Phytochemical Characterization and Antioxidant Activity Evaluation for Some Plant Extracts in Conjunction with Pharmacological Mechanism Prediction: Insights into Potential Therapeutic Applications in Dyslipidemia and Obesity.

Lipid metabolism dysregulation can lead to dyslipidemia and obesity, which are major causes of cardiovascular disease and associated mortality worldwide. The purpose of the study was to obtain and characterize six plant extracts (ACE-Allii cepae extractum; RSE-Rosmarini extractum; CHE-Cichorii extractum; CE-Cynarae extractum; AGE-Apii graveolentis extractum; CGE-Crataegi extractum) as promising adjuvant therapies for the prevention and treatment of dyslipidemia and its related metabolic diseases. Phytochemical screening revealed that RSE was the richest extract in total polyphenols (39.62 ± 13.16 g tannic acid/100 g dry extract) and phenolcarboxylic acids (22.05 ± 1.31 g chlorogenic acid/100 g dry extract). Moreover, the spectrophotometric chemical profile highlighted a significant concentration of flavones for CGE (5.32 ± 0.26 g rutoside/100 g dry extract), in contrast to the other extracts. UHPLC-MS quantification detected considerable amounts of phenolic constituents, especially chlorogenic acid in CGE (187.435 ± 1.96 mg/g extract) and rosmarinic acid in RSE (317.100 ± 2.70 mg/g extract). Rosemary and hawthorn extracts showed significantly stronger free radical scavenging activity compared to the other plant extracts (p < 0.05). Pearson correlation analysis and the heatmap correlation matrix indicated significant correlations between phytochemical contents and in vitro antioxidant activities. Computational studies were performed to investigate the potential anti-obesity mechanism of the studied extracts using target prediction, homology modeling, molecular docking, and molecular dynamics approaches. Our study revealed that rosmarinic acid (RA) and chlorogenic acid (CGA) can form stable complexes with the active site of carbonic anhydrase 5A by either interacting with the zinc-bound catalytic water molecule or by directly binding Zn2+. Further studies are warranted to experimentally validate the predicted CA5A inhibitory activities of RA and CGA and to investigate the hypolipidemic and antioxidant activities of the proposed plant extracts in animal models of dyslipidemia and obesity.

Paragangliomas and Anemia: Literature Review and Case Report.

Paragangliomas are rare neuroendocrine tumors that arise from the extra-adrenal autonomic paraganglia, i.e., small organs consisting mainly of neuroendocrine cells that are derived from the embryonic neural crest and have the ability to secrete catecholamines. Paragangliomas can derive from either parasympathetic or sympathetic paraganglia. Most of the parasympathetic ganglia-derived paragangliomas are nonfunctional, and symptoms result from mass effect. Conversely, the sympathetic paragangliomas are functional and produce catecholamine. Although such patients could have symptoms similar to pheochromocytoma, mass effect symptoms, or non-specific symptoms, being benign tumors, they can also present with anemia, specifically iron-deficiency anemia. Considering that neoplastic pathology is chronically accompanied by moderate, normochromic, normocytic anemia, association between paragangliomas that are mostly benign but with a potential degree of malignancy and anemia is not as frequent as expected, with only 12 cases reported in the literature. We report a case of a 54-year-old female patient diagnosed with a paraganglioma of the carotid glomus accompanied by severe normochromic, normocytic anemia, which reached normal limits after excision of the paraganglioma.

In Vivo Sentinel Lymph Node Detection with Indocyanine Green in Colorectal Cancer.

Introduction: The indocyanine green fluorescence imaging system allows the identification of lymphatic vessels, lymph nodes and blood flow during surgery. Colorectal cancer is the second commonest cancer in women, the third in men, being the fourth commonest cause of cancer death. One of the most important factors for staging and prognosis in colorectal cancer is the involvement of the regional lymph nodes. In the literature, there are several methods for identifying sentinel lymph nodes, including methylene blue, technetium (99m Tc) and indocyanine green. The current article presents the use of indocyanate in the identification of sentinel node/nodes in malignant tumors of the colon, by a technique performed in vivo, before the primary ligation of the vascular pedicles. Material and methods:The study was prospectively conducted on a group of 23 patients who had undergone a standard surgical resection - 21 of them for a malignant tumor of the colon and two patients for a malignant rectal tumor - in the 1st General Surgery Department, Emergency University Hospital, Bucharest, Romania, between January 2020-March 2022. During surgery, sentinel lymph node detection was performed using indocyanine green and the Karl Storz® Vitom ICG probe. Sentinel lymph nodes were separately excised and sent to the Department of Pathological Anatomy for analysis. Results:Sentinel nodes were successfully identified in 13 patients and the overall identification rate was 56.52% (13/23 cases). In seven cases, the number of invaded nodes was the same as that of identified and invaded sentinel nodes. Complete lymphadenectomy was performed in all cases regardless of the staining status of the sentinel lymph nodes. Conclusions:The use of fluorescence imaging with indocyanine green in colorectal cancer remains controversial. Since no specific receptor target is used, the fluorescent signal is not specific for lymph node metastases. The learning curve is particularly important for increasing the accuracy of the technique and is responsible for the negative results in some cases. Cases in which lymph nodes have not been invaded require further evaluation through immunohistochemistry and chain polymerization reaction (RT-PCR).