Anxiolytic and antidepressant-like activity of a standardized extract from Galphimia glauca.

An infusion prepared with aerial parts from Galphimia glauca has been widely used in Mexican traditional medicine as a remedy for nervous excitement. The sedative activity of a methanolic extract from this plant has been demonstrated by neuropharmacological tests. This effect was attributed to the nor-secotriterpene named galphimine B (GB). In the present work, the anxiolytic and antidepressant-like effects of G. glauca methanolic extract (standardized on GB content, 8.3mg/g) were assayed by using the elevated plus-maze, light-dark test and the forced swimming paradigm, on ICR albino mice. This extract, administered orally, three times (24, 18 and 1h before the test), and in different doses (125, 250, 500, 1,000 and 2,000 mg/kg) was able to increase significantly (p<0.05) the number of entries, as well as the time spent in the open arms of the elevated plus-maze, indicating an anxiolytic-like effect. A similar effect was observed in the light-dark paradigm test, the time spent in the light box was increased in treated mice. Nevertheless, this treatment was unable to change any parameter in the forced swimming test. Altogether, these results suggest an anxiolytic-like effect to the methanolic standardized extract of G. glauca on ICR inbred mice.

Antitoxin activity of plants used in Mexican traditional medicine against scorpion poisoning.

Scorpions, especially in urban areas of tropical and subtropical regions, present a common risk of poisoning. In Mexico, scorpion envenomation is considered a public health problem. Despite the frequency of scorpion sting cases, there are to date no uniform criteria for their treatment. In Mexican traditional medicine, different plant species have been widely used as a remedy for treating scorpion poisoning. The aim of this work was to evaluate the effect of Bouvardia ternifolia, Aristolochia elegans and Vitex mollis extracts on Centruroides limpidus limpidus venom lethality in mice, and to determine their antagonist activity on guinea pig ileum. The hexane and methanol extract from B. ternifolia modified the LD50 of C. limpidus limpidus venom from 0.750 +/- 0.08 to 1.64 +/- 0.19 and 1.16 +/- 0.14 mg/kg, respectively. The extracts of A. elegans produced lower antitoxic activity, while extracts of V. mollis did not show any protection. On in vitro test, addition of B. ternifolia and A. elegans extracts strongly inhibited, in a concentration-dependent manner, the ileum contractions induced by venom. In general, the results demonstrated the effectiveness of these two plant species in modifying the lethality of C. limpidus limpidus venom in mice.

Radio-frequency ablation in cirrhotic patients with hepatocellular carcinoma.

Current surgical treatments for hepatocellular carcinoma (HCC) include radio-frequency ablation (RFA), resection, and orthotropic liver transplant (OLT). RFA is particularly attractive in these high-risk patients because surgery is associated with high mortality and there is a relative scarcity of organs available for those in need of transplants. This study was performed to evaluate the management of cirrhotic patients with HCC undergoing RFA at a single Western institution. A retrospective study from March 1999 to June 2002 was performed to evaluate the clinicopathologic and treatment-related variables in cirrhotic patients with HCC. Forty-nine lesions in 26 patients with HCC and cirrhosis underwent RFA. Data was analyzed for safety and overall survival as the main endpoints. The mean age was 60.4 +/- 11 years, 19 patients were male, 5 had hepatitis B virus, and 19 had hepatitis C virus. The Child classification was 26 per cent, 39 per cent, and 35 per cent for A, B, and C; the number of lesions was 1 in 62 per cent, 2 in 23 per cent, and more than 2 in 15 per cent. The approach was laparoscopic in 58 per cent, percutaneous in 15 per cent, and open in 27 per cent. There were no mortalities and only 1 complication. Average hospital stay was 2.7 +/- 2 days. Subsequent to RFA, 9 patients underwent an OLT within a median of 4.1 months. The median follow-up of the whole group was 13 months and the disease-free survival 9.3 months. Tumor recurrence was identified in 3 previously ablated lesions, nonablated liver in 11, and as pulmonary metastases in 3. Overall survival (P = 0.03) was prolonged for those treated with RFA + OLT over RFA alone. We conclude that RFA is a safe ablative technique in high-risk cirrhotic patients with HCC. This technique may provide a bridge to OLT; however, it remains to be proven whether it prolongs survival in those who do not undergo OLT.

Laparoscopic approach to fever of unknown origin.

BACKGROUND: Fever of unknown origin (FUO) is difficult to diagnose. Laparotomy is needed to establish the etiologic diagnosis in some patients. The aim of this study was to analyze the feasibility, safety, and success rate of a protocolized laparoscopy in patients with FUO. METHODS: An extensive clinical evaluation was performed before surgery. Laparoscopy included inspection of the abdominal cavity, wedge and tru-cut liver biopsies, lymph node biopsy, splenectomy, and bone marrow biopsy. Histologic analysis, permanent section analysis, and cultures were obtained. RESULTS: The study involved 15 patients with a mean age of 43.6 +/- 14.5 years. The mean operative time was 122 +/- 60 min. Minor complications occurred in 9% of the patients. One patient bled after surgery and underwent reoperation. There was no operative mortality. An etiologic diagnosis was made in 66% of the patients, and laparoscopy helped to rule out intraabdominal pathology in four additional patients, giving a total success rate of 93%. CONCLUSION: Protocolized laparoscopy in patients with FUO is safe, feasible, and accurate.

Lidocaine as antagonist of scorpion poison toxicity from Centruroides limpidus limpidus.

BACKGROUND: In Mexico, scorpion poisoning is a health problem because the poison has beta toxins that affect sodium channel activation. Lidocaine decreases ion permeability across the sodium channel acting in the opposite manner. The aim of this work is to determine whether lidocaine antagonized the toxic effect of the crude poison of Centruroides limpidus limpidus. METHODS: One half the lethal dose of the crude poison was determined alone and in the presence of different doses of lidocaine. Experiments with crude poison at LD(50) and crude poison plus lidocaine were carried out after 30, 90, and 180 min of poison inoculation; lung, heart, and brain were obtained for histopathologic analysis. RESULTS: Lidocaine (7 mg/kg dose) increased LD(50) of crude poison (2.95 +/- 0.22 to 6.68 +/- 0.25, p <0.001). Intraalveolar hemorrhage at 30, 90, and 180 min, myocardial edema, and brain congestion at 90 min were significantly reduced (p <0.05). CONCLUSIONS: Lidocaine exerts a protective effect against toxicity of the crude poison of Centruroides limpidus limpidus, probably by its antagonist activity on the sodium channel.

Intraoperative fine needle aspiration cytology of pancreatic lesions. A study of 90 cases.

Undiagnosed masses in the pancreas represent a problem at laparotomy. Intraoperative biopsy of pancreatic lesions frequently fails to detect carcinoma and may cause severe complications. The aim of the present study was to determine the diagnostic accuracy of intraoperative fine needle aspiration cytology (FNAC) of pancreatic lesions. Ninety patients were studied from January 1988 to June 1992. The cytologic diagnoses were correlated with histology, autopsy results or clinical follow-up. Aspirates were reported as benign, suspicious, malignant or unsatisfactory. Final diagnosis of malignant pancreatic disease (MPD) was established in 60 patients and of benign pancreatic disease in 30. Among the 60 cases with MPD, the cytologic diagnosis was concordant in 42 and interpreted as suspicious in 4. Seven patients with benign cytology and 7 with unsatisfactory cytology later proved to have malignant disease. A total of 30 patients had benign disease; 26 of them had benign cytology. The remaining four had "unsatisfactory" cytologic reports. No false positives were reported. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for intraoperative FNAC results were 80%, 100%, 100%, 70% and 91%, respectively. No complications followed the procedure. Intraoperative FNA of the pancreas is a safe and highly accurate diagnostic method for pancreatic lesions at laparotomy.

[Contributions to the study of pulmonary carcinoma. Review of 138 cases]. / Contribución al estudio del carcinoma pulmonar. Revisión de 138 casos.

A study was carried out in 138 lung cancer patients from the Department of Radiology and Physiotherapy of the Faculty of Medicine of Cadiz between 1983 and 1986. The patients were classified according to the pathologic anatomy in order to analyze the statistical variations in relation to sex, localization, metastases, clinical stage and radiation therapy. The obtained results about the form of presentation and behavior of each one of the pathologic anatomy types of lung carcinoma agree in some aspects with other works that have been consulted, and may help the radiotherapists in their clinical and therapeutic approach.