Role of Rutin in 5-Fluorouracil-Induced Intestinal Mucositis: Prevention of Histological Damage and Reduction of Inflammation and Oxidative Stress.

Intestinal mucositis, characterized by inflammatory and/or ulcerative processes in the gastrointestinal tract, occurs due to cellular and tissue damage following treatment with 5-fluorouracil (5-FU). Rutin (RUT), a natural flavonoid extracted from Dimorphandra gardneriana, exhibits antioxidant, anti-inflammatory, cytoprotective, and gastroprotective properties. However, the effect of RUT on inflammatory processes in the intestine, especially on mucositis promoted by antineoplastic agents, has not yet been reported. In this study, we investigated the role of RUT on 5-FU-induced experimental intestinal mucositis. Swiss mice were randomly divided into seven groups: Saline, 5-FU, RUT-50, RUT-100, RUT-200, Celecoxib (CLX), and CLX + RUT-200 groups. The mice were weighed daily. After treatment, the animals were euthanized and segments of the small intestine were collected to evaluate histopathological alterations (morphometric analysis); malondialdehyde (MDA), myeloperoxidase (MPO), and glutathione (GSH) concentrations; mast and goblet cell counts; and cyclooxygenase-2 (COX-2) activity, as well as to perform immunohistochemical analyses. RUT treatment (200 mg/kg) prevented 5-FU-induced histopathological changes and reduced oxidative stress by decreasing MDA concentrations and increasing GSH concentrations. RUT attenuated the inflammatory response by decreasing MPO activity, intestinal mastocytosis, and COX-2 expression. These results suggest that the COX-2 pathway is one of the underlying protective mechanisms of RUT against 5-FU-induced intestinal mucositis.

Troxerutin Prevents 5-Fluorouracil Induced Morphological Changes in the Intestinal Mucosa: Role of Cyclooxygenase-2 Pathway.

Intestinal mucositis is a common complication associated with 5-fluorouracil (5-FU), a chemotherapeutic agent used for cancer treatment. Troxerutin (TRX), a semi-synthetic flavonoid extracted from Dimorphandra gardneriana, has been reported as a potent antioxidant and anti-inflammatory agent. In the present study, we aimed to evaluate the effect of TRX on 5-FU-induced intestinal mucositis. Swiss mice were randomly divided into seven groups: Saline, 5-FU, TRX-50, TRX-100, TRX-150, Celecoxib (CLX), and CLX + TRX-100. The weight of mice was measured daily. After treatment, the animals were euthanized and segments of the small intestine were collected to evaluate histopathological alterations (morphometric analysis), levels of malondialdehyde (MDA), myeloperoxidase (MPO), glutathione (GSH), mast and goblet cell counts, immunohistochemical analysis, and cyclooxygenase-2 (COX-2) activity. Compared to the saline treatment, the 5-FU treatment induced intense weight loss and reduction in villus height. TRX treatment (100 mg/kg) prevented the 5-FU-induced histopathological changes and decreased oxidative stress by decreasing the MDA levels and increasing GSH concentration. TRX attenuated inflammatory process by decreasing MPO activity, intestinal mastocytosis, and COX-2 expression. TRX also reversed the depletion of goblet cells. Our findings suggest that TRX at a concentration of 100 mg/kg had chemopreventive effects on 5-FU-induced intestinal mucositis via COX-2 pathway.

Protective Effect of Cashew Gum (Anacardium occidentale L.) on 5-Fluorouracil-Induced Intestinal Mucositis.

Intestinal mucositis is a common complication associated with 5-fluorouracil (5-FU), a chemotherapeutic agent used for cancer treatment. Cashew gum (CG) has been reported as a potent anti-inflammatory agent. In the present study, we aimed to evaluate the effect of CG extracted from the exudate of Anacardium occidentale L. on experimental intestinal mucositis induced by 5-FU. Swiss mice were randomly divided into seven groups: Saline, 5-FU, CG 30, CG 60, CG 90, Celecoxib (CLX), and CLX + CG 90 groups. The weight of mice was measured daily. After treatment, the animals were euthanized and segments of the small intestine were collected to evaluate histopathological alterations (morphometric analysis), levels of malondialdehyde (MDA), myeloperoxidase (MPO), and glutathione (GSH), and immunohistochemical analysis of interleukin 1 beta (IL-1ß) and cyclooxygenase-2 (COX-2). 5-FU induced intense weight loss and reduction in villus height compared to the saline group. CG 90 prevented 5-FU-induced histopathological changes and decreased oxidative stress through decrease of MDA levels and increase of GSH concentration. CG attenuated inflammatory process by decreasing MPO activity, intestinal mastocytosis, and COX-2 expression. Our findings suggest that CG at a concentration of 90 mg/kg reverses the effects of 5-FU-induced intestinal mucositis.

Nocturia is the Lower Urinary Tract Symptom With Greatest Impact on Quality of Life of Men From a Community Setting.

PURPOSE: Lower urinary tract symptoms are numerous, but the specific impact of each of these symptoms on the quality of life (QoL) has not been evaluated in community-dwelling men. An assessment of these symptoms and their effects on QoL was the focus of this study. METHODS: We performed a cross-sectional study with 373 men aged >50 years from a community setting. Patients completed the International Prostate Symptom Score questionnaire, which includes questions on each of the specific urinary symptoms and a question addressing health-related QoL that are graded from 0 to 5. We used the Pearson correlation test to assess the impact of each symptom on QoL. RESULTS: Nocturia (58.9%) was the most prevalent urinary symptom. The mean score was 0.9±1.4 for incomplete emptying, 1.0±1.5 for frequency, 0.9±1.3 for intermittency, 0.8±1.3 for urgency, 1.0±1.5 for weak stream, 0.5±1.0 for straining, and 2.0±1.6 for nocturia. Nocturia and frequency were the only symptoms associated with poorer QoL, with nocturia showing a stronger association. CONCLUSIONS: Nocturia affects 50% of community dwelling men aged >50 years, and is the lower urinary tract symptom with the greatest negative impact on QoL.

Acute onset of renal colic from bilateral ureterolithiasis: a case report.

We report a case of a 32-year-old man, who presented to the emergency department with severe abdominal pain, with radiation to his back. An ultrasound examination revealed mild hydronephrosis bilaterally. A non-enhanced computer tomography was then performed and showed a 9 mm hyperdense image in the left ureter topography along together with an 8-mm hyperdense image in the right ureter topography, allowing us to establish the diagnosis of bilateral ureterolithiasis. The patient was taken to the operating room in order to perform ureteroscopy for endoscopic removal of the stones.

Anastomose portossistêmica intra-hepática transjugular: experiência inicial de 15 casos / Transjugular intrahepatic portosystemic shunt: initial experience of 15 cases

A criaçao de anastomoses (shunts) portossistêmicas intra-hepáticas transjugulares (TIPS) é uma nova alternativa percutânea para reduzir a pressao venosa portal. Foram realizadas TIPS em 15 pacientes com sangramento recorrente por varizes e/ou ascite de difícil tratamento entre outubro de 1992 e abril de 1993, com sucesso em 13 pacientes (86,6 por cento). Nao foi observada morte ou morbidade em decorrência do procedimento. Um paciente apresentou recidiva hemorrágica (6,6 por cento) no período de seguimento de um a sete meses. Quatro pacientes tiveram discretos episódios de encefalopatia dentro de uma semana após o procedimento, com pronto reestabelecimento após tratamento clínico e três dos pacientes apresentaram quadro de encefalopatia grave após o primeiro mês. Houve reduçao consistente da pressao portal em todos os pacientes após TIPS. Todos os shunts permaneceram patentes dentro dos limites do período de seguimento. A experiência com TIPS é inicial, porém já demonstra que é um procedimento seguro e eficiente para o controle da ascite e do sangramento recorrente por varizes em pacientes com hipertensao porta.

Abscessos piogenicos do figado: analise de 36 casos tratados por drenagem percutanea / Pyogenic liver abscess: review of 36 cases treated by percutaneous drainage

Analisaram-se 36 casos de abscessos piogenicos do figado, tratados por drenagem percutanea associada a antibioticoterapia. Os sintomas predominantes foram febre (75 por cento) e dor (72 por cento), sendo os sinais clinicos mais frequentes: hepatomegalia (58,3 por cento) e ictericia (33,3 por cento). O tempo medio entre o inicio dos sintomas e o diagnostico foi de 16 dias, sendo a tomografia computadorizada e a ultrassonografia eficazes em todos os casos. Para a drenagem percutanea realizou-se apenas uma puncao em 19 casos, duas em 8, tres em 8 e mais de quatro em apenas um paciente. Observaram-se tres casos de hemoperitonio (8,3 por cento), um deles submetido a laparotomia, o periodo medio de internacao foi de 24,8 dias, com mortalidade de 5,5 por cento. Concluiu-se ser a drenagem percutanea associada a antibioticoterapia terapeutica pouco invasiva e eficaz no tratamento dos abscessos piogenicos do figado.

Anastomoses intestinais / Intestinal anastomosis

Os autores fazem extensa revisao da literatura, abordando praticamente todos os aspectos relacionados a anastomoses intestinal. Sao relembrados os principios tecnicos da anastomose intestinal, o processo de cicatrizacao que sucede sua realizacao assim como os fatores locais e sistemicos que influenciam na sua realizacao. Compara-se os diversos fios e as diversas tecnicas de sutura inclusive as anastomoses mecanicas com grampeadores...

Tratamento cirúrgico das complicaçöes da doença hepática alcoólica / Surgical treatment of the complications of alcoholic liver disease

O sangramento por varizes de esôfago (VE) rotas e a ascite clinicamente intratável constituem complicaçöes graves da hepatopatia crônica alcoólica. Neste estudo, objetivou-se avaliar 33 pacientes cirróticos alcoólatras portadores de tais complicaçöes, sendo 18 submetidos à anastomose espleno-renal distal (AERD) por sangramento de VE rotas (Grupo I) e 15 submetidos à derivaçäo peritôneo-venosa por válvula de LeVeen (VLV) devido à ascite clinicamente intratável (Grupo II). O Grupo I inclui 4 pacientes Child A, 5-B e 4-C, além de 5 portadores de esquistossomose mansônica (EM) associada a alcoolismo. O Grupo II foi constituído de 7 pacientes Child B e 8-C. Concluímos que: 1) A AFRD näo deve ser empregada em pacientes Child C; 2) A AERD representa boa alternativa cirúrgica para os cirróticos Child A e portadores de EM; 3) A dificuldade técnica na realizaçäo da AERD é seguida de alta morbidade e mortalidade, devendo-se, nestas situaçöes, utilizar-se de outras opçöes cirúrgicas; 4) O implante da VLV, quando bem indicado, oferece melhor qualidade de vida ao cirrótico alcoólatra com ascite; 5) Com a perfeita padronizaçäo técnica, os riscos operatórios säo mínimos, sendo a mortalidade pós-operatória geralmente conseqüência da evoluçäo natural da doença