Fluconazole induces genotoxicity in cultured human peripheral blood mononuclear cells via immunomodulation of TNF-α, IL-6, and IL-10: new challenges for safe therapeutic regimens.

Context: Fluconazole (FNZ) is a drug used in antifungal therapy. However, the minimum FNZ dose to interfering with immune responses or inducing DNA damage is still unknown. Objective: This study investigated the toxicological profile of FNZ on cultured human peripheral blood mononuclear cells (PBMCs) treated with different concentrations of this azole. Materials and methods: Cultured PBMCs were exposed to FNZ (6, 12, 30, 60 and 120 µg/mL) and the toxicological profile was assessed by the following parameters: cytotoxic and nuclear division index (necrotic, apoptotic and viable cells), DNA damage (alkaline comet test), mutagenic potential (micronucleus test), cytokine modulation (IL-1, IL-6, IL-10, TNF-α, IFN-γ), and predictive toxicity (Osiris® and LAZAR® programs). Results: Our results demonstrated that FNZ induced cellular DNA damage and mutagenicity at concentrations above the plasma peak (>30 µg/mL) and 6 µg/mL, respectively, which was associated with increased TNF-α, and decrease IL-6 and IL-10 concentrations. These effects may be related to increased apoptosis and cytotoxic nuclear division index in the cultured PBMCs. In silico results indicated potential mutagenic, tumorigenic, irritant, and carcinogenic effects, which were partially confirmed by the above assays. Discussion and conclusions: Together, these findings suggest the need to rationalize the use of FNZ, especially if it is used for long periods or with concomitant pathologies requiring azole therapy that may increase FNZ's plasma concentration.

Feeding preference of the shredder Phylloicus sp. for plant leaves of Chrysophyllum oliviforme or Miconia chartacea after conditioning in streams from different biomes / Preferência alimentar do fragmentador Phylloicus sp. por folhas de Chrysophyllum oliviforme e Miconia chartacea após condicionadas em riachos de dois biomas

Abstract Macroinvertebrate shredders consume preferably leaves conditioned by fungi and bacteria which offer greater palatability to them. Plant species in Cerrado present high concentration of chemical elements such as lignin and cellulose, phenols and tanins thus making them less attractive for shredders consumption and limiting the palatability. This study aimed to evaluate the feeding preference of a macroinvertebrate shredder of the genus Phylloicus for plant material from two different biomes (Cerrado and Mata Atlântica), after conditioning in a stream of Mata Atlântica and observing their physical and chemical characteristics. Senescent leaves were collected, monthly from the litterfall of riparian vegetation in a 500 m stretch of a stream in each biome from August 2014 to January 201. The most abundant species in each stream was selected for the experiment. The experimental design consisted in with two treatments. The first (T1) comprised leaf discs from Chrysophyllum oliviforme (Cerrado species) together with leaf discs of Miconia chartacea (Atlantic Forest species) which were conditioned in the Atlantic Forest stream. The second treatment (T2) involved leaf discs of Miconia chartacea conditioned in Mata Altlântica and Cerrado streams. Both tests had showed significant differences between the two treatments (T1 and T2). For T1, there was consumption of M. chartacea leaf discs by Phylloicus sp., but there was no consumption of C. oliviforme discs. For T2, there was preference for M. chartaceae leaves conditioned in a stream of Mata Atlântica than in Cerrado stream. The results showed that Phylloicus sp., had presented preference for food detritus of the Mata Antlântica biome and rejection to the one from Cerrado biome.

Resumo Macroinvertebrados fragmentadores consomem folhas preferencialmente condicionadas por fungos e bactérias que lhes oferece uma maior palatabilidade. Nas espécies do cerrado esse condicionamento está também associado às altas concentrações de elementos químicos limitantes à palatabilidade como alto teor de lignina e celulose, que tornam as folhas menos atrativas para os fragmentadores. O trabalho teve como objetivo avaliar a preferência alimentar de macroinvertebrados fragmentador ( Phylloicus sp.) por material vegetal de dois diferentes biomas (Cerrado e Mata Atlântica), após condicionamento em riacho de Mata Atlântica, observando suas características físicas e químicas. Foram coletadas folhas senescentes do aporte vegetal (AV) de espécies nativas da vegetação ripária nesses dois biomas, com periodicidade mensal em um trecho de 500 m de um córrego em cada bioma. O experimento foi delineado com dois tratamentos. O primeiro (T1) compreendeu discos de folhas do Cerrado (Chrysophyllum oliviforme) mais discos de folhas da Mata Atlântica (Miconia chartacea) que foram condicionadas em córrego de Mata Atlântica. O segundo tratamento (T2) envolveu discos de folhas da Mata Atlântica condicionadas em córrego da Mata Atlântica mais discos de folhas da Mata Atlântica condicionadas em córrego do Cerrado. Os dois testes apontaram diferenças significativas entre os dois tratamentos (T1 e T2). Para T1 houve consumo de discos de folha de M. chartacea por Phylloicus sp, mas não houve consumo dos discos de C. oliviforme , de Cerrado. Para T2, houve o consumo, porém a preferência pelas folhas de M. chartaceae condicionadas no córrego da Mata Atlantica foi consideravelmete maior. Os resultados apontam que Phylloicus sp, apresentou preferência alimentar pelo detrito de bioma de Mata Atlântica e rejeição pelo detrito do bioma Cerrado.

Composition of the essential oil of Buddleja thyrsoides Lam. leaves from Brazil.

This study is designed to examine the chemical composition of the essential oil obtained from Buddleja thyrsoides Lam leaves from south Brazil. Gas chromatography/mass spectrometry analysis resulted in the detection of 12 components, representing 91.4% of the total oil composition. Germacrene D (27.16%), 1,10-di-epi-Cubenol (13.37%), α-Cadinol (12.95%), Bicyclogermacrene (9.00%), Globulol (8.59%) and caryophylene E (5.26%) were the main components. To the best of our knowledge, this is the first study of the composition of essential oil of the B. thyrsoides collected in Brazil.

Qualidade microbiologica da carne de frango irradiada em embalagem convencional e a vácuo / Microbiological evaluation of chicken breast meat irradiated in conventional and vacuum package

Foram avaliados os efeitos da radiação gama nas doses de 1,5 e 3,0kGy, em peitos de frango embalados em embalagem convencional e a vácuo. As amostras embaladas foram submetidas à irradiação e estocadas sob refrigeração (4ºC) por 30 dias. A radiação mostrou-se eficiente na redução de mesófilos aeróbios estritos e facultativos viáveis, coliformes totais e termotolerantes, com destaque para Salmonella spp. Os bolores e leveduras mostraram-se bastante resistentes à radiação. Os resultados sugerem que a dose de 3,0kGy pode ser utilizada no controle da microbiota do peito de frango armazenado sob refrigeração, sendo uma alternativa para o aumento da vida de prateleira por até 10 dias, ao garantir a segurança do consumidor pela eliminação de possíveis patógenos.

The effects of gamma radiation doses of 1.5 and 3.0kGy on chicken breasts packed under conventional or vacuum atmosphere were evaluated. The packed samples were subjected to irradiation and stored under refrigeration (4ºC) for 30 days. The radiation was efficient in reducing strict and facultative aerobic mesophiles, total and fecal coliforms, and mainly Salmonella spp. The molds and yeasts were very resistant to radiation. The results suggest that gamma radiation at 3.0kGy can be used to control the microbiota in chicken breast stored under refrigeration, as an alternative to extend the shelf-life for more than ten days and ensure the food safety by eliminating potential pathogens.

Melhor escore de avaliação para hepatocarcinoma

O hepatocarcinoma é uma das complicações mais freqüente e temida da cirrose hepática, independentemente da etiologia. O tratamento requer escolha cuidadosa, uma vez que a função hepática na cirrose encontra-se prejudicada. É o 4º câncer mais prevalente no mundo e possui alta morbidade e mortalidade

Multicentric pheochromocytoma and involvement of the inferior vena cava.

CONTEXT: Extension of pheochromocytomas to the inferior vena cava is rare. Multicentric tumors are rare as well, being present in up to 10% of cases. Surgery is the treatment of choice because of the long-term survival free of disease. DESIGN: Case report. CASE REPORT: We report on a case of right adrenal pheochromocytoma with extension to the supra-diaphragmatic vena cava, which underwent surgical excision through thoracophrenic laparotomy without the need for cardiopulmonary bypass. In a 6-year follow-up, another pheochromocytoma was found in the infra-renal Zuckerkandl's organ. Complete surgical excision of the tumor was performed by a median laparotomy and complete retroperitoneal dissection. In both cases, the total removal of the pheochromocytoma has been guaranteed by having margins free of tumor and a normal post-operative level of catecholamines. The pathological study revealed a malignant pheochromocytoma with margins free of neoplasia in both specimens.

[Causes and prognosis of acute renal failure in elderly patients]. / Causas e prognóstico da insuficiência renal aguda hospitalar em pacientes idosos.

UNLABELLED: The prolonged life span of populations is the obvious reason for an increasing proportion of elderly patients with acute renal failure (ARF). The role of age as a factor indicative of a poor prognosis is a matter of controversy. OBJECTIVE: To evaluate this role we have analyzed the final outcome of elderly patients with ARF treated in our Nephrology Service. MATERIAL AND METHODS: Among 361 ARF cases prospectively studied during a two-year period (January 1995 to December 1996), 130 (36%) occurred in patients over 70 years of age. Etiology, clinical course and prognosis were analyzed. The average age was 76.0 +/- 4.7 years, varying from 70 to 94 years; 84 patients (65%) were male, and surgical causes accounted for 51% of geriatric ARF. RESULTS: The most frequent causes were: ischemic (volume depletion, arterial hypotension, and/or low cardiac output) in 48 patients (38%), sepsis in 40 (312%), nephrotoxic drugs in 46 (35%) and obstructive abnormalities in 10 (7.7%); in other 14 (11%) they were diagnosed more than a causal agent. Oliguria was present in 37. 2% (81 patients), and dialysis was needed in 50 patients (39%). The mortality in the population with age below 70 years was 43% and in the elderly patients was 53.8%; total mortality was similar in both groups of patients (p=0.085). Oliguria, need for dialysis, presence of surgical causes of ARF, and ARF acquired within the intensive care unit were associated with poor prognosis in elderly group. CONCLUSION: We concluded that the percentile of elderly patients with ARF is elevated; they presented mortality about of 50%, and this is not superior to the observed in the youngest population; oliguria, dialysis need, ICU cares and surgery are factors of unfavorable prognostic in these patients.

Causas e prognóstico da insuficiência renal aguda hospitalar em pacientes idosos / Causes and prognosis of hospital acute renal failure in elderly patients

OBJETIVOS: O objetivo deste estudo foi analisar as causas e o prognóstico de pacientes idosos (>70 anos de idade) com IRA tratados em nosso Serviço. CASUISTICA E MÉTODOS: Dos 361 pacientes adultos e portadores de IRA, atendidos em nosso serviço no período de janeiro/95 a dezembro/96, acompanhamos 130 pacientes (36 por cento) com idade superior a 70 anos (média de 76,0 ± 4,7 anos, variando de 70 a 94 anos). Destes, 84 (65 por cento) eram do sexo masculino e 66 (51 por cento) estavam no pós-operatório de cirurgias diversas. Os dados foram obtidos através de formulários padronizados usados no Serviço. RESULTADOS: As causas mais freqüentes foram: isquêmicas 48 (38 por cento), sepsis 40 (31 por cento), nefrotóxicas 46 (35 por cento) e obstrutivas 10 (7,7 por cento); em outros 14 (11 por cento) foram diagnosticados mais de um agente causal. IRA nao-oligúrica ocorreu em 81 pacientes (62,8 por cento) e em 50 pacientes (39 por cento) houve necessidade de diálise. A mortalidade na populaçao com idade abaixo de 70 anos foi 43 por cento e nos idosos 53,1 por cento, nao havendo diferença estatística entre os grupos (p=0,085). A mortalidade foi maior (p<0,0001) nos pacientes idosos oligúricos (86 por cento) do que nos idosos nao-oligúricos (32 por cento); maior em casos de IRA cirúrgica (66,7 por cento) do que em IRA de origem médica (41,8 por cento), e em pacientes internados em UTI (69 por cento) do que nos internados em enfermaria (17 por cento). O número de óbitos também foi maior (p<0,0001) no grupo que necessitou de diálise (84 por cento) do que nos nao dialisados (33 por cento). CONCLUSAO: Concluímos que o percentual de pacientes idosos com IRA é elevado; apresentaram mortalidade ao redor de 50 por cento, nao superior ao observado na populaçao mais jovem; oligúria, cirurgia, necessidade de tratamento em UTI e necessidade de diálise foram fatores de prognóstico desfavorável nesta casuística

Results of the routine use of a modified endoprosthesis to drain the common bile duct after laparoscopic choledochotomy.

BACKGROUND: One hundred eighty-one patients were submitted to laparoscopic common bile duct exploration. METHODS: A transcystic approach was used in 147 patients, choledochotomy in 14, and both in 20. The indications to perform a choledochotomy included stones larger than 20 mm, stones proximal to the cystic duct entrance, and cases in which the transcystic duct approach proved impossible or unsuccessful. RESULTS: The common bile duct was drained by a T-tube in four patients, by laparoscopic sphincterotomy in one, by laparoscopic choledochoduodenostomy in one, and by a 10 Fr endoprosthesis in 28. The stent placement was technically feasible in all patients but one. The biliary drainage was adequate. Mean hospital stay was 2.1 days. Complication was limited to one umbilical infection and one self-limited biliary leak. CONCLUSIONS: The procedure proved to be technically simple, safe, and efficient, and resulted in a low morbidity rate and short hospital stay.

Laparoscopic antegrade sphincterotomy.

The technique of laparoscopic antegrade sphincterotomy is described. This procedure was used to clear the common bile duct in 22 selected patients with documented choledocholithiasis. Indications for attempting laparoscopic antegrade sphincterotomy included multiple common bile duct stones, one or more common hepatic or intrahepatic stones, a dilated common bile duct requiring a drainage procedure, and suspicion of papillary stenosis. No major complications or mortality was observed. Mild hyperamylasemia was observed in two patients. However, both were asymptomatic, and serum amylase levels rapidly returned to normal. One patient was noted to have a drop in her hematocrit from a preoperative value of 39% to a postoperative value of 33%. Laparoscopic antegrade sphincterotomy added a mean of 17 min to the operative procedure. The mean postoperative stay was 1.4 days. The results of this study suggest that laparoscopic antegrade sphincterotomy may prove to be a useful modality in selected patients with complicated choledocholithiasis.