RESUMO
Annonacea species have been reported to possess antitumor properties. However, the in vitro and in vivo antitumor activities of Xylopia aromatica (Annonacea) have not yet been elucidated. This study aimed to investigate the effects of Xylopia aromatica leaves hexane fraction (XaHF) on Ehrlich ascites carcinoma cells lines (EAC), both in vitro and in vivo. In vitro assays revealed a significant cytotoxic effect with the two lower XaHF concentrations (62.5 and 32.3mg/mL). EAC (2.5x106 cells) were inoculated in the right flank of Swiss mice, and the animals were treated intraperitoneally with 32.3mg kg-1 of XaHF daily, for 20 days. Our findings indicate that XaHF suppressed the growth of EAC in vivo, with a significant decrease (46%) in tumor volume. There was also a decrease in the necrosis area (71%), inflammatory infiltrate, and MMP-2 expression. High-Performance Liquid Chromatography with Diode Array Detector (HPLC-DAD) identified secondary metabolites possibly related to phenolic acids, flavonoids, and alkaloids. Thus, the results confirmed the antitumoral activity that may be related to the presence of the identified metabolites in XaHF extract.
Assuntos
Carcinoma de Ehrlich/metabolismo , Proliferação de Células/efeitos dos fármacos , Metaloproteinase 2 da Matriz/efeitos dos fármacos , Extratos Vegetais/farmacologia , Folhas de Planta , Xylopia , Alcaloides/química , Animais , Aporfinas/química , Carcinoma de Ehrlich/patologia , Catequina/química , Linhagem Celular Tumoral , Ácido Clorogênico/química , Cromatografia Líquida de Alta Pressão , Regulação para Baixo , Flavonoides/química , Ácido Gálico/química , Linfócitos do Interstício Tumoral/efeitos dos fármacos , Metaloproteinase 2 da Matriz/metabolismo , Camundongos , Necrose , Fenóis/química , Extratos Vegetais/química , Quercetina/química , Rutina/química , Carga Tumoral/efeitos dos fármacosRESUMO
Gliomas account for nearly 70% of the central nervous system tumors and present a median survival of approximately 12-17 months. Studies have shown that administration of novel natural antineoplastic agents is been highly effective for treating gliomas. This study was conducted to investigate the antitumor potential (in vitro and in vivo) of Miconia chamissois Naudin for treating glioblastomas. We investigated the cytotoxicity of the chloroform partition and its sub-fraction in glioblastoma cell lines (GAMG and U251MG) and one normal cell line of astrocytes. The fraction showed cytotoxicity and was selective for tumor cells. Characterization of this fraction revealed a single compound, Matteucinol, which was first identified in the species M. chamissois. Matteucinol promoted cell death via intrinsic apoptosis in the adult glioblastoma lines. In addition, Matteucinol significantly reduced the migration, invasion, and clonogenicity of the tumor cells. Notably, it also reduced tumor growth and angiogenesis in vivo. Moreover, this agent showed synergistic effects with temozolomide, a chemotherapeutic agent commonly used in clinical practice. Our study demonstrates that Matteucinol from M chamissois is a promising compound for the treatment of glioblastomas and may be used along with the existing chemotherapeutic agents for more effective treatment.
Assuntos
Antineoplásicos Fitogênicos/uso terapêutico , Cromonas/uso terapêutico , Glioblastoma/tratamento farmacológico , Animais , Antineoplásicos Fitogênicos/isolamento & purificação , Antineoplásicos Fitogênicos/farmacologia , Apoptose/efeitos dos fármacos , Linhagem Celular Tumoral , Movimento Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Embrião de Galinha , Membrana Corioalantoide/irrigação sanguínea , Membrana Corioalantoide/efeitos dos fármacos , Cromonas/isolamento & purificação , Cromonas/farmacologia , Glioblastoma/irrigação sanguínea , Humanos , Melastomataceae , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Neovascularização Patológica/tratamento farmacológico , Extratos Vegetais , Folhas de PlantaRESUMO
OBJECTIVE: The aim of this study was to evaluate the immunohistochemical expressions of PD1, CD4+, and CD8+ in premalignant lesions (OPML) that were transformed into oral squamous cell carcinoma OSCC (OPML-OSCC), in OSCC and also in premalignant lesions that were not transformed into OSCC (OPML-NOSSC). MATERIALS AND METHODS: Retrospective analyses were performed in order to verify the demographic characteristics of the patients. CD4, CD8, and PD1 IMH studies were carried out on OPML and OSCC samples from 11 patients with OPML-OSCC and OPML, together with samples from 14 patients with OPML-NOSCC. The differences between OPML-OSCC and OPML-NOSCC were analyzed. RESULTS: Non-homogenous leukoplakia, together with the related oral subsite, and the lack of an exposure to tobacco, were all associated with malignant transformations. There were no statistical differences in the PD1 expression and the CD4+ cells in OPML-OSCC and OPML-NOSCC. A significant increment in the CD8+ cells was noted in the OPML that evolved into carcinomas when compared with OPML-NOSCC (p = 0.05), whereas there were higher CD8+ cells levels in the carcinomas when compared with the OPML that evolved into carcinomas (p = 0.027). CONCLUSIONS: CD8+ cells infiltrate more in OPML-NOSCC than in OPML-OSCC. Carcinoma is more infiltrated by CD8+ cells than its associated OPML. CLINICAL RELEVANCE: Understanding immunological factors associated with malignant transformation of oral premalignant lesions can open a new way to treat this disease.
Assuntos
Linfócitos T CD8-Positivos/citologia , Carcinoma de Células Escamosas/patologia , Neoplasias Bucais/patologia , Lesões Pré-Cancerosas , Carcinoma de Células Escamosas/imunologia , Feminino , Humanos , Masculino , Neoplasias Bucais/imunologia , Estudos RetrospectivosRESUMO
OBJECTIVE: Lower lip squamous cell carcinomas (LLSCC) could be associated with a previous history of potentially malignant oral diseases (PMOD), especially actinic cheilitis (AC), with high sun exposure being a well-described risk factor. Immune evasion mechanisms, such as the PD-1/PD-L1 (programmed cell death protein 1/programmed death-ligand 1) pathway has been gaining prominence since immunotherapy with immune checkpoint inhibitors showed a positive effect on the survival of patients with different types of neoplasms. Concomitant with the characterization of the tumor microenvironment, the expression of either or both PD-1 and PD-L1 molecules may estimate mutual relations of progression or regression of the carcinoma and prognostic values of the patient.Considering the importance of tumor microenvironment characterization, this study aims to determine the immunoexpression of PD-L1 and correlate with the frequency of CD4+ and CD8+ cells in AC and LLSCC lesions and with tumor-infiltrating lymphocytes (TILs) in LLSCC and its relationship with histopathological characteristics. METHODOLOGY: This sample includes 33 cases of AC and 17 cases of LLSCC. The cases were submitted to histopathological analysis and to CD4+, CD8+, and PD-L1+ cell determination by immunohistochemistry. RESULTS: There was a significant difference among the frequencies of CD4+, CD8+, and PD-L1+ cells between AC and LSCC cases, higher in the last group. Moreover, histopathological and atypical changes in AC and LLSCC were correlated with the frequencies of PD-L1+, CD4+, and CD8+ cells. In AC, PD-L1+ cases had a low frequency of CD4+ cells, but on the other hand, PD-L1+ cases of LLSCC had a higher frequency of CD4+ and CD8+ cells. CONCLUSION: Therefore, the PD-L1 molecule may be a potential escape route for the immune response in oral lesions, but the mechanisms differ between AC and LLSCC. Future studies related to immune evasion and immunotherapy in oral lesions should consider the analysis of inflammatory infiltrate and TILs.
Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Antígeno B7-H1/metabolismo , Linfócitos T CD4-Positivos/metabolismo , Linfócitos T CD4-Positivos/patologia , Linfócitos T CD8-Positivos/metabolismo , Linfócitos T CD8-Positivos/patologia , Carcinoma de Células Escamosas/patologia , Queilite , Neoplasias de Cabeça e Pescoço/metabolismo , Humanos , Lábio/metabolismo , Lábio/patologia , Linfócitos do Interstício Tumoral/metabolismo , Linfócitos do Interstício Tumoral/patologia , Prognóstico , Microambiente TumoralRESUMO
Annona crassiflora Mart. is a species native to the Cerrado biome, whose fruit is known as araticum or marolo. Plant parts are widely used in folk medicine to treat inflammation and pain associated with rheumatism, wounds, venereal diseases, snakebites, and microbial infections. Thus, we investigated a fraction rich in phenolic compounds (PCAc) obtained from the crude extract of the peel of these fruits on non-cytotoxic, anti-inflammatory, antioxidant, and collagen biosynthesis properties in the healing of wounds induced on the back of BALB/c mice. For the control group, the induced wounds were not treated and for the others, wounds were treated topically with vehicle or vehicle plus PCAc. Both fractions contained in PCAc demonstrated effective protection on fibroblasts. We highlight the effect of the ethyl acetate fraction which, in addition to the protective effect, has a proliferative activity on these cells. In addition, PCAc caused improvement in healing after 7 days of treatment and in the longest period of treatment with PCAc (7, 14, and 21 days) there was a greater contraction of the wound, accompanied by resolution of the inflammatory process, antioxidant defense, increasing collagen synthesis, and modulation of metalloproteinases. PCAc demonstrated better re-epithelialization and organization of the dermis at the end of treatment. The changes promoted by the phenolic compounds of A. crassiflora were important in the healing process, especially in activities related to inflammation, oxidative stress, and fibrogenesis.
Assuntos
Annona , Animais , Antioxidantes/farmacologia , Fibroblastos , Camundongos , Extratos Vegetais/farmacologia , CicatrizaçãoRESUMO
Although the photoreceptors cell death is the main cause of some retinopathies diseases, the mechanisms involved in this process are poorly understood. The neuroprotective effects of interleukin-4 (IL-4) have been shown in several tissues, including retina. We demonstrate that treatment of rat retinal explants with IL-4 completely inhibited the thapsigargin-induced rod photoreceptor cell death after 24 hr in culture. We also showed that IL-4 receptor alpha subunit (IL-4Ralpha) is abundantly present in retina. Colocalization of IL-4Ralpha and rhodopsin indicate a direct effect of this cytokine in rod photoreceptor cells. Moreover, IL-4 increased the intracellular levels of cAMP in 7.4-fold, indicating that the neuroprotective effect of this cytokine was completely blocked by RpcAMP, an inhibitor of protein kinase (PKA). Our data demonstrate, for the first time, the neuroprotective effect of IL-4 through cAMP/PKA pathway in thapsigargin-induced photoreceptor cell death.
Assuntos
Proteínas Quinases Dependentes de AMP Cíclico/metabolismo , AMP Cíclico/metabolismo , Interleucina-4/farmacologia , Fármacos Neuroprotetores/farmacologia , Células Fotorreceptoras Retinianas Bastonetes/efeitos dos fármacos , Animais , Morte Celular/efeitos dos fármacos , Morte Celular/fisiologia , AMP Cíclico/análogos & derivados , Citoproteção/efeitos dos fármacos , Citoproteção/fisiologia , Inibidores Enzimáticos/toxicidade , Interleucina-4/metabolismo , Degeneração Neural/induzido quimicamente , Degeneração Neural/tratamento farmacológico , Degeneração Neural/prevenção & controle , Fármacos Neuroprotetores/metabolismo , Técnicas de Cultura de Órgãos , Ratos , Receptores de Interleucina-4/efeitos dos fármacos , Receptores de Interleucina-4/metabolismo , Degeneração Retiniana/tratamento farmacológico , Degeneração Retiniana/metabolismo , Degeneração Retiniana/fisiopatologia , Células Fotorreceptoras Retinianas Bastonetes/metabolismo , Células Fotorreceptoras Retinianas Bastonetes/patologia , Rodopsina/metabolismo , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/fisiologia , Tapsigargina/toxicidade , Regulação para Cima/efeitos dos fármacos , Regulação para Cima/fisiologiaRESUMO
Despite the standard approaches to treat the highly aggressive and invasive glioblastoma (GBM), it remains incurable. In this sense, cannabinoids highlight as a promising tool, because this tumor overexpresses CB1 and/or CB2 receptors and being, therefore, can be susceptible to cannabinoids treatment. Thus, this work investigated the action of the cannabinoid agonist WIN55-212-2 on GBM cell lines and non-malignant cell lines, in vitro and in vivo. WIN was selectively cytotoxic to GBM cells. These presented blebbing and nuclear alterations in addition to cell shrinkage and chromatin condensation. WIN also significantly inhibited the migration of GAMG and U251 cells. Finally, the data also showed that the antitumor effects of WIN are exerted, at least to some extent, by the expression of p53 and increased cathepsin D in addition to the decreased expression of HSP70.This data can indicate caspase-independent cell death mechanism. In addition, WIN decreased tumoral perimeter as well as caused a reduction the blood vessels in this area, without causing lysis, hemorrhage or blood clotting. So, the findings herein presented reinforce the usefulness of cannabinoids as a candidate for further evaluation in treatment in glioblastoma treatment.
Assuntos
Benzoxazinas/farmacologia , Glioblastoma/metabolismo , Proteínas de Choque Térmico HSP70/metabolismo , Morfolinas/farmacologia , Naftalenos/farmacologia , Proteína Supressora de Tumor p53/metabolismo , Animais , Apoptose/efeitos dos fármacos , Caspases , Linhagem Celular , Movimento Celular/efeitos dos fármacos , Galinhas , Membrana Corioalantoide/efeitos dos fármacos , Membrana Corioalantoide/fisiologia , HumanosRESUMO
Interleukin-4 (IL-4), an anti-inflammatory cytokine, has been related to the differentiation of the rodent retina in vitro, but constitutive presence of either IL-4 or of IL-4 receptor in the retina has not been reported. In this work we examined the expression of IL-4 and its specific receptor alpha subunit (IL-4Ralpha). IL-4Ralpha is expressed both in neural retina and non-neural ocular tissue, while IL-4 was found mainly in non-neural tissue. We characterized a novel trophic effect of IL-4 upon the retina. We showed that IL-4 can inhibit the proliferation of retinal cells (approximately 40%) through the cAMP-PKA pathway and associated with a reduction of cyclin D1 and increase of p27(kip1). IL-4 also promotes the differentiation of rod photoreceptors. Activation of tyrosine kinases, protein kinase C, and mitogen-activated kinases of the Erk family were required for IL-4-induced rod photoreceptor differentiation, independent of the release of other trophic factors in culture. Taken together, our results show, for the first time, that IL-4 directly modulates proliferation of retinal cells and rod photoreceptor differentiation, through distinct signaling pathways.
Assuntos
Diferenciação Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Interleucina-4/farmacologia , Retina/citologia , Células Fotorreceptoras Retinianas Bastonetes/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Células-Tronco/efeitos dos fármacos , Análise de Variância , Animais , Animais Recém-Nascidos , Antígenos CD/metabolismo , Células Cultivadas , AMP Cíclico/metabolismo , Relação Dose-Resposta a Droga , Ativadores de Enzimas/farmacologia , Inibidores Enzimáticos/farmacologia , Camundongos , Camundongos Endogâmicos C57BL , Proteínas Quinases/metabolismo , Receptores de Superfície Celular/metabolismo , Retina/efeitos dos fármacos , Rodopsina/metabolismo , Transdução de Sinais/fisiologia , Baço/citologia , Timidina/metabolismo , Fatores de TempoRESUMO
Abstract Lower lip squamous cell carcinomas (LLSCC) could be associated with a previous history of potentially malignant oral diseases (PMOD), especially actinic cheilitis (AC), with high sun exposure being a well-described risk factor. Immune evasion mechanisms, such as the PD-1/PD-L1 (programmed cell death protein 1/programmed death-ligand 1) pathway has been gaining prominence since immunotherapy with immune checkpoint inhibitors showed a positive effect on the survival of patients with different types of neoplasms. Concomitant with the characterization of the tumor microenvironment, the expression of either or both PD-1 and PD-L1 molecules may estimate mutual relations of progression or regression of the carcinoma and prognostic values of the patient. Objective: Considering the importance of tumor microenvironment characterization, this study aims to determine the immunoexpression of PD-L1 and correlate with the frequency of CD4+ and CD8+ cells in AC and LLSCC lesions and with tumor-infiltrating lymphocytes (TILs) in LLSCC and its relationship with histopathological characteristics. Methodology: This sample includes 33 cases of AC and 17 cases of LLSCC. The cases were submitted to histopathological analysis and to CD4+, CD8+, and PD-L1+ cell determination by immunohistochemistry. Results: There was a significant difference among the frequencies of CD4+, CD8+, and PD-L1+ cells between AC and LSCC cases, higher in the last group. Moreover, histopathological and atypical changes in AC and LLSCC were correlated with the frequencies of PD-L1+, CD4+, and CD8+ cells. In AC, PD-L1+ cases had a low frequency of CD4+ cells, but on the other hand, PD-L1+ cases of LLSCC had a higher frequency of CD4+ and CD8+ cells. Conclusion: Therefore, the PD-L1 molecule may be a potential escape route for the immune response in oral lesions, but the mechanisms differ between AC and LLSCC. Future studies related to immune evasion and immunotherapy in oral lesions should consider the analysis of inflammatory infiltrate and TILs.
RESUMO
INTRODUCTION: Most patients with laryngeal carcinoma present tumors in the glottis that can be treated by different treatment modalities. Some authors consider open partial laryngectomy as obsolete, while others still deem this as a viable and cost-efficient option. OBJECTIVES: To compare the oncological and functional results of a series of patients undergoing partial laryngectomy vs. external radiotherapy for the treatment of glottic cancer. METHODS: Historical cohort study with a series of glottic carcinoma patients undergoing partial laryngectomy or external radiotherapy during a period of ten years. RESULTS: Sixty-two patients with glottic carcinoma were included. Group A comprised those submitted to partial laryngectomy (n=30), and Group B, those who underwent radiotherapy (n=32). They were homogeneous in the comparison of mean age, 56.4 vs. 60.4 years (p=0.12) and distribution in pathological stage (p=0.91). With regard to oncological outcome, there were no differences in distant metastasis rates, or second primary tumor between groups (p=1.0), as well as in disease-free time, laryngeal rescue-free time, and overall five-year survival. Severe complication rates were also similar between groups. CONCLUSION: Open partial laryngectomy had complication rates and oncological results similar to those of radiotherapy for patients with glottic carcinomas and should still be considered among the main available therapeutic options.
Assuntos
Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/cirurgia , Neoplasias Laríngeas/radioterapia , Neoplasias Laríngeas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Glote , Humanos , Laringectomia/efeitos adversos , Laringectomia/métodos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Complicações Pós-Operatórias , Recidiva , Taxa de SobrevidaRESUMO
AIM: The present study evaluated the expression of α1 and ß1 Na,K-ATPase, as well as the effects of digoxin (DGX) on oral squamous cell carcinomas (OSCCs). PATIENTS AND METHODS: Immunohistochemical expression of α1 and ß1 Na,K-ATPase were evaluated in 60 patients who underwent treatment at the São João de Deus Hospital. SCC-25 viability was assessed by the colorimetric assay. Chi-square or Fisher's exact tests were used to analyze the association of α1 and ß1 Na,K-ATPase expression with the variables. RESULTS: Immunoexpression of α1 and ß1 Na,K-ATPase were observed in 28% and 55% of the tumors, however these proteins were not significant prognostic factors. Tobacco was significantly associated with α1 expression. SCC-25 viability decreased significantly after treatment with 1 µM DGX at 24 h. CONCLUSION: The smoking status of OSCC patients was significantly associated with α1 expression and DGX affected the SCC-25 viability in a dose- and duration-dependent manner.
Assuntos
Carcinoma de Células Escamosas/metabolismo , Digoxina/farmacologia , Inibidores Enzimáticos/farmacologia , Neoplasias Bucais/metabolismo , ATPase Trocadora de Sódio-Potássio/metabolismo , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/genética , Humanos , Neoplasias Bucais/genética , Neoplasias Bucais/mortalidade , Neoplasias Bucais/patologia , Gradação de Tumores , Estadiamento de Neoplasias , Subunidades Proteicas/genética , Subunidades Proteicas/metabolismo , Fatores de Risco , ATPase Trocadora de Sódio-Potássio/genéticaRESUMO
Objetivo avaliar a adesão de pacientes aos tratamentos antineoplásicos orais e identificar os fatores que a influenciam. Método estudo quantitativo, prospectivo, de delineamento não experimental, realizado entre julho de 2013 e janeiro de 2014, em um hospital oncológico no interior do estado de Minas Gerais, Brasil. Os instrumentos utilizados foram: questionário sociodemográfico e clínico, escala Medida de Adesão ao Tratamento e Questionário dos Fatores que podem Influenciar a Adesão ao Tratamento. Os dados foram submetidos a estatística descritiva e testes de correlação entre variáveis. Resultados a média de adesão foi de 6,02 ± 0,8 pontos, e seis (4,9%) pacientes se mostraram não aderentes ao tratamento. Os fatores que mais dificultaram a adesão foram: dificuldade para a aquisição do antineoplásico (36,1%) e utilização de muitos medicamentos (14,8%). Conclusão a taxa de adesão ao uso de antineoplásicos orais é alta, entretanto ainda há muitos fatores que dificultam a adesão e a continuidade do tratamento.
Objetivo evaluar la adhesión de pacientes a los tratamientos antineoplásicos orales e identificar los factores que la influyen. Método estudio cuantitativo, prospectivo, de delineado no experimental, realizado entre julio de 2013 y enero de 2014 en hospital oncológico del interior de Minas Gerais, Brasil. Se utilizaron cuestionario sociodemográfico y clínico, escala Medida de Adhesión al Tratamiento y Cuestionario de Factores que pueden influir en la Adhesión al tratamiento. Los datos fueron sometidos a estadística descriptiva y tests de correlación entre variables. Resultados la media de adhesión fue de 6,02 ± 0,8 puntos, y seis (4,9%) pacientes no adhirieron al tratamiento. Los factores que más dificultaron la adhesión fueron: dificultado para adquirir el antineoplásico (36,1%) y utilización de muchos medicamentos (14,8%). Conclusión la tasa de adhesión al uso de antineoplásicos orales es alta, aunque aún existen numerosos factores que dificultan la adhesión y la continuidad del tratamiento.
Objective to evaluate the adherence of patients to oral antineoplastic therapy and identify the factors influencing it. Method quantitative and prospective study with non-experimental design carried out between July 2013 and January 2014 in an oncology hospital in the state of Minas Gerais, Brazil. The instruments used were: questionnaire for socio-demographic and clinical variables, the Therapy Adherence Measurement scale and the Questionnaire on Factors Influencing Medication Adherence. Data were submitted to descriptive statistics and to correlation tests. Results the mean adherence was 6.02 ± 0.8 points and six (4.9%) patients showed to be non-adherent to treatment. The most frequent factors hindering adherence were: difficulty in acquiring the antineoplastic drug (36.1%) and use of many drugs (14.8%). Conclusion the rate of adherence to oral antineoplastic therapy is high, but there are still many factors that hinder adherence and the continuity of care.
Assuntos
Humanos , Cooperação e Adesão ao Tratamento , Neoplasias/tratamento farmacológico , Antineoplásicos , Qualidade de Vida , Comunicação em SaúdeRESUMO
BACKGROUND AND OBJECTIVES: Due to its pharmacological characteristics, sevoflurane is the ideal anesthetic for short-duration procedures. There are two brands of sevoflurane in the Brazilian market, Sevocris® and Sevorane®, with different formulations and packaging. The objective of this study was to assess whether there are differences between the two anesthetics regarding induction, maintenance, recovery, and consumption. METHODS: One hundred and thirty children were included, divided into two groups according to the brand used: Group 1 was assigned to sevoflurane Cristália® and Group 2 to sevoflurane Abbott®. The following parameters were assessed: heart rate, systolic and diastolic blood pressure, fraction of inspired and expired sevoflurane, BIS values, tympanic temperature, induction and recovery time, agitation upon awakening measured by the PAED scale, and anesthetic consumption by weighing the vaporizers. Anesthesia was induced with 1 MAC and increased every three breaths at 0.5 MAC, up to 3 MAC. RESULTS: There was no difference between groups regarding the duration of the procedure, the anesthesia, and the parameters evaluated at induction. In Group 1, the number of children who required additional bolus of sevoflurane for anesthesia maintenance was higher than in Group 2 (p<0.05). The fraction of inspired and expired sevoflurane at the end of the procedure was lower in Group 1 (p<0.001). Upon awakening, BIS value was lower in Group 1 (p=0.045). Other parameters evaluated in recovery showed no difference between groups. The use of anesthesia was similar between groups.
Assuntos
Acatisia Induzida por Medicamentos , Procedimentos Cirúrgicos Ambulatórios , Período de Recuperação da Anestesia , Anestesia , Anestésicos Inalatórios/administração & dosagem , Éteres Metílicos/administração & dosagem , Acatisia Induzida por Medicamentos/etiologia , Anestésicos Inalatórios/efeitos adversos , Química Farmacêutica , Pré-Escolar , Método Duplo-Cego , Feminino , Humanos , Masculino , Éteres Metílicos/efeitos adversos , Agitação Psicomotora , SevofluranoRESUMO
ABSTRACT INTRODUCTION: Most patients with laryngeal carcinoma present tumors in the glottis that can be treated by different treatment modalities. Some authors consider open partial laryngectomy as obsolete, while others still deem this as a viable and cost-efficient option. OBJECTIVES: To compare the oncological and functional results of a series of patients undergoing partial laryngectomy vs. external radiotherapy for the treatment of glottic cancer. METHODS: Historical cohort study with a series of glottic carcinoma patients undergoing partial laryngectomy or external radiotherapy during a period of ten years. RESULTS: Sixty-two patients with glottic carcinoma were included. Group A comprised those submitted to partial laryngectomy (n = 30), and Group B, those who underwent radiotherapy (n = 32). They were homogeneous in the comparison of mean age, 56.4 vs. 60.4 years (p = 0.12) and distribution in pathological stage (p = 0.91). With regard to oncological outcome, there were no differences in distant metastasis rates, or second primary tumor between groups (p = 1.0), as well as in disease-free time, laryngeal rescue-free time, and overall five-year survival. Severe complication rates were also similar between groups. CONCLUSION: Open partial laryngectomy had complication rates and oncological results similar to those of radiotherapy for patients with glottic carcinomas and should still be considered among the main available therapeutic options.
Resumo Introdução: A maioria dos pacientes com carcinoma de laringe apresentam tumores na região glótica suscetíveis a diferentes modalidades de tratamento. Alguns autores consideram a laringectomia parcial aberta em desuso enquanto outros ainda a indicam como uma opção viável e custo eficiente. Objetivos: Comparar os resultados oncológicos e funcionais de uma série de pacientes submetidos à laringectomia parcial versus radioterapia externa para o tratamento do câncer glótico. Método: Estudo tipo coorte histórica com uma série de pacientes com carcinoma glótico submetidos à laringectomia parcial ou radioterapia externa em período de 10 anos. Resultados: Foram incluídos 62 pacientes com carcinoma glótico distribuídos em Grupo A: submetido à laringectomia parcial (n = 30) e Grupo B submetido a radioterapia (n = 32) que se mostraram homogêneos na comparação de média de idade de 56,4 vs. 60,4 (p = 0,12) e distribuição em estadios patológicos (p = 0,91). Com relação ao desfecho oncológico, não foram observadas diferenças nas taxas de metástase à distancia, ou segundo primário entre os grupos (p = 1,0) assim como no tempo livre de doença, tempo livre de resgate laríngeo e sobrevida geral em 5 anos. As taxas de complicações severas também foram semelhantes entre os grupos. Conclusão: A laringectomia parcial aberta apresentou taxas de complicações e resultados oncológicos semelhante àqueles do tratamento radioterápico para pacientes com carcinomas glóticos e ainda deve ser considera entre as principais opções terapêuticas disponíveis.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/radioterapia , Neoplasias Laríngeas/cirurgia , Neoplasias Laríngeas/radioterapia , Complicações Pós-Operatórias , Recidiva , Taxa de Sobrevida , Estudos Longitudinais , Glote , Laringectomia/efeitos adversos , Laringectomia/métodos , Estadiamento de NeoplasiasRESUMO
PURPOSE: to evaluate psychosocial adaptation to pregnancy by translating and cross-culturally adapting a specific assessment instrument to be used with Brazilian women. METHODS: this was a cross-sectional observational study. the translation and cross-cultural adaptation and of the Prenatal Self-evaluation Questionnaire (PSeQ) was performed following all the required methodological steps. another questionnaire was applied to characterize the sociodemographic and clinical status of the pregnant women (n=36). Statistical analysis consisted of the determination of the mean and standard deviation (SD) and of absolute and relative frequency. the statistical test used for the analysis of internal consistency was Cronbach's alpha coefficient, using SPSS version 17.0. RESULTS: the volunteers were of low socioeconomic status, aged on average 25.1 years ( 5.5), and had an average gestational age of 25.9 weeks ( 8.1). 58.3% of these volunteers had not planned their current pregnancy. the pretest showed that 75% of the pregnant women found the questionnaire easy to understand. Regarding the PSeQ instrument, the identification with the maternal role was the subcategory which showed the highest average, 24.8 ( 5.6), while the relationship with the mother had the lowest average 15.4 ( 7.7). the internal consistency ranged from 0.52 to 0.89. CONCLUSION: the assessment of psychosocial adaptation to pregnancy in pregnant women is very important during the progress of pregnancy and permits intervention through obstetric-neonatal actions of promotion and prevention regarding the well-being of mother and child.
Assuntos
Adaptação Psicológica , Gravidez/psicologia , Inquéritos e Questionários , Adulto , Brasil , Estudos Transversais , Características Culturais , Feminino , Humanos , TraduçõesRESUMO
Emotional stress is a risk factor for cardiovascular disease. Decreased heart rate variability (HRV) is associated to increased mortality rates in certain heart diseases. Current study assessed the co-relation between perceived stress and HRV parameters. The correlation between psychological stress, measured by the perceived stress scale (PSS-14), and HRV parameters obtained during 5 min. at rest was evaluated. Data from 35 healthy young volunteers demonstrated a significant correlation between PSS-14 scores and Low Frequency-LF (ms2) by frequency domain HRV analysis. Other variables such as High Frequency and Standard Deviation of R-R intervals had also negative coefficients but did not have any significant correlation with PSS-14. No correlation between PSS-14 and sympathovagal balance parameters was found. Data interpretation demonstrated that increase in perceived stress was correlated to decrease in heart rate variability, which may point out an important mechanism in cardiovascular pathophysiology that should be further investigated.
O estresse emocional é um fator de risco para doença cardiovascular. A diminuição da Variabilidade da Frequência Cardíaca (VFC) está associada ao aumento da mortalidade em algumas doenças cardíacas. Este estudo teve como objetivo avaliar a correlação entre o estresse percebido e os parâmetros da VFC. Dessa maneira, avaliou-se a correlação existente entre o estresse psicológico mensurado através da escala de estresse percebido (PSS -14) e parâmetros de VFC obtidos durante 5 min. ao repouso. Dados de 35 voluntários jovens e saudáveis demonstraram uma correlação significativa do PSS-14 com os valores de baixa freqüência- LF (ms²) na análise da VFC no domínio frequência. Outras variáveis, tais como alta freqüência e desvio padrão dos intervalos RR, também tiveram coeficientes negativos, mas não se correlacionaram com a PSS-14. Nenhuma correlação entre o PSS-14 e os parâmetros do balanço simpato-vagal foi encontrada. Portanto, a interpretação dos dados demonstra que o aumento no estresse percebido se correlacionou com a diminuição da variabilidade da frequência cardíaca, o que pode ser indicativo de um mecanismo importante na fisiopatologia cardiovascular que deve ser melhor investigado.
Assuntos
Humanos , Adulto , Estresse Psicológico , Doenças Cardiovasculares , Frequência CardíacaRESUMO
Diabetes mellitus (DM) is a risk factor for peripheral arterial disease (PAD). Neither the prevalence of PAD in type 2 (T2) DM nor its detrimental effects on quality of life (QoL) or physical activity (PA) have been well described in the Brazilian population. OBJECTIVES: To evaluate the prevalence of newly diagnosed PAD and its associations with QoL, PA and body composition in a sample of T2DM patients from a University Hospital. METHODS: Seventy-three (73) T2DM patients without previous diagnoses of major complications related to T2DM were enrolled. PAD was assessed using the ankle-brachial index (ABI); QoL was measured using a translated and validated SF-36 questionnaire; PA was measured using a modified Baecke questionnaire; and body composition was measured by segmental multi-frequency bioelectrical impedance. RESULTS: PAD prevalence was 13.7%, predominantly of mild severity (ABI between 0.8-0.9). The ABI results correlated with age (ρ=-0.26, P=0.03), DM duration (ρ=-0.28, P=0.02) and systolic and diastolic blood pressure (ρ=-0.33, P=0.007 and ρ=-0.28, P=0.02; respectively). Scores for the SF-36 physical component summary (PCS) were below the normal range, but no negative impact from PAD was identified by the PCS scores (normal-ABI 42.9±11.2 vs. PAD-ABI 38.12±11.07) or the Baecke PA results. Body composition analysis detected excessive body fat, especially in women, but there was no difference between groups. CONCLUSIONS: The prevalence of previously undiagnosed PAD in this population of T2DM patients was 13.7%, predominantly mild and asymptomatic forms, and was not yet associated with worsened QoL, PA levels or body composition variables...
O Diabetes Mellitus (DM) é fator de risco para a doença arterial obstrutiva periférica (DAOP). A prevalência de DAOP no DM tipo 2 (T2) e o prejuízo adicional causado por esta na qualidade de vida (QoL) e na atividade física (AF) não são bem descritos na população brasileira. OBJETIVOS: Avaliar a prevalência e a associação da DAOP recém-diagnosticada com a QoL, a AF e a composição corporal em pacientes T2DM provenientes de um hospital universitário. MÉTODOS: Setenta e três pacientes T2DM, sem complicações maiores relacionadas ao T2DM, foram incluídos. A DAOP foi avaliada pelo índice tornozelo-braquial (ITB); a QoL, pelo questionário traduzido e validado SF-36, e a AF, pelo questionário modificado de Baecke. A composição corporal foi avaliada pela impedância bioelétrica segmentar multifrequencial. RESULTADOS: A prevalência de DAOP foi 13,7%, predominantemente de severidade leve (ITB entre 0,8-0,9). O ITB correlacionou-se com a idade (ρ= -0,26; P= 0,03), a duração do DM (ρ=-0,28; P=0,02) e a pressão arterial sistólica e diastólica (ρ= -0,33; P= 0,007 e ρ= -0,28; P= 0,02; respectivamente). O sumário de saúde física (PCS) do questionário SF-36 estava abaixo da variação normal; contudo, nenhum impacto negativo da DAOP foi identificado no PCS (ABI normal = 42,9±11,2 vs. ABI-DAOP = 38,12±11,07) ou no nível de AF. A análise da composição corporal demonstrou gordura corporal excessiva, especialmente em mulheres; contudo, sem diferenças entre grupos. CONCLUSÃO: A prevalência de DAOP sem diagnóstico prévio nesta amostra de pacientes T2DM foi de 13,7%, predominantemente assintomática e leve, e ainda não associada com piores índices de QoL, nível de AF e composição corporal...
Assuntos
Humanos , Masculino , Feminino , Composição Corporal/genética , /complicações , Doença Arterial Periférica/diagnóstico , Qualidade de Vida , Índice Tornozelo-Braço/métodos , Prevalência , Sistema Único de SaúdeRESUMO
Although interleukin (IL)-4 is described as a prototypical anti-inflammatory cytokine, in recent years its role as a neuromodulatory cytokine has been extensively discussed. This review highlights the pivotal contributions of IL-4 during the development and normal physiology of neural cells as well as IL-4 connections with the pathophysiology of degenerative or inflammatory processes observed in the central and peripheral nervous system.
Assuntos
Interleucina-4/metabolismo , Sistema Nervoso/metabolismo , Neurotransmissores/metabolismo , Transdução de Sinais , Animais , Doença , Humanos , Sistema Nervoso/patologia , Receptores de Interleucina-4/metabolismoRESUMO
O objetivo deste estudo foi identificar a clientela assistida em um Curso para Gestantes e observar a qualidade de vida dessas mulheres. Estudo descritivo no qual foi aplicado um questionário semiestruturado, abordando os aspectos socioeconômicos e culturais, bem como o protocolo Medical Outcomes Study 36-item Short-form Health Survey (SF-36) para a análise da qualidade de vida. O grupo de participantes constou de 41 gestantes com idades entre 19 e 38 anos, em sua maioria primigestas (95%), casadas (85,4%), empregadas (70,7%) e sedentárias (80,5%), com idade gestacional média de 21 semanas e nível superior de escolaridade (65,9%) e estado nutricional adequado (58,6%). A amostra apresentou média acima do escore médio do protocolo SF-36, com exceção do domínio aspectos físicos (46,95 ±37,58). Em relação à população feminina geral, considerada em outros estudos, as participantes também apresentaram pontuação média significativamente maior em seis dos oito domínios: saúde geral (81,21±16,45), capacidade funcional (66,09±21,98), aspectos emocionais (67,47±43,13), dor (63,58 ±24,30), função social (76,52 ±18,37) e saúde mental (71,70 ±14,32). As mulheres que procuram o Curso para Gestantes são, em sua grande maioria, adultas, casadas, com nível superior de escolaridade, empregadas e relatam renda familiar alta. Apresentam escores de qualidade de vida acima da população feminina em geral, com exceção dos domínios aspectos físicos e vitalidade, que parecem estar comprometidos nesse período.
Identify the clients assisted in a course for pregnant women and observe the quality of life of these women. A descriptive study in which a semi-structured questionnaire was applied, addressing socio-economic and cultural aspects, as well as the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) protocol for analyzing quality of life. The participants were 41 pregnant women with ages between 19 and 38 years, mostly primigravida (95%), married (85,4%), employed (70,7%), and sedentary (80,5%), with a mean gestational age of 21 weeks and a higher education level (65,9%), and an adequate nutritional status (58,6%). The sample presented a mean above the SF-36 protocol mean score, except for the physical aspects domain (46.95 ±37.58). With respect to the general female population, seen in other studies, the participants also had a significantly higher average score in six of eight domains: general health (81.21 ±16.45), functional capacity (66.09 ± 21.98), emotional aspects (67.47 ± 43.13), pain (63.58 ± 24.30), social functioning (76.52 ± 18.37), and mental health (71.70 ± 14.32). The women who seek the Course for Pregnant Women are mostly adults, married, with a college education, employed, and report high family income. They present quality of life scores above the general female population, with the exception of the physical aspects and vitality domains, which appear to be impaired during this period.
Assuntos
Perfil de Saúde , Gravidez , Qualidade de Vida , Epidemiologia , Saúde da MulherRESUMO
O consumo de álcool e outras drogas interfere nas atividades laborais. Esta pesquisa teve como propósito verificar o padrão de uso de substâncias psicoativas entre trabalhadores de obras públicas. Trata-se de estudo exploratório e transversal cuja coleta de dados foi realizada pelo questionário Triagem do Uso de Álcool, Tabaco e Outras Substâncias (ASSIST) aplicado para 200 trabalhadores da Empresa Municipal de Obras Públicas de Divinópolis (MG), no período de março a setembro de 2011. Os resultados indicam que os trabalhadores são predominantemente do sexo masculino (73,5%). Foi constatado elevado consumo de álcool e outras drogas com prejuízos sociais, familiares e de saúde. Concluiu-se que é necessária a implantação e o desenvolvimento de breves intervenções para minimizar os agravos para o grupo investigado, suas famílias e a sociedade.
The consumption of alcohol and other drugs interfere with work activities. This research aimed to assess the pattern of psychoactive substance use among construction workers hired by a municipality. This is a cross-sectional exploratory study whose data collection was conducted by the questionnaire Screening for Alcohol Use, Tobacco, and Other Substances (ASSIST) answered by 200 construction workers hired by the Municipal Building Construction Company in Divinópolis (MG), from March to September 2011. The results indicate that workers are predominantly male (73.5%). It was found out a high consumption of alcohol and other drugs that cause social, family and health disruption. It could be concluded that it is necessary the implementation and development of brief interventions to minimize the problems for the group investigated, their families and society.
El consumo de alcohol y otras drogas interfiere en las actividades laborales. Esta investigación tuvo como objetivo verificar el patrón de uso de sustancias psicoactivas entre los trabajadores de obras públicas. Se trata de un estudio con enfoque exploratorio y transversal cuya recolecta de datos se realizó mediante el cuestionario Triado del Uso del Alcohol, Tabaco y Otras Sustancias (ASSIST) aplicado a 200 trabajadores de la Empresa Municipal de Obras Públicas de Divinópolis (MG), de marzo a septiembre de 2011. Los resultados indican que los trabajadores son en su mayoría varones (73,5%). Se encontró un alto consumo de alcohol y otras drogas con trastornos sociales, familiares y de salud. Se concluye que se hace necesaria la implementación y desarrollo de intervenciones breves para reducir los agravios del grupo investigado, sus familias y la sociedad.