Valdivia, and Temuco, Chile. Prospective surveillance detected 20 hospitalized cases of HUS in children less than 4 years of age in these cities from March 1988 to March 1989. Each HUS patient was matched (by sex and age) with two control children (hospitalized elective-surgery patients). To detect EHEC, DNA from stool culture isolates of E. coli was detected by hybridization with biotin-labelled DNA probes specific for the EHEC virulence plasmid, Shiga-like toxin I (SLT-I) or SLT-II. Stool cultures from 6 of 20 cases (30%) and from 2 of 38 controls (5.3%) yielded EHEC (P = 0.0158). EHEC isolates from all HUS cases hybridized with the EHEC plasmid probe and with probes for SLT-I or -II (or both). The serogroups of the isolates included O157, O26, and O111. EHEC causes HUS in Chile, and the biotinylated gene probes are practical diagnostic tools for epidemiologic studies.

Six new cases of a caterpillar-induced bleeding syndrome

We describe six new cases of a hemorrhagic diathesis induced by contact with Lonomia achelous caterpillars. Onset of clinical bleeding varied between a few hours and 10 days post-exposure. Laboratory coagulation tests showed prolonged PT, PTT and ThT; normal platelets and a marked decrease of fibrinogen, factor V, plasminogen and factor XIII (including its subunits A and S). Factors VII, II and alfa 2 anti-plasmin were variably affected. In addition, activation of the fibrinolytic system and the generation of a procoagulant effect could also be demonstrated. Two cases developed severe hemorrhagic diathesis and one of them died of a cerebral hemorrhage. Different aspects of this rare syndrome are discussed in relation to its complex physiopathology and the variability observed in all clinical and laboratory manifestations. Therapeutic recommendations and some possible hazards following replacement transfusions are also considered.

Epidemiologic patterns of acute diarrhea and endemic Shigella infections in children in a poor periurban setting in Santiago, Chile

To prepare a field site for evaluating preventive interventions against endemic shigellosis, the authors followed prospectively a cohort of 360 children (90 each of children aged 0-11, 12-23, 24-35, and 36-47 months) in Santa Julia, a low socioeconomic area in Santiago, Chile, from November 1986 through April 1989 with twice weekly household visits for diarrheal disease; infants replaced children who reached 60 months of age. Coprocultures on 2 consecutive days from children with diarrhea and from age-matched controls within the cohort were cultured for Shigella. Bacteriologic surveillance was also maintained in the health center and children's hospital serving Santa Julia. In this community, where all households had access to potable water (68% inside) and all but 3% had access to a toilet, but where there was marked crowding, the overall incidence of diarrheal disease in the cohort was low (2.26 episodes/12 child months of observation in children aged 0-11 months and 2.09 in those aged 12-23 months), yet Shigella infections were common. Shigella accounted for 10% of diarrheal episodes in the cohort (vs. 3.2% isolation rate in controls, p less than 0.0001). The incidence of shigellosis in children aged 12-47 months was 0.16 cases per 12 child months of observation; in the first 5 years of life, a child had a 67% chance of experiencing shigellosis. Shigella sonnei, Shigella flexneri 2a, and S. flexneri 6 caused greater than 79% of the infections. Shigella occurred more often in hospitalized cases of diarrhea than in age-matched cases detected in the health center or by household surveillance (p less than 0.0001). An initial episode of Shigella diarrhea did not diminish overall the risk of subsequent shigellosis but did confer 72% protection (p = 0.05) against illness due to the homologous serotype. The high rate of both S. sonnei and S. flexneri shigellosis in a population with a low background rate of diarrhea makes Santa Julia an appropriate site for assessing the efficacy and effectiveness of measures to reduce Shigella infections.

An A alpha Ser-434 to N-glycosylated Asn substitution in a dysfibrinogen, fibrinogen Caracas II, characterized by impaired fibrin gel formation

We have identified a unique N-glycosylated Asn substitution for a Ser at position 434 of the A alpha chain of an abnormal fibrinogen designated fibrinogen Caracas II. This dysfibrinogen was characterized by impaired fibrin monomer aggregation. Since there were 4 Thr residues immediately following the mutation, a new Asn-X-Thr/Ser-type consensus sequence, Asn-Thr-Thr arose for N-glycosylation of the Asn. The extra oligosaccharide was found to consist mainly of a disialylated biantennary structure comprising 81.9%, while a neutral and a monosialylated biantennary oligosaccharide represented only 3.6% and 14.5%, respectively. The mutation resides in the carboxyl-terminal region of the A alpha chain, which could fold back to form an extra small globular region located near the central region of the molecule (Erickson, H.P., and Fowler, W.E. (1983) Ann. N. Y. Acad. Sci. 408, 146-163; Weisel, H.P., Stauffacher, C.V., Bullitt, E., and Cohen, C. (1985) Science 230, 3124-3133). Therefore, the participation of this region, referred to as an additional central domain or an alpha domain, in fibrin gel formation is strongly implicated.

Prothrombin Perija: a new congenital dysprothrombinemia in an Indian family

A Western Venezuelan indigenous Yukpa(Irapa) family with moderate bleeding and discrepancy in the prothrombin values by biological and immunological methods is described. The propositus presented biological activity of 2% by the methods in one-stage including Staphylocoagulase and Echis carinatus. Electrophoretic migration of the prothrombin in plasma was normal, while the serum only showed one precipitation arc instead of the three of normal serum. The propositus appeared to be homozygous for the abnormal prothrombin which we have denominated Prothrombin Perijá.

Potassium activation and its relationship to a highly reactive cysteine residue in fructose 1,6-bisphosphatase

The specific chemical modification by sodium cyanate of highly reactive cysteine residues at pH 7.5 in pig kidney fructose 1,6-bisphosphatase results in the reversible loss of activation of the enzyme by monovalent cations. No loss of activation by potassium ions occurs when modification is carried out in the presence of fructose 2,6-bisphosphate. The effect of Mg2+ on native and cyanate-modified enzyme activities implicates the above cysteine residue as being directly linked to the inhibition by both the divalent cation and fructose 2,6-bisphosphate. Incorporation of [14C]cyanate to the enzyme shows that the blockage of two reactive residues per tetramer is sufficient to eliminate the activation of the enzyme by K+.

Evaluation of the interaction of leucocytes from Chagas disease patients with trypomastigotes of Trypanosoma cruzi

We developed a method to asses the infectivity of Trypanosoma cruzi trypomastigotes for cultured Vero cells, after incubation under different conditions with human leucocyte populations. Total leucocytes, polymorphonuclear (PMN) and mononuclear (MN) cells, from either infected (INF) or cardiomyopathic (CDM) Chagas patients were tested in the presence or absence of autologous serum. Both patient groups had positive complement fixation tests (CFT) for T. cruzi and these were compared with a group of normal controls with negative CFT. Serum alone was found to cause reductions in the infectivity of the trypomastigotes, particularly in the case of CDM. However, in the control and INF groups, a significantly greater effect was observed with combinations of leucocytes and serum. The inhibition caused by cells plus serum was significantly greater in INF and CDM patients than in normal controls. In addition, we evaluated the penetration of trypomastigotes into the different types of leucocytes and found a significantly greater penetration of INF leucocytes at 15 min, compared to the controls, in the presence of both autologous and homologous normal serum. However, after 60 min of incubation the differences were not statistically significant.

Management of autonomic hyperreflexia associated with a low thoracic spinal cord lesion

Autonomic hyperreflexia is a serious peripartum complication associated with spinal cord lesions. Although the majority of reported cases have occurred with lesions at T-5 or higher, we report a case occurring in a patient with a lesion at T-10. Management may be by regional anesthesia or primarily medical.

beta-thromboglobulin (beta-TG) and platelet factor 4 (PF4) in obstetrical cases

The plasma levels of beta-Thromboglobulin (beta-TG) and Platelet Factor 4 (PF4) were measured in patients during the normal obstetrical period and in pre-eclampsia. A significant increase was observed in the two proteins with respect to the non-pregnant control group but no difference was seen between pregnancy and puerperium in either the normal or pre-eclamptic cases. The one significant variation in the concentration of the two proteins was a sharp rise during parturition. There was no correlation between beta-TG, PF4 and either the platelet count or creatinine but urea and uric acid did show a slight correlation with the two platelet proteins.

'Binding' of glutamate and asparatate to synaptosomal fractions of six regions of the feline brain

The order of potency of 'binding' of both glutamate and aspartate to synaptosomal fractions of brain regions was: cerebellar cortex greater than caudate nucleus greater than or equal to cerebral cortex greater than medulla approximately pons greater than corona radiata. Glutamate was bound to a greater extent than aspartate to particles of all regions studied, except for cerebral cortex.