ABSTRACT
Introdução: As Doenças Inflamatórias Intestinais são condições crônicas, que afetama região intestinal, sendo as mais comuns a Colite Ulcerativa e a Doença de Crohn. Possuem duas fases: a fase de doença ativa e a fase de remissão. O objetivo do tratamento farmacológico é aliviar o processo inflamatório e prolongar o período de remissão. Há também outras formas de tratamento, como a fitoterapia, que é à base de plantas e possui efeitos adversos mínimos. Visando o impacto da doença na qualidade de vida, a ingestão de diversos medicamentos e seus efeitos colaterais, o presente estudo tem como principal objetivo identificar e analisar sistematicamente a eficácia da ação anti-inflamatória da Curcuma longa, como tratamento alternativo paraminimizar os danos ao organismo e, consequentemente, melhorar a qualidade de vida, diminuindo as crises agudas. Método: Estudo de revisão sistemática da literatura nacional e internacional de ensaios clínicos randomizados, no período de 2010 à 2021. Os artigos foram consultados nas bases de dados: Pubmed, LILACS, Web of Science, Embase e Biblioteca Virtual de Saúde. Resultados: Todos os estudos incluídos foram ensaios clínicos duplo-cego randomizados e controlados porplacebo, com pacientes maiores de 18 anos, sendo 5 estudos de pacientes com Colite Ulcerativa leve a moderada, 1 estudo de pacientes com Doença de Crohn leve a moderada e 1 estudo de pacientes com Doença de Crohn pós ressecção intestinal. Discussão: Dos cinco estudos incluídos de pacientes com Colite Ulcerativa, quatro estudos demonstraram resultados positivos em relação à remissão clínica. O único estudo que não demonstrou resultados positivos em relação à remissão clínica, utilizou menor quantidade de mesalazina quando comparado com os outros estudos, o que pode ter influenciado no resultado final. O estudo de pacientes com Doença de Crohn pós ressecção intestinal foi interrompido por haver reações adversas graves em 16% dos pacientes que receberam curcumina. Comparando todos os estudos, percebeu-se que os dois estudos que utilizaram tecnologias para melhorar a biodisponibilidade da Curcuma longa, utilizaram menores quantidades diárias, concluindo que os avanços tecnológicos podem ser aliados para um melhor tratamento complementar. Além disso, o estudo que utilizou a via retal também utilizou menor quantidade de curcumina e mesalazina, comprovando que nessa via há melhor aproveitamento da planta. Conclusão: A Curcuma longa pode ser uma ótima alternativa como tratamento complementar nas Doenças Inflamatórias Intestinais para reduzir as recorrências clinicas, entretanto possui poucos estudos clínicos e com pouca amostra para comprovar seus efeitos anti-inflamatórios.
Introduction: Inflammatory Bowel Diseases are chronic conditions that affect the intestinal region, the most common being Ulcerative Colitis and Crohn's. They have two phases: the active disease phase and the remission phase. The goal of pharmacological treatment is to alleviate the inflammatory process and prolong the period of remission. There are also other forms of treatment, such as phytotherapy, which is herbal and has minimal adverse effects. Targeting the impact of the disease quality of life, the intake of various medications and their effects collaterals, the main objective of this study is to identify and analyze systematically the effectiveness of the anti-inflammatory action of Curcuma longa, as alternative treatment to minimize damage to the body and, consequently, improve quality of life, reducing acute crises. Method: Study of systematic review of national and international clinical trial literature randomized, from 2010 to 2021. The articles were consulted in the databases data: Pubmed, LILACS, Web of Science, Embase and Virtual Health Library. Results: All included studies were double-blind clinical trials randomized and placebo-controlled trials, with patients over 18 years of age, being 5 studies of patients with mild to moderate Ulcerative Colitis, 1 study of patients with mild to moderate Crohn's Disease and 1 study of patients with Crohn's Crohn's post intestinal resection. Discussion: Of the five included studies of patients with Ulcerative Colitis, four studies demonstrated positive results in relation to clinical remission. The only study that did not demonstrate results positive in relation to clinical remission, used less mesalazine when compared with other studies, which may have influenced the result Final. The study of patients with Crohn's disease after intestinal resection was discontinued due to serious adverse reactions in 16% of patients who received curcumin. Comparing all the studies, it was noticed that the two studies that used technologies to improve the bioavailability of Curcuma long, used smaller daily amounts, concluding that advances Technological technologies can be allies for better complementary treatment. In addition Furthermore, the study that used the rectal route also used a smaller amount of curcumin and mesalazine, proving that this route improves the use of plant. Conclusion: Curcuma longa can be a great alternative as complementary treatment in Inflammatory Bowel Diseases to reduce clinical recurrences, however there are few clinical studies and little sample to prove its anti-inflammatory effects.
Subject(s)
Humans , Male , FemaleABSTRACT
Hyperphosphorylation of the microtubule-associated protein tau and its resultant aggregation into neurofibrillary tangles (NFT) is a pathological characteristic of neurodegenerative disorders known as tauopathies. Tau is a neuronal protein involved in the stabilization of microtubule structures of the axon and the aberrant phosphorylation of tau is associated with several neurotoxic effects. The discovery of tau pathology and aggregates in the cortex of Temporal lobe epilepsy (TLE) patients has focused interest on hyperphosphorylation of tau as a potential mechanism contributing to increased states of hyperexcitability and cognitive decline. Previous studies using animal models of status epilepticus and tissue from patients with TLE have shown increased tau phosphorylation in the brain following acute seizures and during epilepsy, with tau phosphorylation correlating with cognitive deficits in patients. Suggesting a functional role of tau during epilepsy, studies in tau-deficient and tau-overexpressing mice have demonstrated a causal role of tau during seizure generation. Previous studies, analyzing the impact of seizures on tau hyperphosphorylation, have mainly used animal models of acute seizures. These models, however, do not replicate all aspects of chronic epilepsy. In this study, we investigated the effects of acute seizures (status epilepticus) and chronic epilepsy upon the expression and phosphorylation of tau using the intra-amygdala kainic acid (KA)-induced status epilepticus mouse model. Status epilepticus resulted in an immediate increase in total tau levels in the hippocampus, in particular, the dentate gyrus, and phosphorylation of the AT8 epitope (Ser202, Thr205), with phosphorylated tau mainly localizing to the mossy fibers of the dentate gyrus. During epilepsy, abnormal phosphorylation of tau was detected again at the AT8 epitope with lower total tau levels in the CA3 and CA1 subfields of the hippocampus. Chronic epilepsy in mice also resulted in a strong localization of AT8 phospho-tau to microglia, indicating a distinct pattern of tau hyperphosphorylation during chronic epilepsy compared to status epilepticus. Our results reaffirm previous observations of tau phosphorylation post-status epilepticus, but also elaborate on tau alterations in epileptic mice which more faithfully mimic TLE. Our results confirm seizures affect tau hyperphosphorylation, however, suggest epitope-specific phosphorylation of tau and differences in cell-specific localization according to disease progression.
ABSTRACT
Brachial plexus neuropathies are common complaints among patients seen at orthopedic clinics. The causes range from traumatic to occupational factors and symptoms include paresthesia, paresis, and functional disability of the upper limb. Treatment can be surgical or conservative, but detailed knowledge of the brachial plexus is required in both cases to avoid iatrogenic injuries and to facilitate anesthetic block, preventing possible vascular punctures. Therefore, the objective of this study was to evaluate the topography of the infraclavicular brachial plexus fascicles in different upper limb positions adopted during some clinical procedures. A formalin-preserved, adult, male cadaver was used. The infraclavicular and axillary regions were dissected and the distance of the brachial plexus fascicles from adjacent bone structures was measured. No anatomical variation in the formation of the brachial plexus was observed. The metric relationships between the brachial plexus and adjacent bone prominences differed depending on the degree of shoulder abduction. Detailed knowledge of the infraclavicular topography of neurovascular structures helps with the diagnosis and especially with the choice of conservative or surgical treatment of brachial plexus neuropathies.
Las neuropatías del plexo braquial son quejas comunes entre los pacientes atendidos en las clínicas ortopédicas. Las causas van desde traumas a factores ocupacionales y los síntomas incluyen parestesias, paresia e incapacidad funcional del miembro superior. El tratamiento puede ser quirúrgico o conservador, pero se requiere un conocimiento detallado del plexo braquial en ambos casos para evitar lesiones iatrogénicas y para facilitar el bloqueo anestésico, evitando posibles lesiones vasculares. Por lo tanto, el objetivo de este estudio fue evaluar la topografía de los fascículos del plexo braquial infraclavicular en diferentes posiciones de los miembros superiores adoptadas durante algunos procedimientos clínicos. Se llevó a cabo la disección de las regiones infraclavicular y axilar de un cadáver adulto, de sexo masculino, conservado en formaldehído. Se midió la distancia de los fascículos del plexo braquial en relación a las estructuras óseas adyacentes. No se observó variación anatómica en la formación del plexo braquial. Las relaciones métricas entre el plexo braquial y las prominencias óseas adyacentes difieren en función del grado de abducción del hombro. El conocimiento detallado de la topografía infraclavicular de las estructuras neurovasculares ayuda con el diagnóstico y sobre todo con la elección del tratamiento conservador o quirúrgico de las neuropatías del plexo braquial.
