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Pulmonary mucoepidermoid carcinoma (PMEC) in children is a rare entity. The diagnosis is often unrecognized, often treated as pneumonia, a more frequent diagnosis at this age. Case presentation: The authors report in this article, the case of a 12-year-old child with a clinical history of chronic cough evolving for 6 months with recurrent episodes of pneumonia. The presence of a foreign body was suggested on the thoracic computed tomography (CT). PMEC was histopathologically determined on biopsy. Fluorine-18-fluorodesoxyglucose positron emission tomography (18 F-FDG PET)/CT was performed as part of the extension work-up prior to surgical management. Clinical discussion: Preoperative imaging with 18F-FDG PET/CT seems to be a valuable tool for predicting tumor grade, nodal stage, and postsurgical prognosis in mucoepidermoid carcinoma. PMEC patients with high 18F-FDG PET/CT uptake may need extensive mediastinal lymph node dissection and adjuvant therapy. Conclusion: PMEC has different presentations depending on the degree of tumor differentiation on PET/CT whose input in the management of these rare cancers requires further studies.
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INTRODUCTION: Parathyroid carcinoma (PC) is exceptional cause of primary hyperparathyroidism (PHPT). It has an estimated prevalence of 0.3 to 5.6% and is rarely associated with non-medullary thyroid cancer. OBSERVATION: We report a case of parathyroid carcinoma resulting in a hyperparathyroidism and revealing a papillary thyroid carcinoma and emphasize on the management particularities of this entity. A 37-year-old woman, with prolactin secreting pituitary microadenoma, presented with asthenia and bone pain. Laboratory findings were consistent with PHPT. Neck ultrasonography showed a 3 cm nodule adjacent to the right thyroid lobe with no abnormalities in the thyroid gland. Parathyroid scintigraphy showed a right inferior parathyroid adenoma. Because of the patient age and the decreased renal function, surgical treatment was required. During the intra-operative neck exploration, a juxta-thyroid tumoral right mass was strongly adherent to the right infra-hyoid muscle and the recurrent laryngeal nerve. The frozen examination of the mass demonstrated malignancy features suggesting a poorly differentiated thyroid carcinoma. Thus, a total thyroidectomy with bilateral central neck dissection was carried out. Final histopathological examination showed a 3.5 cm PC infiltrating the thyroid gland with a papillary thyroid microcarcinoma of the left thyroid lobe. External radiotherapy of the neck, indicated for PC, was performed 1 month after surgery. A radioactive iodine therapy was used 6 months postoperatively. CONCLUSION: Despite its rarity, PC is to bear in mind in case of PHPT. The association between PC and differentiated thyroid carcinoma is not to be ignored.
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Adenocarcinoma , Neoplasias das Paratireoides , Neoplasias da Glândula Tireoide , Feminino , Humanos , Adulto , Câncer Papilífero da Tireoide , Radioisótopos do Iodo , PescoçoRESUMO
Background: Rosmarinus officinalis L.is traditionally used as an infusion in the treatment of several diseases and in particular against neuropsychiatric disorders, such as anxiety and depression. It was established that rosemary extracts show an antidepressant effect on animal models. However, to the best of our knowledge, there is no scientific data that highlights the therapeutic effects of rosemary intake on human mental health.Aim: This study investigated whether rosemary tea consumption affects the plasma levels of anxiety and depression biomarkers in healthy volunteers.Methods: Twenty-two healthy volunteers aged between 20 and 50 years old consumed rosemary tea prepared from 5 g of dried rosemary in 100 mL boiled water once a day for 10 days. Plasma concentrations of Brain-Derived Neurotrophic Factor (BDNF), Interleukine-6 (IL-6), Interleukine-4 (IL-4), Tumor Necrosis Factor- alpha (TNF-α), Interferon-gamma (IFNÏ), and cortisol were measured by enzyme-linked immunosorbent assay using commercial ELISA kits (R&D systems) before rosemary consumption and at the end of the experiment.Results: Rosemary tea consumption significantly increased the concentration of BDNF([BDNF]D0 = 22363.86 ± 12987.66 pg/mL, [BDNF]D10 = 41803.64 ± 28109.19, p = 0.006) and TNF-α([TNF-α] D0 = 39.49 ± 14.44 pg/mL, [TNF-α] D10 = 56.24 ± 39.01, p = 0.016). However, a slight variation that was statistically non-significant in INFÏ, cortisol, IL-4, IL-6 levels and in the ratio IL-4/INFÏ was observed (p > 0.05).Conclusion: Our findings highlight the promising anxiolytic and/or antidepressant effects of rosemary tea consumption in healthy volunteers since it increases the level of the most reliable depression biomarker BDNF. However, more powerful studies with larger sample size, carefully-chosen target population and, an extended intervention period are required.
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Rosmarinus , Animais , Antidepressivos/uso terapêutico , Ansiedade/tratamento farmacológico , Biomarcadores , Fator Neurotrófico Derivado do Encéfalo , Depressão/tratamento farmacológico , Voluntários Saudáveis , Humanos , Hidrocortisona , Interleucina-4 , Interleucina-6 , Projetos Piloto , Chá , Fator de Necrose Tumoral alfaRESUMO
Rosmarinus officinalis L. is a widespread aromatic plant commonly consumed as a tea in traditional cuisine and in folk medicine to treat various illnesses due to its therapeutic properties. To the best of our knowledge, there are no reports on the bioavailability and metabolism of R. officinalis tea polyphenols in humans. This study was aimed at assessing the bioavailability and nutrikinetics of R. officinalis phenolic compounds in healthy humans for the first time. Forty-eight compounds were identified in plasma and urine. Few un-metabolized compounds were detected since rosemary polyphenols were extensively metabolized into phase II conjugates, with rapid appearance and clearance in plasma, pointing to small intestinal absorption. Phase II derivatives of caffeic acid showed kinetics compatible with both intestinal and colonic hydrolysis of rosmarinic acid yielding free caffeic and 3,4-dihydroxyphenyl-lactic acids, which were absorbed and metabolized into phase II derivatives. These metabolites, along with reduced forms of caffeic acid and their phase II metabolites, and those of hydroxyphenylpropionic, hydroxylphenylacetic, benzoic and hippuric acids, highlight the importance of colonic absorption. Total urinary excretion of the phenols added up to 235 µmol, corresponding to 22.3% of the ingested amount (1055 µM). In conclusion, rosemary tea polyphenols are partially bioavailable and extensively metabolized, mainly by the colonic microbiota.
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Rosmarinus , Disponibilidade Biológica , Humanos , Fenóis , Polifenóis , CháRESUMO
BACKGROUND: Thyroid metabolism involves iodine, which allows us to use radioactive iodine for diagnostic and therapy purposes. The efficiency of radioiodine therapy depends on several parameters; the ability of thyroid tissue to uptake radioactive iodine is one of them. OBJECTIVE: The objective of this work is to quantify the radioactive iodine uptake on thyroid tissue. METHODS: In this work, we developed a method to quantify the in vivo uptake of iodine-131 on sections of thyroid glands removed by thyroidectomies. We performed an analysis of histological sections of the thyroid tissue by beta imaging. We had the opportunity to quantify the fixed radioactivity and to analyze its distribution in the thyroid gland, thanks to the good spatial resolution available with the type of detector used. RESULTS: The results gave a high image resolution showing the heterogeneity of iodine-131 fixation by the thyroid tissue. We were able to quantify the tissue radioactivity in mega Becquerel (MBq) per volume unit. CONCLUSION: This work has shown that the direct quantification of the thyroid tissue uptake is possible using the beta imaging system.
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Iodo , Neoplasias da Glândula Tireoide , Humanos , Iodetos , Radioisótopos do IodoRESUMO
BACKGROUND: The aim of this study was to evaluate whether the glutathione S-transferase M1 (GSTM1) and T1 (GSTT1) null alleles may contribute to carbamazepine-induced hepatotoxicity. METHODS: A cross-sectional prospective study was conducted to identify the frequency distribution of GSTM1 and GSTT1 alleles in 129 Tunisian epileptic patients treated with carbamazepine. Null alleles were determined using a Polymerase Chain Reaction. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured by standard methods. RESULTS: Our results showed that the frequencies of GSTM1 (-) null allele and GSTT1 null (-) allele were 74.4 and 17.8% respectively. The ALT and AST levels were elevated in 46 (35.7%) and 33 (25.6%) cases. The mean values of ALT and AST were approximately 1.32 and 3.61 times higher than the upper limit of normal levels, respectively. The values of ALT and AST were significantly higher in GSTM1 (-) allele than in GSTM1 (+) (p = 10-3.and 0.004, respectively). The level of ALT was significantly higher in combination of GSTM1 (-)/T1(-) than in combined GSTM1(-)/T1(+) and combined GSTM1(+)/T1(+) (p = 0.2 and 0.03, respectively), and that of AST was significantly higher in combination of GSTM1(-)/T1(-) and in combination of GSTM1(+)/T1(-) than in combination of GSTM1(+)/T1(+) (p = 10-3 and 10-3, respectively). CONCLUSIONS: Our findings suggest that the GSTM1 (-) allele may be considered as a key factor for the development of carbamazepine-induced hepatotoxicity. Results related to GSTT (-) allele and elevation in AST levels should be considered with caution as AST may be elevated in other pathophysiological conditions.
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Carbamazepina/efeitos adversos , Doença Hepática Induzida por Substâncias e Drogas/genética , Predisposição Genética para Doença/genética , Glutationa Transferase/genética , Adulto , Alelos , Estudos Transversais , Epilepsia/tratamento farmacológico , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Estudos Prospectivos , Fatores de Risco , Tunísia , Adulto JovemRESUMO
INTRODUCTION: The prescribed dose and carbamazepine plasma concentration to achieve the optimal therapeutic efficacy are highly variable from one patient to the other. Our study aimed to determine whether biological parameters may be used as plasma markers that can individually adjust the carbamazepine dose necessary to optimize therapeutic efficacy. MATERIAL AND METHODS: Ninety-four epileptic patients under carbamazepine monotherapy and who have never used combination therapy were recruited from the consecutive admissions at the Department of Neurology "CHU Sahloul" of Sousse Central Hospital in Tunisia from February 2010 to April 2011. The patients were monitored for epilepsy for three years on average. Carbamazepine and 10,11-epoxide-carbamazepine concentrations were analyzed through high-performance liquid chromatography. Simultaneously, therapeutic efficacy was assessed through the annual number of seizures in each patient. RESULTS: Our results showed the absence of any significant correlations between specific dose (mg/kg/day), carbamazepine plasma concentrations and therapeutic efficacy (r = 0.0025, p = 0.30; r = 0.1584, p = 0.38 respectively), whereas both plasma 10,11-epoxide-carbamazepine concentration and 10,11-epoxide-carbamazepine to plasma carbamazepine ratio were closely correlated with therapeutic efficacy (r = 0.34, p = 0.03; r = 0.45, p = 0.008 respectively). The optimum therapeutic response was observed among patients who simultaneously had a plasma concentration of 0.8 µg/ml of metabolite and 5.5 µg/ml of carbamazepine. CONCLUSIONS: The results suggest that plasma levels of both carbamazepine and of 10,11-epoxide-carbamazepine must be set to achieve an optimum therapeutic response.
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Glutathione S-transferases (GSTs) enzymes are involved in the detoxification of several endogenous and exogenous substances. In this study, we evaluated the effects of two glutathione S-transferase polymorphisms, (GSTM1 and GSTT1) on bipolar disorder (BPD) risk susceptibility in a Tunisian population. These polymorphisms were analyzed in 229 healthy subjects and 109 patients with BPD, using a polymerase chain reaction. Statistical analysis was performed using SPSS 18.0. The relative associations between the GSTs genotypes and BPD were assessed by calculating odds ratios (ORs) and 95% confidence intervals (CLs). The study results demonstrated that individuals with GSTM1 [OR=1.51, 95% CI: 0.93-2.45, p=0.081] or GSTT1 [OR=1.65, 95% CI: 0.95-2.88, p=0.060] were not associated with the risk of BPD, whereas a significant association was found between individuals with both GSTM1/T1 null genotype and BPD risk [OR=2.96, 95% CI (1.26-7.03), p=0.005]. These genotyping finding revealed that the absence of both GSTM1 and GSTT1 activity could be a contributor factor for the development of BPD.
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Transtorno Bipolar/genética , Glutationa Transferase/genética , Polimorfismo Genético , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Tunísia , Adulto JovemRESUMO
The aim of this study was to evaluate the impact of polymorphisms in the EPHX1 (c.416A > G, c.337T > C) and CYP3A4*22 genes involved in carbamazepine (CBZ) metabolism and pharmacoresistance among 118 Tunisian patients with epilepsy under maintenance dose of CBZ. These genetic polymorphisms were analyzed by PCR-RFLP. Associations between plasma CBZ concentration, CBZ-E concentration, maintenance doses and metabolic ratio (CBZ-E:CBZ, CBZ-D:CBZ-E) were analyzed with each polymorphism. Both variants of EPHX1 c.416A > G and c.337T > C are significantly associated with higher metabolic ratio CBZ-E:CBZ and seem to decrease the activity of the epoxide hydrolase. The CYP3A4*22 variant allele is significantly associated with lower CBZ-D:CBZ-E ratio and seems also to be associated with less activity of the cytochrome. Our data suggest that certain polymorphisms of metabolizing enzyme genes could influence inter-individual variability of CBZ metabolism.
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Anticonvulsivantes/metabolismo , Carbamazepina/metabolismo , Citocromo P-450 CYP3A/genética , Resistência a Medicamentos/genética , Epilepsia/tratamento farmacológico , Epóxido Hidrolases/genética , Adulto , Anticonvulsivantes/uso terapêutico , Carbamazepina/uso terapêutico , Epilepsia/genética , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , TunísiaAssuntos
Deficiência da Di-Hidropirimidina Desidrogenase/diagnóstico , Neoplasias/sangue , Uracila/análogos & derivados , Uracila/sangue , Antimetabólitos Antineoplásicos/sangue , Antimetabólitos Antineoplásicos/farmacocinética , Antimetabólitos Antineoplásicos/uso terapêutico , Cromatografia Líquida de Alta Pressão , Deficiência da Di-Hidropirimidina Desidrogenase/sangue , Deficiência da Di-Hidropirimidina Desidrogenase/genética , Família , Fluoruracila/sangue , Fluoruracila/farmacocinética , Fluoruracila/uso terapêutico , Humanos , Mutação , Neoplasias/tratamento farmacológico , Neoplasias/genética , Fenótipo , TunísiaRESUMO
Spindle epithelial tumor with thymus-like differentiation (SETTLE) of the thyroid is a rare tumor that occurs habitually in children and young adults. To date, about 20 cases of SETTLE have been reported in the English medical literature. It is considered to be a tumor of low malignancy with a favorable outcome, but delayed blood-borne metastases have been reported (sometimes over 20 years after initial treatment). In the current report, the authors describe an interesting case of SETTLE in a young woman. Double phase Tc-99m tetrofosmin scintigraphy showed accumulation of the tracer in the thyroid mass.