Efeito modulador do Firocoxib (Previcox®) sobre a ação carcinogênica da doxorrubicina por meio do teste de tumores epiteliais (ETT) em Drosophila melanogaster / Modulatory effect of Firocoxib (Previcox®) on the carcinogenic action of doxorubicin through the epithelial tumor teste (TTE) in Drosophila melanogaster

Introdução: a superexpressão da COX-2 relaciona-se com o aumento da produção de fatores de crescimento vascular e como consequência, com o desenvolvimento tumoral. O Firocoxib é um anti-inflamatório não esteroidal utilizado para inflamação associada à osteoartrite em cães. É o inibidor mais seletivo da COX-2, reduzindo eficientemente a ação desta enzima. Estudos indicam os benefícios do Firocoxib na terapia antineoplásica. Objetivo: este trabalho objetivou avaliar o efeito modulador do Firocoxib sobre a ação da doxorrubicina (DXR) por meio do teste de tumores epiteliais (ETT) em Drosophila melanogaster. Metodologia: foram preparadas três concentrações de Firocoxib: 2,5; 5 e 10 mg/mL, utilizadas isoladamente e em associação à doxorrubicina. O tratamento ocorreu com larvas de D. melanogaster descendentes do cruzamento de fêmeas wts/TM3 com machos mwh/mwh. Resultados: os resultados sugerem que o Firocoxib possui atividade moduladora sobre a ação carcinogênica da DXR, pois houve redução significativa nas frequências tumorais dos indivíduos tratados com diferentes concentrações de Firocoxib em cotratamento com a doxorrubicina quando comparadas à frequência tumoral do controle positivo. Conclusão: conclui-se que, nas presentes condições experimentais, o Firocoxib reduziu a frequência de tumores induzidos pela doxorrubicina em D. melanogaster.

Introduction: COX-2 overexpression is related to increased production of vascular growth factors and, as a consequence, to tumor development. Firocoxib is a non-steroidal anti-inflammatory drug used for inflammation associated with osteoarthritis in dogs. It is the most selective inhibitor of COX-2, efficiently reducing the action of this enzyme. Studies indicate the benefits of Firocoxib in anticancer therapy. Objective: this study aimed to evaluate the modulatory effect of Firocoxib on the action of doxorubicin (DXR) by means of the epithelial tumor test (ETT) in Drosophila melanogaster. Methodology: three concentrations of Firocoxib were prepared: 2.5; 5 and 10 mg/mL, used alone and in association with doxorubicin. The treatment occurred with D. melanogaster larvae descended from the crossing of wts/TM3 females with mwh/mwh males. Results: the results suggest that Firocoxib has modulating activity on the carcinogenic action of DXR, as there was a significant reduction in tumor frequencies in individuals treated with different concentrations of Firocoxib in co-treatment with doxorubicin when compared to the tumor frequency of the positive control. Conclusion: it is concluded that, under the present experimental conditions, Firocoxib reduced the frequency of tumors induced by doxorubicin in D. melanogaster.

Application study on improving the methods of endotracheal cuff pressure measurement to prevent ventilator-associated pneumonia / 中华危重病急救医学

To compare the intra cuff pressure changes during improved and the traditional method of cuff pressure measurement, then evaluate the effects of ventilator-associated pneumonia (VAP) prevention. The results highlighted practical recommendations in the process of ETT cuff pressure measurement. Methods① Experimental studies were carried out on the tracheal model with two groups: traditional pressure measurement group and improved pressure measurement group. The traditional pressure measurement group was connected to a handheld pressure gauge with the indicate cuff to get the intra-cuff pressure. The improved method was to insert a 3-way stopcock between the handheld pressure gauge and the indicate cuff. The 3-way stopcock to stabilize handheld pressure gauge reading at 32 cmH2O (1 cmH2O = 0.098 kPa) before measure the intra-cuff pressure. The pressure loss caused by two pressure measurement methods and the leakage of liquid on the balloon after 10 minutes was compared.② Clinical researches: a historic cohort study, patients with mechanical ventilation (MV) admitted to intensive care unit (ICU) of Guangxi Medical University Cancer Hospital from June 2014 to May 2018 were enrolled. The control group (249 cases) was treated with traditional method during June 2014 to May 2016, and the observation group (314 cases) was treated with improved method during June 2016 to May 2018. Clusters of strategies and actions of VAP prevention were applied in both groups. Incidence of VAP, duration of MV, and the length of ICU stay were compared between the two groups. Results ① Experimental study: the pressure leakage of the traditional pressure measurement group was (10.18±0.47) cmH2O, and that of the improved pressure measurement group was (1.33±0.42) cmH2O, with statistically significant difference between the two groups (t = 32.535, P = 0.000). All fluid on the cuffs leak after 10 minutes of traditional ways of measurement, however, no visible fluid on the cuffs leaked with improved procedures. ② Clinical research: the incidence of VAP in the observation group was slightly lower than that in the control group, however there was no significant difference [5.10% (16/314) vs. 8.43% (21/249), P > 0.05]. The duration of MV and the length of ICU stay in the observation group were significantly shorter than those in the control group (days: 9.93±3.14 vs. 16.77±5.45, 11.63 ±2.28 vs. 19.12±5.10, both P < 0.01). Conclusion The improved procedures of intra-cuff pressure measurement is a practical method to avoid the pressure leakage and fluid leakage, and the clinical course of MV patients can be significantly improved by combining the clusters of nursing strategies and actions.

A spectrum of gestational trophoblastic neoplasia

Gestational trophoblastic disease is a spectrum of diseases caused by overgrowth of chorionic villi of placenta. They range from most Benign to most Malignant. Those with local invasion or metastasis are labelled as Gestational trophoblastic Neoplasia (GTN). We have conducted a retrospective observational study of various Gestational trophoblastic neoplasias (GTN) at NRIGH for a period of 3 years, out of which, one example of each variety is being presented. All these varieties have been successfully treated and all the patients are under follow up.

Murphy’s Eye: A Last Moment Saviour for Anaesthesiologist In Case of Surgery for Recurrent Vocal Cord Polyposis.

Securing the airway in Juvenile papillomas of the vocal cords and trachea is sometimes hazardous and potentially lethal. In our case, when such patient was planned under GA, her right sided chest developed decreased air entry with varying degree of severity, while her left side chest presented as silent chest gradually during surgery. On exploration, the possible reason for ventilation on the right side was found to be the presence of Murphy’s eye, which functioned as a vent, when the primary distal opening of an ETT became occluded.

Ectopic Thyroid Tissue Co-Existing with a Eutopic Thyroid.

Ectopic thyroid tissue, a developmental defect of thyroid gland, is met with rarity in day to day clinical practice. The diagnosis of ectopic thyroid demands a meticulous clinical examination and use of different imaging modalities. We are here reporting a case which presented as an anterior neck swelling, moving with deglutition, and also on and off dysphagia. After necessary investigations she underwent surgery and then the diagnosis of ectopic thyroid was made which was later confirmed with biopsy report which was suggestive of lymphocytic thyroiditis.

Submental Intubation with Reinforced Tube for Intubating Laryngeal Mask Airway

Submental endotracheal intubation is a simple and secure alternative to either nasoendotracheal intubation or a tracheostomy in the airway management of maxillofacial trauma. However, a submental endotracheal intubation is quite difficult to manage if adverse events such as a tube obstruction, accidental extubation, or a leaking cuff with the endotracheal tube in the submental route occur, which could endanger the patient. This paper describes the use of a LMA-Fastrach (TM) ETT in the submental endotracheal intubation of patients suffering from maxillofacial trauma. One of the patients was a 16-year-old male, and the other was a 19-year-old male. They were scheduled for an open reduction and internal fixation of the maxillofacial fracture including naso-orbital-ethmoidal (NOE) complex, and a zygomaticomaxillary complex fracture. A submental intubation with a LMA-Fastrach (TM) ETT was performed in both cases, and the operation proceeded without any difficulties. These cases show that the use of the LMA- Fastrach (TM) ETT can improve the safety and efficacy of submental endotracheal intubation. This is because the LMA- Fastrach (TM) ETT has a freely detachable connector, and is flexible enough to keep the patency despite the acute angle of airway.