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1.
Biomolecules ; 10(11)2020 11 19.
Artigo em Inglês | MEDLINE | ID: mdl-33228230

RESUMO

Extracts from the defatted evening primrose (Oenothera paradoxa Hudziok) seeds are the source of a range of stable polyphenolic compounds, including ellagic acid, gallic acid, and catechin. Our studies evaluate, for the first time, the influence of evening primrose isopropanol extract (EPE) on malignant pleural mesothelioma (MPM) cells. MPM is rarely diagnosed, its high aggressiveness and frequently noted chemoresistance limit its treatment schemes and it is characterized by low prognostic features. Here, we demonstrate that EPE inhibited MPM growth in a dose-dependent manner in cells with increased invasion properties. Moreover, EPE treatment resulted in cell cycle arrest in the G2/M phase and increased apoptosis in invasive MPM cell lines. Additionally, EPE strongly limited invasion and MMP-7 secretion in MPM cancer cells. Our original data provide evidence about the potential anti-invasive effects of EPE in MPM therapy treatment.


Assuntos
Mesotelioma Maligno/patologia , Oenothera biennis , Extratos Vegetais/farmacologia , Pleura/efeitos dos fármacos , Pleura/patologia , Polifenóis/farmacologia , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/fisiologia , Relação Dose-Resposta a Droga , Humanos , Mesotelioma Maligno/tratamento farmacológico , Invasividade Neoplásica/patologia , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/uso terapêutico , Polifenóis/isolamento & purificação , Polifenóis/uso terapêutico , Sementes
2.
Arch Bronconeumol (Engl Ed) ; 55(7): 357-367, 2019 Jul.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30473265

RESUMO

INTRODUCTION: The usefulness of sericin as pleurodesis agent has previously been described. Present study aims to compare sericin pleurodesis regarding success, effectiveness, tolerability, and side-effects. METHODS: Adult, 12-week-old Wistar-albino rats (n=60), divided to five groups as sericin, talcum-powder, doxycycline, silver-nitrate and control. Agents were administrated through left thoracotomy, rats sacrificed twelve-days after. RESULTS: Highest ratio of collagen fibers was observed in sericin group, and the intensity was higher than talcum-powder group (p<0.05). Compared to silver nitrate, sericin group displayed better mesothelial reaction, and multi-layer mesothelium was also better (p<0.05). Foreign body reaction and emphysema were less frequent in sericin group (p<0.05). The presence of biological tissue in parenchyma was less prominent in sericin group (p<0.05). Foreign body reaction on thoracic wall was less common in sericin group (p<0.05). Presence of biological tissue glue in thoracic wall was less prominent in sericin group (p<0.05). Glomerular degeneration was lower in sericin group compared to the silver nitrate group (p<0.05), and tubular degeneration was less common in sericin group than talcum group (p<0.05). Pericarditis was less common in sericin group compared to the other groups (p<0.05). CONCLUSION: As an intrinsic, natural glue protein, sericin protects the lung parenchyma and tissues, and its glue-like characteristics enable pleurodesis. The success of sericin in pleurodesis was demonstrated in the present study based on investigations of the pleurae. Being cost-effective and better tolerated agent associated with a low potential of side effects, sericin is more effective, less expensive and provides more lung parenchyma protection.


Assuntos
Doxiciclina/uso terapêutico , Pleurodese/métodos , Soluções Esclerosantes/uso terapêutico , Sericinas/uso terapêutico , Nitrato de Prata/uso terapêutico , Talco/uso terapêutico , Animais , Colágeno/análise , Análise Custo-Benefício , Doxiciclina/economia , Doxiciclina/toxicidade , Avaliação Pré-Clínica de Medicamentos , Enfisema/induzido quimicamente , Epitélio/efeitos dos fármacos , Epitélio/patologia , Fibrose , Reação a Corpo Estranho/induzido quimicamente , Pulmão/efeitos dos fármacos , Pulmão/patologia , Masculino , Miocárdio/química , Pleura/efeitos dos fármacos , Pleura/patologia , Pleurodese/efeitos adversos , Pleurodese/economia , Ratos , Ratos Wistar , Soluções Esclerosantes/economia , Soluções Esclerosantes/toxicidade , Sericinas/economia , Sericinas/toxicidade , Nitrato de Prata/economia , Nitrato de Prata/toxicidade , Talco/economia , Talco/toxicidade , Toracotomia , Vísceras/patologia
3.
Anal Chem ; 90(15): 8831-8837, 2018 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-29961333

RESUMO

Laterally resolved chemical analysis (chemical imaging) has increasingly attracted attention in the Life Sciences during the past years. While some developments have provided improvements in lateral resolution and speed of analysis, there is a trend toward the combination of two or more analysis techniques, so-called multisensor imaging, for providing deeper information into the biochemical processes within one sample. In this work, a human malignant pleural mesothelioma sample from a patient treated with cisplatin as a cytostatic agent has been analyzed using laser ablation inductively coupled plasma mass spectrometry (LA-ICPMS) and matrix-assisted laser desorption/ionization mass spectrometry (MALDI MS). While LA-ICPMS was able to provide quantitative information on the platinum distribution along with the distribution of other elemental analytes in the tissue sample, MALDI MS could reveal full information on lipid distributions, as both modes of polarity, negative and positive, were used for measurements. Tandem MS experiments verified the occurrence of distinct lipid classes. All imaging analyses were performed using a lateral resolution of 40 µm, providing information with excellent depth of details. By analyzing the very same tissue section, it was possible to perfectly correlate the obtained analyte distribution information in an evaluation approach comprising LA-ICPMS and MALDI MS data. Correlations between platinum, phosphorus, and lipid distributions were found by the use of advanced statistics. The present proof-of-principle study demonstrates the benefit of data combination for outcomes beyond one method imaging modality and highlights the value of advanced chemical imaging in the Life Sciences.


Assuntos
Lipídeos/análise , Neoplasias Pulmonares/química , Mesotelioma/química , Fósforo/análise , Platina/análise , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , Antineoplásicos/análise , Antineoplásicos/farmacocinética , Cisplatino/análise , Cisplatino/farmacocinética , Cisplatino/uso terapêutico , Elementos Químicos , Humanos , Terapia a Laser , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/patologia , Mesotelioma/diagnóstico por imagem , Mesotelioma/tratamento farmacológico , Mesotelioma/patologia , Mesotelioma Maligno , Imagem Molecular/métodos , Imagem Multimodal/métodos , Análise Multivariada , Platina/farmacocinética , Platina/uso terapêutico , Pleura/química , Pleura/diagnóstico por imagem , Pleura/efeitos dos fármacos , Pleura/patologia , Manejo de Espécimes , Espectrometria de Massas em Tandem/métodos
4.
Acta Cir Bras ; 31(4): 243-9, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27168536

RESUMO

PURPOSE: To evaluate macro and microscopically, changes following the use of the aqueous extract of babassu (Orbignya phalerata) in the lung parenchyma and pleura of rats. METHODS: Sixty adult male rats with average weight of 350 g, were randomized into two groups of 30 animals (experimental and control) further divided into sub-groups of 10 to be sacrificed at 48 h, 72 h and 21 days. The substance was injected into the right pleura of the animals. RESULTS: There was intense pleuropulmonary macroscopic reaction with statistically significant differences between groups respectively (p<0.05, p<0.02, p<0.03). Microscopically, no statistically significant difference was evident (p>0.05). CONCLUSION: The aqueous extract of babassu (Orbignya phalerata) was found to be highly irritating to the pleura and lung of rats, evidenced macroscopically by numerous adhesions and inflammation while no major changes were evident microscopically.


Assuntos
Arecaceae/química , Pulmão/efeitos dos fármacos , Extratos Vegetais/farmacologia , Pleura/efeitos dos fármacos , Pleurodese/métodos , Animais , Anti-Inflamatórios/farmacologia , Modelos Animais de Doenças , Pulmão/patologia , Masculino , Pleura/patologia , Pneumonia/induzido quimicamente , Distribuição Aleatória , Ratos , Reprodutibilidade dos Testes , Fatores de Tempo , Cicatrização
5.
Acta cir. bras ; Acta cir. bras;31(4): 243-249, Apr. 2016. tab
Artigo em Inglês | LILACS | ID: lil-781328

RESUMO

PURPOSE: To evaluate macro and microscopically, changes following the use of the aqueous extract of babassu (Orbignya phalerata) in the lung parenchyma and pleura of rats. METHODS: Sixty adult male rats with average weight of 350 g, were randomized into two groups of 30 animals (experimental and control) further divided into sub-groups of 10 to be sacrificed at 48 h, 72 h and 21 days. The substance was injected into the right pleura of the animals. RESULTS: There was intense pleuropulmonary macroscopic reaction with statistically significant differences between groups respectively (p<0.05, p<0.02, p<0.03). Microscopically, no statistically significant difference was evident (p>0.05). CONCLUSION: The aqueous extract of babassu (Orbignya phalerata) was found to be highly irritating to the pleura and lung of rats, evidenced macroscopically by numerous adhesions and inflammation while no major changes were evident microscopically.


Assuntos
Animais , Masculino , Ratos , Pleura/efeitos dos fármacos , Extratos Vegetais/farmacologia , Pleurodese/métodos , Arecaceae/química , Pulmão/efeitos dos fármacos , Pleura/patologia , Pneumonia/induzido quimicamente , Fatores de Tempo , Cicatrização , Distribuição Aleatória , Reprodutibilidade dos Testes , Modelos Animais de Doenças , Pulmão/patologia , Anti-Inflamatórios/farmacologia
6.
Eur J Pediatr ; 173(6): 823-6, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24573572

RESUMO

UNLABELLED: Congenital chylothorax is a rare condition, but it is the most common cause of pleural effusion in neonates and infants. Here, we report on the first trials of the intrapleural instillation of an extract of Viscum album (European mistletoe) (Abnobaviscum Q®) in two infants with congenital chylothorax that was refractory to standard conservative management and thoracic duct ligation. CONCLUSION: The clinical course of both children improved with no side effects related to the extract after following up the children for 2 years and 9 months, respectively. Randomized multicenter prospective studies will help determine the effectiveness of pleurodesis with a V. album extract and the occurrence of long-term side effects with this agent.


Assuntos
Quilotórax/congênito , Fitoterapia/métodos , Extratos Vegetais/administração & dosagem , Pleurodese/métodos , Viscum album/química , Quilotórax/diagnóstico por imagem , Quilotórax/tratamento farmacológico , Feminino , Humanos , Lactente , Masculino , Pleura/diagnóstico por imagem , Pleura/efeitos dos fármacos , Radiografia
7.
Pharmacol Rep ; 65(5): 1263-71, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24399722

RESUMO

BACKGROUND: Dihydrocorynantheol (DHC) is an alkaloid compound isolated from Esenbeckia leiocarpa Engl. that has demonstrated anti-inflammatory properties in experimental models. The aim of this study was to investigate whether the modification of the chemical structure of DHC could alter its anti-inflammatory effect in a mouse model of pleurisy induced by carrageenan. METHODS: DHC was isolated from Esenbeckia leiocarpa Engl. Capillary electrophoresis, physical characteristics, spectral data produced by infrared analysis and nuclearmagnetic resonance ((1)H and (13)C), and mass spectrometry analysis were used to identify and elucidate DHC structure. The DHC compound was subjected to chemical structural modifications by nucleophilic substitution reactions, yielding five analogous compounds: acetyl (1), p-methylbenzoyl (2), benzoyl (3), p-methoxybenzoyl (4) and p-chlorobenzoyl (5). Swiss mice were used throughout the experiments. Pro-inflammatory parameters leukocyte migration, exudate concentrations and myeloperoxidase (MPO) activity were quantified in the fluid leakage from the mouse pleural cavities at 4 h after pleurisy induction. RESULTS: DHC and its analogues acetyl, p-methylbenzoyl, benzoyl, p-methoxybenzoyl and p-chlorobenzoyl inhibited total and differential leukocyte migration and MPO activity (p < 0.05). Only DHC significantly decreased the exudate concentrations (p < 0.01). CONCLUSIONS: DHC was more effective than its analogues as an anti-inflammatory agent in the mouse model of pleurisy induced by carrageenan. We did not determine what physicochemical modifications altered the anti-inflammatory effect of DHC, but this effect may be due to the modifications on the hydroxyl group at carbon 17 of the DHC.


Assuntos
Alcaloides/farmacologia , Anti-Inflamatórios/farmacologia , Extratos Vegetais/farmacologia , Pleura/efeitos dos fármacos , Pleurisia/prevenção & controle , Alcaloides/química , Animais , Anti-Inflamatórios/química , Carragenina , Quimiotaxia de Leucócito/efeitos dos fármacos , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Exsudatos e Transudatos/efeitos dos fármacos , Exsudatos e Transudatos/imunologia , Feminino , Masculino , Camundongos , Estrutura Molecular , Infiltração de Neutrófilos/efeitos dos fármacos , Peroxidase/metabolismo , Fitoterapia , Casca de Planta , Extratos Vegetais/química , Plantas Medicinais , Pleura/imunologia , Pleura/metabolismo , Pleurisia/induzido quimicamente , Pleurisia/imunologia , Pleurisia/metabolismo , Rutaceae , Relação Estrutura-Atividade
9.
Planta Med ; 75(3): 211-5, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19085684

RESUMO

Oleanolic acid, a triterpenoid known for its anti-inflammatory properties, is commonly present in several medicinal plants. The present study evaluated the effect of oleanolic acid on sPLA (2), a key enzyme in inflammatory reactions. Oleanolic acid inhibited sPLA (2) activities of human synovial fluid (HSF), human pleural fluid (HPF) and VIPERA RUSSELLI (VRV-PL-V) and NAJA NAJA (NN-PL-I) snake venoms in a concentration-dependent manner. The IC (50) values of sPLA (2) from these sources ranged from 3.08 to 7.78 muM. Increasing calcium (Ca (2+)) concentrations from 2.5 to 15 mM and substrate concentration up to 180 nM did not affect the level of inhibition. Oleanolic acid enhanced the relative intrinsic fluorescence intensity of sPLA (2) (VRV-PL-V). In the presence of oleanolic acid, an apparent shift in the far UV-CD spectrum of sPLA (2) was observed. These studies indicate direct interaction with the enzyme and formation of an sPLA (2)-oleanolic acid complex. The complex formed resulted in irreversible inhibition of sPLA (2). Oleanolic acid inhibited indirect hemolytic activity and mouse paw edema induced by sPLA (2). Inhibition of IN VITRO and IN VIVO sPLA (2) activity by oleanolic acid explains the observed anti-inflammatory properties of several oleanolic acid-containing medicinal plants.


Assuntos
Anti-Inflamatórios/farmacologia , Inflamação/tratamento farmacológico , Ácido Oleanólico/farmacologia , Fosfolipases A2 Secretórias/antagonistas & inibidores , Extratos Vegetais/farmacologia , Líquido Sinovial/efeitos dos fármacos , Animais , Anti-Inflamatórios/uso terapêutico , Cálcio/farmacologia , Relação Dose-Resposta a Droga , Edema/tratamento farmacológico , Hemólise/efeitos dos fármacos , Humanos , Camundongos , Ácido Oleanólico/farmacocinética , Ácido Oleanólico/uso terapêutico , Extratos Vegetais/farmacocinética , Extratos Vegetais/uso terapêutico , Pleura/efeitos dos fármacos , Venenos de Serpentes/enzimologia
10.
Eur J Pharmacol ; 511(2-3): 219-27, 2005 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-15792791

RESUMO

A previous study showed that the novel tetrazolephtalimide derivative LASSBio 552 (2-4-[3-(1H-1,2,3,4-tetraazol-5-yl)propoxy]phenethyl-1,3-isoindolinedione) prevents LTD(4)-evoked tracheal contraction. This led us to examine the putative anti-inflammatory effect of LASSBio 552 in comparison with the leukotriene CysLT(1) receptor antagonist zafirlukast using a model of allergic pleurisy in rats. Treatment with either LASSBio 552 (24-96 micromol/kg, i.p.) or zafirlukast (9-72 micromol/kg, i.p.), 1 h before challenge, inhibited eosinophil and mononuclear cell influx into the pleural cavity 24 h post-challenge, but failed to alter the increased levels of eotaxin, plasma leakage, mast cell degranulation and neutrophil infiltration noted 6 h post-challenge. CD4(+) T cell recruitment 24 h post-challenge was also sensitive to LASSBio 552. This treatment failed to alter cysteinyl leukotriene production at 6 h, but clearly inhibited the phenomenon 24 h and 48 h post-challenge. In in vitro settings LASSBio 552 inhibited allergen-evoked cysteinyl leukotriene generation from isolated mast cells, while histamine release remained unchanged. It also slightly inhibited cysteinyl leukotriene production by eosinophils and mononuclear cells triggered by Ca(+2) ionophore A23187. A leukotriene CysLT(1) receptor transfected cell-based assay revealed that LASSBio 552 did not prevent LTD(4)-evoked Ca(+2) influx, indicating that it was not a leukotriene CysLT(1) receptor antagonist. These findings indicate that LASSBio 552 is able to inhibit eosinophil influx triggered by allergen chalenge in a mechanism at least partially associated with suppression of CD4(+) T cell influx and cysteinyl leukotriene production.


Assuntos
Alérgenos/imunologia , Indóis/farmacologia , Inflamação/prevenção & controle , Tetrazóis/farmacologia , Animais , Antiasmáticos/farmacologia , Linfócitos T CD4-Positivos/citologia , Linfócitos T CD4-Positivos/efeitos dos fármacos , Células CHO , Cálcio/metabolismo , Movimento Celular/efeitos dos fármacos , Quimiocina CCL11 , Quimiocinas CC/biossíntese , Cricetinae , Cricetulus , Cisteína/metabolismo , Relação Dose-Resposta a Droga , Avaliação Pré-Clínica de Medicamentos , Eosinófilos/citologia , Eosinófilos/efeitos dos fármacos , Feminino , Indóis/química , Inflamação/imunologia , Isoindóis , Leucotrieno D4/farmacologia , Leucotrienos/metabolismo , Masculino , Proteínas de Membrana/genética , Proteínas de Membrana/metabolismo , Fenilcarbamatos , Pleura/efeitos dos fármacos , Pleura/imunologia , Pleurisia/imunologia , Pleurisia/metabolismo , Pleurisia/prevenção & controle , Ratos , Ratos Wistar , Receptores de Leucotrienos/genética , Receptores de Leucotrienos/metabolismo , Sulfonamidas , Tetrazóis/química , Compostos de Tosil/farmacologia , Transfecção
11.
J Antimicrob Chemother ; 51(3): 665-9, 2003 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-12615869

RESUMO

OBJECTIVES: Pleural empyema is a serious complication of pneumonia, the optimal therapy of which is still unknown. The objective of this study was to evaluate the use of moxifloxacin in this condition. METHODS: Pleural empyema was induced in rabbits by intrapleural administration of Pasteurella multocida (10(5-6) cfu) or turpentine (0.3 mL) followed 3 h later by instillation of Streptococcus pneumoniae (ATCC 49619) (10(6) cfu) into the pleural cavity. The MICs of moxifloxacin for S. pneumoniae and P. multocida were 0.4 and 0.05 mg/L, respectively. Starting 30 h following S. pneumoniae challenge intramuscular moxifloxacin 12.5 and 25 mg/kg was administered x 4 (every 12 h). Pleural empyema fluid samples were obtained for bacterial count at 12 h intervals following the first three moxifloxacin administrations. Moxifloxacin levels in pleural empyema and serum samples were obtained at 0, 30, 60, 120, 240, 360 and 480 min and 12 h after the 4th dose and determined by bioassay. RESULTS: In control animals, S. pneumoniae (and P. multocida) persisted in the pleural empyema. S. pneumoniae also persisted in the pleural empyema fluid when moxifloxacin was administered at 12.5 mg/kg (x4 administrations). Mean serum and pleural empyema peak moxifloxacin levels (following the 25 mg/kg dose) were 7.6 (+/-3.2) and 4.8 (+/-2.5) mg/L, respectively. Pleural empyema peak moxifloxacin concentration lagged 1 h after serum moxifloxacin. Serum and pleural empyema half-lives were approximately 1.5 and approximately 6 h, respectively. Serum AUC(1-12) was 29.4 (+/-6.8) mg.h/L and serum area under the inhibitory concentration curve (AUIC) was 73.5 mg.h/L. Pleural empyema AUC(1-12) was 34.3 (+/-11.7) mg/L and pleural empyema AUIC was 85.8 mg.h/L. S. pneumoniae was eradicated from pleural empyema following a single dose of moxifloxacin 25 mg/kg in 52% of the animals and in 96% following four doses. Moxifloxacin was also effective in eradication of P. multocida. The rate of pleural empyema sterilization was related to moxifloxacin serum AUIC (r = 0.82) as well as serum peak moxifloxacin level (r = 0.84), but not to pleural empyema AUIC (r = 0.19) or pleural empyema peak levels. The results were similar for both methods of induction of pleural empyema. CONCLUSIONS: Moxifloxacin appears to penetrate well into experimental pleural empyema and effectively sterilize it from S. pneumoniae. Sterilization of S. pneumoniae is related to serum AUIC rather than to moxifloxacin pharmacokinetics in pleural empyema.


Assuntos
Anti-Infecciosos/uso terapêutico , Compostos Aza , Modelos Animais de Doenças , Empiema Pleural/tratamento farmacológico , Fluoroquinolonas , Infecções Pneumocócicas/tratamento farmacológico , Quinolinas , Animais , Anti-Infecciosos/metabolismo , Empiema Pleural/metabolismo , Masculino , Moxifloxacina , Pleura/efeitos dos fármacos , Infecções Pneumocócicas/metabolismo , Coelhos , Terebintina/toxicidade
12.
Phytother Res ; 16(6): 519-23, 2002 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12237807

RESUMO

Mikania laevigata Schultz Bip. ex Baker, M. involucrata Hook. et Arn. and M. hirsutissima DC. (Asteraceae), commonly occurring in the southern Brazilian State of Rio Grande do Sul, were submitted to biological tests to evaluate their potential antiinflammatory activity. Decoctions from the leaves and stems were analysed by the induced rat paw oedema and pleurisy models. The animals were treated orally with different decoction doses. In the induced rat paw oedema test, the animals treated with leaf decoctions from M. laevigata (200 mg/ kg) and M. involucrata (50 mg/ kg) presented an oedema inhibition of 81.56% and 81.67%, respectively, 3 h after the administration of the phlogistic agent. Leaf decoctions from M. hirsutissima (400 mg/ kg) did not show such an activity. Stem decoctions displayed lower antiinflammatory activity when compared with the same doses and response time of the leaf decoctions for all analysed species. In the pleurisy assay, leaf decoctions from M. laevigata (400 mg/ kg) and M. involucrata (200 mg/ kg) inhibited leukocyte migration to the pleural exudate by 28.26% and 54.35%, respectively.


Assuntos
Anti-Inflamatórios/farmacologia , Asteraceae , Inflamação/tratamento farmacológico , Extratos Vegetais/farmacologia , Animais , Anti-Inflamatórios/uso terapêutico , Brasil , Carragenina/farmacologia , Inibição de Migração Celular , Edema/tratamento farmacológico , Membro Posterior/efeitos dos fármacos , Masculino , Fitoterapia , Extratos Vegetais/uso terapêutico , Folhas de Planta/química , Caules de Planta/química , Pleura/efeitos dos fármacos , Pleurisia/tratamento farmacológico , Ratos , Ratos Wistar
13.
Rev. Asoc. Med. Crit. Ter. Intensiva ; 10(6): 249-53, nov.-dic. 1996. tab, ilus
Artigo em Espanhol | LILACS | ID: lil-187833

RESUMO

Introducción: la instilación de anestésicos locales en el espacio pleural se ha usado para mejorar el dolor de las fracturas costales. Objetivo: determinar la eficacia y seguridad de la analgesia interpleural en pacientes con trauma torácico en una UCI. Pacientes y métodos: se hizo un estudio prospectivo y aleatorio de analgesia interpleural en nueve pacientes con trauma torácico. Instilamos solución de bupivacaína al 5 por ciento o placebo (grupo A, grupo B, respectivamente) dentro del espacio pleural a través de un catéter insertado específicamente para este propósito. El nivel de analgesia se evaluó mediante la escala visual análoga (EVA). Resultados: después de la instilación de las soluciones, EVA fue de 4.4/10 en el grupo A y 7.5/10 en el grupo B, y el uso de analgésicos fue 1.2 y 5.2 dosis, respectivamente. Conclusión: proponemos el uso de analgesia interpleural en pacientes de la UCI con trauma torácio severo como primera elección


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Anestesia Local , Anestesia Local/instrumentação , Bupivacaína/administração & dosagem , Bupivacaína/farmacocinética , Medição da Dor , Pleura/efeitos dos fármacos , Traumatismos Torácicos
14.
Chest ; 108(4): 1080-3, 1995 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-7555123

RESUMO

The ideal agent to produce pleurodesis has not been identified. Tetracycline, the drug used most commonly in the 1980s, is no longer available. Talc either aerosolized or in a slurry is the agent used just most commonly at the present time, but there are concerns about its safety. Another possibility is silver nitrate, which was widely used in the past, but was abandoned on account of side effects. We hypothesized that lower concentrations of silver nitrate than had been used in the past would be effective in creating a pleurodesis in rabbits. The following medications in a total volume of 2 mL were instilled intrapleurally in three groups of ten anesthetized rabbits: 0.25% or 0.50% silver nitrate and 35 mg/kg tetracycline. Twenty-eight days after the injection, the animals were sacrificed and the pleural spaces were assessed grossly for evidence of pleurodesis and microscopically for evidence of fibrosis and inflammation. The intrapleural injection of 0.50% silver nitrate produced an effective pleurodesis. The mean degree of gross pleurodesis in the rabbits that received 0.50% silver nitrate (3.4 +/- 1.2) did not differ significantly from that of the rabbits that received tetracycline (3.5 +/- 0.7) (scale 0 to 4). The mean degree of microscopic pleural fibrosis in the rabbits that received 0.50% silver nitrate (3.4 +/- 0.7) did not differ significantly from that of the rabbits that received tetracycline (3.9 +/- 0.3). However, 0.25% silver nitrate was ineffective in creating pleural fibrosis, either grossly or microscopically. No rabbits died after the intrapleural injection of the drugs. There were no observed side effects after the injection of silver nitrate. The present study demonstrates that 0.50% silver nitrate instilled into the pleural space is an effective agent for producing pleurodesis in the rabbit; its effect is comparable to tetracycline 35 mg/kg. This agent should be compared with tetracycline derivatives and talc in studies in humans.


Assuntos
Pleurodese/métodos , Soluções Esclerosantes/administração & dosagem , Nitrato de Prata/administração & dosagem , Tetraciclina/administração & dosagem , Análise de Variância , Animais , Relação Dose-Resposta a Droga , Avaliação Pré-Clínica de Medicamentos , Fibrose , Pulmão/efeitos dos fármacos , Pulmão/patologia , Pleura/efeitos dos fármacos , Pleura/patologia , Pleurisia/induzido quimicamente , Pleurisia/patologia , Pleurodese/estatística & dados numéricos , Coelhos , Soluções Esclerosantes/toxicidade , Nitrato de Prata/toxicidade , Estatísticas não Paramétricas , Tetraciclina/toxicidade
15.
Chest ; 104(5): 1582-4, 1993 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-7693399

RESUMO

The two agents most commonly used for producing a pleurodesis are tetracycline and bleomycin. Tetracycline is no longer available due to more stringent requirements on the manufacturing process. The objective of this project was to determine whether bleomycin is an effective sclerosant in an experimental model in rabbits. The following medications were instilled intrapleurally in anesthetized male rabbits: tetracycline, 35 mg/kg, or bleomycin, 1.5 or 3.0 IU/kg diluted to a total volume of 1 ml with bacteriostatic saline solution. Twenty-eight days after the instillation, the animals were killed, and the pleural spaces were assessed grossly for evidence of pleurodesis and microscopically for evidence of fibrosis and inflammation. The intrapleural injection of bleomycin was ineffective in creating pleural fibrosis, either grossly or microscopically. The mean degree of gross pleurodesis in the six rabbits who received tetracycline was 2.7 +/- 1.5 (scale 0 to 4), while that in the rabbits who received the highest dose of bleomycin was 0.0 +/- 0.0. Based on this study, we recommend that bleomycin not be used as a pleural sclerosant in patients with nonneoplastic pleural disease, eg, those with pneumothorax, congestive heart failure or cirrhosis, and pleural effusion.


Assuntos
Bleomicina/administração & dosagem , Pleura/efeitos dos fármacos , Soluções Esclerosantes/administração & dosagem , Tetraciclina/administração & dosagem , Análise de Variância , Animais , Avaliação Pré-Clínica de Medicamentos , Fibrose/induzido quimicamente , Fibrose/patologia , Masculino , Pleura/patologia , Pleurisia/induzido quimicamente , Pleurisia/patologia , Coelhos , Fatores de Tempo
16.
Rofo ; 152(5): 569-73, 1990 May.
Artigo em Alemão | MEDLINE | ID: mdl-2160691

RESUMO

The authors performed 68 liver embolizations in 51 patients. As selectively as possible, Lipiodol, to block the capillary bed, and a chemotherapeutic agent were injected into the liver tumors. A CT performed 24 hours after treatment showed the distribution of the contrast medium which is also an indicator of the distribution of the chemotherapeutic agents. It was found that the contrast medium had accumulated not only in the liver but also in the lungs. Here, four different degrees of accumulation were found, according to the amount of Lipiodol used. Embolization of the liver thus involves potential hazards for the lungs, such as microembolisms, pneumonia, and toxic effects of the chemotherapeutic agents.


Assuntos
Embolização Terapêutica , Óleo Iodado/uso terapêutico , Neoplasias Hepáticas/terapia , Pulmão/efeitos dos fármacos , Mitomicinas/uso terapêutico , Pleura/efeitos dos fármacos , Adulto , Idoso , Carcinoma Hepatocelular/terapia , Neoplasias do Colo/terapia , Feminino , Humanos , Óleo Iodado/efeitos adversos , Óleo Iodado/farmacocinética , Neoplasias Hepáticas/secundário , Pulmão/metabolismo , Masculino , Pessoa de Meia-Idade , Mitomicinas/efeitos adversos , Mitomicinas/farmacocinética , Pleura/metabolismo
17.
Chest ; 93(3): 533-6, 1988 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-3342661

RESUMO

Chemical pleurodesis with tetracycline is frequently complicated by pleuritic chest pain. The most promising approach to control pain is to optimize the use of intrapleural lidocaine. While administering amounts of intrapleural lidocaine larger than commonly reported, we attempted to determine a safe and more effective dose, by using a subjective and objective assessment of pain, by measuring serum concentrations of lidocaine, and by observing patients for possible toxic effects of lidocaine. Chemical pleurodesis with tetracycline was performed on ten patients receiving an intrapleural dose of 200 mg of lidocaine (group 1) and on ten patients receiving a 250-mg dose (group 2). A significantly greater number of patients in group 2 were free of pain following pleurodesis (7/10 vs 1/10; p = 0.006). Of the 80 serum lidocaine levels obtained, only one value (6.1 micrograms/ml), in an asymptomatic patient in group 1, exceeded the therapeutic range (1.5 micrograms/ml to 5.5 micrograms/ml). One patient in group 2 experienced transient numbness of the right hand, a possible side effect of lidocaine. We conclude that to achieve optimum anesthesia during chemical pleurodesis with tetracycline, it is necessary to use doses of intrapleural lidocaine large than previously reported. Until the feasibility of a further escalation is demonstrated, 250 mg should be considered the standard dose.


Assuntos
Anestesia Local/métodos , Lidocaína , Tetraciclina/administração & dosagem , Relação Dose-Resposta a Droga , Humanos , Lidocaína/administração & dosagem , Lidocaína/efeitos adversos , Lidocaína/sangue , Pleura/efeitos dos fármacos , Postura , Toracostomia , Fatores de Tempo , Aderências Teciduais , Distribuição Tecidual
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