Decreased total antioxidant levels and increased oxidative stress in South African type 2 diabetes mellitus patients

Background: Chronic hyperglycaemia in diabetes mellitus leads to increased lipid peroxidation in the body, followed by the development of chronic complications due to oxidative stress.Objective: The aim of this study was to compare total antioxidant (TAO) levels and oxidative stress in type 2 diabetes mellitus (T2DM) patients with that of healthy controls without diabetes.Methods: A total of 98 participants (57 T2DM and 41 healthy people) gave their consent and participated in the study. Routine biochemical methods were used for fasting plasma glucose (FPG), glycosylated haemoglobin (HbA1c) and lipid profile measurements. Serum TAO levels, malondialdehyde (MDA), oxidised low-density lipoprotein (ox-LDL) levels and superoxide dismutase (SOD) activity were analysed using standard commercial reagent kits.Results: A significant rise in FPG, HbA1c, triglycerides, MDA and ox-LDL, and a significant reduction in TAO and high-density lipoprotein cholesterol (HDL-C) was observed in T2DM patients compared with controls. A significant negative relationship was observed between TAO levels and MDA levels in the T2DM group. Increased lipid peroxidation and reduced antioxidant levels were observed in T2DM patients.Conclusion: Early management through an antioxidant-rich diet and lifestyle changes in T2DM patients would help to avert the debilitating complications of diabetes

Age Related Changes in Cerebrovascular Reactivity and Its Relationship to Global Brain Structure.

Introduction: There is growing evidence to suggest that vascular and CSF haemodynamic effects are related to structural changes in the ageing brain. We investigated these effects in a sample of healthy participants by measuring changes in cerebrovascular reactivity induced by hypercapnia and comparing these to global and ROI based cerebral volume measures. Methods: Forty five participants aged 21 to 58 years (23 female) were recruited. Cerebrovascular reactivity was determined from hypercapnia induced BOLD signal change during two 3-minute intervals of breathing 6% CO2, interleaved with three 2-minute intervals of breathing room air. Parametric maps of reactivity were calculated as the ratio of % BOLD signal change to end-tidal CO2 (mmHg). High resolution 3D T1-weighted images were segmented and lateral ventricle volume and white matter hypointensity volume determined. Results: Significant negative correlations between both grey matter (p = .042) and white matter (p = .021) reactivity and age were found and significant negative correlations between grey matter (p = .013) and white matter (p = .004) reactivity and lateral ventricle volume were also found while correcting for age and total intracranial volume. A significant negative correlation between white matter reactivity and white matter hypointensity volume was found (p = .049) after correcting for age. Conclusion: These results support the hypothesis that cerebrovascular haemodynamics influence structural brain changes that occur during normal ageing that are independent of the age of the individual.

Pure Laparoscopic Radical Heminephrectomy for a Large Renal-Cell Carcinoma in a Horseshoe Kidney

Introduction Horseshoe Kidneys are the most common renal fusion anomaly. When surgery is contemplated for renal-cell carcinoma in such kidneys, aberrant vasculature and isthmusectomy are the major issues to consider. We describe a case of a pure laparoscopic radical heminephrectomy with hand-sewn management of the isthmus for a 11 cm tumour in a horseshoe kidney. Presentation A 47-year-old man complaining of palpable left flank mass for two months. Magnetic resonance of the abdomen revealed a 11 cm renal mass arising from the left moiety of an incidentally discovered horseshoe kidney. Preoperative CT angiography revealed a dominant anterior renal artery feeding the upper and midpole, with two other arteries feeding the lower pole and isthmus. The patient was placed in a modified flank position. A four-port transperitoneal technique was used, the colon was reflected. Renal pedicle was dissected and the renal arteries and renal vein were secured with polymer clips. The kidney was fully mobilized and a Satinsky clamp was placed on the isthmus for its division. A running 2-0 vicryl hand-sewn was used for parenchyma hemostasis. The specimen was extracted intact in a plastic bag through an inguinal incision. Results The operative time was 220 minutes, and the estimated blood loss was 200 mL. There were no immediate or delayed complications. The patient resumed oral intake on postoperative day 1 and was discharged on postoperative day 2. Pathologic examination of the specimen confirmed a 11 cm organ-confined chromophobe renal-cell carcinoma, with negative margins. Discussion Laparoscopic oncologic surgery in patients with horseshoe kidneys can be technically challenging. The presence of a large cancer in a horseshoe kidney should not preclude a purely laparoscopic approach. With the aid of a Satinsky clamp, the isthmus can be sharply divided and sutured in a fashion ...

Chemical and technological evaluation of the Phyllanthus niruri aerial parts as a function of cultivation and harvesting conditions

Tea from Phyllanthus niruri L., Phyllanthaceae, aerial parts is commonly used by Brazilian folk medicine for its benefits on the treatment of genitourinary disorders, for what the polyphenolic compounds are mainly responsible. The yield of such compounds may be influenced by several variables related with the plant growth. The effects of planting periods and harvesting conditions are investigated in this work, including four different seasons. The cultivation was characterized by dry mass yield of aerial parts, and the effect of pruning was analyzed. Leaves, stems and their mixtures were analyzed after drying and milling. Loss on drying and water soluble extractives were used as physical parameters for quality control. Flavonoid content and gallic acid were chosen as chemical markers for this work. The spectrophotometric trial based on the aluminum chloride complexes was applied to evaluate the total flavonoids content. Gallic acid contents were measured from the water extractive solutions by high-performance liquid chromatography. The pruning caused a positive influence on the amount of leaves and stems. The highest flavonoids and gallic acid contents were found in the leaves, which were developed over the summer and the winter, respectively, both from the second harvesting (after pruning). Chomatographic profile by HPLC was characterizes by the presence of gallic acid and two other major peaks (not identified substances), which relation was peculiar to each aerial part. In conclusion, these results suggest that even under less favorable climatic conditions, in winter, the pruning seems to cause a strong influence over the P. niruri polyphenolics production. Indeed, the total flavonoids content, as well as the HPLC profile, can be used as indicative parameters of the ratio of leaves and stem in the vegetal raw material.

Carcinoma base of tongue: Single institution 15 year experiences.

Aims: To report the outcome with radiotherapy and concomitant chemoradiotherapy in patients with locally advanced squamous cell carcinoma base of tongue treated and followed up at single institution over a period of 15 years. Materials and Methods: This study was carried out by auditing the medical records of 103 patients treated at our institution between 1991 and 2006. Mean age with standard deviation of patients in the Radiotherapy only (group I) and chemoradiotherapy (group II) was 55.26 ± 14.16 and 49.81 ± 12.16 years. 46 patients were treated with radiotherapy alone and 57 patients were treated with concurrent chemo radiotherapy using infusion cisplatinum 3 weekly and 5 fluorouracil twice weekly. Mean follow up was 13.35 months. All the patients characteristic and treatment characteristics were recorded. Results: There were 81 men and 22 women in the study. Group I contains 15 and 31 cases of stage III and IV tumors while group II contains 19 and 38 cases of stage III and IV respectively. Group II has shown improved loco regional control rate for the T3 and T4 tumors as compared to group I. Disease free survival and overall survival in the group II is 25.51 months and 22.53 months while group I has 8.67 months and 6.74 months respectively. Grade III mucosal toxicity incidence was higher in group II as compared to group I. Conclusions: In locally advanced squamous cell carcinoma of base of tongue tumors concomitant chemoradiotherapy with infusional cisplatinum and 5 fluorouracil results in higher disease free and overall survival as compared to radiotherapy as single modality. This better tumor response with chemoradiotherapy comes at cost of higher incidence of mucosal toxicity.

Psychosocial and Behavioural Correlates of Attitudes Towards Antiretroviral Therapy (ART) in a Sample of South African Mineworkers

Despite being one of the worst affected sectors in South Africa; the mining sector has proven to be one of the most active in intervention efforts in the fight against HIV and AIDS (Ellis; 2007). Owing to low uptake rates of antiretroviral therapy (ART) in mining companies in recent years (Connelly et Rosen; 2006) and the positive relationship between attitudes towards ART and ART uptake (Cooper et al.; 2002; Horne; Cooper; Gellaitry; Leake; et Fisher; 2007); this study sought to describe and investigate the psychosocial and behavioural correlates of attitudes towards ART in a sample of South African mineworkers. A total of 806 mineworkers from a large South African mine participated in this quantitative study. Despite a high rate of HIV testing behaviour (83.0) as well as favourable attitudes towards ART; analysis indicated that temporary employees and contractors were more vulnerable in terms of HIV risk; HIV testing behaviours and ART knowledge and attitudes. Employees who had more positive attitudes towards ART were more knowledgeable of ART and; importantly; had a more favourable attitude towards the mine's HIV/AIDS treatment programme. These findings are discussed in relation to the low ART uptake rates in this context and recommendations for the improvement of ART uptake amongst employees at this mining site

Estudo da relação estrutura-atividade de saponinas hemolíticas e/ou imunoadjuvantes mediante uso de análise multivariada / Study of the structure-activity relationship of adjuvant and/or hemolytic saponins by use of multivariate analysis

Entre as diversas atividades biológicas relatadas para as saponinas, merecem destaque aquelas relacionadas ao aumento da resposta imune e a ruptura das membranas dos eritrócitos. No desenvolvimento de vacinas, ambas as propriedades exercem atividades antagônicas, contudo, as informações sobre as relações estrutura-atividade são relativamente escassas e, às vezes, conflitantes. O presente trabalho visa contribuir no estabelecimento das relações estruturais envolvidas com as atividades imunoadjuvante e hemolítica de saponinas triterpênicas. Para isso, foram selecionadas vinte saponinas de estrutura triterpênica, isoladas das espécies Aesculus hippocastanum, Dolichos lablab e Glycine max. A relação entre grupamentos substituintes do anel triterpênico e as atividades biológicas foi estudada mediante análise de agrupamentos e análise de componentes principais. Os resultados confirmam a importância da presença de açúcares em C-3 para a atividade hemolítica. Porém o efeito causado pela presença de uma hidroxila em C-16, de CH2OH em C-17, de uma acetila em C-22 e de um grupamento acila em C-21 sobre essa atividade parece ser mais acentuado. Já a presença de uma hidroxila em C-21, de uma metila em C-17 e de dois açúcares ligados à aglicona parece ser determinante para a atividade imunoadjuvante. Além disso, observa-se a existência de uma relação inversa entre as atividades hemolítica e imunoadjuvante.

Among the various biological activities reported for saponins, those related with increase immune response and the destruction of the membrane of red blood cells deserve attention. In the development of vaccines, these properties exert antagonistic activities. However, the information about the structure-activity relationships is relatively scarce and sometimes contradictory. This paper aims to contribute to the establishment of structural relations involved with the hemolytic and adjuvant activities of triterpenic saponins by the analysis of the different groups linked to aglycone, with the use of multivariate statistical techniques. For this, we had twenty triterpenic saponins previously isolated from Aesculus hippocastanum, Dolichos lablab. and Glycine max species. Their adjuvant and hemolytic activities are available in the literature. These saponins were analyzed as groups linked to the triterpenic ring and biological activities resulting in an array of date that was submitted to cluster analysis and principal components analysis. The results confirm the importance of sugars in C-3 for hemolytic activity. However, the effect caused by the presence of a hydroxyl in C-16, CH2OH in C-17, acetyl in C-22 and acyl in C-21 on the hemolytic activity seems to be more important. On the other way, the presence of a hydroxyl in C-21, a methyl in C-17 and two sugars linked to aglycone seem determinant for adjuvant activity. Moreover, there is an inverse relationship between adjuvant and hemolytic activities in the set of saponins analyzed.

ROS is not involved in induction of cell death by Ent-11 alpha-hydroxy-15-oxo-kaur-16-en-19-oic-acid in HepG2 cells / 中国中药杂志

<p><b>OBJECTIVE</b>To identify the role of reactive oxygen species (ROS) formation on cell death induced by Ent-11alpha-hydroxy-15-oxo-kaur-16-en-19-oic-acid (5F) in HepG2 cells.</p><p><b>METHOD</b>MTT assay was used to determine the effect of 5F on proliferation of HepG2 cells, and apoptotic morphological changes were assessed using Hoechst/PI assay. To evaluate intracellular ROS levels, a GENMED kit was used. HepG2 cells were treated with 5F for 24 h or with 1 mmol x L(-1) GSH for 1 h prior to treatment with 5F for 24 h, then cytoplasmic mono- and oligonucleosomes were assessed with Cell Death Detection ELISA kit.</p><p><b>RESULT</b>The cytotoxicity of 5F on HepG2 cells was elevated with increasing 5F concentrations, as evidenced by the cell viability assay, and the apoptotic changes such as chromatin condensation were confirmed by Hoechst/PI staining. The decrease in ROS generation was observed in HepG2 cells following treatment with 5F. Cytoplasmic mono- and oligonucleosomes induced by 5F were not changed by decreasing basal level of ROS-mediated signaling with GSH. Further more, induction of ROS production by cisplatinum (CDDP) was canceled by treatment with 5F and 5F revealed a additive effect to cell killing by CDDP.</p><p><b>CONCLUSION</b>5F can not only induce apoptosis through non-ROS-depandent pathway, and can abate oxidant stress.</p>

Bridging the Gap between VCT and HIV/AIDS Treatment Uptake: Perspectives from a Mining-Sector Workplace in South Africa

This qualitative study sought to understand users' perceptions of the voluntary counselling and testing (VCT) and HIV-treatment services offered by a mining company in South Africa; with the intention of making recommendations to improve the rates of uptake. A purposive sample of 75 employees was interviewed and three focus groups were conducted with VCT users as well as with HIV-positive employees currently enrolled in the company's treatment programme. The relatively high uptake of VCT at the workplace appeared to be a function of the convenience afforded by rapid testing and the on-site nature of the company's annual campaign; the group nature of the campaign; and increased HIV awareness facilitated by pre-test counselling. Notwithstanding this; the study revealed barriers to uptake of VCT in the workplace; including: perceived violations of confidentiality by healthcare staff and doubts about the voluntary basis of HIV testing; organisational factors; including the visible group nature of the VCT campaign; and fear of a HIV-positive result and discrimination in that event. In contrast to VCT uptake; there was a relatively low rate of enrolment in the treatment programme: a significant proportion of HIV-positive employees identified in the VCT campaign did not present to the company's clinic for treatment. Impediments to treatment uptake included fears of being identified in the workplace as HIV-positive; which arose from perceived confidentiality violations on the part of the healthcare staff as well as organisational factors they believed allowed easy identification of the programme's users; limited time to attend the clinic; poor quality of post-test counselling and follow-up; difficulties in coping with the diagnosis; and traditional explanatory models of illness; which precluded medical care. A combination of the current annual; opt-in VCT campaign and a provider-initiated opt-out approach to VCT should be carefully considered in order to bridge the gap between the current levels of VCT and HIV-treatment uptake by employees at the company

Peptide and protein modulation of local Ca2+ release events in permeabilized skeletal muscle fibers

Local discrete elevations in myoplasmic Ca2+ (Ca2+ sparks) arise from the opening of a small group of RyRs. Summation of a large number of Ca2+ sparks gives rise to the whole cell Ca2+ transient necessary for muscle contraction. Unlike sarcoplasmic reticulum vesicle preparations and isolated single channels in artificial membranes, the study of Ca2+ sparks provides a means to understand the regulation of a small group of RyRs in the environment of a functionally intact triad and in the presence of endogenous regulatory proteins. To gain insight into the mechanisms that regulate the gating of RyRs we have utilized laser scanning confocal microscopy to measure Ca2+ sparks in permeabilized frog skeletal muscle fibers. This review summarizes our recent studies using both exogenous (ImperatoxinA and domain peptides) and endogenous (calmodulin) modulators of RyR to gain insight into the number of RyR Ca2+ release channels underlying a Ca2+ spark, how domain-domain interactions within RyR regulate the functional state of the channel as well as gating mechanisms of RyR in living muscle fibers.

Kangaroo Mother Care in very low birth weight infants.

OBJECTIVE: This study was conducted (i) to study through a randomized control trial the effect of Kangaroo Mother Care (KMC) on breast feeding rates, weight gain and length of hospitalization of very low birth neonates and (ii) to assess the acceptability of Kangaroo Mother Care by nurses and mothers. METHODS: Babies whose birth weight was less than 1500 Grams were included in the study once they were stable. The effect of Kangaroo Mother Care on breast feeding rates, weight gain and length of hospitalization of very low birth weight neonates was studied through a randomized control trial in 28 neonates. The Kangaroo group (n = 14) was subjected to Kangaroo Mother Care of at least 4 hours per day in not more than 3 sittings. The babies received Kangaroo Care after shifting out from NICU and at home. The control group (n = 14) received only standard care (incubator or open care system). Attitude of mothers and nurses towards KMC was assessed on Day 3 +/- 1 and on day 7 +/- 1 after starting Kangaroo Care in a questionnaire using Likert's scale. RESULTS: The results of the clinical trial reveal that the neonates in the KMC group demonstrated better weight gain after the first week of life (15.9 +/- 4.5 gm/day vs. 10.6 +/- 4.5 gm/day in the KMC group and control group respectively p < 0.05) and earlier hospital discharge (27.2 +/- 7 vs. 34.6 +/- 7 days in KMC and control group respectively, p < 0.05). The number of mothers exclusively breastfeeding their babies at 6 week follow-up was double in the KMC group than in the control group (12/14 vs. 6/14) (p < 0.05). CONCLUSION: KMC managed babies had better weight gain, earlier hospital discharge and, more impressively, higher exclusive breast-feeding rates. KMC is an excellent adjunct to the routine preterm care in a nursery.

From a medicinal plant to a pharmaceutical dosage form. A (still) long way for Brazilian medicinal plants

Phytopharmaceutical drugs play an important role in the Brazilian health system considering both economic and cultural perspectives. Pondering the richness of the Brazilian flora and the wide use of medicinal plants by the population, there should be sufficient knowledge to apply that information as a suitable starting point to transform medicinal plants into adequate industrial pharmaceutical dosage forms. Problems involving lack of organized knowledge and scientific information are not sufficiently solved to accomplish the modern drug concept, which has to consider efficacy, safety and constant quality. On basis of one of the most used medicinal plants in southern Brazil, Achyrocline satureioides, this paper presents and discusses the problems involving the transformation of medicinal plants into phytopharmaceutical drugs, showing some steps carried out by the academic milieu in order to provide answers to solve this question.

Consideraciones clínicas de los problemas endo-periodontales / Clinical considerations of endo-periodontology problem

Presenta una revisión del complejo endoperiodontal, resaltando el efecto que puede tener la enfermedad pulpar sobre el tejido periodontal y viceversa. Establece la importancia del diagnóstico diferencial, puesto que ello normará la correcta orientación del tratamiento. Si la lesión es inicialmente de origen pulpar, el tratamiento endodóntico "per se", podría ser suficiente. Si Su origen es periodontal, una terapia endo-periodontal será necesaria. Muestra ilustraciones de casos clínicos, revisa los problemas y tratamientos en dientes anteriores y multiradiculares