Prospecção fitoquímica preliminar de plantas nativas do cerrado de uso popular medicinal pela comunidade rural do assentamento vale verde - Tocantins / Preliminary phytochemical screening of native Cerrado plants of medicinal popular use by the rural community of the Vale Verde settlement - Tocantins

Este estudo objetivou caracterizar qualitativamente grupos de metabólitos secundários e alguns constituintes de 9 espécies de plantas medicinais nativas do cerrado utilizadas pela comunidade rural do Assentamento Vale Verde, identificando potencialidades biológicas e farmacológicas. As informações referentes às plantas de uso medicinal foram obtidas por meio de estudos etnobotânicos e etnofarmacológicos, realizados no período de 2010 a 2012. O material botânico coletado foi identificado e depositado no Herbário da Universidade Federal do Tocantins, Porto Nacional (TO). O extrato etanólico e metanólico foi obtido a partir do material seco em estufa, filtrado e concentrado em evaporador rotatório sob pressão reduzida, pesados e novamente colocados em estufa por 24h a 50ºC, obtendo o rendimento (m/m) resultante da relação entre a massa de extrato concentrado e após seco. A análise fitoquímica das plantas selecionadas foi feita usando a metodologia da Prospecção Preliminar, realizando testes para detecção de alguns constituintes importantes e dos principais grupos de metabólitos: saponinas, fenóis e taninos, catequinas, esteróides e triterpenóides, cumarinas, antraquinonas e flavonóides. Os testes foram considerados positivos através de reações de precipitados com colorações, formações de espumas e manchas coloridas. Os testes fitoquímicos realizados nos extratos revelarem a presença de constituintes do metabolismo secundário das plantas que podem contribuir para a identificação de marcadores químicos para as espécies estudadas, sendo estes indispensáveis para os testes de qualidade e integridade de fitoterápicos e uso popular mais seguro das plantas medicinais, possibilitando melhor controle farmacognóstico dessas espécies e direcionamento dos seus usos e aplicações na pesquisa pela bioatividade preliminarmente conhecida. Neste caso, especialmente devido às atividades antimicrobianas, antioxidantes e contra insetos, sugerindo relação com a presença de compostos fenólicos e flavonoídicos, positivos nos extratos da maioria das espécies. Estas informações são inéditas no Tocantins e estratégicas para fortalecimento das políticas de conservação de Áreas de Reserva Legal no âmbito do Cerrado, bioma prioritário para conservação da biodiversidade, melhorando a caracterização dos recursos medicinais ainda disponíveis na flora nativa regional bem como vislumbrando suas aplicações biológicas e farmacológicas.

This qualitative study aimed to characterize the groups of secondary metabolites and some constituents of 9 species of native medicinal plants of the Cerrado region used by the rural community of Vale Verde Settlement, identifying their biological and pharmacological potential. The information on medicinal plants were obtained through ethnobotanical and ethnopharmacological studies performed during the period 2010-2012. The botanical material collected was identified and deposited in the Herbarium of the Federal University of Tocantins, Porto Nacional (TO). The ethanolic and methanolic extracts were obtained from the oven dried material, filtered and concentrated in a rotary evaporator under reduced pressure, then weighed and placed again in an oven for 24h at 50 ° C, obtaining the yield (m / m), resulting from the ratio between the mass of concentrated extract and the mass after drying. Phytochemical analysis of selected plants was done using the methodology of Preliminary Prospecting, with tests for the detection of some important constituents and of the main groups of metabolites: saponins, phenols and tannins, catechins, steroids and triterpenoids, coumarins, anthraquinones and flavonoids. The tests were considered positive by the reactions of precipitates with colorations, the formation of foams and colored stains. Phytochemical tests performed on the extracts revealed the presence of constituents of secondary metabolism of plants, which can help to identify chemical markers of species. These markers are indispensable for testing quality and integrity of phytochemicals and a safer popular use of medicinal plants, enabling a better pharmacognostic control of these species and guidance for their use and applications in research by the preliminarily known bioactivity. In this case, it is especially due to the antimicrobial, antioxidant and anti insect activities, suggesting an association with the presence of phenolic compounds and flavonoids, positive in extracts of most species. These data are novel in Tocantins and strategic for the strengthening of conservation policies of Legal Reserve Areas within the Cerrado, priority biome for the conservation of biodiversity, improving the characterization of medicinal resources still available in the regional native flora, also foreseeing their biological and pharmacological applications.

[Early and delayed cardiac mortality after acute myocardial infarction in the pre-thrombolytic era. Prognosis value of an ergometric test and coronary arteriography]. / Mortalidade cardíaca precoce e tardia pós-infarto agudo do miocárdio na era pré-trombólise. Valor prognóstico do teste ergométrico e da coronariografia.

PURPOSE: To determine the relationship among clinical data, attenuated treadmill stress test (ST), cinecoronaryarteriography (CINE), ejection fraction (EF) with early-late mortality in patients after acute myocardial infarction (AMI). METHODS: Prospective study in 96 consecutive patients aged < 70 with AMI that were submitted to ST and CINE. Assessment of cardiac mortality was made 1-3 years post-AMI (period I) and at the end of follow-up (7-10 years-period II). RESULTS: First year and 10th year mortalities were 8% and 36%, respectively. Positive predictive value for cardiac death in period I was 10% for ST, 7% for multivessel coronary artery disease (MVCAD) and 9% for left ventricular ejection fraction (LVEF) < 30, while in period II they were 45%, 42% and 50%, respectively. Actuarial survival analysis (Kaplan-Meyer) disclosed mortality rates of 53% and 20% (p = 0.06) on period II for positive and negative ST, respectively, 45% and 22% (p < 0.03) for MVCAD and single-vessel disease, respectively, and 73% and 35% (p < 0.001) for those with and without left main coronary artery obstruction, respectively. In the multivariate regression analysis (Cox's model), only MVCAD (p < 0.002), LVEF < 30 (p < 0.003), positive ST (p < 0.007) and post-AMI angina (p < 0.01) were independently related to late mortality. CONCLUSION: Both attenuated ST and CINE are poor predictors of post-AMI early and late mortalities. However, multivariate regression analysis disclosed positive ST, MVCAD and LVEF < 30 as independent variables related to late mortality. This data indicate that myocardial ischemia, number of obstructed coronary arteries and poor left ventricular systolic function are the true determinants of post-infarction cardiac mortality.

[Is coronary cineangiography more accurate than early bicycle ergometry test in the identification of high-risk acute myocardial infarction survivors?]. / E a cinecoronariografia mais acurada que o teste ergométrico precoce na identificação de sobreviventes de infarto agudo do miocárdio de alto risco?

PURPOSE: To determine if attenuated early treadmill stress testing is more or less accurate than cinecoronary arteriography in the identification of high-risk acute myocardial infarction (AMI) survivors. PATIENTS AND METHODS: In a prospective study 96 non-selected and consecutive AMI survivors underwent cinecoronary arteriography in the 4th week of hospitalization and were followed up for a period of 3 to 39 (21.7 +/- 11.0) months. One-half of the patients were randomly submitted to an attenuated heart rate-limited treadmill stress testing in the 3rd week. Seven patients were lost in the follow-up. Of the remaining 89 patients 5 died of cardiac causes. Cardiac events (death, reinfarction, angina and heart failure) occurred in 26 patients. Multivessel coronary artery disease was found in 67 patients (75%) and mean left ventricular ejection fraction was 49.1 +/- 15.6%. Positive treadmill stress testing for myocardial ischemia occurred in 20 of 43 patients (46%). RESULTS: All patients who died of cardiac causes or who had a cardiac event had multivessel coronary artery disease, the mean left ventricular ejection fraction was 38.6 +/- 16.6% and 45.2 +/- 16.4%, respectively, and two-thirds of patients had positive stress testing. For cardiac death, multivessel coronary artery disease had better sensitivity than positive stress testing and left ventricular ejection fraction less than 0.3 (100% vs 67% vs 20%, respectively) while ejection fraction had better specificity than stress testing and multivessel coronary artery disease (87% vs 55% vs 21%, respectively). Stress testing had a better positive predictive value than multivessel coronary artery disease and ejection fraction (53% vs 38% vs 36%, respectively while multivessel coronary artery disease had better negative predictive value than stress testing and ejection fraction (100% vs 77% vs and 70%, respectively). The association of data obtained from cinecoronarography study between themselves and with positive treadmill stress testing did not significantly improve the sensitivities, specificities and predictive values in relation to the results obtained by isolated data. CONCLUSION: In survivors of acute myocardial infarction cinecoronary arteriography is not more accurate than, treadmill stress testing and both have limited value in the identification of patients who are candidates for cardiac death or events in the first few years after AMI. A negative stress testing and coronary arteriography (one-vessel disease) is more informative than a positive one.