High Dose Ascorbic Acid During Acute Resuscitation in Critically Burn Patients.

Ascorbic acid (AA) is a potent oxygen-free radical scavenger. We hypothesized that treating severe burn patients with high doses of AA (HDAA) can reduce fluid resuscitation requirements and prevent organ dysfunction. We performed a unicentric, retrospective case-control study of 75 burn patients: 25 patients admitted from 2018 to 2019 with more than 30% Total Surface Body Surface Area (TSBA) burned who received HDAA (66 mg/kg/h as soon as possible after admission until 36 h after injury), and 50 patients admitted from 2014 to 2017 with similar Abbreviated Burn Severity Index (ABSI)/Baux scores who were treated with the same protocol but did not receive HDAA. During the first 24 hours of burn resuscitation the HDAA group required less fluids than the control group (3.06 ± 0.87 ml/kg/%TBSA vs 4.32 ± 1.51 P < .05), but the overall reduction of fluid requirements during the first 72 hours was not significant. There were no significant differences in Sequential Organ Failure Assessment (SOFA), other hemodynamic parameters, complications, or mortality. We also did not find an increase acute kidney injury in patients who received HDAA even though the mean urine oxalate/creatinine ratio was 0.61 (0.02-0.96). We conclude that in severe burn patients treated with a restrictive fluid therapy protocol, administration of HDAA can decrease only the initial fluid requirements but not total fluid intakes. We did not find differences in severity score after resuscitation or in mortality. Nor did we find an increase in renal failure in patients administered with HDAA.

Vasodilatory properties of Solanum crispum Ruiz & Pav. a South American native plant / Propiedad vasodilatadora de Solanum crispum Ruiz & Pav. una planta nativa de América de Sur

Solanum crispum Ruiz & Pav. (S. crispum) is a southern South American native plant that is usually used in traditional medicine for the treatment of symptoms associated with both, acute and chronic ailments. Enema and infusion of leaves and stems are used to treat fever, headache, inflammation and hypertension. In this study, we aim to assess the vasoactive effect of hydroalcoholic extracts of S. crispum on isolated rat aorta rings. The hydroalcoholic extract of S. crispum induced a vasodilatory effect (42.6 +/- 4.1 percent) in aortic rings precontracted with phenylephrine (0.1 μM). The aortic relaxation was largely endothelium-dependent and mediated by nitric oxide (NO). The endothelium- and NO-dependence was demonstrated by a drastic fall in the dilatation induced by the extract when the endothelium was removed (10.6 +/- 2.3 percent) and when nitric oxide synthase (NOS) was inhibited (12.3 +/- 2.5 percent) by nitro-L-arginine (L-NNA). This result supports the popular use of S. crispum in the treatment of hypertension that may be due, at least in part, to the vasodilator effect of one o more compounds present in their leaves and stems. Further studies should be performed to clarify this phenomenon.

Solanum crispum Ruiz & Pav. (S. crispum) es una planta nativa de América del Sur meridional que se utiliza generalmente en medicina tradicional para el tratamiento de los síntomas asociados con dolencias agudas y crónicas. El enema y la infusión de las hojas y tallos se utilizan para tratar la fiebre, el dolor de cabeza, la inflamación y la hipertensión. El objetivo de este estudio fue evaluar el efecto vasoactivo de un extracto hidroalcohólico de S. crispum en anillos aislados de aorta de rata. El extracto hidroalcohólico de S. crispum indujo un efecto vasodilatador (42,6 +/- 4,1 por ciento) en anillos aórticos precontraídos con fenilefrina (0,1 μM). La relajación de la aorta fue en gran parte dependiente del endotelio y mediada por el óxido nítrico (NO). La dependencia de endotelio y NO se demostró por una caída drástica de la dilatación inducida por el extracto cuando el endotelio fue removido (10,6 +/- 2,3 por ciento) y cuando se inhibió la óxido nítrico sintasa (NOS) (12,3 +/- 2,5 por ciento) mediante nitro-L-arginina (L-NNA). Este resultado apoya el uso popular de S. crispum en el tratamiento de la hipertensión que puede ser debido, al menos en parte, al efecto vasodilatador de uno o más compuestos presentes en sus hojas y tallos. Se deben realizar más estudios para aclarar este fenómeno.

Centaurium cachanlahuen (Mol) Robinson, a Chilean native plant with a vasodilatory effect / Centaurium cachanlahuen (Mol) Robinson una planta nativa chilena con efecto vasodilatador

Centaurium cachanlahuen (Mol.) Robinson is a chilean native plant widely used in traditional medicine for the treatment of many diseases, including cardiovascular disorders. Studies carried out in normal and hypertensive rats suggested that extract of Centaurium cachanlahuen has antihypertensive effect. In this work, we aim to evaluate the effect of aqueous and hydroalcoholic extracts of Centaurium cachanlahuen on the vascular reactivity using rat aorta rings precontrated with phenylephrine (0.1 uM). Results showed that both aqueous (3 mg/mL) and hydroalcoholic extracts (3 mg/mL) produced rat aorta vasodilatation that was higher (P < 0.001) in the hydroalcoholic extract compared to the aqueous extract. This effect had an important endothelium-dependent component that was mediated by nitric oxide (NO), as supported by the inhibition of the response in the presence of N-nitro-L-arginine (L-NNA, 100 uM), a nitric oxide synthase (NOS) inhibitor. We suggest that xanthones present in the plant may play a key role in the vasodilator effect of Centaurium cachanlahuen extracts. The present study provides experimental evidence supporting the folkloric use of Centaurium cachanlahuen as hypotensive agent.

Centaurium cachanlahuen (Mol) Robinson es una planta nativa chilena ampliamente utilizada en medicina tradicional para el tratamiento de varias enfermedades, que incluyen alteraciones cardiovasculares. Estudios llevados a cabo en ratas normales e hipertensas sugieren que el extracto de Centaurium cachanlahuen tiene efecto antihipertensivo. El propósito de este trabajo fue evaluar el efecto de extractos acuosos e hidroalcohólicos de Centaurium cachanlahuen sobre la reactividad vascular de aorta de rata precontraída con fenilefrina (0.1 uM). Tanto el extracto acuoso (3 mg/mL) como el extracto hidroalcohólico (3 mg/mL) produjeron relajación de aorta de rata, la cual fue de mayor magnitud (P < 0.001) con el extracto hidroalcohólico respecto del extracto acuoso. El efecto observado tuvo un importante componente mediado por óxido nítrico (NO), tal como lo demuestra la inhibición de esta respuesta en presencia de N-nitro-L-arginina (L-NNA, 100 uM), un inhibidor de la óxido nítrico sintasa (NOS). Se sugiere que las xantonas presente en la planta pueden jugar un papel clave en el efecto vasodilatador observado por los extractos de Centaurium cachanlahuen. Este estudio constituye una evidencia experimental que apoya el uso popular de Centaurium cachanlahuen como agente hipotensor.

[Mucosal healling: a realistic aim or marketing myth?]. / Cicatrización mucosa: ¿un objetivo realista o un mito empresarial?

The classical aim of the treatment of ulcerative colitis is to induce and maintain remission. However, this aim has not been shown to prevent long-term complications. Current treatment goals attempt to prevent complications. In some studies, healing of the intestinal mucosa has been shown to improve long-term outcomes. In ulcerative colitis, mucosal healing reduces recurrence, the risk of colorectal cancer and the need for surgery, and improves patients' quality of life. The drugs for which there is greatest evidence of their efficacy in inducing and maintaining mucosal healing are salicylates and biological agents. In the near future, endoscopic monitoring may be required to evaluate response to the treatment and decisions may have to be taken according to the persistence or disappearance of these lesions.