RESUMO
Skin cancer is a public health problem due to its high incidence. Ultraviolet radiation (UVR) is the main etiological agent of this disease. Photochemoprotection involves the use of substances to avoid damage caused by UV exposure. The aim of this work was to determine the phytochemical fingerprint and photochemoprotective effect against UVB radiation-induced skin damage such as erythema and carcinogenesis of H. mociniana methanolic extract (MEHm). The chemical composition of the MEHm was analysed by LC/ESI-MS/MS. Three quercetin derivatives, two pectinolides, and two caffeic acid derivatives were identified in the methanolic extract. MEHm has antioxidant effect and it is not cytotoxic in HaCaT cells. Phytochemicals from H. mociniana have a photochemopreventive effect because they absorb UV light and protect HaCaT cells from UVR-induced cell death. Also, in SKH-1 mice -acute exposure-, it decreased erythema formation, modulating the inflammatory response, reduced the skin damage according to histological analysis and diminished p53 expression. Finally, MEHm protects from photocarcinogenesis by reducing the incidence and multiplicity of skin carcinomas in SKH-1 mice exposed chronically to UVB radiation.
Assuntos
Eritema/prevenção & controle , Hyptis/química , Neoplasias Induzidas por Radiação/prevenção & controle , Compostos Fitoquímicos/química , Compostos Fitoquímicos/farmacologia , Protetores contra Radiação/farmacologia , Neoplasias Cutâneas/prevenção & controle , Raios Ultravioleta , Animais , Carcinogênese/efeitos dos fármacos , Linhagem Celular , Eritema/etiologia , Feminino , Humanos , Camundongos , Camundongos Pelados , Neoplasias Cutâneas/patologiaRESUMO
The chief pineal secretory product, melatonin, is an efficient free radical scavenger and antioxidant. The current study tested whether the life-long reduction of endogenous melatonin levels due to pinealectomy would influence the accumulation of oxidatively damaged products as the animals aged. Rats were either pinealectomized or sham operated when they were 2-months-old. At 25 months of age these animals were killed along with 2-month-old controls. Aging in the pineal-intact animals was associated with increased levels of lipid peroxidation products (malondialdehyde and 4-hydroxyalkenals in the lung, kidney and skin), rises in an oxidatively damaged DNA product (8-hydroxy-deoxyguanosine in liver, kidney and pancreas), and in the levels of protein carbonyls (in the liver). Likewise, advanced age was associated with a significant decrease in membrane fluidity (increased membrane rigidity) of hepatic microsomes in pineal-intact rats. For all of these parameters and in a number of organs, pinealectomy caused further increases in the indices of oxidative damage. Consistent with previous suggestions, the implications of these findings is that aging is associated with the augmented accumulation of oxidatively damaged macromolecules and that these increases are exaggerated when a relative melatonin deficiency is induced by pinealectomy. The findings are consistent with the idea that the accelerated accumulation of oxidatively damaged products after pinealectomy was due to reduction in melatonin since it functions as a free radical scavenger and antioxidant. On the other hand, other pineal secretory products that were reduced as a consequence of pineal removal may have also been responsible for some of the observed changes.
Assuntos
Melatonina/deficiência , Estresse Oxidativo , Envelhecimento/metabolismo , Animais , Antioxidantes/metabolismo , Dano ao DNA , Sequestradores de Radicais Livres/metabolismo , Peroxidação de Lipídeos , Masculino , Fluidez de Membrana , Microssomos Hepáticos/metabolismo , Glândula Pineal/fisiologia , Proteínas/metabolismo , Ratos , Ratos Sprague-Dawley , Distribuição TecidualRESUMO
We describe a five year old boy with inversion duplication of chromosome 15 (inv dup (15)) who, at the age of six months had started to develop West's syndrome. He later developed cryptogenic myoclonic epilepsy which was resistant to medication. On examination there was dysmorphia, overall hypotonia and diffuse pyramidalism. On starting ACTH the crises of flexion spasms were reduced but these were soon followed by myoclonic crises, both tonic and atonic, which did not respond to the various anticonvulsive treatments given. We comment on the changes in chromosome 15 linked to convulsions, and particularly the phenotypes of the inv dup (15) which depend on the size and genetic composition of the anomaly. This is the third case described in the literature of a patient with West's syndrome associated with supernumerary inversion duplication of chromosome 15. It is suggested that the karyotype be included when studying convulsive encephalopathies and cryptogenic refractory epilepsy, especially in infantile spasms.
Assuntos
Inversão Cromossômica , Cromossomos Humanos Par 15/genética , Família Multigênica/genética , Espasmos Infantis/genética , Pré-Escolar , Humanos , MasculinoRESUMO
To assess the efficacy of 4 mg of intravenous ondansetron versus placebo for the prevention of postoperative nausea and vomiting (PONV) in cholecystectomy, a type of surgery that is highly emetic. A random, double blind, placebo controlled study of 40 women over 18 years of age who were scheduled for non urgent laparoscopic cholecystectomy under general anesthesia. The patients were assigned to two groups to receive ondansetron (n = 23) or placebo (n = 17). Premedication and anesthesia were similar for all. The severity of PONV in the first 24 hours after surgery was recorded. There were no significant differences between the two groups with respect to biological characteristics or other factors that might influence the presentation or severity of PONV. The percentage of PONV-free patients was significantly higher in the ondansetron group than in the control group (73.91 and 11.76%, respectively; p < 0.001). Intravenous administration of 4 mg ondansetron is significantly superior to placebo for PONV prophylaxis after laparoscopic cholecystectomy.
Assuntos
Antieméticos/uso terapêutico , Colecistectomia Laparoscópica , Náusea/prevenção & controle , Ondansetron/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Vômito/prevenção & controle , Adulto , Idoso , Método Duplo-Cego , Feminino , Humanos , Pessoa de Meia-Idade , Náusea/etiologia , Estudos Prospectivos , Vômito/etiologiaRESUMO
OBJECTIVES: To assess the prevalence of abnormal electrocardiograms (ECG) recorded routinely in patients undergoing elective surgery as well as the prevalence of ECG abnormalities that could not be predicted by the patient's medical history. To determine the influence of ECG results on patient care. To identify patient groups at high risk for abnormal ECG. PATIENTS AND METHODS: Retrospective study of 2,146 patients scheduled for non cardio-thoracic surgery requiring anesthesia. Two physicians reviewed the preoperative ECG reports in consultation with a cardiologist. The reports were considered normal, abnormal but expected or abnormal and unexpected based on agreement or not with the patient's medical history. RESULTS: The 161 (7.4%) patients for whom data was missing were excluded. Preoperative ECGs were performed in 1,898 (95.6%) cases. Abnormal ECG results were reported for 351 (18.5%), most often for men, patients over 45 years of age, those classified ASA III-V, those with cardiovascular disease, kidney failure and diabetes mellitus. Two hundred seventy unexpected abnormalities were found in 234 (12.3%) patients. Of these, 117 (43.3%) were considered major. The unexpected abnormalities motivated changes of attitude toward 4 (1.7%) patients, but new treatment was established for only 2 (0.8%) of them. The prevalence of unexpected abnormalities was higher in men, patients over 45 years of age and those classified as ASA III-V. CONCLUSIONS: The prevalence of unexpected preoperative ECG abnormalities among non cardio-thoracic surgical patients is high but the influence of such results is minimal. The sensitivity and specificity of preoperative ECG for detecting electrocardiographic abnormalities are low. We suggest that performance of ECG before surgery is useful in patients over 45 years of age or in those with cardiovascular disease, chronic kidney failure, diabetes mellitus, physical state ASA III-V and those for whom it has not been possible to obtain an adequate medical history or perform a complete physical.
Assuntos
Arritmias Cardíacas/epidemiologia , Procedimentos Cirúrgicos Eletivos , Eletrocardiografia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Prevalência , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
In order to evaluate the efficacy of a single oral dose of ranitidine 150 mg and the optimum time for its administration, we studied pH and volume measurements in 138 surgical patients, who formed six groups according to the time elapsed from ranitidine administration to gastric fluid aspiration as follows: group A: no ranitidine, group B: 60-90 min, group C: 91-120 min, group D: 121-150 min, group E: 151-180 min and group F: > 180 min. The patients from groups B, C, D, E and F had a significant increase in gastric pH and a significant decrease in gastric fluid volume when compared to the patients from group A. 33.3% (95% CI 16.63-53.22%) of patients in group A were deemed 'at risk' of acid aspiration compared to 0.9% (95% CI 0.02-4.90%) in the other groups. No significant differences were found between the patients receiving ranitidine after 60 min with respect to risk of acid aspiration. It is concluded that a single oral dose of ranitidine 150 mg is effective against the acid aspiration syndrome 60 min after administration.
Assuntos
Antagonistas dos Receptores H2 da Histamina/uso terapêutico , Pneumonia Aspirativa/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Medicação Pré-Anestésica , Ranitidina/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Esquema de Medicação , Feminino , Humanos , Concentração de Íons de Hidrogênio/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
UNLABELLED: We report a 5-year-old boy with propionic acidaemia who developed a rapidly fatal necrosis of the basal ganglia after an episode of clinical deterioration. Neither metabolic acidosis nor hyperammonaemia were present. Organic acid analysis in both urine and CSF showed increased levels of methylcitric and 3-hydroxypropionic acids. Propionic acidaemia was confirmed by demonstrating a propionyl-CoA carboxylase deficiency (11% of control value) in skin fibroblasts. DNA analysis revealed that the patient was a compound heterozygote for two mutations in the PCCB gene. CONCLUSION: Propionic acidaemia can present as a sudden and fatal neurological disease and not only as an organic aciduria with severe biochemical dis-turbances and progressive neurological deterioration.
Assuntos
Erros Inatos do Metabolismo dos Aminoácidos/diagnóstico , Doenças dos Gânglios da Base/diagnóstico , Gânglios da Base/patologia , Propionatos/metabolismo , Erros Inatos do Metabolismo dos Aminoácidos/complicações , Erros Inatos do Metabolismo dos Aminoácidos/genética , Doenças dos Gânglios da Base/etiologia , Carboxiliases/deficiência , Pré-Escolar , Progressão da Doença , Evolução Fatal , Humanos , Imageamento por Ressonância Magnética , Masculino , Metilmalonil-CoA Descarboxilase , Mutação , Necrose , Propionatos/sangueRESUMO
CDG Ie is caused by a deficiency of dolichol-phosphate-mannose synthase 1 (DPM1), an enzyme involved in N-glycan assembly in the endoplasmic reticulum. Three proteins are known to be part of the synthase complex: DPM 1, DPM2 and DPM3. Only mutations in DPM1, the catalytic subunit, have been described in three families. One was homozygous for the c274C>G (R92G) mutation in DPM1 and two others were compound heterozygous for R92G and a c628delC deletion or a c331-343del13, respectively. Clinical features were a severe infantile encephalopathy, early intractable seizures, acquired microcephaly, and some dysmorphic features. We report a patient with milder symptoms: microcephaly, dysmorphic features, developmental delay, optic atrophy, and cerebellar dysfunction without cerebellar atrophy. The patient is homozygous for a new mutation in exon 9 of the DPM1 gene (c742T>C (S248P)). Our findings extend the spectrum of CDG Ie.