Direct intraperitoneal resuscitation with lidocaine, methylene blue and pentoxiphylline combination does not decreases inflammation after intestinal ischemia-reperfusion injury in rats

ABSTRACT PURPOSE: To evaluate the effects of an intraperitoneal solution of methylene blue (MB), lidocaine and pentoxyphylline (PTX) on intestinal ischemic and reperfusion injury METHODS: Superior mesenteric artery was isolated and clamped in 36 adult male Sprague Dawley rats. After 60 minutes, clamp was removed and a group received intraperitoneally UNITO solution (PTX 25mg/kg + lidocaine 5mg/kg + MB 2mg/kg), while the other group was treated with warm 0.9% NaCl solution. Rats were euthanized 45 min after drug administration. Lung and bowel were collected for histological evaluation (using Park's score) and determination of myeloperoxidase (MPO) and malondialdehyde (MDA) levels. RESULTS: Control samples showed lymphoplasmocytic infiltrate and crypt necrosis of villi. MPO and MDA measurements shown no differences between treated and control groups. CONCLUSION: The combination of lidocaine, methylene blue and pentoxyphylline administered intraperitoneally at the studied dose, did not decreased histological lesion scores and biochemical markers levels in intestinal ischemia/reperfusion injury.

The effects of vardenafil and pentoxifylline administration in an animal model of ischemic colitis

OBJECTIVES: Vardenafil enhances dilatation of vascular smooth muscle and inhibits platelet aggregation. The purpose of this study was to evaluate the clinical effects of vardenafil and pentoxifylline administration in an experimental model of ischemic colitis. METHODS: Forty female Wistar albino rats weighing 250-300 g were randomized into five experimental groups (each with n = 8) as follows:1) a sham group subjected to a sham surgical procedure and administered only tap water; 2) a control group subjected to a standardized surgical procedure to induce ischemic colitis and administered only tap water; 3) and 4) treatment groups subjected to surgical induction of ischemic colitis followed by the postoperative administration of 5 mg/kg or 10 mg/kg vardenafil, respectively; and 5) a treatment group subjected to surgical induction of ischemic colitis followed by postoperative administration of pentoxifylline at 50 mg/kg/day per day as a single dose for a 3-day period. All animals were sacrificed at 72 h post-surgery and subjected to relaparotomy. We scored the macroscopically visible damage, measured the ischemic area and scored histopathology to determine the severity of ischemia. Tissue malondialdehyde levels were also quantified. RESULTS: The mean Gomella ischemic areas were 63.3 mm2 in the control group; 3.4 and 9.6 mm2 in the vardenafil 5 and vardenafil 10 groups, respectively; and 3.4 mm2 in the pentoxifylline group (p = 0.0001). The mean malondialdehyde values were 63.7 nmol/g in the control group; 25.3 and 25.6 nmol/g in the vardenafil 5 and vardenafil 10 groups, respectively; and 22.8 nmol/g in the pentoxifylline group (p = 0.0001). CONCLUSION: Our findings indicate that vardenafil and pentoxifylline are effective treatment options in an animal model of ischemic colitis. The positive clinical effects produced by these drugs are likely due to their influence on the hemodynamics associated ...

[ effect of local pentoxifylline in prevention of abdominal adhesion after laparotomy in rat models]

The aim of this study was to investigate the role of local pentoxifylline in reducing peritoneal adhesions after laparotomy performed on rats. In this randomized double-blind study, 30 male white rats weighing approximately 280-300 g were divided into two equal groups. In the control group, after induction of anesthesia and under sterile conditions, with a midline incision of 3 cm the muscles and the peritoneum opened. Animal cecum was determined by the surgeon and with one gauge, abrasions were made on antimesentric edge of cecum. Then the cecum was placed back in the abdomen and the abdomen was closed in 2 layers using nylon string "2-0" and running sutures. In case group all the above steps were repeated. The abdomen was washed with local pentoxifylline. After 2 weeks, rats were re- laparotomy. Blasting locations were studied in a previous surgery and adhesion were recorded from 0 to 3. And finally the data were analyzed by SPSS v.11 software using of statistical tests. In all of control group, adhesion was founded. In case group adhesions were founded in seven cases. Adhesion rate difference between the two groups was significant [P=0.013]. According to obtained findings from this and other similar studies, the surgeons can reduced adhesions after abdominal surgery by using local pentoxifylline

Recurrent cutaneous leishmaniasis / Leishmaniose recidiva cútis

We present a case of an 18-year-old male patient who, after two years of inappropriate treatment for cutaneous leishmaniasis, began to show nodules arising at the edges of the former healing scar. He was immune competent and denied any trauma. The diagnosis of recurrent cutaneous leishmaniasis was made following positive culture of aspirate samples. The patient was treated with N-methylglucamine associated with pentoxifylline for 30 days. Similar cases require special attention mainly because of the challenges imposed by treatment.

Paciente do sexo masculino, 18 anos. Dois anos após tratamento insuficiente para leishmaniose tegumentar americana, apresentou, na mesma localização, lesão formada por cicatriz atrófica central e nódulos verrucosos na periferia. Era imunocompetente, hígido e negava qualquer trauma local. O diagnóstico de leishmaniose recidiva cutis foi feito através de cultura do aspirado da lesão. Realizou tratamento com N-metilglucamina (20mgSbV/kg/dia) associado à pentoxifilina (1200mg/dia) durante 30 dias alcançando cura clínica. Os casos semelhantes requerem atenção diferenciada pela dificuldade ao tratamento.

Is there a therapeutic window for pentoxifylline after the onset of acute pancreatitis? / Existe uma janela terapêutica para a pentoxifilina após o início da pancreatite aguda?

PURPOSE: To investigate the effects of pentoxifylline (PTX) in experimental acute pancreatitis (AP) starting drug administration after the induction of the disease. METHODS: One hundred male Wistar rats were submitted to taurocholate-induced AP and divided into three groups: Group Sham: sham-operated rats, Group Saline: AP plus saline solution, and Group PTX: AP plus PTX. Saline solution and PTX were administered 1 hour after induction of AP. At 3 hours after AP induction, peritoneal levels of tumor necrosis factor (TNF)-α, and serum levels of interleukin (IL)-6 and IL-10 levels were assayed by Enzyme-Linked Immunosorbent Assay (ELISA). Determinations of lung myeloperoxidase activity (MPO), histological analysis of lung and pancreas, and mortality study were performed. RESULTS: PTX administration 1 hour after induction of AP caused a significant decrease in peritoneal levels of TNF-α and in serum levels of IL-6 and IL-10 when compared to the saline group. There were no differences in lung MPO activity between the two groups with AP. A decrease in mortality was observed in the PTX treatment compared to the saline group. CONCLUSIONS: Administration of PTX after the onset of AP decreased the systemic levels of proinflammatory cytokines, raising the possibility that there is an early therapeutic window for PTX after the initiation of AP.

OBJETIVO: Investigar os efeitos da pentoxifilina (PTX) na pancreatite aguda (PA) experimental administrando a droga após a indução da doença. MÉTODOS: Cem ratos machos Wistar foram submetidos à indução da PA através da infusão de taurocolato de sódio e divididos em três grupos: Grupo Sham: sham-operated ratos, Grupo Salina: AP e solução salina, e Grupo PTX: AP e PTX. Solução salina e PTX foram administradas 1 hora após a indução da PA. Três horas após indução da PA os níveis de fator de necrose tumoral (TNF)-α no líquido peritoneal e os níveis séricos de interleucina (IL)-6 e IL-10 foram analisados pelo método de Enzima Imunoensaio (ELISA). A atividade da mieloperoxidase (MPO) foi analisada no pulmão e foram realizadas análises histológicas do pulmão e pâncreas, além do estudo da mortalidade. RESULTADOS: A administração de PTX 1 hora após a indução da PA reduziu significativamente os níveis de TNF-α peritoneal e os níveis séricos de IL-6 e IL-10 quando comparado ao grupo salina. Redução na mortalidade foi observado após o tratamento com PTX comparado ao grupo salina. CONCLUSÃO: A administração de PTX após a indução da PA diminuiu os níveis sistêmicos de citocinas pró-inflamatórias, sugerindo a possibilidade de que existe uma janela terapêutica para PTX após o início do PA.

Systemic treatment in severe cases of recurrent aphthous stomatitis: an open trial

PURPOSE: This study aimed to evaluate the efficacy of the systemic drugs thalidomide, dapsone, colchicine, and pentoxifylline in the treatment of severe manifestations of RAS. METHODS: An open, 4-year clinical trial was carried out for 21 consecutive patients with severe RAS. Initially, patients were given a 2-week course of prednisone to bring them to a baseline status. Simultaneously, one of the four test drugs was assigned to each patient to be taken for a period of 6 months. During the course of the trial, patients were switched to one of the other three drugs whenever side effects or a lack of satisfactory results occurred, and the 6-month limit of the treatment was then reset. RESULTS: The most efficient and best-tolerated drug was thalidomide, which was administered to a total of eight patients and resulted in complete remission in seven (87.5 percent). Dapsone was prescribed for a total of nine patients, of whom eight (89 percent) showed improvement in their symptoms, while five showed complete remission. Colchicine was administered to a total of ten patients, with benefits observed in nine (90 percent), of whom four showed complete remission. Pentoxyfilline was administered to a total of five patients, with benefits observed in three (60 percent), of whom one patient showed complete remission. CONCLUSION: The therapeutic methods used in this trial provided significant symptom relief. Patients experienced relapses of the lesions; however, this occurred after withdrawal of their medication during the follow-up period.

The effects of pentoxifylline into the kidneys of rats in a model of unilateral hindlimb ischemia/reperfusion injury

PURPOSE: To study the role of pentoxifylline (PTX) on remote kidney injury caused by muscle ischemia of left hindlimb of rats. METHODS: After xylazine and ketamine anesthesia, the left hindlimb of rats (n=66) were submitted to 6 hours ischemia (clamping the left common iliac artery). Three groups were used: sham group (SG, n=6), early group (EG, n=30) with reperfusion after 4 hours and late group (LG, n=30) with reperfusion after 24 hours. The saline solution (EG1, n=10 and LG1, n=10) or PTX (40mg.Kg-1) was administered in the reperfusion beginning (EG2, n=10/LG2, n=10) or divided in two doses in the ischemia beginning and reperfusion beginning (EG3, n=10/LG3, n=10). The plasmatic creatinokinase, urea, creatinine, sodium and potassium values were measure and histological samples from left kidney were prepared and H&E stained for scored cellular necrosis and degeneration of kidney tubules and thickness glomerulus determination. The apoptosis index was determined by immunohistochemical expression of the caspase-3. The tests of Mann-Whitney and Kruskal-Wallis (p < 0.05) were applied. RESULTS: The urea (90.5 ± 30.96 mg.dL-1), creatinine (2.28 ± 0.54 mg.dL-1), potassium (16 ± 3.66 mmol.dL-1) and mesangium thickness (0.97 ± 0.42 µm) values were significantly higher in group LG3. There was no significantly difference of caspase 3 expression between EG2 (16.35 ± 1.65 percent) and LG3 (15.57 ± 2.54 percent), and both were significantly worse than SG (9.8 ± 1.98 percent). CONCLUSIONS: The PTX has some protecting effect on remote kidney injury due to hindlimb ischemia/reperfusion injury only in the early phase of reperfusion.

OBJETIVO: Estudar o papel da pentoxifilina (PTX) nas lesões à distância no rim causadas pela isquemia no membro posterior esquerdo de ratos. MÉTODOS: Sob anestesia com xilazina e quetamina, o membro posterior de ratos (n=66) foi submetido a 6 horas de isquemia pelo clampeamento da artéria ilíaca comum esquerda. Foram estudados três grupos: grupo simulado (SG, n=6), grupo precoce (EG, n=30) após quatro horas de reperfusão e grupo tardio (LG, n=30) após 24 de reperfusão. A solução salina (EG1, n=10 e LG1, n=10) ou a PTX (40mg.Kg-1) foram administradas no início da reperfusão(EG2, n=10/LG2, n=10) ou divididas em duas aplicações no início da isquemia e no início da reperfusão (EG3, n=10/LG3, n=10). Foram medidos os valores plasmáticos da creatinofosfoquinase, uréia, creatinina, sódio e potássio. Amostras do rim esquerdo foram preparadas e coradas em HE para realizar o escore de necrose de células tubulares renais ou presença de obstrução tubular renal na área do córtex renal e da presença do espessamento do mesângio glomerular. O índice de apoptose foi determinado pela expressão imunoistoquímica da caspase-3. Foram aplicados os testes de Mann-Whitney e Kruskal-Wallis (p < 0.05). RESULTADOS: a dosagem de uréia (90,5 ± 30,96 mg.dL-1), creatinina (2,28 ± 0,54 mg.dL-1), potássio (16 ± 3,66 mmol.dL-1) e a espessura do mesângio(0,97 ± 0,42 µm) foram significantemente maiores nos animais do grupo LG3. Não houve diferença significante na expressão da caspase-3 entre os grupos EG2 (16,35 ± 1,65 por cento) e LG3 (15,57 ± 2,54 por cento) e ambos foram significantemente piores que o grupo SG (9,8 ± 1,98 por cento). CONCLUSÃO: A PTX oferece algum efeito protetor nas lesões à distância nos rins de animais submetidos à lesão de isquemia e reperfusão de membro posterior, no período de até quatro horas após a reperfusão.

Treatment of perniosis with oral pentoxyfylline in comparison with oral prednisolone plus topical clobetasol ointment in Iraqi patients

To evaluate the effectiveness and safety of pentoxyfylline in treatment of perniosis in comparison with prednisolone plus topical clobetasol ointment. This is an open comparative therapeutic trial conducted in the Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq between January and March 2008. Forty patients with perniosis were enrolled in this study, and divided randomly into 2 equal groups, according to the sort of treatment. Group A comprised patients who received oral prednisolone 0.5 mg/kg in 2 divided doses, and topical clobetasol ointment for 2 weeks. Group B comprised patients who received pentoxyfylline tablet 1200 mg/day in 3 divided doses for 2 weeks. Detailed history and full clinical examination were carried out for each case, regarding all relevant points related to the disease. The age of patients ranged from 5-60 mean +/- SD 22 +/- 6.2 years, with 31 females and 9 males with a female to male ratio of 3.5:1. All patients did not receive any treatment before the study. In group A, 11 patients completed the treatment course, and only 3 27.2% patients showed good improvement and complete cure after 2 weeks. In group B, 9 patients completed the regime, and 5 55.5% patients showed good improvement, in which symptoms disappeared and lesions resolved after 2 weeks. Pentoxyfylline was shown to be an effective and safe drug for treatment of perniosis, and superior to oral plus topical glucocorticoids p < 0.05.

Pentoxifylline therapy: a new adjunct in the treatment of oral submucous fibrosis.

OBJECTIVE: This study was designed to determine the effect of pentoxifylline (Trental) on the clinical and pathologic course of oral submucous fibrosis. This drug is a methylxanthine derivative that has vasodilating properties and was envisaged to increase mucosal vascularity. STUDY DESIGN: This investigation was conducted as a randomized clinical trial incorporating a control group (Standard drug group SDG, multivitamin, and local heat therapy) in comparison to pentoxifylline test cases (Experimental drug group EDG, 400mg 3 times daily, as coated, sustained release tablets). The stipulated treatment period was 7 months and a total of 29 cases of advanced fibrosis (14 test subjects and 15 age and sex matched diseased controls) were included in this study and 100% compliance was reported at the end ofthe test period. RESULTS: Mild gastric irritation that could be managed by diet protocols was the only untoward symptom reported during this trial. Review of the patients and controls was done at an interval of 30 days and subjective and objective measurements were recorded. The follow up data at each visit with respect to each other and to base-line values was calibrated using a nonparametric test of Mann-Whitney (Kruskal-Wallis test). Significant comparisons with regard to improvement were recorded as objective criteria of mouth opening (t=11.285, p= 0.000), tongue protrusion (t= 3.898, p = 0.002), and relief from perioral fibrotic bands (p = 0.0001554). Subjective symptoms of intolerance to spices (p = 0.0063218), burning sensation of mouth (p = 0.0005797), tinnitus (p=0.000042), difficulty in swallowing (p=0.0000714). and difficulty in speech (p=0.0000020) were also recorded significant improvement at the end of the trial period. CONCLUSION: This pilot investigation points to the effectiveness of pentoxifylline as an adjunct therapy in the routine management of oral submucous fibrosis.

Efecto de la infusión temporal de pentoxifilina sobre la relación aporte/consumo de oxígeno en el perioperatorio del paciente de alto riesgo / Effect of a temporary infusion of pentoxifylline on the oxygen delivery/consumption relationships in the high risk surgical patient

Introducción. Se han descrito algunos métodos para tratar de detectar a los portadores de deuda crónica de oxígeno, especialmente en pacientes críticamente enfermos. Con el objeto de encontrar pacientes con sufrimiento tisular crónico en el pre operatorio, se diseño una prueba de estimulación utilizando una metilxantina con efecto sobre determinantes de oxigenación tisular. Material y Métodos. Se estudiaron 10 pacientes sometidos a cirugía de alto riesgo o portadores de patología múltiple. Los pacientes se monitorizaron en forma avanzada y recibieron una infusión de 300 mg de pentoxifilina después de la inducción. Se determinaron parámetros hemodinámicos, respiratorios y de oxigenación tisular. La prueba se consideró positiva cuando se obtenía un incremento superior al 10 por ciento del nivel de exceso de base (EB) con respecto a su basal. Resultados. Se encontró un descenso significativo en los valores de pH (basal: 7.44 ñ 0.02; post infusión: 7.40 ñ0.03; p=0.05) y EB (basal: -2.1 ñ 3; post infusión: -6.0 ñ2; p=0.02). El aporte y consumo de oxígeno incrementaron sus valores en forma no significativa. Discusión. Estos resultados, sugieren que la pentoxifilina condiciona una mejor perfusión de tejidos crónicamente comprometidos, lo cual es evidenciado por el hallazgo de incremento en los niveles de exceso de base

Pentoxifylline and enalapril and its effects on polycythemia induced by hypobaric hypoxia in mice

Se estudió 70 ratones Swiss macho de 3-4 meses de edad, para evaluar los efectos profilácticos y terapéuticos del analapril y la pentoxifilina en la policitemia inducida por hipoxia. Se dividió a los animales en dos grupos: grupo pentoxifilina (n=39) y grupo enalapril (n=31). Cada uno fue adicionalmente dividido en un grupo profiláctico que recibió el medicamento antes de la exposición a hipoxia hipobárica intermitente (IHH) y en un grupo terapéutico que recibió el medicamento luego de la exposición a IHH. Cada Subgrupo tuvo su respectivo control. La exposición a IHH fue realizada a través de una cámara hipobárica que simulaba una altura equivalente a 4500m, 22 horas por día. Se midió semanalmente peso y hematocrito. La evolución del peso corporal en el tiempo no mostró diferencias sustanciales entre los animales tratados y los controles en los grupos profilácticos y terapéuticos, tanto en los grupos pentoxifilina como enalapril. Hubo una disminución significativa del hematocrito a los 36 y 47 días del inicio de la profilaxis en el grupo pentoxifilina. En el grupo profiláctico enapril los hematocritos fueron significativamente menores en los animales tratados. Concluimos que ambas drogas son efectivas cuando son usadas profilácticamente antes de la exposición a IHH. Se sugiere que las drogas podrían ejercer su efecto a través de un bloqueo parcial de la producción de eritropoyetina (EPO).

Tratamiento de la alopecia areata / Treatment of the alopecia areata

En una patología como la alopecía areata, la que se presenta de distintas formas clínicas, con asociaciones variadas, donde las remiciones son posibles y los tratamientos disponibles no son 100 por ciento eficaces, es dificil evaluar la terapéutica más adecuada. lLos tratamientos disponibles pueden dividirse en tópicos y sistémicos. Los corticoides ocupan un lugar importante en el arsenal terapéutico, en especial los tópicos o en inyecciones intralesionales. Otrs productos se usan con resultados varioables como la inminoterapia tópica, en especial con el minoxidil, la difenciprona y la antralina. La medicación sistïrmica se reserva para casos severos (corticosteroides,ciclosporina A, etc). La mayoría actuarían alterando la respuesta inmune y en otros en controvertida. Consideramos a la afección dentro de su marco general, más que etético, pero sin descuidar la integridad del individuo y hacia esto debemos apuntar en nuestra estrategia de tratamiento. La relación paciente-médico es fundamental para manejar esta enfermedad en la que aún no tenemos una medicación curativa.

Efectos de la pentoxifilina sobre la movilidad espermática en pacientes normo y oligoastenospérnicos y su relación con la fecundación in vitro

Objetivo: Determinar los efectos de la incubación de espermatozoides (spz) con Pentoxifilina (PF) sobre las características de movimiento de pacientes normo y oligoastenospérmicos y el resultado de su utilización en la fecundación in vitro (FIV) por oligoastenospermia severa. Material y Métodos: Sobre un total de 46 pacientes divididos en tres grupos: Grupo I(n=10) normospérmicos; Grupo 2a(n=14) oligoastenospermia moderada y Grupo 2b(n=22) oligoastenospermia severa se cuantificaron los parámetros de movimiento usando computer-assited sperm analysis (CASA). Una segunda parte del estudio consistió en la evaluación del resultado de fecundación in vitro(FIV) en 16 parejas del grupo 2b. Los resultados de FIV e inseminación subzonal (SUZI) con o sin PF fueron comparados. Preparación del Semen: El semen fue preparado con gradiente de percoll y dividido en dos partes, uno como control y la otra mitad fue incubada con pentoxifilina 1 mg/ml después de dos horas de capacitación. Luego de remover la PF del semen, fue analizado con CASA y tres horas después. Resultados: Se encontró un incremento significativo del desplazamiento lateral de la cabeza (ALH) solamente en el grupo 2b después de la utilización de la PF (Pmenor 0.05). En los otros dos grupos ningún efecto superior significativo de los parámetros de movimiento fue observado en comparación a una preparación solamente de percoll. Ningún aumento de la taza de fecundación fue observada cuando el semen tratado con PF fue usado comparado con el semen control. Conclusiones: Aunque la pentoxifilina puede mejorar los parámetros de movimiento en algunos pacientes con oligoastenospermia, dicho tratamiento no supera la capacidad fecundante cuando el semen ha sido previamente seleccionado con gradiente de percoll. Su utilidad en FIV por infertilidad masculina deberá ser evaluada en un grupo más amplio

Hipoacusia súbita: experiencia clínica con 54 pacientes / Sudeafness: experience in 54 patients

La hipoacusía súbita es una emergencia otorrinolaringológica, en la cual existe una pérdida auditiva mayor de 30 decibeles, que se desarrolla en menos de 3 días, en tres frecuencias contíguas. Se han desarrollado en el transcurso de los años una serie de propuestas terapeúticas para el manejo pronto y adecuado de esta patología, de origen multifactorial y con una gran gama de manifestaciones clínicas acompañantes. El objetivo de nuestro estudio fue determinar el grado de recuperación auditiva en una muestra de 54 pacientes con hipoacusía súbita, utilizando un esquema de tratamiento consistente en la asociación de agentes hemorreológicos y esteroides, con variables determinadas en base a grupos de edad, sexo, enfermedad uni o bilateral, etiología probable y grado de la hipoacusía. En base al analisis de los resultados, observamos que el 95 por ciento de los pacientes tratados mostraron diversos grados de recuperación de la agudeza auditiva al término del estudio

Porfiria hereditaria con doble deficiencia enzimática / Hereditary porphyria with double enzymatic deficiency

La porfiria intermitente aguda es una enfermedad hereditaria autosómica dominante, que puede presentarse con cuadro de dolor abdominal intermitente, en ocasiones simula abdomen agudo y los pacientes son llevados a cirugía abdominal por desconocer el defecto enzimático que han heredado. En la literatura existe múltiple información al respecto, citaremos el caso de la porfiria Chester, en el que describen cómo el diagnóstico no fue realizado en base a la similitud de esta alteración con otras enfermedades agudas, así como la existencia de una doble deficiencia enzimática no descrita antes. En este estudio se informa de un caso donde el diagnóstico fue omitido y el tratamiento incorrecto propicio o agravó la evolución de la enfermedad y también se detectó una doble deficiencia parcial enzimática, por la coexistencia de porfiria intermitente aguda y coproporfiria