Características Clínicas dos Pacientes Submetidos à Nefrectomia Parcial e Presença de Carcinoma Renal / Clinical Characteristics of Patients Undergoing Partial Nephrectomy and the Occurrence of Renal Carcinoma / Características Clínicas de Pacientes con Nefrectomía Parcial y Presencia de Renal Carcinoma

Introdução: Existem poucos relatos correlacionando dados clínicos com a presença de carcinoma renal após o diagnóstico do tumor no exame de imagem. Objetivos: Analisar as características clínicas de pacientes submetidos à nefrectomia parcial (NP); correlacionar dados clínicos e da evolução no pós-operatório com a presença de carcinomas renais. Método: Estudo clínico observacional, retrospectivo, com 178 pacientes submetidos à NP entre 2009 a 2013. Foram avaliadas as características demográficas; morbidades: diabetes mellitus, hipertensão, doença cardiovascular; complicações do intra e pós-operatório e evolução. Os dados foram descritos em porcentagens, médias e desvio-padrão e significância estatística se p<0,05. Resultados: Foram analisados 178 pacientes de 54,0±13,4 anos, 61,2% do sexo masculino, 18,6% com tumores benignos e 81,4% com carcinomas renais. Entre os carcinomas, 69,7% foram de células claras e, entre os tumores benignos, 72,7% eram oncocitomas. A NP aberta foi realizada em 55,9% das vezes e em 44,1% por via laparoscópica. Após a cirurgia, 31,4 % necessitaram de unidade de terapia intensiva; 13,4 % apresentaram lesão renal aguda; 2,3 % alguma infecção; e 1,8% (n=3) foram a óbito após a alta. Entre as características, somente a obesidade e a redução do ritmo de filtração glomerular estimado (eRFG) em sete dias foi significativamente maior nos pacientes com carcinomas. Conclusões: Pacientes submetidos à NP eram predominantemente do sexo masculino e portadores de carcinomas de células claras. Pacientes com carcinomas eram mais obesos e tiveram maior redução do eRFG em sete dias do pós-operatório

Introduction: There are few reports correlating clinical data with renal carcinoma after the diagnosis of the tumor in the imaging examination. Objectives: To analyze the clinical characteristics of patients submitted to partial nephrectomy (PN); to correlate clinical and evolution data in the postoperative period with the presence of renal carcinomas. Method: A retrospective, observational clinical study, with 178 patients undergoing to PN between 2009 and 2013. Demographic characteristics were assessed; Morbidities: diabetes mellitus, hypertension, cardiovascular disease; intra and postoperative period complications and evolution. Data were described in percentages, means and standard deviation, and statistical significante if p<0.05. Results: 178 patients, 54.0 ± 13.4 years old, 61.2% male, 18.6% with benign tumors and 81.4% with renal carcinomas were analyzed. Among the carcinomas, 69.7% were Clear Cells and among the benign tumors 72.7% were oncocytomas. Open PN was performed in 55.9% and 44.1 laparoscopy. After surgery: 31.4% needed intensive care unit, 13.4% presented acute renal injury; 2.3% some infection and 1.8% (n=3) died after discharge. Among the characteristics only obesity and reduction of estimated glomerular filtration rate (eRFG) in seven days was significantly higher in patients with carcinomas. Conclusion: Patients submitted to PN were predominantly male and had clear cell carcinomas. Patients with carcinomas were more obese and had greater reduction of eRFG within seven days of postoperative period.

Introducción: Hay pocos informes que correlacionan los datos clínicos con la presencia de un carcinoma renal después del diagnóstico de imágenes de tumores. Objetivos: Analizar las características clínicas de los pacientes sometidos a nefrectomía parcial (NP); correlacionar datos clínicos y de la evolución en el postoperatorio con la presencia de carcinomas renales. Método: Estudio observacional clínico, retrospectivo, con 178 pacientes sometidos a NP entre 2009 y 2013. Fueran evaluadas las características demográficas; morbilidades: diabetes mellitus, la hipertensión, enfermedades cardiovasculares; complicaciones de intraoperatorio y postoperatorio. Los datos se presentan en porcentajes, medias y desviaciones estándar, y significancia estadística si p<0,05. Resultados: 178 pacientes analizadas con respecto a 54,0 ± 13,4 años 61,2% varones, 18,6% con tumores benignos y 81,4% con carcinomas renales. Entre los carcinomas, 69,7% eran células claras y entre tumores benignos 72,7% eran oncocitomas. NP abierta se realizó en 55,9% y 44,1% laparoscópica. Después de la cirugía: 31,4% unidad de terapia intensiva es necesario, 13,4% tenían una lesión renal aguda; 2,3% una infección y 1,8% (n=3) murieron después de la descarga. Entre las características, la obesidad y la reducción del ritmo de filtración glomerular estimado (eRFG) en siete días fue mayor significativamente en los pacientes con carcinoma. Conclusión: Los pacientes sometidos a NP, principalmente varones, los pacientes con carcinomas de células claras. Los pacientes con carcinomas eran más obesos y tenían una mayor reducción en eRFG siete días apartado de correos.

Yerba Mate (Ilex paraguariensis) modulates NF-kappaB pathway and AKT expression in the liver of rats fed on a high-fat diet.

To investigate the effect of Yerba Mate (YM) aqueous extract intake on the NF-kB pathway and AKT expression in the liver, muscle, and adipose tissue of rats submitted to a high-fat diet (HFD). Male Wistar rats were fed a control (CON) (n = 24) or a HFD (n = 24) for 12 weeks. Afterwards, rats received YM daily (1 g/kg body weight) for 4 weeks. Intake of YM aqueous extract reduced body weight gain (p < 0.05) and total blood cholesterol (p < 0.05) in the HFD group in comparison to the non-treated HFD group. HFD group demonstrated an increased glycemic response at 5 and 10 min after insulin injection. YM decreased the ratio between phosphorylated and total kinase inhibitor of κB (IKK), increased the ratio of phosphorylated to total form of protein kinase B (AKT) and reduced NF-κB phosphorylation in the liver of the HFD group. Our data suggest a beneficial role of YM in improving metabolic dysfunctions induced by HFD.

The Effects of Yerba Maté (Ilex Paraguariensis) consumption on IL-1, IL-6, TNF-α and IL-10 production by bone marrow cells in wistar rats fed a high-fat diet.

An excessive consumption of a high-fat diet (HFD) results in becoming overweight or obese, which triggers a chronic inflammatory condition that is associated with a high white blood cell count. Because of the potential for yerba maté (Ilex paraguariensis) (YM) to impact obesity, this study aimed to investigate the effects of YM consumption on the hematological response and on the production of interleukin (IL)-1α, IL-6, tumor necrosis factor (TNF)-α, and IL-10 by bone marrow cells from Wistar rats fed a HFD. Male Wistar rats were fed a control (CON) or HFD diet for twelve weeks. At the end of this period, the rats received YM (1 g/kg/day body weight) for 4 weeks. After euthanasia, hemograms and myelograms were evaluated, while the bone marrow cells were cultured in the presence or absence of lipopolysaccharide (LPS) to evaluate the production of IL-1α, IL-6, TNF-α, and IL-10. The consumption of YM reduced the body weight, the body adiposity, and the cholesterol levels in HFD-fed rats. Bone marrow cells from the HFD group produced more IL-1α, IL-6, and TNF-α, and less IL-10, when compared to cells from the control group, and YM consumption reduced the IL-1α, IL-6, and TNF-α production by the cells. However, cells from the HFD rats that were stimulated with LPS increased their IL-1α, IL-6, and TNF-α production, but YM consumption did not change this result. In summary, the consumption of YM affects the production of IL-1α, IL-6, and TNF-α by bone marrow cells, promotes weight loss, decreases the number of white blood cells, and significantly improves serum cholesterol level in HFD-fed rats. However, the bone marrow cells from the HFD+YM-fed rats challenged with LPS did not show improvement in the inflammatory response compared to the cells from animals fed only a HFD that were also challenged with LPS.

Isocaloric intake of a high-fat diet promotes insulin resistance and inflammation in Wistar rats.

The aim of this study was to investigate the effect of isocaloric intake from a high-fat diet (HFD) on insulin resistance and inflammation in rats. Male Wistar rats were fed on an HFD (n = 12) or control diet (n = 12) for 12 weeks. Subsequently, all animals were euthanized, and blood glucose, insulin, free fatty acids, C-reactive protein, lipid profile, cytokines and hepatic-enzyme activity were determined. Carcass chemical composition was also analyzed. During the first and the twelfth weeks of the experimental protocol, the oral glucose tolerance test and insulin tolerance test were performed and demonstrated insulin resistance (P < 0.05) in the HFD group. Although food intake (g) was lower (P < 0.05) in the HFD group compared with the control group, the concentration of total cholesterol, low-density lipoprotein, C-reactive protein and liver weight were all significantly higher. The kinase inhibitor of κB, c-Jun N-terminal kinase and protein kinase B expressions were determined in the liver and skeletal muscle. After an insulin stimulus, the HFD group demonstrated decreased (P = 0.05) hepatic protein kinase B expression, whereas the kinase inhibitor of κB phospho/total ratio was elevated in the HFD muscle (P = 0.02). In conclusion, the isocaloric intake from the HFD induced insulin resistance, associated with impaired insulin signalling in the liver and an inflammatory response in the muscle.

Efeito da erva-mate (Ilex paraguariensis) sobre a resposta inflamatória e via da sinalização da insulina no fígado de ratos / Effect of the high-fat diet and yerba mate aqueous extract intake (Ilex paraguariensis) on the expression of proteins involved in the inflammatory response and insulin signaling regulation in the liver of Wistar rats

Introdução A obesidade está associada a um quadro de inflamação crônica e de baixa intensidade, que predispõe à resistência à ação da insulina e ao desenvolvimento do diabetes mellitus (DM) tipo 2. O aumento da concentração sanguínea de ácidos graxos não esterificados e de citocinas pró-inflamatórias eleva a expressão hepática de quinases (quinase do inibidor do fator nuclear kappa B (IKK)- e a c-jun N-terminal quinase (JNK)) que aumentam a resposta inflamatória e prejudicam a via de sinalização da insulina. A erva-mate (Ilex paraguariensis) contém compostos bioativos que apresentam a capacidade de reduzir a expressão de genes envolvidos na resposta inflamatória. Objetivo Investigar o efeito da ingestão do extrato aquoso de erva-mate (EAEM) sobre a resposta inflamatória e via de sinalização da insulina no fígado de ratos alimentados com ração hiperlipídica (HL). Métodos Ratos Wistar, machos, foram submetidos à dieta controle (CON) (n= 18) ou HL (n= 18) durante 12 semanas. Após esse período, seis animais de cada grupo foram eutanasiados, enquanto o restante dos animais foi distribuído em grupos que receberam, ou não, por gavagem, o EAEM (1 g/kg massa corporal/dia) durante quatro semanas. Após esse período, todos os animais foram eutanasiados e determinou-se as concentrações de glicose, insulina, colesterol total, HDL-colesterol, LDL-colesterol, VLDL-colesterol, triacilgliceróis (TAG), leptina, adiponectina, TNF-, IL-6, inibidor do ativador do plasminogênio-1 (PAI-1) e a MCP-1 e a atividade sérica das enzimas alanina aminotransferase (ALT) e aspartato aminotransferase (AST). Foi realizada análise histológica para verificação da infiltração de lipídios. Foi avaliada também a composição corporal dos animais. Para a análise da expressão das proteínas JNK, IKK-, AKT e IRS-1 nas suas formas totais e fosforiladas, e da proteína NF-B, na sua forma fosforilada, um grupo de animais (n = 36) foi submetido ao mesmo protocolo experimental, porém neste foi realizada a inf...