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1.
BMC Anesthesiol ; 24(1): 62, 2024 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-38341531

RESUMEN

BACKGROUND: The development of endoscopic systems that include bipolar electrocautery has enabled the use of normal saline irrigation in transurethral or transcervical endoscopic surgery. However, excessive saline absorption can cause hyperchloremic metabolic acidosis. CASE PRESENTATION: Patient 1: A 76-year-old man was scheduled for transurethral resection of the prostate with saline irrigation. Approximately 140 min after the surgery, abdominal distension and cervical edema were observed. Abdominal ultrasound examination indicated a subhepatic hypoechoic lesion, which suggested extravasation of saline. Arterial blood gas analysis revealed hyperchloremic metabolic acidosis. The patient was extubated 2 h after the operation with no subsequent airway problems, and the electrolyte imbalance was gradually corrected. Patient 2: A 43-year-old woman was scheduled for transcervical resection of a uterine fibroid with saline irrigation. When the drape was removed after the operation was finished, notable upper extremity edema was observed. Arterial blood gas analysis revealed hyperchloremic metabolic acidosis. The patient's acidemia, electrolyte imbalance, and neck edema gradually resolved, and the patient was extubated 16 h after the operation without subsequent airway problems. CONCLUSIONS: Anesthesiologists should be aware of acidemia, cardiopulmonary complications, and airway obstruction caused by excessive saline absorption after saline irrigation in endoscopic surgery.


Asunto(s)
Acidosis , Resección Transuretral de la Próstata , Masculino , Femenino , Humanos , Adulto , Anciano , Resección Transuretral de la Próstata/efectos adversos , Solución Salina , Acidosis/etiología , Electrólitos , Edema/complicaciones , Irrigación Terapéutica/efectos adversos
2.
Hum Cell ; 37(2): 465-477, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38218753

RESUMEN

Lymphedema, resulting from impaired lymphatic drainage, causes inflammation, fibrosis and tissue damage leading to symptoms such as limb swelling and restricted mobility. Despite various treatments under exploration, no standard effective therapy exists. Here a novel technique using the pyro-drive jet injection (PJI) was used to create artificial clefts between collagen fibers, which facilitated the removal of excess interstitial fluid. The PJI was used to deliver a mixture of lactated Ringer's solution and air into the tail of animals with secondary skin edema. Edema levels were assessed using micro-CT scanning. Histopathological changes and neovascularization were evaluated on the injury-induced regenerative tissue. Regarding tissue remodeling, we focused on connective tissue growth factor (CTGF) and vascular endothelial growth factor (VEGF)-C. PJI markedly diminished soft tissue volume in the experimental lymphedema animals compared to the non-injected counterparts. The PJI groups exhibited a significantly reduced proportion of inflammatory granulation tissue and an enhanced density of lymphatic vessels and α-smooth muscle actin (αSMA)-positive small vessels in the fibrous granulation tissue compared to the controls. In addition, PJI curtailed the prevalence of CTGF- and VEGF-C-positive cells in regenerative tissue. In a lymphedema animal model, PJI notably ameliorated interstitial edema, promoted lymphatic vessel growth, and bolstered αSMA-positive capillaries in fibrous granulation tissue. PJI's minimal tissue impact post-lymph node dissection indicates significant potential as an early, standard preventative measure. Easily applied in general clinics without requiring specialized training, it offers a cost-effective and highly versatile solution to the management of lymphedema.


Asunto(s)
Vasos Linfáticos , Linfedema , Animales , Factor A de Crecimiento Endotelial Vascular/metabolismo , Linfedema/terapia , Linfedema/etiología , Linfedema/patología , Vasos Linfáticos/diagnóstico por imagen , Vasos Linfáticos/patología , Piel/metabolismo , Edema/complicaciones , Edema/metabolismo , Edema/patología
3.
JAMA Intern Med ; 184(1): 70-80, 2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38048090

RESUMEN

Importance: Bothrops venom acts almost immediately at the bite site and causes tissue damage. Objective: To investigate the feasibility and explore the safety and efficacy of low-level laser therapy (LLLT) in reducing the local manifestations of B atrox envenomations. Design, Setting, and Participants: This was a double-blind randomized clinical trial conducted at Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, in Manaus, Brazil. A total of 60 adult participants were included from November 2020 to March 2022, with 30 in each group. Baseline characteristics on admission were similarly distributed between groups. Data analysis was performed from August to December 2022. Intervention: The intervention group received LLLT combined with regular antivenom treatment. The laser used was a gallium arsenide laser with 4 infrared laser emitters and 4 red laser emitters, 4 J/cm2 for 40 seconds at each application point. Main Outcomes and Measures: Feasibility was assessed by eligibility, recruitment, and retention rates; protocol fidelity; and patients' acceptability. The primary efficacy outcome of this study was myolysis estimated by the value of creatine kinase (U/L) on the third day of follow-up. Secondary efficacy outcomes were (1) pain intensity, (2) circumference measurement ratio, (3) extent of edema, (4) difference between the bite site temperature and that of the contralateral limb, (5) need for the use of analgesics, (6) frequency of secondary infections, and (7) necrosis. These outcomes were measured 48 hours after admission. Disability assessment was carried out from 4 to 6 months after patients' discharge. P values for outcomes were adjusted with Bonferroni correction. Results: A total of 60 patients (mean [SD] age, 43.2 [15.3] years; 8 female individuals [13%] and 52 male individuals [87%]) were included. The study was feasible, and patient retention and acceptability were high. Creatine kinase was significantly lower in the LLLT group (mean [SD], 163.7 [160.0] U/L) 48 hours after admission in relation to the comparator (412.4 [441.3] U/L) (P = .03). Mean (SD) pain intensity (2.9 [2.7] vs 5.0 [2.4]; P = .004), circumference measurement ratio (6.6% [6.6%] vs 17.1% [11.6%]; P < .001), and edema extent (25.8 [15.0] vs 40.1 [22.7] cm; P = .002) were significantly lower in the LLLT group in relation to the comparator. No difference was observed between the groups regarding the mean difference between the bite site temperature and the contralateral limb. Secondary infections, necrosis, disability outcomes, and the frequency of need for analgesics were similar in both groups. No adverse event was observed. Conclusions and Relevance: The data from this randomized clinical trial suggest that the use of LLLT was feasible and safe in a hospital setting and effective in reducing muscle damage and the local inflammatory process caused by B atrox envenomations. Trial Registration: Brazilian Registry of Clinical Trials Identifier: RBR-4qw4vf.


Asunto(s)
Coinfección , Terapia por Luz de Baja Intensidad , Mordeduras de Serpientes , Adulto , Animales , Femenino , Humanos , Masculino , Analgésicos , Bothrops atrox , Creatina Quinasa , Edema/complicaciones , Necrosis/complicaciones , Mordeduras de Serpientes/terapia , Mordeduras de Serpientes/complicaciones , Resultado del Tratamiento , Persona de Mediana Edad
4.
Phys Ther ; 101(9)2021 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-34003282

RESUMEN

OBJECTIVE: The aim of this case report was to describe the use of complete decongestive therapy (CDT) with a new approach in the management of a male with facial edema related to Morbus Morbihan Syndrome (MMS). METHODS: An 18-year-old male with MMS after acne treatment was the subject of this case report. Volume assessment was performed with distance measurements of the facial area using standard reference points, the overflow method, and the measurement of the percentage of subdermal fluid. Participant-reported symptoms of lymphedema (feeling of swelling and tightness) and body image perception were evaluated with the visual analogue scale, and the severity of anxiety was evaluated with the State and Trait Anxiety Inventory. In addition, the participant's perception of improvement was determined using a Likert-type scale. Evaluations were performed at baseline, week 4 (during the treatment), and week 8 (immediately after treatment). CDT was applied to the participant in a total of 24 sessions, 3 d/wk for 8 weeks. RESULTS: Compared with the baseline measurement, the facial distances (tragus-mental cavity, tragus-mouth corner, mandibula-nasal canal, mandibula-internal orbita, mandibula-external orbita, mental cavity-internal orbita, mental cavity-mandibula, right-left tragus, and hairline in the forehead-mental cavity), the volume, and the percentage of subdermal fluid of facial area were decreased at the week 4 and 8 measurements. The anxiety score, participant reports of feelings of swelling and tightness, and body image perception improved after the 8 weeks of treatment compared with baseline. CONCLUSION: This case report described the use of CDT in treating edema and participant symptoms in an individual with facial lymphedema related to MMS. Body image and level of anxiety improved.


Asunto(s)
Edema/terapia , Dermatosis Facial/terapia , Linfedema/terapia , Drenaje Linfático Manual/métodos , Rosácea/terapia , Adolescente , Drenaje/métodos , Edema/complicaciones , Dermatosis Facial/etiología , Humanos , Linfedema/complicaciones , Masculino , Rosácea/complicaciones , Resultado del Tratamiento
5.
Clin Nutr ; 40(2): 624-631, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-32698958

RESUMEN

BACKGROUND & AIMS: Change in hydration is common in children with severe acute malnutrition (SAM) including during treatment, but is difficult to assess. We investigated the utility of bio-electrical impedance vector analysis (BIVA), a quick non-invasive method, for indexing hydration during treatment. METHODS: We studied 350 children 0·5-14 years of age with SAM (mid-upper arm circumference <11·0 cm or weight-for-height <70% of median, and/or nutritional oedema) admitted to a hospital nutrition unit, but excluded medically unstable patients. Weight, height (H), resistance (R), reactance (Xc) and phase angle (PA) were measured and oedema assessed. Similar data were collected from 120 healthy infants and preschool/school children for comparison. Means of height-adjusted vectors (R/H, Xc/H) from SAM children were interpreted using tolerance and confidence ellipses of corresponding parameters from the healthy children. RESULTS: SAM children with oedema were less wasted than those without (p < 0·001), but had BIVA parameters that differed more from those of healthy children (P < 0·05) than those non-oedematous. Initially, both oedematous and non-oedematous SAM children had mean vectors outside the reference 95% tolerance ellipse. During treatment, mean vectors migrated differently in the two SAM groups, indicating fluid loss in oedematous patients, and tissue accretion in non-oedematous patients. At admission, R/H was lower (oedematous) or higher (non-oedematous) among children who died than those who exited the hospital alive. CONCLUSIONS: BIVA can be used in children with SAM to distinguish tissue-vs. hydration-related weight changes during treatment, and also identify children at high risk of death enabling early clinical interventions.


Asunto(s)
Antropometría/métodos , Impedancia Eléctrica , Evaluación Nutricional , Terapia Nutricional , Desnutrición Aguda Severa/fisiopatología , Adolescente , Estatura , Peso Corporal , Niño , Preescolar , Edema/complicaciones , Edema/fisiopatología , Femenino , Humanos , Lactante , Masculino , Estado Nutricional , Estado de Hidratación del Organismo , Desnutrición Aguda Severa/mortalidad , Desnutrición Aguda Severa/terapia
6.
Phytother Res ; 34(10): 2577-2585, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32314844

RESUMEN

AIM: Chronic venous insufficiency (CVI) is common in adults. Some complications include skin changes, edema, heavy legs, muscle cramps, pain, and varicose veins. In traditional medicine, red vine leaf extract (AS 195) has been used to cure the symptoms of CVI. This systematic review was aimed to assess the effects of AS 195 in patients with CVI. MATERIAL AND METHODS: A systematic literature search was performed to identify trials that reported the impact of red vine leaf extract on CVI. The primary outcomes investigated were Leg (limb) volume, calf circumference, ankle circumference, tired and heavy legs, a sensation of tension, tingling sensation, and pain. RESULTS: From the 56 studies, 5 trials were selected according to our inclusion criteria. Red vine leaf extract significantly improved numbers of outcomes (lower leg volume, calf and ankle circumference, tired, heavy legs, tingling sensation, pain, the sensation of tension in the legs, cutaneous microcirculation, and transcutaneous oxygen pressure) in only some trials. The tolerability for red vine leaf extract was reported good or satisfactory. CONCLUSIONS: Red vine leaf extract had a beneficial therapeutic role in patients with CVI. Further high-quality trials are required to be carried out to provide strong evidence.


Asunto(s)
Extractos Vegetales/uso terapéutico , Insuficiencia Venosa/tratamiento farmacológico , Adulto , Enfermedad Crónica , Ensayos Clínicos como Asunto/estadística & datos numéricos , Edema/complicaciones , Edema/tratamiento farmacológico , Femenino , Humanos , Masculino , Dolor/tratamiento farmacológico , Dolor/etiología , Hojas de la Planta/química , Várices/tratamiento farmacológico , Várices/etiología , Insuficiencia Venosa/complicaciones
7.
J Crit Care ; 57: 13-18, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32006896

RESUMEN

PURPOSE: Paroxysmal Permeability Disorders (PPDs) comprise a variety of diseases characterized by recurrent and transitory increase of endothelial permeability. Idiopathic Systemic Capillary Leak Syndrome (ISCLS) is a rare PPD that leads to an abrupt massive shift of fluids and proteins from the intravascular to the interstitial compartment. In some cases, tissue edema may involve the myocardium, but its role in the development of shock has not been elucidated so far. MATERIALS AND METHODS: Assessment of cardiac involvement during ten life-threatening ISCLS episodes admitted to ICU. RESULTS: Transthoracic echocardiographic examination was performed in eight episodes, whereas a poor acoustic window prevented cardiac ultrasound assessment in two episodes. Myocardial edema was detected by echocardiography in eight episodes and marked pericardial effusion in one-episode. Cardiac magnetic resonance showed diffuse myocardial edema in another episode. In one case, myocardial edema caused fulminant left ventricular dysfunction, which required extracorporeal life support. The mean septum thickness was higher during the shock phase compared to the recovery phase [15.5 mm (13.1-21 mm) vs. 9.9 mm (9-11.3 mm), p = .0003]. Myocardial edema resolved within 72 h. CONCLUSIONS: During early phases of ISCLS, myocardial edema commonly occurs and can induce transient myocardial dysfunction, potentially contributing to the pathogenesis of shock.


Asunto(s)
Síndrome de Fuga Capilar/complicaciones , Edema/complicaciones , Choque/complicaciones , Acústica , Adulto , Síndrome de Fuga Capilar/diagnóstico por imagen , Cardiomiopatías/complicaciones , Cardiomiopatías/diagnóstico por imagen , Comorbilidad , Edema/diagnóstico por imagen , Oxigenación por Membrana Extracorpórea/efectos adversos , Corazón/fisiopatología , Hemodinámica , Humanos , Inflamación , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Permeabilidad , Choque/diagnóstico por imagen , Ultrasonografía , Disfunción Ventricular Izquierda/fisiopatología , Tabique Interventricular/fisiopatología
8.
Lasers Med Sci ; 35(6): 1277-1287, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31729609

RESUMEN

Rheumatoid arthritis denotes hyperplasia and intense inflammatory process. Treatment involves exercise protocols and use of resources such as low-level laser therapy (LLLT) to modulate the inflammatory process and maintain physical capacity. The objective was to investigate whether treatment with LLLT and exercise modulates the inflammatory process and peripheral functionality. Sample is composed of 128 male rats, separated into three groups, control, treated and untreated, in the acute and chronic period of the disease with 64 animals in each group, divided into 8 subgroups with n = 8. The animals were immunized with injection at the base of the tail and 7 days after intra-articular injection with complete Freund adjuvant (CFA) for lesion groups, and saline solution for the controls. Joint disability was evaluated by PET (paw elevation time) and joint edema and treated with LLLT and/or resisted stair climbing exercise. Normality Shapiro-Wilk test, ANOVA mixed for the functional analyses, and ANOVA one-way for the variables of cellular differentiation, with Bonferroni post hoc, p = 5% were used. For the evaluations of joint disability and nociception, there was a significant difference between the evaluations, the groups, and the interaction groups-evaluations. The treated groups showed recovery of functionality; it is still verified that laser therapy increased the nociceptive threshold of the chronic inflammatory period, and the exercise reflected in significant functional improvement and modulation of the inflammatory process both in the acute and chronic periods. LLLT, resistance exercise, or a combination of treatments had a positive effect on the modulation of the inflammatory process, reducing the migration of leukocytes, in addition to helping the return of peripheral functionality by reducing joint disability in a model of rheumatoid arthritis induced by CFA in rats.


Asunto(s)
Artritis Reumatoide/patología , Artritis Reumatoide/radioterapia , Movimiento Celular , Leucocitos/citología , Terapia por Luz de Baja Intensidad , Condicionamiento Físico Animal , Animales , Artritis Reumatoide/complicaciones , Artritis Reumatoide/diagnóstico por imagen , Edema/complicaciones , Inflamación/patología , Terapia por Luz de Baja Intensidad/métodos , Masculino , Nocicepción , Tomografía de Emisión de Positrones , Ratas Wistar , Líquido Sinovial/metabolismo
10.
Biomed Pharmacother ; 108: 309-315, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30227323

RESUMEN

Smilax glabra Roxb. (Tufuling) and Bolbostemma paniculatum (Maxim.) Franquet (Tubeimu) are used as couplet medicine in traditional Chinese medicine for the treatment of arthritis. This study is conducted to provide evidence on their therapeutic effects on rheumatoid arthritis (RA) and to explore its possible mechanisms of action. The identification and quantification of representative components (Astilbin and Tubeimoside I) in the n-butyl alcohol fraction of this couplet medicine (BFCM) were carried out by HPLC-UV assays. The contents of Astilbin and Tubeimoside I in BFCM were 13.13% (15.434 min) and 3.4% (18.619 min) respectively. For the assessment of anti-RA and anti-inflammatory activities, a carrageenan-induced paw edema model in rats was used. The swelling rates of paws and levels of IL-1ß, IL-6 and TNF-α in the swelling tissue were determined. We observed that the BFCM exhibited significant inhibitory activity on carrageenan-induced paw edema model (p<0.01). The down regulated levels of IL-1ß, IL-6 and TNF-α (all p<0.05) were reported. The results indicate that BFCM possesses significant anti-RA and anti-inflammatory effects, and it has a potential to be developed as a new therapeutic agent against RA.


Asunto(s)
Artritis Reumatoide/tratamiento farmacológico , Cucurbitaceae/química , Edema/tratamiento farmacológico , Extractos Vegetales/uso terapéutico , Smilax/química , Animales , Artritis Reumatoide/sangre , Artritis Reumatoide/complicaciones , Artritis Reumatoide/patología , Peso Corporal , Carragenina , Citocinas/metabolismo , Modelos Animales de Enfermedad , Edema/sangre , Edema/complicaciones , Edema/patología , Mediadores de Inflamación/metabolismo , Riñón/efectos de los fármacos , Riñón/patología , Riñón/fisiopatología , Hígado/efectos de los fármacos , Hígado/patología , Hígado/fisiopatología , Masculino , Modelos Biológicos , Especificidad de Órganos , Extractos Vegetales/química , Extractos Vegetales/farmacología , Ratas Sprague-Dawley
11.
Biomed Pharmacother ; 97: 1710-1721, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29793335

RESUMEN

Ziziphora clinopodioides has been used in traditional medicine for its anti-inflammatory properties. Current study is believed to first time report the potential of Z. clinopodioides extracts to ameliorate joint inflammation using model of chronic joint inflammation (FCA-induced rheumatoid arthritis). The study further investigates the effects on joint inflammation using acute inflammatory paw edema models. The anti-inflammatory effects were also supported by using xylene-induced ear edema model. Results showed that Z. clinopodioides significantly ameliorated rheumatoid arthritis as indicated by the inhibition of arthritic development and paw edema. Histopathological examination showed significant attenuation in pannus formation, bone erosion, and joint inflammation. Treatment with the plant extracts also nearly normalized counts of RBCs, platelets, and total leukocytes along with hemoglobin (Hb) content. Biochemical analysis (AST, ALT, urea, and creatinine) showed that plant extracts did not possess hepatotoxic or nephrotoxic effects. Water displacement plethysmometric analysis showed that Z. clinopodioides significantly attenuated carrageenan-induced paw edema. To evaluate the mechanism, anti-inflammatory effects were further evaluated using histamine- and serotonin-induced inflammatory paw edema models. Z. clinopodioides significantly suppressed paw edema induced by both histamine and serotonin, and also caused the inhibition of xylene-induced ear edema. This suggested the inhibition of autacoids as one of the mechanisms of anti-inflammatory effects of plant. GC-MS analysis showed that the plant is rich in essential oils, including terpenoids, esters, alcohols, furans, cyclic ketones, epoxides, oxanes, and acyclic hydrocarbons. In conclusion, current study demonstrated that Z. clinopodioides possessed significant anti-arthritic and anti-inflammatory properties which might be attributed to the inhibition of autacoids.


Asunto(s)
Artritis Reumatoide/tratamiento farmacológico , Edema/tratamiento farmacológico , Inflamación/tratamiento farmacológico , Lamiaceae/química , Extractos Vegetales/uso terapéutico , Enfermedad Aguda , Animales , Artritis Experimental/sangre , Artritis Experimental/complicaciones , Artritis Experimental/tratamiento farmacológico , Artritis Experimental/patología , Artritis Reumatoide/sangre , Artritis Reumatoide/complicaciones , Artritis Reumatoide/patología , Carragenina , Enfermedad Crónica , Edema/sangre , Edema/complicaciones , Edema/patología , Femenino , Hemoglobinas/metabolismo , Histamina , Inflamación/sangre , Inflamación/complicaciones , Inflamación/patología , Masculino , Ratones Endogámicos BALB C , Fitoquímicos/análisis , Extractos Vegetales/farmacología , Ratas Sprague-Dawley , Xilenos
12.
Mol Neurobiol ; 55(7): 5580-5593, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28980210

RESUMEN

Although photobiomodulation therapy (PBM) has been applied clinically for the treatment of pain and inflammation, wound healing, sports and soft tissue injuries, as well as to repair injured spinal cords and peripheral nerves, it remains unclear which molecular substrates (receptor) are implicated in the cellular mechanisms of PBM. Here, we reported that PBM (660 nm, 30 mW, 0.06 cm2, 50 J/cm2, plantar irradiation) significantly inhibited carrageenan-induced paw oedema, but not noxious thermal response, through positive modulation to both CB1 and CB2 cannabinoid receptors. The use of CB1 antagonist AM281 or CB2 antagonist AM630 significantly reversed the anti-inflammatory effect of PBM. Analysis of signalling pathway downstream of cannabinoid receptors activation reveals that anti-inflammatory effects of PBM depend, in great extent, on its ability to activate ATP-dependent K+ channels and p38 mitogen-activated protein kinase. Moreover, PBM therapy significantly reduced the levels of pro-inflammatory cytokine IL-6 in both paw and spinal cord, and restored the reduction of the level of anti-inflammatory cytokine IL-10 in spinal cord after carrageenan injection. Unlike the potent cannabinoid receptor agonist (WIN 55212-2), PBM did not exert any CNS-mediated effects in the tetrad assay. Finally, PBM does not reduce inflammation and noxious thermal response induced by LPS and zymosan, a TLR4 and TLR2/dectin-1 ligand, respectively. Thus, cannabinoid receptors and, possibly, the endocannabinoid system, represent an important site of action of PBM that opens the possibility of complementary and nonpsychotropic therapeutic interventions in clinical practice. Graphical Abstract ᅟ.


Asunto(s)
Inflamación/radioterapia , Canales KATP/metabolismo , Terapia por Luz de Baja Intensidad , Sistema de Señalización de MAP Quinasas , Receptor Cannabinoide CB1/metabolismo , Receptor Cannabinoide CB2/metabolismo , Proteínas Quinasas p38 Activadas por Mitógenos/metabolismo , Animales , Carragenina , Citocinas/metabolismo , Edema/complicaciones , Edema/patología , Edema/radioterapia , Hiperalgesia/complicaciones , Hiperalgesia/patología , Inmunomodulación , Inflamación/complicaciones , Inflamación/patología , Lectinas Tipo C/metabolismo , Masculino , Ratones , Modelos Biológicos , Médula Espinal/patología , Receptores Toll-Like/metabolismo
13.
Ugeskr Laeger ; 179(41)2017 Oct 09.
Artículo en Danés | MEDLINE | ID: mdl-28992840

RESUMEN

Erysipelas is a common skin infection involving the lymphatic vessels, which induces an oedema. This has a tendency of persisting after infection is treated. The lymphatic system plays an important role in the immune system, and the impaired lymph drainage leads to a state of local immune deficiency. This is essential to the pathogenesis of recurrent erysipelas, as each episode of erysipelas further damages the lymphatic system and increases the risk of a new infection. This vicious circle makes it important to treat both erysipelas and oedema appropriately to reduce recurrence and morbidity.


Asunto(s)
Vendajes de Compresión , Edema/terapia , Erisipela/terapia , Índice Tobillo Braquial , Antibacterianos , Diagnóstico Diferencial , Edema/complicaciones , Edema/microbiología , Erisipela/complicaciones , Erisipela/diagnóstico , Erisipela/tratamiento farmacológico , Humanos , Recurrencia , Factores de Riesgo
14.
BMC Musculoskelet Disord ; 18(1): 396, 2017 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-28899386

RESUMEN

BACKGROUND: At present, there are no registered products for the treatment of subchondral Bone Marrow Edema Lesion (BML) and associated knee pain. Patients who do not respond to current anti-inflammatory therapies are left with limited treatment options, and may resort to operative management with Total Knee Arthroplasty (TKA). We report the use of Pentosan Polysulphate Sodium (PPS) for the treatment of BMLs of the knee. CASE PRESENTATION: We report the case of a 70-year-old female with knee osteoarthritis presenting with a high level of knee pain, scoring 8 on the Numerical Rating Scale (NRS), and functional limitation demonstrating a poor Lysholm Knee Score of 37. MRI scans of the knee revealed subchondral BML in the medial femoral condyle and medial tibial plateau. The patient was administered a course of Pentosan Polysulphate Sodium (PPS) intramuscularly twice weekly, for 3 weeks. MRI scans 2 weeks post-treatment showed complete resolution of the bone marrow edema at the medial femoral condyle and medial tibial plateau with concomitant recovery from pain (NRS pain score of 0), and a 43% improvement of the Lysholm Knee Score. In addition, marked reduction in joint effusion was also demonstrated in the MRI scan post PPS therapy. CONCLUSION: The MRI interpretations demonstrate improved clinical outcome measures ensuing therapeutic intervention with PPS, and warranting further investigation into the efficacy of PPS in the treatment of BML associated pain and dysfunction in the osteoarthritic population via randomized controlled trial, or equivalent rigorous methodological technique.


Asunto(s)
Anticoagulantes/administración & dosificación , Artralgia/tratamiento farmacológico , Enfermedades de la Médula Ósea/tratamiento farmacológico , Edema/tratamiento farmacológico , Osteoartritis de la Rodilla/tratamiento farmacológico , Poliéster Pentosan Sulfúrico/administración & dosificación , Anciano , Artralgia/complicaciones , Artralgia/diagnóstico por imagen , Enfermedades de la Médula Ósea/complicaciones , Enfermedades de la Médula Ósea/diagnóstico por imagen , Edema/complicaciones , Edema/diagnóstico por imagen , Femenino , Humanos , Inyecciones Intramusculares , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/efectos de los fármacos , Osteoartritis de la Rodilla/complicaciones , Osteoartritis de la Rodilla/diagnóstico por imagen , Resultado del Tratamiento
15.
Biomed Pharmacother ; 95: 837-846, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28903179

RESUMEN

Hydrocotyle umbellata Linn. (Araliaceae) is specie used in the treatment of inflammatory diseases. Crude extract (E-HU) was prepared from H. umbellata subterraneous parts and fractionated by liquid-liquid partition, resulting hexane fraction (HF-HU), dichloromethane fraction (DF-HU), ethyl acetate fraction (EAF-HU) and aqueous fraction (AF-HU). The hibalactone (HU-1) was isolated from the DF-HU and its structure was elucidated by 1H NMR and 13C NMR Spectroscopy, mass spectrometry and crystallographic x-ray analysis. The formalin-induced nociception was used to evaluate antinociceptive activity; carrageenan-induced edema and pleurisy tests to evaluate anti-inflammatory activity and light-dark box to evaluate anxiolytic-like activity in mice. The acute oral treatments with E-HU (1000mg/kg), DF-HU (150mg/kg), EAF-HU (400mg/kg) and HU-1 (33mg/kg) decreased the licking time in both phases of the formalin test. In the carrageenan-induced inflammation models, the treatment with the same doses of E-HU, DF-HU, EAF-HU and HU-1 reduced the paw edema formation and leukocytes account into pleural cavity. In silico findings suggest that hibalactone present anti-inflammatory activity by interacting with the enzymes 5-lipoxygenase and cyclooxygenase-2. In the light dark box, the treatments with DF-HU, EAF-HU and HU-1 revealed an anxiolytic like effect. Thus, the E-HU and fractions of H. umbellata showed antinociceptive, anti-inflammatory and anxiolytic like activities, as also hibalactone, a possible phytoconstituent responsible for the biological effects of this specie.


Asunto(s)
Analgésicos/farmacología , Ansiolíticos/farmacología , Antiinflamatorios/farmacología , Araliaceae/química , Etanol/química , Lactonas/aislamiento & purificación , Extractos Vegetales/farmacología , Administración Oral , Analgésicos/uso terapéutico , Animales , Ansiolíticos/uso terapéutico , Antiinflamatorios/uso terapéutico , Carragenina , Edema/complicaciones , Edema/tratamiento farmacológico , Formaldehído , Ratones , Conformación Molecular , Simulación del Acoplamiento Molecular , Nocicepción/efectos de los fármacos , Fitoterapia , Extractos Vegetales/uso terapéutico , Pleuresia/complicaciones , Pleuresia/tratamiento farmacológico
16.
Biomed Pharmacother ; 93: 705-708, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28697485

RESUMEN

As proteins isolated from the Rhinella schneideri parotoid gland secretion (RsPP) exhibit anti-inflammatory activity, the goal of this work was to investigate their anti-nociceptive effects using acetic acid-induced writhing, formalin, and hot-plate tests. The intraperitoneal administration of RsPP (2.5 or 5mg/kg) one hour prior to stimuli significantly reduced the abdominal constrictions induced by acetic acid (73.06 and 72.69% inhibition, respectively) and the inflammatory phase of paw licking time induced by formalin (69.3% inhibition, at 2.5mg/kg). However, RsPP (1, 2.5 or 5mg/kg) did not change the latency in response at the hot-plate test. The involvement of inflammatory mediators on the anti-nociceptive effect of RsPP was further demonstrated. RsPP (2.5mg/kg) significantly inhibited the inflammatory peak of paw edema induced by histamine (44.0%), bradykinin (51.3%), or prostaglandin E2 (53.7%). Our data indicate that RsPP may act on the pain process by inhibiting the effect of inflammatory mediators.


Asunto(s)
Analgésicos/farmacología , Bufonidae/metabolismo , Inflamación/complicaciones , Nocicepción/efectos de los fármacos , Extractos Vegetales/farmacología , Proteínas/farmacología , Ácido Acético/farmacología , Animales , Antiinflamatorios/farmacología , Modelos Animales de Enfermedad , Edema/complicaciones , Masculino , Ratones , Dolor/tratamiento farmacológico , Dimensión del Dolor/métodos
17.
Turk Neurosurg ; 27(5): 823-826, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-27509460

RESUMEN

Bilateral thalamic dysfunction secondary to venous congestion may result from either venous sinus thrombosis or high flow arteriovenous malformations or a combination of both. We present a case of bilateral thalamic edema resulting from concomitant choroid plexus arteriovenous malformation (AVM) and straight sinus thrombosis and describe our treatment approach. The patient presented with several weeks of progressive confusion and memory deficits. Magnetic resonance imaging and venography (MRI/ MRV) showed bilateral thalamic T2 hyperintensities and straight sinus thrombosis. Subsequent cerebral angiography revealed a choroid plexus AVM within the right lateral ventricle. The patient underwent surgical resection of the AVM resulting in postoperative resolution of bilateral thalamic edema on MRI and improvement of his confusion and memory deficits. This case demonstrates a rare example of reversible bilateral thalamic edema secondary to venous hypertension from both an AVM and sinus occlusion after appropriate treatment of the AVM.


Asunto(s)
Plexo Coroideo/patología , Edema/cirugía , Malformaciones Arteriovenosas Intracraneales/cirugía , Trombosis de los Senos Intracraneales/cirugía , Tálamo/patología , Adulto , Edema/complicaciones , Humanos , Malformaciones Arteriovenosas Intracraneales/complicaciones , Malformaciones Arteriovenosas Intracraneales/diagnóstico por imagen , Masculino , Trastornos de la Memoria/complicaciones , Trastornos de la Memoria/cirugía , Trombosis de los Senos Intracraneales/inducido químicamente
19.
J Photochem Photobiol B ; 162: 367-373, 2016 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-27424097

RESUMEN

Inflammatory bowel disease (IBD) presents intense inflammatory infiltrate, crypt abscesses, ulceration and even loss of function. Despite the clinical relevance of IBD, its current therapy remains poorly effective. Infrared wavelength phototherapy shows therapeutic potential on inflammation. Our goal was to evaluate whether light-emitting diodes (LED) at 940nm are capable of mitigating the colitis-induced inflammatory process in mice. Forty male Swiss mice were assigned into five groups: control; control treated with LED therapy; colitis without treatment; colitis treated with LED therapy; colitis treated with Prednisolone. Experimental colitis was induced by acetic acid 7.5% (pH2.5) rectal administration. LED therapy was performed with light characterized by wavelength of 940nm, 45nm bandwidth, intensity of 4.05J/cm(2), total power of 270mW and total dose of 64.8J for 4min in a single application. Colitis-induced intestinal transit delay was inhibited by LED therapy. Colitis caused an increase of colon dimensions (length, diameter, total area) and colon weight (edema), which were inhibited by LED therapy. LED therapy also decreased colitis-induced tissue gross lesion, myeloperoxidase activity, microscopic tissue damage score and the presence of inflammatory infiltrate in all intestinal layers. Furthermore, LED therapy inhibited colitis-induced IL-1ß, TNF-α, and IL-6 production. We conclude LED therapy at 940nm inhibited experimental colitis-induced colon inflammation in mice, therefore, rendering it a promising therapeutic approach that deserves further investigation.


Asunto(s)
Colitis/terapia , Equipos y Suministros Eléctricos , Fototerapia , Animales , Colitis/complicaciones , Colitis/metabolismo , Colitis/fisiopatología , Colon/metabolismo , Colon/efectos de la radiación , Edema/complicaciones , Tránsito Gastrointestinal/efectos de la radiación , Interleucina-1beta/biosíntesis , Interleucina-6/biosíntesis , Masculino , Ratones , Peroxidasa/metabolismo , Factor de Necrosis Tumoral alfa/biosíntesis
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