Terapia a longo prazo com lítio e o risco de danos renais: revisão integrativa da literatura / Long-term lithium therapy and the risk of kidney damage: integrative literature review

Este estudo objetivou avaliar os potenciais efeitos adversos nos rins associado ao tratamento de longo prazo com lítio em pacientes com transtorno bipolar, a partir de uma revisão integrativa literatura. Os artigos foram identificados nas bases de dados SciELO, Medline (Pubmed) e Biblioteca Virtual em Saúde (BVS), publicados entre 2010 e 2021. Aplicados os critérios de inclusão e exclusão, identificaram-se 18 artigos para a análise. Verificou-se que o tratamento com lítio durante um período prolongado está associado à redução da taxa de filtração glomerular, porém, outras variáveis devem ser consideradas como idade e comorbidades associadas. Por outro lado, não foi associado evolução da doença renal crônica em estágio terminal por uso do medicamento. A investigação dos estudos revelou que a droga em doses terapêuticas e com monitoramento laboratorial contínuo não demonstrou toxicidade ou efeitos colaterais severos nos rins sendo a sua descontinuação relacionada com exarcebações do humor. [au]

This study aimed to assess the potential adverse effects on the kidneys associated with long-term lithium treatment in patients with bipolar disorder, based on an integrative literature review. The articles were identified in the SciELO, Medline (Pubmed) and Virtual Health Library (VHL) databases, published between 2010 and 2021. After applying the inclusion and exclusion criteria, 18 articles were identified for analysis. It was found that treatment with lithium for a prolonged period is associated with a reduction in the glomerular filtration rate, however, other variables must be considered, such as age and associated comorbidities. On the other hand, evolution of end-stage chronic kidney disease due to drug use was not associated. The investigation of the studies revealed that the drug at therapeutic doses and with continuous laboratory monitoring did not show toxicity or severe side effects in the kidneys and its discontinuation was related to mood exacerbations. [au]

Antifungal activity study of the monoterpene thymol against Cryptococcus neoformans.

Cryptococcus neoformans is a yeast fungus, which causes cryptococcosis, triggered by basidiospore inhalation and consequent dissemination to the central nervous system. In this study, we analyzed the antifungal action of thymol against 10 clinical strains of C. neoformans and analyzed the interaction of this monoterpene with sterols. The MICs of thymol ranged from 20 to 51 µg/ml, while the MFC values varied between 40 and 101 µg/ml. For the strains ICB-2601 and LM-39, in the presence of ergosterol, the MIC of thymol was 64 µg/ml, and in the presence of cholesterol, its MIC was 32 µg/ml. Based on the results, thymol presents antifungal action and seems to interact with ergosterol, but not with cholesterol. Complementary studies are needed to analyze its full effects.

Investigation of the antifungal activity of carvacrol against strains of Cryptococcus neoformans.

BACKGROUND: Cryptococcus neoformans is the etiologic agent of opportunistic systemic fungal infection cryptococcosis, which affects individuals with compromised immune systems. Thus, natural products research has become important, since monoterpenes such as carvacrol, a promising molecule in the search antifungal agents, have shown significant biological activity. OBJECTIVE: The study aimed to investigate the antifungal activity and mode of action of carvacrol against strains of C. neoformans. METHODS: The minimum inhibitory concentration (MIC) was determined by microdilution method. Minimum fungicidal concentration (MFC) was performed by seeding technique on solid media. Studying the mode of action was performed using broth microdilution. RESULTS: The MIC ranged from 25 to 81 µg/mL and the MFC ranged from 25 to 102 µg/mL. Carvacrol bonded to exogenous ergosterol and cholesterol. DISCUSSION: The results suggest that carvacrol has antifungal activity against C. neoformans and its mode of action is related to fungal membrane instability. CONCLUSIONS: The phytoconstituent carvacrol may eventually become a drug; however, further studies are needed to elucidate its mechanism.