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1.
Rev Bras Ter Intensiva ; 33(4): 583-591, 2022.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-35081243

RESUMEN

OBJECTIVE: To ascertain the cumulative incidence of acute organ failure and intensive care unit admission in cancer patients. METHODS: This was a single-center prospective cohort study of adult cancer patients admitted for unscheduled inpatient care while on systemic cancer treatment. RESULTS: Between August 2018 and February 2019, 10,392 patients were on systemic treatment, 358 had unscheduled inpatient care and were eligible for inclusion, and 285 were included. The mean age was 60.9 years, 50.9% were male, and 17.9% of patients had hematologic cancers. The cumulative risk of acute organ failure was 39.6% (95%CI: 35 - 44), and that of intensive care unit admission among patients with acute organ failure was 15.0% (95%CI: 12 - 18). On admission, 62.1% of patients were considered not eligible for artificial organ replacement therapy. The median follow-up time was 9.5 months. Inpatient mortality was 17.5%, with an intensive care unit mortality rate of 58.8% and a median cohort survival of 134 days (95%CI: 106 - 162). In multivariate analysis, acute organ failure was associated with 6-month postdischarge mortality (HR 1.6; 95%CI: 1.2 - 2.2). CONCLUSION: The risk of acute organ failure in cancer patients admitted for unscheduled inpatient care while on systemic treatment was 39.6%, and the risk of intensive care unit admission was 15.0%. Acute organ failure in cancer patients was an independent poor prognostic factor for inpatient hospital mortality and 6-month survival.


OBJETIVO: Determinar a incidência cumulativa de falência aguda de órgão e internamento em unidade de terapia intensiva em pacientes oncológicos. MÉTODOS: Estudo de coorte prospectivo de pacientes oncológicos adultos em tratamento sistêmico antineoplásico, internados de forma não programada. RESULTADOS: Entre agosto de 2018 e fevereiro de 2019, 10.392 pacientes foram submetidos a tratamento sistêmico antineoplásico, sendo que 358 necessitaram de internamento hospitalar não programado e foram elegíveis para inclusão; por fim, 258 desses pacientes foram incluídos. A média de idade foi de 60,9 anos, e 50,9% eram do sexo masculino; 17,9% dos pacientes tinham câncer hematológico. O risco acumulado de falência de órgãos foi de 39,6% (IC95% 35 - 44) e o risco de internamento na unidade de terapia intensiva em pacientes com falência aguda de órgão foi de 15,0% (IC95% 12 - 18). À admissão em internamento, 62,1% dos pacientes foram considerados não elegíveis para terapia de substituição artificial de órgãos. O tempo mediano de seguimento foi de 9,5 meses. A mortalidade hospitalar foi de 17,5%, na unidade de terapia intensiva de 58,8%. A mediana de sobrevivência da coorte foi de 134 dias (IC95% 106 - 162). Na análise multivariada, a falência aguda de órgão se associou com a mortalidade aos 6 meses após a alta (hazard ratio: 1,6; IC95% 1,2 - 2,2). CONCLUSÃO: O risco de falência aguda de órgão em pacientes oncológicos admitidos para tratamento hospitalar não programado durante o tratamento sistémico foi de 39,6% e o risco de internamento em unidade de terapia intensiva foi de 15,0%. A falência aguda de órgão em pacientes oncológicos foi um fator de prognóstico independente para maior mortalidade intra-hospitalar e menor sobrevivência aos 6 meses após a alta.


Asunto(s)
Cuidados Posteriores , Neoplasias , Adulto , Estudios de Cohortes , Mortalidad Hospitalaria , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Neoplasias/complicaciones , Neoplasias/epidemiología , Neoplasias/terapia , Alta del Paciente , Pronóstico , Estudios Prospectivos , Estudios Retrospectivos
2.
Rev. bras. ter. intensiva ; 33(4): 583-591, out.-dez. 2021. tab, graf
Artículo en Inglés, Portugués | LILACS | ID: biblio-1357189

RESUMEN

RESUMO Objetivo: Determinar a incidência cumulativa de falência aguda de órgão e internamento em unidade de terapia intensiva em pacientes oncológicos. Métodos: Estudo de coorte prospectivo de pacientes oncológicos adultos em tratamento sistêmico antineoplásico, internados de forma não programada. Resultados: Entre agosto de 2018 e fevereiro de 2019, 10.392 pacientes foram submetidos a tratamento sistêmico antineoplásico, sendo que 358 necessitaram de internamento hospitalar não programado e foram elegíveis para inclusão; por fim, 258 desses pacientes foram incluídos. A média de idade foi de 60,9 anos, e 50,9% eram do sexo masculino; 17,9% dos pacientes tinham câncer hematológico. O risco acumulado de falência de órgãos foi de 39,6% (IC95% 35 - 44) e o risco de internamento na unidade de terapia intensiva em pacientes com falência aguda de órgão foi de 15,0% (IC95% 12 - 18). À admissão em internamento, 62,1% dos pacientes foram considerados não elegíveis para terapia de substituição artificial de órgãos. O tempo mediano de seguimento foi de 9,5 meses. A mortalidade hospitalar foi de 17,5%, na unidade de terapia intensiva de 58,8%. A mediana de sobrevivência da coorte foi de 134 dias (IC95% 106 - 162). Na análise multivariada, a falência aguda de órgão se associou com a mortalidade aos 6 meses após a alta (hazard ratio: 1,6; IC95% 1,2 - 2,2). Conclusão: O risco de falência aguda de órgão em pacientes oncológicos admitidos para tratamento hospitalar não programado durante o tratamento sistémico foi de 39,6% e o risco de internamento em unidade de terapia intensiva foi de 15,0%. A falência aguda de órgão em pacientes oncológicos foi um fator de prognóstico independente para maior mortalidade intra-hospitalar e menor sobrevivência aos 6 meses após a alta.


ABSTRACT Objective: To ascertain the cumulative incidence of acute organ failure and intensive care unit admission in cancer patients. Methods: This was a single-center prospective cohort study of adult cancer patients admitted for unscheduled inpatient care while on systemic cancer treatment. Results: Between August 2018 and February 2019, 10,392 patients were on systemic treatment, 358 had unscheduled inpatient care and were eligible for inclusion, and 285 were included. The mean age was 60.9 years, 50.9% were male, and 17.9% of patients had hematologic cancers. The cumulative risk of acute organ failure was 39.6% (95%CI: 35 - 44), and that of intensive care unit admission among patients with acute organ failure was 15.0% (95%CI: 12 - 18). On admission, 62.1% of patients were considered not eligible for artificial organ replacement therapy. The median follow-up time was 9.5 months. Inpatient mortality was 17.5%, with an intensive care unit mortality rate of 58.8% and a median cohort survival of 134 days (95%CI: 106 - 162). In multivariate analysis, acute organ failure was associated with 6-month postdischarge mortality (HR 1.6; 95%CI: 1.2 - 2.2). Conclusion: The risk of acute organ failure in cancer patients admitted for unscheduled inpatient care while on systemic treatment was 39.6%, and the risk of intensive care unit admission was 15.0%. Acute organ failure in cancer patients was an independent poor prognostic factor for inpatient hospital mortality and 6-month survival.


Asunto(s)
Humanos , Masculino , Adulto , Persona de Mediana Edad , Cuidados Posteriores , Neoplasias/complicaciones , Neoplasias/terapia , Neoplasias/epidemiología , Alta del Paciente , Pronóstico , Estudios Prospectivos , Estudios Retrospectivos , Estudios de Cohortes , Mortalidad Hospitalaria , Unidades de Cuidados Intensivos
3.
Artículo en Inglés | MEDLINE | ID: mdl-34360380

RESUMEN

Indoor air pollution has obtained more attention in a moment where "stay at home" is a maximum repeated for the entire world. It is urgent to know the sources of pollutants indoors, to improve the indoor air quality. This study presents some results obtained for twelve incense products, used indoors, at home, and in temples, but also in spa centers or yoga gymnasiums, where the respiratory intensity is high, and the consequences on health could be more severe. The focus of this study was the gaseous emissions of different types of incense, performing a VOC screening and identifying some specific VOCs different from the usual ones, which are known or suspected to cause severe chronic health effects: carcinogenic, mutagenic, and reprotoxic. Thirteen compounds were selected: benzene, toluene, styrene, naphthalene, furfural, furan, isoprene, 2-butenal, phenol, 2-furyl methyl ketone, formaldehyde, acetaldehyde, and acrolein. The study also indicated that incense cone type shows a higher probability of being more pollutant than incense stick type, as from the 12 products tested, four were cone type, and three of them were in the group of the four higher polluters. Benzene and formaldehyde presented worrying levels in the major part of the products, above guideline values established by the WHO. Unfortunately, there are no limit values established for indoor air for all the compounds studied, but this fact should not exempt us from taking action to alert the population to the potential dangers of using those products. From this study, acetaldehyde, acrolein, furfural, and furan emerge as compounds with levels to deserve attention.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire Interior , Contaminantes Ambientales , Compuestos Orgánicos Volátiles , Contaminantes Atmosféricos/análisis , Contaminantes Atmosféricos/toxicidad , Contaminación del Aire Interior/análisis , Benceno/análisis , Formaldehído/análisis , Formaldehído/toxicidad , Humanos , Compuestos Orgánicos Volátiles/análisis , Compuestos Orgánicos Volátiles/toxicidad
4.
Clin Case Rep ; 9(4): 2489-2491, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33936726

RESUMEN

The case highlights the importance of actively obtaining informative samples at an early stage and of prompt initiation of combination therapy with antifungal drugs.

5.
Food Res Int ; 140: 110071, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33648293

RESUMEN

Ten truffle species of Tuber and Terfezia genera were chemical characterized, assessing their proximate composition, individual nutrient compounds and some bioactive molecules. The bioactive properties of these species were also evaluated, namely their antioxidant, antimicrobial and cytotoxic potential. Carbohydrates were the main macronutrients present in truffles, followed by proteins. Furthermore, the levels of polyunsaturated fatty acids (PUFA), subsequently presented as a percentage, were higher in truffles (38.2-79.3%) except in Tuber magnatum and Terfezia arenaria, which have a more saturated fatty acids (SFA) profile (70.7% and 53.7%, respectively). Comparing the species, T. magnatum revealed the highest levels of total phenolic compounds (TPC) (290 mg GAE/100 g truffle), as also the best results in the four methods used to evaluate the antioxidant activity. On the other hand, only five extracts obtained from some studied truffle species (Terfezia magnusii, Tuber aestivum, Tuber gennadii, and Tuber melanosporum) showed a slight inhibition of microbial growth, tested against different bacteria. Terfezia and T. gennadii extracts, showed potential to inhibit the cellular growth of NCI-H460, HeLa, HepG2, and MCF-7 cell lines (GI50 concentrations range: 19-78, 33-301, 83-321 and 102-321 µg/mL, respectively), indicating anti-proliferative activity. Nevertheless, T. arenaria revealed some potential hepatotoxicity, inhibiting the growth of PLP2 cells (GI50 concentration of 220 µg/mL), a primary cell culture obtained from porcine liver.


Asunto(s)
Antiinfecciosos , Antioxidantes , Animales , Antiinfecciosos/farmacología , Antioxidantes/farmacología , Ascomicetos , Porcinos
7.
JMIR Res Protoc ; 7(8): e10304, 2018 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-30072360

RESUMEN

BACKGROUND: Falls are a major health problem among older adults. The risk of falling can be increased by polypharmacy, vision impairment, high blood pressure, environmental home hazards, fear of falling, and changes in the function of musculoskeletal and sensory systems that are associated with aging. Moreover, individuals who experienced previous falls are at higher risk. Nevertheless, falls can be prevented by screening for known risk factors. OBJECTIVE: The objective of our study was to develop a multifactorial, instrumented, screening tool for fall risk, according to the key risk factors for falls, among Portuguese community-dwelling adults aged 50 years or over and to prospectively validate a risk prediction model for the risk of falling. METHODS: This prospective study, following a convenience sample method, will recruit community-dwelling adults aged 50 years or over, who stand and walk independently with or without walking aids in parish councils, physical therapy clinics, senior's universities, and other facilities in different regions of continental Portugal. The FallSensing screening tool is a technological solution for fall risk screening that includes software, a pressure platform, and 2 inertial sensors. The screening includes questions about demographic and anthropometric data, health and lifestyle behaviors, a detailed explanation about procedures to accomplish 6 functional tests (grip strength, Timed Up and Go, 30 seconds sit to stand, step test, 4-Stage Balance test "modified," and 10-meter walking speed), 3 questionnaires concerning environmental home hazards, and an activity and participation profile related to mobility and self-efficacy for exercise. RESULTS: The enrollment began in June 2016 and we anticipate study completion by the end of 2018. CONCLUSIONS: The FallSensing screening tool is a multifactorial and evidence-based assessment which identifies factors that contribute to fall risk. Establishing a risk prediction model will allow preventive strategies to be implemented, potentially decreasing fall rate. REGISTERED REPORT IDENTIFIER: RR1-10.2196/10304.

8.
J Intensive Care Med ; 33(7): 415-419, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27509916

RESUMEN

OBJECTIVE: This was an observational retrospective study aimed to examine the frequency and associated factors of withdrawing or withholding life support (WWLS) in the intensive care unit (ICU) of a comprehensive cancer center. METHODS: Medical records of adult patients with cancer admitted to the ICU between January 2010 and December 2014 were reviewed. Patients who died during that period were classified into 2 groups: full life support and withdrawing and withholding life support. The relative impact of demographic and clinical factors was assessed using logistic regression. RESULTS: A total of 247 patients died in our unit (mortality rate of 16.3%). Their median age was 62 (interquartile range [IQR] 51-73) years, there were 142 (57.5%) male patients, and they had predominantly solid malignancies (62.3%). The median Simplified Acute Physiology Score II and Acute Physiology and Chronic Health Evaluation scores were 67 (IQR 54-80) and 29 (IQR 23-55), respectively. Ninety-six (38.9%) patients died after WWLS with no statistically significant differences in decisions to limit therapy during the study period. Patients with advanced age, solid malignancies, nonneutropenic, and longer duration of mechanical ventilation were more likely to die after WWLS. In multivariate analysis, presenting with neutropenia was independently associated with a lower likelihood of dying after WWLS (odds ratio: 0.34, 95% confidence interval: 0.15-0.80). CONCLUSION: Limitation of therapy has been a common practice in oncologic ICUs over recent years. Neutropenia is an independent predictor of limitation of therapy.


Asunto(s)
Toma de Decisiones , Unidades de Cuidados Intensivos , Neoplasias/terapia , Cuidado Terminal/métodos , Privación de Tratamiento , Anciano , Europa (Continente) , Familia/psicología , Femenino , Mortalidad Hospitalaria , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/psicología , Neutropenia , Estudios Retrospectivos , Cuidado Terminal/psicología
9.
Food Funct ; 8(6): 2155-2164, 2017 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-28534588

RESUMEN

The present work is aimed at developing nutraceutical formulations based on the mycelium of Agaricus bisporus and Pleurotus ostreatus, highlighting the potential of in vitro culture as a tool to improve the production of bioactive compounds, namely phenolic acids and ergosterol. The mycelia of both species were cultured in different solid and liquid media in order to compare the growth rate and yielded biomass. Fruiting bodies, mycelia and culture media were compared regarding the antioxidant activity, anti-inflammatory effects in RAW264.7 cells and cytotoxicity in human tumor cell lines and non-tumor porcine liver cells. P. ostreatus mycelia showed higher contents of ergosterol and phenolic compounds, and stronger antioxidant activity than the corresponding fruiting body. P. ostreatus and A. bisporus did not show anti-inflammatory activity, and P. ostreatus was the only one showing cytotoxicity in tumor cell lines. The results show that these mushrooms provide compounds with antioxidant and cytotoxic capacities, with variations among species.


Asunto(s)
Agaricus/química , Suplementos Dietéticos/análisis , Micelio/química , Extractos Vegetales/análisis , Pleurotus/química , Agaricus/crecimiento & desarrollo , Agaricus/metabolismo , Antioxidantes/análisis , Antioxidantes/metabolismo , Antioxidantes/farmacología , Línea Celular Tumoral , Supervivencia Celular/efectos de los fármacos , Medios de Cultivo/química , Medios de Cultivo/metabolismo , Cuerpos Fructíferos de los Hongos/química , Cuerpos Fructíferos de los Hongos/crecimiento & desarrollo , Cuerpos Fructíferos de los Hongos/metabolismo , Humanos , Micelio/crecimiento & desarrollo , Micelio/metabolismo , Fenoles/análisis , Fenoles/metabolismo , Fenoles/farmacología , Extractos Vegetales/metabolismo , Extractos Vegetales/farmacología , Pleurotus/crecimiento & desarrollo , Pleurotus/metabolismo
10.
Food Chem ; 230: 40-48, 2017 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-28407928

RESUMEN

Mushrooms are important sources of natural bioactive compounds. Pleurotus eryngii (DC.) Quél is recognized for its organoleptic quality and health effects, being extensively commercialized. Instead, Suillus bellinii (Inzenga) Watling is an ectomycorrhizal symbiont, whose main properties were scarcely reported. Considering current trends, the mycelia and the culture media of these mushrooms might be potential sources of bioactive compounds. Accordingly, P. eryngii and S. bellinii were studied for their phenolic acids and sterols, antioxidant capacity, anti-inflammatory effect and anti-proliferative activity. S. bellinii mycelia showed higher contents of ergosterol and phenolic compounds (also higher in its fruiting body) and stronger antioxidant activity than P. eryngii. Conversely, P. eryngii mycelia showed anti-inflammatory (absent in S. bellinii mycelia) and a cytotoxicity similar (sometimes superior) to its fruiting bodies, contrarily to S. bellinii. Furthermore, the assayed species showed differences in the growth rate and produced mycelia, which should be considered in further applications.


Asunto(s)
Agaricales/química , Antiinflamatorios/farmacología , Antioxidantes/análisis , Citotoxinas/farmacología , Micelio/química , Esteroles/análisis , Animales , Antiinflamatorios/análisis , Línea Celular , Citotoxinas/análisis , Humanos , Ratones
11.
Molecules ; 21(2): 246, 2016 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-26907239

RESUMEN

This work presents the chemical profile of two edible species of mushrooms from the genus Leccinum: Leccinum molle (Bon) Bon and Leccinum vulpinum Watling, both harvested on the outskirts of Bragança (Northeastern Portugal). Both species were prepared and characterized regarding their content in nutrients (i.e., free sugars, fatty acids and vitamins), non-nutrients (i.e., phenolic and other organic acids) and antioxidant activity. To the best of our knowledge, no previous studies on the chemical characterization and bioactivity of these species have been undertaken. Accordingly, this study intends to increase the available information concerning edible mushroom species, as well as to highlight another important factor regarding the conservation of the mycological resources--their potential as sources of nutraceutical/pharmaceutical compounds. Overall, both species revealed similar nutrient profiles, with low fat levels, fructose, mannitol and trehalose as the foremost free sugars, and high percentages of mono- and polyunsaturated fatty acids. They also revealed the presence of bioactive compounds, namely phenolic (e.g., gallic acid, protocatechuic acid and p-hydroxybenzoic acid) and organic acids (e.g., citric and fumaric acids) and presented antioxidant properties.


Asunto(s)
Agaricales/química , Antioxidantes/química , Basidiomycota/química , Análisis de los Alimentos , Carbohidratos/química , Ácidos Grasos/química , Humanos , Vitaminas/química
12.
Food Chem Toxicol ; 90: 45-54, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26854920

RESUMEN

The current work aimed to study the antitumour activity of a phenolic extract of the edible mushroom Leccinum vulpinum Watling, rich essentially in hydroxybenzoic acids. In a first approach, the mushroom extract was tested against cancer cell growth by using four human tumour cell lines. Given the positive results obtained in these initial screening experiments and the evidence of some studies for an inverse relationship between mushroom consumption and breast cancer risk, a detailed study of the bioactivity of the extract was carried out on MCF-7 cells. Once the selected cell line to precede the work was the breast adenocarcinoma cell line, the human breast non-malignant cell line MCF-10A was used as control. Overall, the extract decreased cellular proliferation and induced apoptosis. Furthermore, the results also suggest that the extract causes cellular DNA damage. Data obtained highlight the potential of mushrooms as a source of biologically active compounds, particularly with antitumour activity.


Asunto(s)
Agaricales/química , Antineoplásicos Fitogénicos/farmacología , Apoptosis/efectos de los fármacos , Neoplasias de la Mama/tratamiento farmacológico , Daño del ADN , Antineoplásicos Fitogénicos/química , Proliferación Celular , Femenino , Cuerpos Fructíferos de los Hongos/química , Humanos , Células MCF-7
13.
Food Chem ; 182: 309-15, 2015 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-25842342

RESUMEN

As with all mushrooms, Amanita species demonstrates several conservation problems, due to a post-harvest life limited to a few days. Drying is one of the most commonly used methods in mushroom preservation. Food irradiation is another possible way to improve food quality and insure its security. Among the emerging irradiation technologies, electron beam irradiation has wide applications, allowing for high throughput, wide flexibility and potential, without any negative effect on the environment. The effects of different electron beam irradiation doses in Amanita genus, were assessed by measuring the changes produced on a wide variety of nutritional, chemical and antioxidant indicators. The evaluated profiles indicated differences between non-irradiated and irradiated samples, however a high similarity was observed among different doses. This finding advises that the highest assayed dose (10 kGy) be applied, ensuring a higher effectiveness from a decontamination and disinfestation perspective, without having any stronger effects than those observed by the lower doses.


Asunto(s)
Agaricales/efectos de la radiación , Amanita/efectos de la radiación , Antioxidantes/química , Irradiación de Alimentos/efectos adversos , Antioxidantes/análisis , Electrones , Irradiación de Alimentos/métodos , Análisis de Componente Principal
14.
Arq Bras Endocrinol Metabol ; 58(6): 656-60, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25211450

RESUMEN

The uncommon aggressive pituitary tumors are named carcinomas when metastases are detected, either in the central nervous system and/or systemically. Some cases are associated with hormonal overproduction, but most are diagnosed because of local symptoms. These neoplasias are generally refractory to current treatments. A 51 year-old woman presented sudden onset of headache, left arm paresis and left facial hypoesthesia. Computed tomography scan and magnetic resonance imaging revealed a pituitary tumor invading the left sphenoidal and cavernous sinuses. Laboratory data excluded hormonal hypersecretion. The patient underwent transsphenoidal surgery and histological findings showed a neoplasia with Ki-67 estimated at 75%. Medical imaging excluded both a primary occult tumor and central nervous system or systemic dissemination. Three weeks postoperatively, neurological condition worsened, with new onset of ataxia, bilateral ptosis, ophthalmoplegia and an increase in the size of the lesion, leading to surgical intervention by craniotomy, followed by only a few sessions of radiotherapy, because of severe disease progression. Patient died nearly 2 months after the initial manifestations. This case illustrates the aggressiveness of some pituitary lesions, the limited efficacy of current treatment modalities such as surgery or radiotherapy and the pitfalls of the current pituitary tumors classification. To our knowledge, this case corresponds to one of the most aggressive pituitary neoplasms reported so far, with a very high Ki-67 index (75%) and short survival (2 months). Ki-67 index could be of prognostic value in pituitary tumors. Pituitary tumors World Health Organization (WHO) classification could be revisited.


Asunto(s)
Carcinoma , Antígeno Ki-67/aislamiento & purificación , Neoplasias Hipofisarias , Carcinoma/diagnóstico , Carcinoma/patología , Resultado Fatal , Femenino , Humanos , Espectroscopía de Resonancia Magnética , Persona de Mediana Edad , Hipófisis/cirugía , Neoplasias Hipofisarias/diagnóstico , Neoplasias Hipofisarias/patología , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X
15.
Arq. bras. endocrinol. metab ; 58(6): 656-660, 08/2014. graf
Artículo en Inglés | LILACS | ID: lil-721392

RESUMEN

The uncommon aggressive pituitary tumors are named carcinomas when metastases are detected, either in the central nervous system and/or systemically. Some cases are associated with hormonal overproduction, but most are diagnosed because of local symptoms. These neoplasias are generally refractory to current treatments. A 51 year-old woman presented sudden onset of headache, left arm paresis and left facial hypoesthesia. Computed tomography scan and magnetic resonance imaging revealed a pituitary tumor invading the left sphenoidal and cavernous sinuses. Laboratory data excluded hormonal hypersecretion. The patient underwent transsphenoidal surgery and histological findings showed a neoplasia with Ki-67 estimated at 75%. Medical imaging excluded both a primary occult tumor and central nervous system or systemic dissemination. Three weeks postoperatively, neurological condition worsened, with new onset of ataxia, bilateral ptosis, ophthalmoplegia and an increase in the size of the lesion, leading to surgical intervention by craniotomy, followed by only a few sessions of radiotherapy, because of severe disease progression. Patient died nearly 2 months after the initial manifestations. This case illustrates the aggressiveness of some pituitary lesions, the limited efficacy of current treatment modalities such as surgery or radiotherapy and the pitfalls of the current pituitary tumors classification. To our knowledge, this case corresponds to one of the most aggressive pituitary neoplasms reported so far, with a very high Ki-67 index (75%) and short survival (2 months). Ki-67 index could be of prognostic value in pituitary tumors. Pituitary tumors World Health Organization (WHO) classification could be revisited.


Os raros tumores pituitários agressivos são chamados carcinomas quando são detectadas metástases, sejam sistêmicas e/ou em sistema nervoso central. Alguns casos estão associados com superprodução de hormônio, mas a maioria é diagnosticada em função dos sintomas locais. Essas neoplasias são geralmente refratárias aos tratamentos atuais. Uma mulher com 51 anos de idade apresentou dor de cabeça de início súbito, paralisia de braço esquerdo e hipoestesia facial esquerda. A tomografia e a ressonância magnética revelaram um tumor pituitário invadindo os seios esfenoidal e cavernoso esquerdos. Os dados laboratoriais excluíram hipersecreção hormonal. A paciente foi submetida à cirurgia transesfenoidal, e os achados histológicos mostraram uma neoplasia com Ki-67 estimado em 75%. As imagens excluíram tanto um tumor oculto primário quanto disseminação sistêmica ou do sistema nervoso central. Três semanas após a cirurgia, a condição neurológica apresentou piora com início de ataxia, ptose bilateral, oftalmoplegia e aumento do tamanho da lesão, levando à intervenção cirúrgica por craniotomia, seguida por apenas algumas sessões de radioterapia devido à progressão grave da doença. A paciente veio a óbito depois de quase dois meses das manifestações iniciais. O caso ilustra a agressividade de algumas lesões pituitárias, a eficácia limitada das modalidades atuais de tratamento, como a cirurgia ou a radioterapia, e as limitações da classificação atual de tumores pituitários. Até onde sabemos, esse caso corresponde a uma das neoplasias pituitárias mais agressivas descritas até hoje, com um nível muito alto de Ki-67 (75%) e sobrevida curta (2 meses). O nível de Ki-67 pode ser de valor prognóstico em tumores pituitários. A classificação da Organização Mundial da Saúde (OMS) para tumores pituitários deveria ser revisitada.


Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Carcinoma , /aislamiento & purificación , Neoplasias Hipofisarias , Carcinoma/diagnóstico , Carcinoma/patología , Resultado Fatal , Espectroscopía de Resonancia Magnética , Hipófisis/cirugía , Neoplasias Hipofisarias/diagnóstico , Neoplasias Hipofisarias/patología , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X
16.
Food Chem ; 149: 91-8, 2014 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-24295681

RESUMEN

It was previously demonstrated that gamma irradiation was the processing technology with the highest capacity to maintain the chemical profile of fresh Macrolepiota procera wild mushroom, when compared to freeze-dried or oven-dried samples. Herein, it was aimed to evaluate gamma irradiation effects on processed samples. Chemical composition and antioxidant potential of irradiated (0.5 and 1 kGy) fresh, frozen and dried samples were determined by chromatographic techniques and in vitro assays, respectively. M. procera irradiation attenuated the effects caused by oven-drying or freezing; combining freeze treatment with 0.5 kGy dose preserved total tocopherols. Rather than a conservation methodology, gamma irradiation might act as a useful adjuvant to other conservation techniques (e.g., freezing or oven-drying).


Asunto(s)
Agaricales/química , Agaricales/efectos de la radiación , Antioxidantes/química , Irradiación de Alimentos/métodos , Extractos Vegetales/química , Verduras/química , Desecación , Manipulación de Alimentos , Rayos gamma
17.
Environ Monit Assess ; 185(8): 6447-57, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23307050

RESUMEN

In the last decade, the development of novel analytical methodologies enabled the identification of several environmental pollutants responsible for health problems associated with indoor exposure. Polycyclic aromatic hydrocarbons (PAHs) are among the potential hazardous chemicals present in ambient air. Due to their bioaccumulation potential and carcinogenic/mutagenic effects, 16 PAHs are currently listed as priority air pollutants. The main goal of this work was to implement a new and simple method for sampling and determination of PAHs in air by using a thermal desorption (TD) technique followed by gas chromatography coupled with mass spectrometry analysis. A detailed study was carried out to optimise the experimental method in each of its phases, including (active) sampling, TD and chromatographic analysis. The results demonstrate that this approach allowed the detection and quantification of the six more volatile PAHs, namely, naphthalene, acenaphthylene, acenaphthene, fluorene, phenanthrene, and anthracene. Acceptable precision and good linearity over the explored range were obtained. No carry-over was observed during experimental tests and the method provided a reproducible answer. The applicability of the novel methodology was tested in real environment, namely, on the roof of a building in an urban area, in a domestic kitchen and in a collective car garage. The method enabled the identification of two PAHs in the field samples, specifically, naphthalene (two rings) and phenanthrene (three rings). With regard to PAHs sample composition, the most abundant PAH found, in the three different locations, was naphthalene, accounting for about 84-100 % of the total PAH mass detected.


Asunto(s)
Contaminantes Atmosféricos/análisis , Monitoreo del Ambiente/métodos , Hidrocarburos Policíclicos Aromáticos/análisis , Cromatografía de Gases y Espectrometría de Masas
18.
Food Chem ; 135(2): 596-602, 2012 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-22868134

RESUMEN

In the present work, methanolic, ethanolic and boiled water extracts of Suillus collinitus were chemically characterised and submitted to an evaluation of their bioactive properties (antioxidant potential and cytotoxic activity in tumor cell lines). Phenolic acids and sugars were identified chromatographically and quantified in the methanolic and boiled water extracts, respectively. S. collinitus ethanolic extract had the highest antioxidant activity. Nevertheless, with respect to cell growth inhibition, the methanolic extract was the most potent extract, particularly in MCF-7 cells (GI(50) 25.2±0.2 µg/ml). Moreover, the GI(50) concentration of this extract induced a G1 cell cycle arrest, with a concomitant decrease in the percentage of cells in the S phase. Furthermore, it caused an increase in the percentage of apoptotic cells, from 6.0±0.2% in untreated cells, to 15.3±2.0% in cells treated with the GI(50) concentration and to 16.3±2.0% in cells treated with 2×GI(50) concentration. In addition, 48 h treatment with the GI(50) concentration caused a strong increase in the levels of p53, p21, and cleaved PARP, together with a decrease in Bcl-2 and XIAP. Results indicate that S. collinitus may be a promising source of bioactive compounds. Particularly, its methanolic extract appears to have a p53-mediated effect on the normal cell cycle distribution and apoptosis induction in a human breast tumor cell line.


Asunto(s)
Apoptosis/efectos de los fármacos , Basidiomycota/química , Factores Biológicos/farmacología , Neoplasias de la Mama/genética , Neoplasias de la Mama/fisiopatología , Proteína p53 Supresora de Tumor/genética , Regulación hacia Arriba/efectos de los fármacos , Factores Biológicos/aislamiento & purificación , Neoplasias de la Mama/metabolismo , Puntos de Control del Ciclo Celular/efectos de los fármacos , Femenino , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Humanos , Hidroxibenzoatos/aislamiento & purificación , Hidroxibenzoatos/farmacología , Células MCF-7 , Proteína p53 Supresora de Tumor/metabolismo
19.
J Agric Food Chem ; 60(18): 4634-40, 2012 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-22515547

RESUMEN

Mushrooms do not constitute a significant portion of the human diet, but their consumption continues to increase due to their functional benefits and presence of bioactive compounds. Some of those compounds can be found in the phenolic, polysaccharidic, and lipidic fractions of edible and inedible species. Herein, those fractions of five wild mushrooms (Coprinopsis atramentaria, Lactarius bertillonii, Lactarius vellereus, Rhodotus palmatus, and Xerocomus chrysenteron) from northeastern Portugal were studied for their chemical composition and antioxidant properties. Protocatechuic, p-hydroxybenzoic, p-coumaric, and cinnamic acids were found in the phenolic fraction; rhamnose, xylose, fucose, arabinose, fructose, glucose, manose, mannitol, sucrose, maltose, and trehalose were quantified in polysaccharidic fraction; and linoleic and stearic (only in Lactarius sp.) acids, and ß- and γ-tocopherols were the main compounds in the lipidic fraction. C. atramentaria and X. chrysenteron phenolic fractions gave the highest free radical scavenging activity, reducing properties, and lipid peroxidation inhibition in brain homogenates, which is in agreement with its highest content in total phenolics. Furthermore, among the polysaccharidic fractions C. atramentaria also gave the highest antioxidant activity, which is in agreement with its highest total polysaccharides content and sugars obtained after hydrolysis.


Asunto(s)
Antioxidantes/farmacología , Basidiomycota/química , Productos Biológicos/farmacología , Descubrimiento de Drogas , Lípidos/farmacología , Fenoles/farmacología , Polisacáridos/farmacología , Agaricales/química , Antineoplásicos/análisis , Antineoplásicos/química , Antineoplásicos/farmacología , Antioxidantes/análisis , Antioxidantes/química , Productos Biológicos/química , Cinamatos/análisis , Cinamatos/farmacología , Peroxidación de Lípido/efectos de los fármacos , Lípidos/análisis , Fenoles/análisis , Polisacáridos/análisis , Portugal
20.
Food Chem Toxicol ; 50(5): 1201-7, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22369965

RESUMEN

The present study reports a comparison of the antioxidant properties and phenolic profile of the most consumed species as fresh cultivated mushrooms and their mycelia produced in vitro: Agaricus bisporus (white and brown), Pleurotus ostreatus (oyster), Pleurotus eryngii (king oyster) and Lentinula edodes (shiitake). The antioxidant activity was evaluated through reducing power (Folin-Ciocalteu and Ferricyanide/Prussian blue assays), free radical scavenging activity (DPPH assay) and lipid peroxidation inhibition (ß-carotene/linoleate and TBARS assays). The analysis of phenolic compounds was performed by HPLC/PAD. The mushroom species with the highest antioxidant potential was Agaricus bispous (brown). However, concerning to the species obtained in vitro, it was L. edodes that demonstrate the highest reducing power. Generally, in vivo samples revealed higher antioxidant properties than their mycelia obtained by in vitro techniques. About the phenolic compounds researched, they were detected both in mushrooms and mycelia without any particular abundance. Results showed that there is no correlation between the studied commercial mushrooms and the corresponding mycelia obtained in vitro. Nevertheless, this study contributes to the rise of data relatively to the species consumed as fresh mushrooms and the possibility of their in vitro production as a source of bioactive compounds.


Asunto(s)
Agaricales , Antioxidantes/farmacología , Fenoles/farmacología , Cromatografía Líquida de Alta Presión , Técnicas In Vitro , Peroxidación de Lípido , Estándares de Referencia , Sustancias Reactivas al Ácido Tiobarbitúrico/metabolismo
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