Casinga-cheirosa organic extract impairment over Balb-c male mice behavioral phenotype

ABSTRACT Laetia suaveolens (Poepp.) Benth., Salicaceae, popularly known as "casinga-cheirosa", "caferana", or "laranjinha", is native to Brazil but not endemic to this country. A crude organic extract was obtained from the leaves and stem and intraperitoneally administered in male Balb-c mice. Its behavioral effects were evaluated in the open field and elevated plus maze in a two-stage experiment that assessed ten different parameters related to behavior as locomotion, emotionality, and anxiety. In the first stage of the experiment, intraperitoneal the crude organic extract administration dose-dependently impaired locomotion and emotionality 30–120 min after administration. A significant decrease in defecation was observed, which was related to emotionality. No alterations in the elevated plus maze were found; thus, this apparatus was not used in the next stage of the experiment. In the second stage, the previously determined non-lethal dose of 0.1563 g/kg was intraperitoneally administered, which impaired locomotion and rearing frequency and increased immobility time. Necropsy revealed smooth intestine hemorrhage. Rutin, leucoside, nicotiflorin, guaijaverin, and astragalin were isolated from the crude organic extract. This is the first time that these compounds have been identified in L. suaveolens. In conclusion, the crude organic extract impaired locomotion and emotionality and caused hemorrhage in male Balb-c mice, indicating that its consumption can be harmful to humans and animals. The present results provide a basis for further studies on the pharmacology, toxicology, and natural product chemistry of the crude organic extract.

Influence of the intraperitoneal administration of antitumor Abarema auriculata extract on mice behavior

The organic extract EB689, obtained from the stem of Abarema auriculata (Benth.) Barneby & J.W.Grimes, Fabaceae, commonly known as "saboeiro-ferro", was chemically studied, as well as its influence over behavioral effects such as locomotion, emotionality and anxiety, after intra-peritonial administration were assessed. The open-field and elevated-plus maze were used in experiments divided into two stages. The first stage aimed for the identification of the main effects over behavior using a reduced number of animals against half-fold diluted doses of EB689. The same variables were also tested in a second stage of the experiment using the non-lethal intra-peritoneal dose of 4.8 mg/kg in a larger number of animals. It was observed that EB689 clearly decreased locomotion, which was probably caused by internal hemorrhage causing hypovolemic shock. Although it is the first time lupeol and eucryphin are described in A. auriculata, it is still not clear if they are involved in the toxicology of A. auriculata. The undesirable effects of EB689 are better understood, the basis for further pharmacological assays aiming antitumor activity are supported.

Traqueostomia percutânea: técnica ideal? / Percutaneous Tracheosthomy: ideal technique?

A traqueostomia percutânea tem substituído a traqueostomia convencional em muitas Unidades de Terapia Intensiva, devido à facilidade e segurança do método realizado à beira do leito, dispensando o transporte do paciente da Unidade de Terapia Intensiva para o Centro Cirúrgico. Alguns autores sugerem que a dissecção limitada resulta em menor dano tecidual, diminui o risco de sangramento e infecção de ferida operatória. Esta revisão visa analisar e sintetizar estudos prospectivos e randomizados, revisões sistemáticas e meta-análises, comparando a traqueostomia percutânea e traqueostomia convencional em pacientes adultos em Unidades de Terapia Intensiva.

OBJECTIVES: The percutaneous dilatational tracheostomy has become the technique of choice in the Intensive Care Unit, due safety and facilities to be performed at bedside, wich may overcome the risks associated with transport of critically ill patients to the Operating Room. Proponents of percutaneous dilatational tracheostomy suggest that the limited dissection results in less tissue damage, lowers the risk of bleeding and wound infection. The aim of this study is to review the techniques of percutaneous dilatational tracheostomy through a critical analysis of it's indications, contra-indications and complications, as well to compare percutaneous dilatational tracheostomy to surgical tracheostomy. This manuscript analysis and synthesizes randomized prospective studies, meta-analysis and systematic reviews, comparing both techniques in adult critically ill patients in the Intensive Care Unit.

Evaluation of the effects of ozone therapy in the treatment of intra-abdominal infection in rats

INTRODUCTION: The antibacterial effect of ozone (O3) has been described in the extant literature, but the role of O3 therapy in the treatment of certain types of infection remains controversial. OBJECTIVES: To evaluate the effect of intraperitoneal (i.p.) O3 application in a cecal ligation/puncture rat model on interleukins (IL-6, IL-10) and cytokine-induced neutrophil chemoattractant (CINC)-1 serum levels, acute lung injury and survival rates. METHODS: Four animal groups were used for the study: a) the SHAM group underwent laparotomy; b) the cecal ligation/puncture group underwent cecal ligation/puncture procedures; and c) the CLP+O2 and CLP+O3 groups underwent CLP+ corresponding gas mixture infusions (i.p.) throughout the observation period. IL-6, CINC-1 and IL-10 concentrations were determined by enzyme-linked immunosorbent assay (ELISA). Acute lung injury was evaluated with the Evans blue dye lung leakage method and by lung histology. P<0.05 was considered significant. RESULTS: CINC-1 was at the lowest level in the SHAM group and was lower for the CLP+O3 group vs. the CLP+O2 group and the cecal ligation/puncture group. IL-10 was lower for the SHAM group vs. the other three groups, which were similar compared to each other. IL-6 was lower for the SHAM group vs. all other groups, was lower for the CLP+O3 or CLP+O2 group vs. the cecal ligation/puncture group, and was similar for the CLP+O3 group vs. the CLP+O2 group. The lung histology score was lower for the SHAM group vs. the other groups. The Evans blue dye result was lower for the CLP+O3 group vs. the CLP+O2 group and the cecal ligation/puncture group but similar to that of the SHAM group. The survival rate for the CLP+O3 group was lower than for the SHAM group and similar to that for the other 2 groups (CLP and CLP+O2). CONCLUSION: Ozone therapy modulated the inflammatory response and acute lung injury in the cecal ligation/puncture infection model in rats, although there was no ...

Surgical resection of lung metastases: results from 529 patients

OBJECTIVE: The aim of this study is to determine clinical, pathological, and treatment-relevant variables associated with long-term (90-month) overall survival in patients with lung metastases undergoing pulmonary metastasectomy. METHODS: A retrospective review was performed of patients who were admitted with lung metastases, and who underwent thoracotomy for resection, after treatment of a primary tumor. Data were collected regarding demographics, tumor features, treatment, and outcome.RESULTS: Patients (n = 529) were submitted to a total of 776 thoracotomies. Median follow-up time across all patients was 21.6 months (range: 0-192 months). The postoperative complication rate was 9.3%, and the 30-day mortality rate was 0.2%. The ninety-month overall survival rate for all patients was 30.4%. Multivariate analysis identified the number of pulmonary nodules detected on preoperative CT-scan, the number of malignant nodules resected, and complete resection as the independent prognostic factors for overall survival.CONCLUSION: These results confirm that lung metastasectomy is a safe and potentially curative procedure for patients with treated primary tumors. A select group of patients can achieve long-term survival after resection.

Evaluation of the mortality rate caused by different periods of selective portal vein occlusion in rats / Avaliação da mortalidade causada por diferentes períodos de oclusão seletiva da veia porta em ratos

Mortality from acute selective portal vein occlusion (SPVO) is a matter of concern for surgeons during the management of traumatic portal vein injury. However, mortality rates related to different periods of SPVO remains undetermined. PURPOSE: To determine the mortality rates resulting from different periods of acute SPVO in rats. METHODS: Wistar male rats were randomized into 8 experimental, and 8 control groups. Experimental animals underwent SPVO during 15 to 75 minutes, and control groups underwent sham procedures. All surviving animals were followed up to 14 days for assessment of mortality rate. RESULTS: Death rates varied from 0 percent in the 15 min SPVO group, to 100 percent with 65 and 75 minutes of SPVO. A strongly positive correlation was observed between mortality rates and SPVO periods (p 30 min) of SPVO.

A mortalidade da oclusão seletiva da veia porta (OSVP) preocupa os cirurgiões durante o tratamento de lesão traumática da veia porta. Entretanto, as taxas de mortalidade decorrentes de diferentes períodos de OSVP não estão determinadas. OBJETIVO: Determinar a mortalidade Decorrente de diferentes períodos de oclusão seletiva da veia porta (OSVP) em ratos. MÉTODOS: Ratos Wistar machos foram randomizados em 8 grupos experimentais e 8 controles. Os experimentais foram submetidos a OSVP por períodos de 15 a 75 minutos, seguidos de observação até o óbito, e os sobreviventes até 14 dias. Os grupos controles receberam idênticos procedimentos, exceto a OSVP. RESULTADOS: A mortalidade, a partir do momento da oclusão, aumentou progressivamente, de 0 por cento no grupo de 15min, atingindo 100 por cento nos grupos de 65min e 75min de OSVP. Houve alta correlação positiva entre mortalidade e duração da OSVP (p 30 minutos).

Evaluation of the mortality rate caused by different periods of selective portal vein occlusion in rats

Mortality from acute selective portal vein occlusion (SPVO) is a matter of concern for surgeons during the management of traumatic portal vein injury. However, mortality rates related to different periods of SPVO remains undetermined. PURPOSE: To determine the mortality rates resulting from different periods of acute SPVO in rats. METHODS: Wistar male rats were randomized into 8 experimental, and 8 control groups. Experimental animals underwent SPVO during 15 to 75 minutes, and control groups underwent sham procedures. All surviving animals were followed up to 14 days for assessment of mortality rate. RESULTS: Death rates varied from 0 percent in the 15 min SPVO group, to 100 percent with 65 and 75 minutes of SPVO. A strongly positive correlation was observed between mortality rates and SPVO periods (p<0.001) with either linear or quadratic regression analysis tests. All deaths in the 20min and 25min SPVO groups occurred after 75 min from the moment of clamping (or after 60 min from unclamping); death from 30 or more min SPVO occurred predominantly within 75 min from clamping moment (or within 60 min from unclamping). (Exact Fisher test, p=0.009). CONCLUSIONS: The mortality from SPVO in rats increases with longer duration of SPVO; with deaths occurring later for short periods (< 25 min) of SPVO and earlier for longer periods (> 30 min) of SPVO.

A mortalidade da oclusão seletiva da veia porta (OSVP) preocupa os cirurgiões durante o tratamento de lesão traumática da veia porta. Entretanto, as taxas de mortalidade decorrentes de diferentes períodos de OSVP não estão determinadas. OBJETIVO: Determinar a mortalidade Decorrente de diferentes períodos de oclusão seletiva da veia porta (OSVP) em ratos. MÉTODOS: Ratos Wistar machos foram randomizados em 8 grupos experimentais e 8 controles. Os experimentais foram submetidos a OSVP por períodos de 15 a 75 minutos, seguidos de observação até o óbito, e os sobreviventes até 14 dias. Os grupos controles receberam idênticos procedimentos, exceto a OSVP. RESULTADOS: A mortalidade, a partir do momento da oclusão, aumentou progressivamente, de 0 por cento no grupo de 15min, atingindo 100 por cento nos grupos de 65min e 75min de OSVP. Houve alta correlação positiva entre mortalidade e duração da OSVP (p<0.001; tanto em teste de Regressão linear quanto quadrática). Os óbitos decorrentes de 20 e 25 min de OSVP ocorreram após 75min do clampeamento (ou após 60 min do desclampeamento); os decorrentes de 30min ou mais ocorreram predominantemente antes de decorridos 75 min do clampeamento (ou 60 min do desclampeamento). (Teste exato de Fisher, p<0.05). CONCLUSÕES: A mortalidade da OSVP em ratos aumenta com a maior duração da oclusão; os óbitos ocorrem mais tardiamente após oclusões breves (< 25 min), e mais precocemente nas oclusões mais prolongadas (> 30 minutos).

Antibacterial and cytotoxic activity of Brazilian plant extracts - Clusiaceae

Twelve extracts obtained from nine plants belonging to six different genera of Clusiaceae were analyzed against Gram-negative (Escherichia coli and Pseudomonas aeruginosa) and Gram-positive (Staphylococcus aureus and Enterococcus faecalis) bacteria using the microdilution broth assay. Tovomita aff. longifolia, T. brasiliensis, Clusia columnaris, Garcinia madruno, Haploclathra paniculata, and Caraipa grandifolia extracts showed significant results against the bacteria. The organic extract obtained from the leaves of T. aff. longifolia showed minimal inhibitory concentration (MIC) = 70 µg/ml and minimal bactericidal concentration (MBC) = 90 µg/ml against E. faecalis and the organic extract made with the stem of C. columnaris showed MIC = 180 µg/ml and MBC = 270 µg/ml against P. aeruginosa. None of the antibacterial extracts showed lethal activity against brine shrimp nauplii. On the other hand, both aqueous and organic extracts obtained from the aerial organs of Vismia guianensis that were cytotoxic to brine shrimp nauplii did not show a significant antibacterial activity in the assay.

Intestinal ischemia/reperfusion induces bronchial hyperreactivity and increases serum TNF-alpha in rats

INTRODUCÃO: A isquemia/reperfusão intestinal ou hepática induz lesão pulmonar aguda em modelos animais de falência de múltiplos órgãos. O fator de necrose tumoral (TNF-a) está envolvido no mecanismo inflamatório da síndrome da angústia respiratória aguda. Embora a cascata inflamatória que leva à síndrome da angústia respiratória aguda tenha sido extensamente investigada, os componentes mecânicos desta ainda não são completamente compreendidos. Nós levantamos a hipótese de que a isquemia/reperfusão esplâncnica provoca aumento da reatividade contráctil das vias aéreas, bem como aumento do TNF-a sérico. OBJETIVO: avaliar a reatividade da musculatura lisa brônquica sob estimulação com metacolina, e medir os níveis séricos de TNF-a após isquemia/reperfusão intestinal e/ou hepática em ratos. MÉTODO: Ratos Wistar foram submetidos a 45 min de isquemia intestinal, ou 20 minutos de isquemia hepática, ou a ambas (isquemia dupla), ou controle, seguidos por 120 min de reperfusão. A resposta brônquica a concentrações molares (10-7 to 3x10-4) de metacolina foi avaliada usando-se uma preparação ex-vivo de musculatura brônquica. RESULTADOS: A resposta brônquica (g/100mg de tecido) mostrou reatividade aumentada a concentrações crescentes de metacolina na isquemia intestinal e isquemia dupla, mas não na isquemia hepática. Similarmente, o TNF-a sérico aumentou na isquemia intestinal e isquemia dupla, mas não na isquemia hepática. CONCLUSÃO: Isquemia intestinal, quer isolada ou associada à hepática, provocou hiper-reatividade da musculatura brônquica, sugerindo um possível papel da constrição brônquica na disfunção respiratória conseqüente à isquemia/reperfusão esplâncnica. Este aumento foi simultâneo ao do TNF-a sérico, porém o possível efeito causal do TNF-a na contractilidade brônquica permanece a ser determinado.

Nonsmall cell lung cancer: evaluation of 737 consecutive patients in a single institution

OBJETIVO: Analisar o resultado e fatores prognósticos de patients com CPNPC admitidos em uma única instituição e correlacionar os dados com o sistema atual de estadiamento. MÉTODO: Setecentos e trinta e sete pacientes com diagnóstico de CPNPC foram admitidos ao Hospital do Cancer A. C. Camargo entre 1990 e 2000. Todos os pacientes foram incluídos em um banco de dados contínuo prospectivo e seus dados foram analisados. Após o estadiamento, uma equipe multidisciplinar estabeleceu decisões sobre o manejo adequado para o caso. Variáveis analisadas incluíram idade, sexo, tipo histológico, índice de Karnofsky, perda de peso, estadio clínico, estadio cirúrgico, quimioterapia, radioterapia e taxa de sobrevida. RESULTADOS: 75,5% dos pacientes eram do sexo masculino. A distribuição dos tipos histológicos foi carcinoma espino celular 51,8%, adenocarcinoma 43,% e carcinoma indiferenciado de grandes células 5,1%. A maior parte apresentou perda de peso significativa e um Karnofsky Index de 80%. O estadiamento clínico foi IA 3,8%, IB 9,2%, IIA 1,4%, IIB 8,1%, IIIA 20,9%, IIIB 22,4%, IV 30,9%. A ressecção total do tumor foi possível em 24,6% dos casos. A distribuição do estadiamento cirúrgico foi IA 25,3%, IB 1,4%, IIA 1,4%, IIB 17,1%, IIIA 16,1%, IIIB 20,3%, IV 11,5%. Quimioterapia e radioterapia também foram consideradas opções terapêuticas. A sobrevida global de 5 anos em nosso estudo foi de 28%, sendo a sobrevida mediana de18,9 meses. CONCLUSÕES: CPNPC é uma doença que requer atenção especial, devido aos altos índices de morbi-mortalidade. Melhor prognóstico está associado à ressecção completa do tumor, com dissecção de linfonodos. Todavia, isso só é possível em estadios clínicos mais precoces.

Computed tomography-guided biopsy of mediastinal lesions: fine versus cutting needles

PURPOSE: To report the experience of a radiology department in the use of computed tomography guided biopsies of mediastinal lesions with fine and cutting needles, describing the differences between them. The results of adequacy of the sample and histologic diagnoses are presented according to the type of needle used. METHODS: We present a retrospective study of mediastinal biopsies guided by computed tomography performed from January 1993 to December 1999. Eighty-six patients underwent mediastinal biopsy in this period, 37 with cutting needles, 38 with fine needles, and 11 with both types (total of 97 biopsies). RESULTS: In most cases, it was possible to obtain an adequate sample (82.5 percent) and specific diagnosis (67.0 percent). Cutting-needle biopsy produced a higher percentage of adequate samples (89.6 percent versus 75.5 percent, P = 0.068) and of specific diagnosis (81.3 percent versus 53.1 percent, P = 0.003) than fine-needle biopsy. There were no complications that required intervention in either group. CONCLUSION: Because they are practical, safe, and can provide accurate diagnoses, image-guided biopsies should be considered the procedure of choice in the initial exploration of patients with mediastinal masses. In our experience, cutting needles gave higher quality samples and diagnostic rates. We recommend the use of cutting needles as the preferred procedure

Hypertonic/hyperoncotic solution in hypovolemic patients: experience in the emergency room

Hypertonic solutions have been studied extensively in the treatment of hypovolemic shock, both in experimental and clinical models. Safety, efficacy, and long-term effects on animals and patients have been evaluated. The present article reviews indications, safety, mortality rates, and outcome in patients with hemorrhagic hypovolemic shock who were treated after admission with a hypertonic/hyperoncotic solution under strict observation in the emergency room

Computed tomography-guided cutting needle biopsy of pulmonary lesions

PURPOSE: To report the experience of a radiology department in the use of computed tomography - guided cutting needle biopsy of pulmonary nodules, by evaluating diagnostic yield and incidence of complications. METHODS: This is a retrospective analysis of 52 consecutive patients who underwent lung lesion biopsy guided by computed tomography, performed between May 1997 and May 2000. Thirty-five patients were male and 17 were female, with ages ranging from 5 to 85 years (median, 62 years). The size of the lesions ranged from 1.8 to 15 cm (median, 5.4 cm). RESULTS: In a total of 52 biopsies of lung lesions, 51 biopsies (98.1 percent) supplied appropriate material for histopathological diagnosis, with 9 diagnosed (17.3 percent) as benign and 42 (80.8 percent) as malignant lesions. Specific diagnosis was obtained in 44 (84.6 percent) biopsies: 4 benign (9.1 percent) and 40 (90.9 percent) malignant lesions. The sensitivity, specificity, and accuracy of the cutting needle biopsies for determining presence of malignancy were 96.8 percent, 100 percent, and 97.2 percent, respectively. Complications occurred in 9 cases (17.3 percent), including 6 cases (11.5 percent) of small pneumothorax, 1 (1.9 percent) of hemoptysis, 1 (1.9 percent) of pulmonary hematoma, and 1 (1.9 percent) of thoracic wall hematoma. All had spontaneous resolution. There were no complications requiring subsequent intervention. CONCLUSION: The high sensitivity and specificity of the method and the low rate of complications have established cutting needle biopsy as an efficient and safe tool for the diagnosis of lung lesions. In our hospital, cutting needle biopsy is considered a reliable procedure for the evaluation of indeterminate pulmonary nodules

Chemotherapy versus best supportive care in stage IV non-small cell lung cancer, non metastatic to the brain

Stage IV non-small cell lung cancer is a fatal disease, with a median survival of 14 months. Systemic chemotherapy is the most common approach. However the impact in overall survival and quality of life still a controversy. OBJECTIVES: To determine differences in overall survival and quality of life among patients with stage IV non-small cell lung cancer non-metastatic to the brain treated with best supportive care versus systemic chemotherapy. PATIENTS: From February 1990 through December 1995, 78 eligible patients were admitted with the diagnosis of stage IV non-small cell lung cancer . Patients were divided in 2 groups: Group A (n=31 -- treated with best supportive care ), and Group B (n=47 -- treated with systemic chemotherapy). RESULTS: The median survival time was 23 weeks (range 5 -- 153 weeks) in Group A and 55 weeks (range 7.4 -- 213 weeks) in Group B (p=0.0018). In both groups, the incidence of admission for IV antibiotics and need of blood transfusions were similar. Patients receiving systemic chemotherapy were also stratified into those receiving mytomycin, vinblastin, and cisplatinum, n=25 and those receiving other combination regimens (platinum derivatives associated with other drugs, n=22). Patients receiving mytomycin, vinblastin, and cisplatinum, n=25 had a higher incidence of febrile neutropenia and had their cycles delayed for longer periods of time than the other group. These patients also had a shorter median survival time (51 versus 66 weeks, p=0.005). CONCLUSION: In patients with stage IV non-small cell lung cancer, non-metastatic to the brain, chemotherapy significantly increases survival compared with best supportive care

The role of video-assisted thoracic surgery in patients with lung cancer

A videotoracoscopia tem sido indicada com freqüência progressivamente maior como abordagem cirúrgica em pacientes com tumores torácicos. O presente estudo apresenta o estado atual das indicações deste método, sua aplicação em câncer de pulmão, e os resultados obtidos até a presente data.

Pathophysiology of cancer cachexia

Cancer cachexia is a frequent complication observed in patients with malignant tumors. Although several decades have passed since the first focus on the metabolic dysfunction's associated with cancer, few effective therapeutic interventions have been successfully introduced into the medical armamentarium. The present study thoroughly reviews the basic pathophysiology of cancer cachexia and the treatment options already investigated in that field. Experimental and clinical studies were evaluated individually in order to clarify the intricate alterations observed in tumor-bearing patients. The difficulties in introducing sound and effective nutritional support or metabolic manipulation to reverse cancer cachexia are outlined in this review.