Atresia esofágica tipo III associada a ânus imperfurado: um relato de caso / Esophageal atresia type III associated to imperforate anus: a case report

Introdução: As malformações congênitas são defeitos que ocorrem durante o desenvolvimento embrio-fetal, principalmente entre a terceira e oitava semana de gestação, podendo ser suspeitado no período pré-natal. A atresia de esôfago com ou sem fístula traqueoesofágica pode estar associada a outras anomalias congênitas, como o ânus imperfurado, o qual faz parte uma síndrome denominada malformação anorretal. Objetivo: discutir o caso de um recém-nascido (RN) portador de atresia de esôfago tipo III e ânus imperfurado, bem como associar suas ocorrências simultâneas. Relato de caso: paciente do sexo masculino, advindo de uma gestação gemelar complicada por pré-eclâmpsia, apresentava ao nascimento ausência do reflexo de busca e sucção, bradicardia e cianose central. Foi diagnosticado com ânus imperfurado e atresia esofágica. Foram realizados cirurgia de Colostomia em Duas Bocas e tratamento cirúrgico da atresia de esôfago. O paciente ficou 48 dias em incubadora com intubação orotraqueal e ventilação mecânica por 26 dias. Resultado: a programação pós- alta indicada foi o acompanhamento com cirurgião pediátrico e neurocirurgião, tendo evoluído bem e aguardando anorretoplastia. Conclusão: o rápido diagnóstico é tão necessário, nesses casos, quanto as abordagens cirúrgicas. O apoio psicológico aos familiares é de extrema importância, pois visa a melhor aceitação da família frente ao caso, propiciando dessa forma, melhores prognóstico e tratamento do paciente.

Introduction: Congenital malformations are defects that occur during embryo-fetal development, especially between the third and eighth week of pregnancy, and may be suspected in the prenatal period. Esophageal atresia with or without tracheoesophageal fistula may be associated with other congenital anomalies, such as the imperforate anus, which is part of a syndrome called anorectal malformation. Objective: to discuss the case of a newborn (NB) with type III esophageal atresia and imperforate anus, as well as to associate its simultaneous occurrences. Case report: male patient, resulting from a twin pregnancy complicated by pre-eclampsia, had at birth the absence of the search and suction reflex, bradycardia and central cyanosis. He was diagnosed with imperforate anus and esophageal atresia. Double-barrel colostomy surgery and esophageal atresia surgery were performed. The patient spent 48 days in an incubator with orotracheal intubation and mechanical ventilation for 26 days. Results: the post-discharge schedule indicated was for follow-up with a pediatric surgeon and neurosurgeon. Patient evolved well and awaits anorectomy. Conclusion: rapid diagnosis is as necessary in these cases as surgical approaches. Psychological support to family members is extremely important, as it aims at better family acceptance in the case, thus providing better prognosis and treatment for the patient.

1-Phenyl-6,7-dihydroxy-isochroman suppresses lipopolysaccharide-induced pro-inflammatory mediator production in human monocytes.

Extra-virgin olive oil is an integral ingredient of the Mediterranean diet, and it has been suggested that its high consumption has beneficial effects on human health. Its protective effect, in particular against the development of CVD, has been related not only to the high content of oleic acid, but also to the antioxidant and anti-inflammatory properties of polyphenols. In order to verify the anti-inflammatory and anti-atherogenic properties of hydroxy-isochromans, a class of ortho-diphenols present in extra-virgin olive oil, we investigated the potential ability of 1-phenyl-6,7-dihydroxy-isochroman (L137) to modulate the production of key inflammatory mediators by human monocytes, by evaluating its in vitro effects on prostanoid (thromboxane A(2) and PGE(2)) and cytokine (TNF-α) production. Its effect on the protein expression of the inducible form of cyclo-oxygenase-2 (COX-2), a pro-inflammatory enzyme responsible for elevated prostanoid levels, was also explored. The results showed that L137 significantly inhibited both prostanoid and TNF-α production in lipopolysaccharide-primed human monocytes in a dose-dependent manner, by inhibiting the COX activity of COX-2. We also demonstrated that the effects of the isochroman are mediated, at least partly, through the suppression of NF-κB activation leading to the down-regulation of the synthesis of COX-2.

DDQ oxidation of hydroxyisochromans and homologues.

Some hydroxyisochromans and hydroxyphthalans are tested under oxidative conditions obtaining hydroxybenzophenone derivatives. All reactions were followed by (1)H NMR spectroscopy. Some final main oxidation products were also isolated and characterised.

An investigation on dihydroxy-isochromans in extra virgin olive oil.

Recently, some dihydroxy-isochromans were discovered in extra virgin olive oil. In this work, the authors tried to investigate whether these substances are natural compounds, present also in the olive fruit, or whether they are formed during the crushing and malaxation procedures, or during the subsequent storage of oil. The variation of dihydroxy-isochroman amounts during extra virgin olive oil ageing have also been investigated.

Synthesis of hydroxystilbenes and their derivatives via Heck reaction.

A group of differently substituted acetoxy- and methoxystilbenes were synthesised via Heck reaction. A comparison between the use--as coupling reagents--of iodobenzene derivatives and diazonium salts was performed. A successful microwave-assisted demethylation by pyridine hydrochloride of some methoxystilbenes was carried out.

An improved synthesis of resveratrol.

In this article we report an improved total synthesis of resveratrol, increasing the overall yield from 22 to 71%. The synthesis reported in our previous publication was made up of two fundamental steps: a Wittig reaction and a Heck coupling. Here we studied these steps separately to increase the individual yields. The yield of the Wittig reaction was increased up to 98%; however, we could not find better reaction conditions for the Heck coupling than those reported in the previous article.

A new diacylglycerol from fresh olive pulp.

The isolation from olive pulp of a diacylglycerol showing an oleic as well as an elenoic acid residue, the latter probably derived from a natural enzymatic oleuropein hydrolysis, is reported. The given structure is supported by 1H- and 13C-NMR data.

Highlights in oleuropein aglycone structure.

Oleuropein hydrolysis products, obtained both by endogenous beta-glucosidase and almond commercial one, were investigated by classic methodologies and by 1HNMR experiments. We found that both presence and relative amount of the different compounds in the reaction mixture are stricly related to the used enzyme.

Olive oil isochromans inhibit human platelet reactivity.

The effects of certain polyphenolic compounds in red wine, such as resveratrol and quercetin, have been widely investigated to determine the relationship between dietary phenolic compounds and the decreased risk of cardiovascular diseases. However, the effects of polyphenolic compounds contained in other foods, such as olive oil, have received less attention and little information exists regarding the biological activities of the phenol fraction in olive oil. The aim of this study was to evaluate the antiplatelet activity and antioxidant power of two isochromans [1-(3'-methoxy-4'-hydroxy-phenyl)-6,7-dihydroxy-isochroman (encoded L116) and 1-phenyl-6,7-dihydroxy-isochroman (encoded L137)] recently discovered in olive oil and synthesized in our laboratory from hydroxytyrosol. These compounds were effective free radical scavengers and inhibited platelet aggregation and thromboxane release evoked by agonists that induce reactive oxygen species-mediated platelet activation including sodium arachidonate and collagen, but not ADP. Release of tritiated arachidonic acid from platelets was also impaired by L116 and L137. These results indicate that other Mediterranean diet nutraceuticals also exhibit antioxidant activity that could be beneficial in the prevention of vascular diseases.