Glioma of the optic nerve and chiasm: a case report / Glioma óptico-quiasmático: um relato de caso

ABSTRACT This article reports the case of an 11-year-old male patient with a history of proptosis and low progressive visual acuity in the left eye. He presented with a best corrected visual acuity of 20/25 in the right eye and light perception in the left eye. Exotropia and limitation in adduction were observed in the left eye. On automated perimetry, inferiortemporal quadrantopsia was observed in the right eye, while total scotoma was observed in the left eye. On magnetic resonance imaging, there was an expansive lesion in the left optic nerve, extending to the brainstem with chiasmatic involvement. This article aims to report a case of optic pathway glioma, as well as to discuss its clinical findings and their interconnection with the current literature.

RESUMO Este artigo relata o caso de um paciente do sexo masculino, 11 anos de idade, com história de proptose e baixa de acuidade visual progressiva. Ao exame oftalmológico apresentava melhor acuidade visual de 20/25 em olho direito e percepção de luz em olho esquerdo. Existia exotropia e limitação à adução no olho esquerdo. À campimetria automatizada, observou-se quadrantopsia temporal inferior em olho direito e escotoma total em olho esquerdo. À ressonância magnética, evidenciou-se lesão expansiva em trajeto do nervo óptico esquerdo estendendo-se até região do tronco encefálico, com acometimento quiasmático. O objetivo deste artigo é relatar o glioma de vias ópticas, bem como discutir os achados e sua interligação com a literatura atual.

Glioma of the optic nerve and chiasm: a case report.

This article reports the case of an 11-year-old male patient with a history of proptosis and low progressive visual acuity in the left eye. He presented with a best corrected visual acuity of 20/25 in the right eye and light perception in the left eye. Exotropia and limitation in adduction were observed in the left eye. On automated perimetry, inferiortemporal quadrantopsia was observed in the right eye, while total scotoma was observed in the left eye. On magnetic resonance imaging, there was an expansive lesion in the left optic nerve, extending to the brainstem with chiasmatic involvement. This article aims to report a case of optic pathway glioma, as well as to discuss its clinical findings and their interconnection with the current literature.

Safe intake of an oral supplement containing carbohydrates and whey protein shortly before sedation to gastroscopy; a double blind, randomized trial.

OBJECTIVE: To investigate the gastric emptying of an oral supplement containing carbohydrate plus whey protein drunk before sedation for gastroscopy. METHODS: This is a randomized double-blind trial including adult patients (ages 18-65) with a chief complaint of epigastric burning and who were candidates to elective gastroscopy. After overnight fast subjects were randomized to drink 200 mL of an oral nutritional supplement containing maltodextrine in addition to whey protein 150 to 210 min before the gastroscopy (intervention group, n = 12) or to undergo the endoscopic procedure with no supplement (control group, n = 12). The residual gastric volume (RGV) suctioned and measured during the exam was the main endpoint of the study. RESULTS: There were no complications during all exams. The median (range) fasting time was greater (P < 0.001) in control group (770 min, ranging from 660-917 min) than in the study group (175 min ranging from 150 to 210 min). The median (range) RGV was similar in between the two groups (control group: 25 (10-70) mL versus intervention group: 10 (0-100) mL; p = 0.32). CONCLUSION: Gastric emptying 150-210 min after the ingestion of an oral supplement containing carbohydrate plus whey protein is similar to an overnight fasting condition. Although limited by the number of cases, the sedation for endoscopic procedures is safe with this fasting protocol.

Objetivo: Investigar el vaciado gástrico de un suplemento oral que contiene hidratos de carbono, más proteínas de suero de leche tomado antes de la sedación para endoscopia. Método: Se trata de un estudio doble ciego aleatorizado, que incluyó pacientes adultos (18-65 años de edad) por presentar epigastralgia y que eran candidatos a gastroscopia electiva. Después de una noche de ayuno los pacientes fueron asignados aleatoriamente para tomar 200 ml de un suplemento nutricional oral que contiene maltodextrina y proteína de suero de leche, de 150 a 210 minutos antes de la sedación, para gastroscopia (grupo de intervención, n = 12) o continuar en ayuno para el procedimiento endoscópico (grupo control, n = 12). El volumen gástrico residual (RGV) aspirado y medido durante el examen fue la variable de evaluación principal del estudio. Resultados: No hubo complicaciones durante los exámenes. El tiempo medio de ayuno (rango) fue mayor (P.

Safe intake of an oral supplement containing carbohydrates and wheyprotein shortly before sedation to gastroscopy; a double-blind, randomized Trial / Ingesta segura de un suplemento oral que contiene hidratos de carbono y proteínas de suero de leche poco antes de sedación para endoscopia; un ensayo doble ciego y aleatorizado

Objective: To investigate the gastric emptying of an oral supplement containing carbohydrate plus whey protein drunk before sedation for gastroscopy. Methods: This is a randomized double-blind trial including adult patients (ages 18-65) with a chief complaint of epigastric burning and who were candidates to electivegastroscopy. After overnight fast subjects were randomized to drink 200 mL of an oral nutritional supplement containing maltodextrine in addition to whey protein 150to 210 min before the gastroscopy (intervention group, n =12) or to undergo the endoscopic procedure with no supplement (control group, n = 12). The residual gastric volume (RGV) suctioned and measured during the examwas the main endpoint of the study. Results: There were no complications during all exams. The median (range) fasting time was greater (P < 0.001)in control group (770 min, ranging from 660-917 min)than in the study group (175min ranging from 150 to 210min). The median (range) RGV was similar in between the two groups (control group: 25 (10-70) mL versus intervention group: 10 (0-100) mL; p = 0.32).Conclusion: Gastric emptying 150-210 min after the ingestion of an oral supplement containing carbohydrate plus whey protein is similar to an overnight fasting condition. Although limited by the number of cases, the sedation for endoscopic procedures is safe with this fasting protocol (AU)

Objetivo: Investigar el vaciado gástrico de un suplemento oral que contiene hidratos de carbono, más proteínas de suero de leche tomado antes de la sedación paraendoscopia. Método: Se trata de un estudio doble ciego aleatorizado, que incluyó pacientes adultos (18-65 años de edad) por presentar epigastralgia y que eran candidatos a gastroscopia electiva. Después de una noche de ayuno los pacientes fueron asignados aleatoriamente para tomar 200 ml de un suplemento nutricional oral que contiene maltodextrina y proteína de suero de leche, de 150 a 210 minutos antes de la sedación, para gastroscopia (grupo de intervención, n = 12)o continuar en ayuno para el procedimiento endoscópico(grupo control, n = 12). El volumen gástrico residual(RGV) aspirado y medido durante el examen fue la variable de evaluación principal del estudio. Resultados: No hubo complicaciones durante los exámenes.El tiempo medio de ayuno (rango) fue mayor (P<0,001) en el grupo control (770 min, 660 - 917 min) que en el grupo de estudio (175 min, 150-210 min). El RGV(mediana y rango) fue similar entre los dos grupos (grupo control: 25 (10-70) ml y grupo de intervención: 10 (0-100)ml, p = 0,32).Conclusión: El vaciado gástrico 150-210 minutos después de la ingestión de un suplemento oral que contiene hidratos de carbono y proteína de suero de leche es similar al ayuno tradicional durante toda la noche. Aunque limitado por el número de casos, la sedación para procedimiento endoscópico es segura con este protocolo de ayuno (AU)

Evaluation of antiulcer activity of chromanone fraction from Calophyllum brasiliesnse Camb.

ETHNOPHARMACOLOGICAL RELEVANCE: Calophyllum brasiliense Camb. (Clusiaceae), popularly known as 'guanandi', is found in the tropical areas and swampy lands. The latex exuding from its bark is used in the treatment of gastric ulcer in folk medicine. Several active compounds have been isolated from its stem bark among them, are the chromanone acids. Therefore, this study aimed to evaluate antiulcer activity and probable mechanism(s) of action of a fraction containing a mixture of chromanone acids (BI), derived by column chromatography fractionation of the hexane extract of the stem bark of Calophyllum brasiliense (HECb), using experimental in vitro and in vivo models. MATERIALS AND METHODS: Ulcer was induced by oral administration of ethanol (75%, v/v) and indomethacin (50mg/kg). Malondialdehyde, reduced glutathione and catalase activity was measured in stomach tissue after ethanol induced ulcer. In order to evaluate the effect of BI on nitric oxide, ulcer was induced by ethanol in l-NAME pretreated animals. Anti-Helicobacter pylori activity was verified in disk diffusion and broth microdilution in vitro assays, using cagA+ and vacA+ Helicobacter pylori strains. RESULTS: BI prevented the gastric ulceration caused by ethanol and indomethacin treatments. Its gastroprotective mechanism in ethanol-induced ulcer was partly due to reduction of MDA and CAT levels in the gastric tissue. BI did not affect the GSH levels and its gastroprotective effect was not reversed by pretreatment with l-NAME. BI showed anti-Helicobacter pylori in the both assays. CONCLUSION: The results indicate that BI is partly responsible for the HECb antiulcer and anti-Helicobacter pylori effects.