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Foreign body ingestion is an infrequent cause of small bowel obstruction and, rarely, perforation. It is a common occurrence among pediatric patients, mentally impaired and the edentulous elderly population majority of which will pass through the gastrointestinal tract uneventfully. The likelihood of complications such as perforation, bleeding or fistula formation increases markedly particularly for sharp, stiff, and elongated objects (i.e. toothpicks, meat bones, pins, and razor blades). Diagnosis can be difficult as frequently patients are incognizant of the nature and time of ingestion. Imaging is commonly non-specific as well. We present an unusual case of a 65-year-old male who had an ileal perforation secondary to a coconut leaf midrib skewer initially presenting as small bowel obstruction. Intraoperatively, adhesions were seen in the ileum with note of the foreign body perforating two bowel loops that was not identified in preoperative imaging. This case highlights the importance of considering atypical causes of small bowel obstruction even in the background of previous surgery. Finally, early recognition, accurate diagnosis, and timely intervention are essential to improve patient outcomes and decrease mortality in such cases.
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INTRODUCTION: Ameloblastomas are slow growing and locally aggressive odontogenic tumors with a high propensity for recurrence. It frequently arises in the mandible and has been reported to metastasize commonly in the lungs. An updated World Health Organization classification re-categorized metastasizing ameloblastomas under benign tumors. Other rare metastatic sites include the skull, maxilla, kidney, and liver. CASE PRESENTATION: We present a 53-year-old female with a gradually enlarging right breast mass for 2 years. She previously underwent right hemimandibulectomy with clavicular bone grafting 15 years ago for a primary ameloblastoma. Preoperative imaging showed a resectable, heterogenous right breast mass with a biopsy revealing spindle cell neoplasm. She subsequently underwent radical mastectomy with a latissimus dorsi myocutaneous flap as a reconstructive procedure. Histopathologic findings were consistent with a metastasizing ameloblastoma. The patient remains disease-free as of most recent follow-up. DISCUSSION: There are several proposed mechanisms for metastasizing ameloblastomas. Based on the history and location of the tumor, we surmised that tumor seeding from the first surgery done 15 years ago may explain this rare occurrence. Preoperative imaging and biopsy determine resectability and surgical approach. Radical surgery is frequently performed which largely depends on the site of the tumor. Complete primary resection with adequate margins remains to be the treatment of choice to prevent recurrence or metastasis. The role of adjuvant radiotherapy or chemotherapy are still to be established. CONCLUSION: This case highlights the value of history-taking and having a high-index of suspicion for metastasis several years after primary resection of ameloblastomas.
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Background@#The introduction of new therapeutic options and advances in the field of breast surgery has put the importance of patient satisfaction and quality of life at par with long-term survival. These essential parameters help physicians and patients decide on the appropriate approach when managing both malignant and benign breast conditions. They have also been used to measure the outcome and success of breast surgery, whether cosmetic or reconstructive, using patients’ perspectives. To date, there is no available questionnaire that is translated, culturally adapted, and validated among Filipino patients to specifically assess their quality of life (QOL) and satisfaction after breast reconstructive surgery.@*Objective@#This study aims to translate a previously validated, internationally accepted, patient-reported outcome (PRO) instrument, the Breast-Q Reconstruction Module, and validate its use among Filipino patients. @*Methods@#This is a tool validation study of a Filipino translation of the Breast-Q Reconstruction Module for the preoperative and postoperative settings. Forward and backward translations were done for the two questionnaires and were finalized after assessment of accuracy and feasibility by language professionals and bilingual patients. We recruited patients referred to the Division of Plastic Surgery of a tertiary government hospital for breast reconstruction to answer the final questionnaires, with 15 re-taking each questionnaire after two weeks. Psychometric properties of the questionnaires, including internal consistency, construct validity, test-retest reliability, and acceptability, were then evaluated. @*Results@#We included 30 patients in this validation study. The internal consistencies of the translated Preoperative and Postoperative Breast-Q Reconstruction Module had high Cronbach’s α coefficients (range: 0.92–0.98 and 0.97–1.00, respectively). Internal consistency was also supported by high mean item-total correlations in all dimensions. The two questionnaires had good test-retest reliability as supported by high intraclass correlation (range for Preoperative: 0.995–1.000 and for Postoperative: 0.95–1.00). Construct validity was supported by inter-scale correlations with low to moderate Spearman’s coefficients (range for Preoperative: 0.22–0.34 and for Postoperative: 0.11–0.27). The sexual well-being dimension had the lowest inter-scale Spearman’s coefficient in both questionnaires and is the only dimension with low acceptability. @*Conclusion@#The translated Preoperative and Postoperative Breast-Q Reconstruction Module has high internal consistency, test-retest reliability, acceptability, and low to moderate construct validity among Filipino patients after breast reconstruction surgery. However, the “Satisfaction with the Nipple Reconstruction” subscale is pending since there were no qualified respondents in the sample population. In considering how their relatively conservative culture influences the way Filipino patients tend to view the importance of sexual satisfaction as it relates to their medical management, the sexual well-being domain is suggested to be interpreted separately when assessing the patient’s overall satisfaction with breast reconstruction procedure.
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Mamoplastia , Qualidade de VidaRESUMO
Liposarcoma is a malignant mesenchymal neoplasm composed of adipose tissue with varying degrees of atypia. These tumors grow slowly and may reach an enormous size particularly if located in the retroperitoneum. We report a 40-year-old male with a 6-month history of gradual abdominal enlargement. Computed tomography (CT) of the abdomen showed a huge retroperitoneal mass with characteristic features consistent with liposarcoma. On laparotomy, the mass was noted to be encasing the right ureter for which a wide excision with en bloc ureterectomy and subsequent renal autotransplantation for organ preservation was done. Post-operative course was uneventful with excellent outcome after 6 months of follow-up. Final histopathologic diagnosis was low-grade, well differentiated liposarcoma, which has favorable prognosis following radical surgery. This was the first report of such a case in the Philippines.
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The objective of this study is to perform the energy and exergy analysis of an integrated ground-source heat pump (GSHP) system, along with technical assessment, for geothermal energy production by deployment of Engineering Equation Solver (EES). The system comprises heat pump cycle and ground heat exchanger for extracting geothermal energy from underground mine water. A simultaneous energy and exergy analysis of the system is brought off. These analyses provided persuasive outcomes due to the use of an economic and green source of energy. The energetic coefficient of performance (COP) of the entire system is 2.33 and the exergy efficiency of the system is 28.6%. The exergetic efficiencies of the compressor, ground heat exchanger, evaporator, expansion valve, condenser and fan are computed to be 38%, 42%, 53%, 55%, 60% and 64%, respectively. In the numerical investigation, different alteration such as changing the temperature and pressure of the condenser show promising potential for further application of GSHPs. The outcomes of this research can be used for developing and designing novel coupled heat and power systems.
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Energia Geotérmica , Temperatura Alta , TemperaturaRESUMO
BACKGROUND: To evaluate functional visual parameters using photocromic and selective blue-violet light filtering spectacle lenses in patients affected by central or peripheral scotoma due to retinal diseases. Sixty patients were enrolled in this study: 30 patients affected by central scotoma, group 1, and 30 affected by peripheral scotoma, group 2. Black on White Best Corrected Visual Acuity (BW-BCVA), White on Black Best Corrected Visual Acuity (WB-BCVA), Mars Contrast Sensitivity (CS) and a Glare Test (GT) were performed to all patients. Test results with blue-violet filter, a short-pass yellow filter and with no filters were compared. RESULTS: All scores from test results increased significantly with blue-violet filters for all patients. The mean BW-BCVA increased from 0.30 ± 0.20 to 0.36 ± 0.21 decimals in group 1 and from 0.44 ± 0.22 to 0.51 ± 0.23 decimals in group 2 (Mean ± SD, p < 0.0001 in both cases). The mean WB-BCVA increased from 0.31 ± 0.19 to 0.38 ± 0.23 decimals in group 1 and from 0.46 ± 0.20 to 0.56 ± 0.22 decimals in group 2 (Mean ± SD, p < 0.0001 in both cases). The letter count for the CS test increased from 26.7 ± 7.9 to 30.06 ± 7.8 in group 1 (Mean ± SD, p = 0.0005) and from 31.5 ± 7.6 to 33.72 ± 7.3 in group 2 (Mean ± SD, p = 0.031). GT was significantly reduced: the letter count increased from 20.93 ± 5.42 to 22.82 ± 4.93 in group 1 (Mean ± SD, p < 0.0001) and from 24.15 ± 5.5 to 25.97 ± 4.7 in group 2 (Mean ± SD, p < 0.0001). Higher scores were recorded with the Blue filter compared to Yellow filter in all tests (p < 0.05). No significant differences in any test results could be detected between the Yellow filter and the No filter condition. CONCLUSIONS: The use of a combination of photocromic lens with a selective blue-violet light filter showed functional benefit in all evaluated patients.
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Óculos , Luz , Doenças Retinianas/reabilitação , Escotoma/reabilitação , Adulto , Idoso , Idoso de 80 Anos ou mais , Sensibilidades de Contraste/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Retinianas/fisiopatologia , Escotoma/fisiopatologia , Acuidade Visual/fisiologiaRESUMO
PurposeTo study the correlation of the local ganglion cell layer-inner plexiform layer (GCL-IPL) thickness with corresponding retinal sensitivity as studied with microperimetry in patients with Type 2 diabetes and no signs of diabetic retinopathy.Patients and methodsWe analyzed 35 healthy subjects (68 eyes) and 26 Type 2 diabetic patients (48 eyes) with no signs of diabetic retinopathy. We tested best corrected visual acuity (BCVA), monocular and binocular constrast sensitivity (CS, Pelli - Robson chart) and retinal sensitivity with microperimetry, and acquired dense macular SD-OCT scans. We then studied the correlation between local GCL-IPL thickness and local sensitivity.ResultsMean BCVA was 1.09 (±1.03) decimals in diabetic subjects and 1.02 (±0.15) decimals in healthy subjects. Only binocular CS was significantly higher in healthy subjects (1.18±0.42 for healthy subjects, 1.62±0.63 for diabetic subjects). In both local and global analysis we observed higher GCL-IPL thickness and higher sensitivity in normal compared with diabetic subjects, but no difference reached significance (p<0.05). Using a mixed multivariate linear model, we found a significant correlation between retinal sensitivity and the correspondent GCL-IPL thickness in diabetic subjects (0.022±0.006 dB/µm, p=0.0007) but not in healthy subjects (-0.002±0.006 dB/µm, p=0.77).Conclusiondespite close similarities between the two groups, we found a significant difference in the structure-function relationship in diabetic subjects without diabetic retinopathy, suggesting that diabetes might act as an additional effect in the normal deterioration of the visual function related to the inner retina.
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Retinopatia Diabética/diagnóstico , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Testes de Campo Visual/métodos , Campos Visuais , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Retinopatia Diabética/etiologia , Retinopatia Diabética/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologiaRESUMO
Mutations in more than 60 different genes have been associated with non-syndromic and syndromic retinitis pigmentosa (RP), a heterogeneous group of inherited retinal dystrophies. To increase the understanding of the molecular epidemiology of the disease in Italy, we analyzed 56 patients with syndromic and non-syndromic forms of RP attending the Retinitis Pigmentosa Center of San Paolo Hospital (Milan, Italy). Patients underwent detailed clinical examination. Genomic DNA isolated from peripheral blood samples was screened for mutations in different genes according to RP form by direct sequencing analysis. The impact of novel missense mutations on protein functions was predicted by in silico analysis and protein sequence alignment. Cosegregation analysis was performed between available family members. Forty-one of the 56 probands analyzed had non-syndromic and 15 had syndromic RP forms. Putative disease-causing mutations were identified in 19 of 56 unrelated RP probands. Mutation screening identified a total of 22 different heterozygous variants. Notably, 12 of these putative pathogenic mutations have not been previously reported. New variants were found to be located on the USH2A, RPGR, EYS, and RHO genes. All 3 new variants detected in X-linked RP probands were confirmed in other affected family members. We found a positivity rate of 24.4% and 60% for probands with non-syndromic and syndromic RP, respectively. This is the first report of RPGR X-linked RP proband-ORF15 mutations in Italian patients with X-linked (XL)-RP. In addition, this is the first report of data regarding the association between EYS mutations and non-syndromic RP forms in the Italian population.
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Predisposição Genética para Doença/genética , Mutação , Retinose Pigmentar/genética , Retinose Pigmentar/patologia , Adulto , Idoso , Sequência de Aminoácidos , Sequência de Bases , Análise Mutacional de DNA , Proteínas da Matriz Extracelular/genética , Proteínas do Olho/genética , Saúde da Família , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Linhagem , Rodopsina/genética , Homologia de Sequência de Aminoácidos , Síndrome , Adulto JovemRESUMO
Kabuki syndrome (KS) is a multiple congenital anomaly/mental retardation syndrome with characteristic facial features. Despite more than 350 documented cases and recent correlation of MLL2 mutations as a genetic cause, its full clinical spectrum is still being defined. This report describes two patients who were initially diagnosed with Van der Woude syndrome (VWS) based on the presence of lower lip pits. However, this finding can occur with KS, albeit infrequently. For patients with lower lip pits, a thorough evaluation should be made to distinguish between VWS and KS, as there are differences in long-term prognosis.
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Anormalidades Múltiplas/diagnóstico , Anormalidades Múltiplas/cirurgia , Fenda Labial/diagnóstico , Fissura Palatina/diagnóstico , Cistos/diagnóstico , Face/anormalidades , Doenças Hematológicas/diagnóstico , Doenças Hematológicas/cirurgia , Lábio/anormalidades , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/cirurgia , Diagnóstico Diferencial , Face/cirurgia , Feminino , Humanos , Lactente , MasculinoRESUMO
Although the use of medicinal plants or natural products has increased in recent decades all over the world, little information is available on their potential risk to health. Annona crassiflora Mart., a plant commonly known as araticum in Brazil, has been widely used in folk medicine for a long time since its seeds and leaves are often utilised in the treatment of cancer, snake bites, and venereal diseases, its fruits are consumed as tonic and astringent, and its bark powder has anti-fungal and anti-rheumatic properties. To evaluate the genotoxic and mutagenic properties induced by the ethanolic extract of araticum leaves, we performed the prophage λ induction (Inductest) and bacterial mutagenicity assays. We used Escherichia coli WP2s(λ) and RJF013 strains in the lysogenic induction test, whereas the mutagenic studies were carried out using Salmonella typhimurium histidine auxotroph strains TA97a, TA98, TA100, and TA102. Each experiment was performed three times in duplicate and included positive and negative controls. No statistically significant (p > 0.05) positive results were obtained for any of the strains tested, which suggests that the ethanolic extract of araticum leaves did not exhibit direct mechanisms of genotoxicity or mutagenicity that could be detected by the tests used in the present work.
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Annona/química , Escherichia coli/efeitos dos fármacos , Testes de Mutagenicidade/métodos , Extratos Vegetais/toxicidade , Salmonella typhimurium/efeitos dos fármacos , Dano ao DNA/efeitos dos fármacos , Dano ao DNA/genética , Escherichia coli/genética , Prófagos/efeitos dos fármacos , Prófagos/genética , Resposta SOS em Genética/efeitos dos fármacos , Resposta SOS em Genética/genética , Salmonella typhimurium/genéticaRESUMO
Landscape planning and restoration in mine closure areas is not only an inevitable choice to sustain mining areas but also an important path to maximize landscape resources and to improve ecological function in mine closure areas. The analysis of the present mine development shows that many mines are unavoidably facing closures in China. This paper analyzes the periodic impact of mining activities on landscapes and then proposes planning concepts and principles. According to the landscape characteristics in mine closure areas, this paper classifies available landscape resources in mine closure areas into the landscape for restoration, for limited restoration and for protection, and then summarizes directions for their uses. This paper establishes the framework of spatial control planning and design of landscape elements from "macro control, medium allocation and micro optimization" for the purpose of managing and using this kind of special landscape resources. Finally, this paper applies the theories and methods to a case study in Wu'an from two aspects: the construction of a sustainable land-use pattern on a large scale and the optimized allocation of typical mine landscape resources on a small scale.
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Conservação dos Recursos Naturais , Mineração , ChinaRESUMO
Hydrolysable tannins, total phenols and flavonoids in Eugenia uniflora leaves were monthly analysed for one year. The results were correlated with climate conditions (rainfall, humidity, cloudiness and mean temperature) through chemometric methods. Principal component analysis revealed high levels of hydrolysable tannins in the rainy season, whereas flavonoids were mainly produced in the dry season. These facts suggest that climatic changes may be one of the factors affecting phenol levels in Eugenia uniflora.
Taninos hidrolisáveis, fenóis totais e flavonóides presentes em folhas de Eugenia uniflora foram quantificados mensalmente durante um ano. Os resultados foram correlacionados com as condições climáticas (pluviosidade, umidade, nebulosidade e temperatura média) através de métodos quimiométricos. Análise de componentes principais revelou a ocorrência de altos teores de taninos hidrolisáveis durante a estação de chuvas, enquanto os flavonóides foram produzidos principalmente na estação seca. Estes fatos sugerem que mudanças climáticas podem ser um dos fatores que afetam os níveis de fenóis em Eugenia uniflora.
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Eugenia/crescimento & desenvolvimento , Fenóis/síntese química , Estações do Ano/efeitos adversos , Mudança Climática , Taninos HidrolisáveisRESUMO
A carqueja-amarga [Baccharis trimera (Asteraceae)] é uma espécie originária do centro-sul da América do Sul. Análises qualitativas e quantitativas foram realizadas utilizando-se a técnica de CG-MS, para avaliar o efeito de diferentes formas de beneficiamento pós-colheita de drogas vegetais constituídas de partes aéreas de carqueja na composição química do óleo essencial, bem como verificar variações na composição quando conservado a -6ºC, durante 8 meses. O armazenamento da droga pulverizada reduziu significativamente o teor de óleo essencial, o que não aconteceu na droga fragmentada. Os teores dos constituintes majoritários espatulenol e ledol não foram influenciados pelo tratamento pós-colheita, embora tenham apresentado variações distintas redução nas concentrações de ledol e aumento nos teores de espatulenol. Verificou-se que as drogas fragmentadas podem ser armazenadas por até 12 meses e pulverizadas no momento da extração, não conferindo redução no teor de óleo essencial, nem dos constituintes químicos. O armazenamento a -6ºC por até oito meses, provocou variações quantitativas em alguns constituintes minoritários, tais como a-guaieno, b-selineno, germacreno B e espatulenol.
"Carqueja-amarga" [Baccharis trimera (Asteraceae)] is a species from the central south of South America. Qualitative and quantitative analyses were performed using the technique gas chromatography coupled to mass spectrometry to evaluate the effect of different post-harvest processing forms of drugs constituted of parts of "carqueja" on the chemical composition of its essential oil. The variation in the chemical composition of the essential oil stored at -6ºC for up to eight months was also evaluated. Storage of powdered drug significantly reduced the essential oil content, which was not observed for fragmented drug. The concentration of the major constituents of "carqueja" essential oil, spathulenol and ledol, was not affected by the post-harvest treatment, although they presented distinct variations, with ledol concentrations reducing and spathulenol concentrations increasing. We found that fragmented drugs can be stored for up to 12 months and powdered at the moment of extraction, without reducing the concentration of the essential oil or its chemical constituents. Storage at -6ºC for eight months caused quantitative variations in some minor constituents of the essential oil such as a-guaiene, b-selinene, germacrene B and espathulenol.
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Produção Agrícola , Baccharis/química , Extratos Vegetais/farmacocinética , Óleos Voláteis , Asteraceae/química , Sinergismo Farmacológico , Manejo de Espécimes/efeitos adversos , Plantas Medicinais , Estudos de Avaliação como Assunto , Estudos de Avaliação como AssuntoRESUMO
BACKGROUND: Improved treatment have modified survival outcome in patients with diffuse large B-cell lymphoma (DLBCL) and altered the importance of previously recognized prognostic markers. DESIGN AND METHODS: To evaluate International Prognostic Index (IPI) score before and after rituximab introduction and to validate the absolute lymphocyte count (ALC)/revised International Prognostic Index (R-IPI) model, we carried out a retrospective analysis on a total of 831 patients with DLBCL. RESULTS: Our results show that IPI lost its discriminating power with the introduction of rituximab. The analysis of our second set allowed us to validate the ALC/R-IPI model. The R-IPI and ALC/R-IPI could still be used for designing clinical trials, but both have difficulty recognizing a high percentage of poor prognosis patients, though it remains an important goal of a good prognostic model considering the modest impact of salvage treatments on survival. CONCLUSIONS: A new model on the basis of significant variables in the rituximab era and built on a large database of patients treated with rituximab is urgently needed. As prognostic models are changing with the efficacy and mechanisms of action of treatment utilized, looking for a new prognostic score is a never-ending story in which researchers are trying to hit a continuously moving target.
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Anticorpos Monoclonais/uso terapêutico , Antineoplásicos/uso terapêutico , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Modelos Estatísticos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Murinos , Feminino , Seguimentos , Humanos , Contagem de Linfócitos , Linfoma Difuso de Grandes Células B/mortalidade , Linfoma Difuso de Grandes Células B/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Indução de Remissão , Estudos Retrospectivos , Rituximab , Taxa de Sobrevida , Adulto JovemRESUMO
Some neuromuscular disorders, such as Duchenne muscular dystrophy, hereditary inclusion body myopathy, malignant hyperthermia, alcoholic myopathy and mitochondrial myopathies are characterized by oxidative stress and loss of muscle fibres due to apoptosis. In this study we have analyzed muscle cell death in vitro utilizing C2C12 myoblasts and myotubes, inducing apoptosis by means of UVB irradiation. C2C12 cells were analysed by scanning and transmission electron microscopy (SEM, TEM) as well as by TUNEL reaction. DNA analysis was performed by gel electrophoresis and flow cytometry. MitoTracker red CMXRos and JC-1 fluorescent probes were also used to study mitochondrial behavior. Finally, caspase activity was investigated by means of Western blot, while caspase-9 and -3 inhibitor effects by means of SEM. SEM showed the typical membrane blebbing while TEM revealed the characteristic chromatin condensation. The TUNEL reaction presented a certain positivity too. Apoptotic and non-apoptotic nuclei in the same myotube were identified both by TUNEL and TEM. Gel electrophoresis never showed oligonucleosomal DNA fragmentation, in agreement with the cell cycle analysis performed by flow cytometry which did not reveal a sharp subdiploid peak. Mitochondrial response to UVB was later investigated and a decrease in mitochondrial functionality appeared. Caspase-9 and -3 cleavage, and, consequently, the activation of the caspase cascade, was also demonstrated by Western blot. Moreover a decrease in apoptotic cell number was noted after caspase-9 and-3 inhibitor treatment. All these results indicated that UVB irradiation induces apoptosis, both in myoblasts and in myotubes, the second being more resistant. DNA fragmentation, at least the nucleosomic type, does not occur. A certain double-strand cleavage appears in TUNEL analysis, as well as characteristic ultrastructural changes in chromatin.
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Apoptose/fisiologia , Músculo Esquelético/citologia , Músculo Esquelético/metabolismo , Animais , Western Blotting , Caspases/metabolismo , Linhagem Celular , DNA/análise , DNA/biossíntese , DNA/genética , Eletroforese em Gel de Poliacrilamida , Citometria de Fluxo , Marcação In Situ das Extremidades Cortadas , Potenciais da Membrana/fisiologia , Microscopia Eletrônica de Varredura , Microscopia Eletrônica de Transmissão , Microscopia de Fluorescência , Membranas Mitocondriais/fisiologia , Fibras Musculares Esqueléticas/fisiologia , Fibras Musculares Esqueléticas/ultraestrutura , Mioblastos/fisiologia , Mioblastos/ultraestrutura , Raios UltravioletaRESUMO
INTRODUCTION: At variance from office spirometry, telespirometry has not been tested as a tool for improving the ability of general practitioners (GPs) to manage chronic airway diseases. METHODS: After adequate training, 937 Italian GPs agreed to perform telespirometry in subjects attending their clinics who had risk factors, persistent respiratory symptoms, or a previous diagnosis of asthma or COPD. Each subject performed at least three forced expiratory manoeuvres using a turbine spirometer. Traces were sent by telephone to a Telespirometry Central Office, where they were interpreted by a pulmonary specialist, according to defined criteria. The result was sent in real time to the GP to assist the management of the patient. RESULTS: During 2 years, 20,757 telespirometries were performed, with a mean of 22.2+/-25.2 examinations for each GP. 70% of the tests met the criteria for good or partial co-operation, allowing spirometric abnormalities to be detected in more than 40% of the tracings. The rate of telespirometries that could not be evaluated at all was reasonably low (9.2%). For a subset of the telespirometries, a comparison between acceptability criteria for telespirometry and those recommended for laboratory (ATS) or office spirometry showed that the majority of telespirometries with good co-operation satisfied completely, or with minor deviations, the ATS and Office criteria. CONCLUSIONS: Telespirometry was well accepted by Italian GPs, who obtained acceptable screening traces in a large percentage of subjects. Therefore it might be considered a useful alternative to office spirometry in improving the management of chronic airway diseases by GPs.
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Asma/diagnóstico , Medicina de Família e Comunidade/métodos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Espirometria/métodos , Telemedicina/métodos , Adulto , Asma/terapia , Competência Clínica , Estudos de Viabilidade , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Médicos de Família , Doença Pulmonar Obstrutiva Crônica/terapia , Garantia da Qualidade dos Cuidados de Saúde , Fatores de Risco , Espirometria/instrumentação , Telemedicina/instrumentação , Resultado do TratamentoRESUMO
The pineal gland hormone melatonin has been recently described to downregulate the intrinsic (or damage-induced) pathway of apoptosis in human leukocytes. These properties appear to depend on a specific mitochondrial signaling of melatonin which is associated with a lower generation of reactive oxygen species and a better control of redox-sensitive components such as the antiapoptotic protein Bcl-2. Other elements upstream in this signaling are expected to contribute regulatory roles that remain unexplored. The aim of this study was to investigate whether the extracellular signal-regulated kinase (ERK), which controls the balance between survival and death-promoting genes throughout the MAPK pathway, is involved in the antiapoptotic signaling of melatonin. Human monocytic U937 cells irradiated with UVB light were used as a model of stress-induced apoptosis. In this model we found that pharmacological concentrations of melatonin (1 mM) were able to decrease superoxide anion production, mitochondrial damage, and caspase-dependent apoptosis by improved Bcl-2 levels and decreased Cyt c release in the cytoplasm. Moreover, melatonin increased the phosphorylative activation of ERK 1/2 independently from the presence of UVB stress, and decreased the UVB-mediated activation of the stress kinases p38 MAPK and JNK. The ERK 1/2 inhibitor PD98059, but not the p38 MAPK inhibitor SB203580, abolished to different extents the effects that melatonin had on the UVB-induced ROS generation, mitochondrial dysfunction, and apoptosis. Using these inhibitors, a cross-talk effect between stress and survival-promoting kinases was tentatively identified, and confirmed the hierarchical role of ERK MAPK phosphorylation in the signaling of melatonin. In conclusion, melatonin sustains the activation of the survival-promoting pathway ERK MAPK which is required to antagonize UVB-induced apoptosis of U937 cells. This kinase mediates also the antioxidant and mitochondrial protection effects of this hormonal substance that may find therapeutic applications in inflammatory and immune diseases associated with leukocyte oxidative stress and accelerated apoptosis.
Assuntos
Citocromos c/metabolismo , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Melatonina/metabolismo , Monócitos/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Apoptose/efeitos da radiação , Citocromos c/genética , MAP Quinases Reguladas por Sinal Extracelular/antagonistas & inibidores , MAP Quinases Reguladas por Sinal Extracelular/genética , Flavonoides/farmacologia , Humanos , Imidazóis/farmacologia , Mitocôndrias/metabolismo , Mitocôndrias/efeitos da radiação , Monócitos/citologia , Monócitos/efeitos da radiação , Proteínas Proto-Oncogênicas c-bcl-2/genética , Piridinas/farmacologia , Tolerância a Radiação , Transdução de Sinais/efeitos da radiação , Células U937 , Raios Ultravioleta , Proteínas Quinases p38 Ativadas por Mitógeno/antagonistas & inibidoresRESUMO
Hyptis marrubioides Epling (hortelã-do-campo) é espécie de uso medicinal conhecida pelas suas atividades contra infecções gastrointestinais, infecções de pele, dores e câimbras. Objetivou-se com este trabalho, avaliar o teor e composição química do óleo essencial de H. marrubioides em diferentes genótipos (roxo e branco) e partes da planta fresca (folhas, inflorescências e caule). Os genótipos estudados foram identificados através das inflorescências das plantas que apresentam coloração roxa e branca. O delineamento experimental foi inteiramente casualizado, contendo as três partes da planta de ambos os genótipos, perfazendo um fatorial 3x2, com quatro repetições. O óleo essencial foi extraído por hidrodestilação por duas horas e analisado por Cromatografia Gasosa acoplada a Espectrometria de Massas (CG-EM). O maior teor de óleo essencial foi observado na inflorescência do genótipo roxo. A composição do óleo essencial de H. marrubioides variou quantitativamente entre as partes das plantas analisadas e entre os genótipos. O composto α-tujona apresentou a maior porcentagem de área do pico nas inflorescências de genótipo roxo. As porcentagens das plantas com genótipo roxo foram em média superiores às plantas com genótipo branco.
Hyptis marrubioides Epling ("hortelã-do-campo") is a medicinal species known for its activities against gastrointestinal and skin infections, pains and cramps. The aim of this work was to evaluate essential oil content and chemical composition in H. marrubioides of different genotypes (purple and white), as well as fresh plant parts (leaves, inflorescences and stem). The studied genotypes were identified based on the inflorescences, which are purple and white. The experimental design was completely randomized, including the three parts of both genotypes, in a 3X2 factorial arrangement, with four replicates. Essential oil was extracted through hydrodistillation for two hours and analyzed using Gas Chromatography attached to a Mass Spectrometry (GC-MS). The highest essential oil content was found for the inflorescence of purple genotype. Hyptis marrubioides essential oil composition quantitatively varied among the analyzed plant parts and between genotypes. The compound α-thujone had the highest percentage of apex area in inflorescences of purple genotype. The percentages of purple genotype were on average higher than those of white one.
Assuntos
Óleos Voláteis/química , Química , Hyptis/fisiologia , Genótipo , Plantas Medicinais/classificação , Cromatografia Gasosa/métodos , Mentha/classificaçãoRESUMO
A typical Brazilian plant, araticum (Annona crassiflora Mart.), is widely used in humans as therapeutic medicine to treat several diseases such as diarrhea, rheumatism and syphilis. It contains acetogenins which present cytotoxic, antitumogenic, and antiparasitic properties. In this study, mutagenic, antimutagenic and cytotoxic effects of araticum leaves ethanolic extract were evaluated by micronucleus test in mice. To evaluate the mutagenic activity, animals were treated with ethanolic extract of araticum (EEA) using 10, 20, 50, 100 and 160 mg.kg(-1). For all doses, micronucleated polychromatic erythrocytes (MNPCE) frequency was evaluated at 24, 48 and 72 hours after treatment. To evaluate the antimutagenic activity, animals were treated with 10, 20, 50 and 100 mg.kg(-1) of EEA and 4 mg.kg(-1) of MMC simultaneously. The frequency of MNPCE was evaluated 36 hours after exposure. Cytotoxicity was evaluated by the polychromatic and normochromatic erythrocytes ratio (PCE/NCE). In the mutagenicity assessment, all doses of EEA resulted in no significant increase of MNPCE (P > 0.05), compared to solvent- control group. Regarding administration time, no significant difference among three evaluation periods was observed (P > 0.05). Such results indicate that EEA did not exert mutagenic activity. Cytotoxicity was evident in doses of 50, 100 and 160 mg.kg(-1) at 24 and 48 hours after exposure. Concerning antimutagenicity, except the 10 mg.kg(-1) co-administered with 4 mg/kg of MMC, all doses reduced significantly the frequency of MNPCE compared to the positive control group (P < 0.05). These results, therefore, indicate an antimutagenic activity of the EEA. Cytotoxicity was significantly increased (P < 0.01) at 100 mg.kg(-1) EEA doses co-administered with 4 mg.kg(-1) of MMC.
Assuntos
Annona/química , Antimutagênicos/farmacologia , Medula Óssea/efeitos dos fármacos , Eritrócitos Anormais/efeitos dos fármacos , Extratos Vegetais/farmacologia , Animais , Antimutagênicos/isolamento & purificação , Relação Dose-Resposta a Droga , Masculino , Camundongos , Testes para MicronúcleosRESUMO
During muscle tissue differentiation, in particular in the formation of myotubes from the myoblasts, plasma membrane changes its morpho-functional characteristics. In this study, muscle cell membrane behaviour has been studied along the differentiation of C2C12, a mouse myoblastic adherent cell line. Flat undifferentiated cells, cultured for 3-4 days in the differentiation medium, progressively become thick, long and multinucleated myotubes covered with microvilli. They lose stress fibers and adhesion to the underlying substrate evidentiating an actin redistribution, followed by the spatial organization of thick and thin myofilaments. Sarcomeres and myofibrils occasionally appear, even if a certain percentage of "myosacs" containing randomly oriented filaments can be identified all along the differentiation. M-cadherin, a molecule involved in cell-cell adhesion, also appears in the early differentiation stage, during myoblast fusion. Occasional focal contractions can also be observed in myotubes, which prompt an electrophysiological membrane analysis. When studied by means of patch clamp technique, resting membrane potential appears to undergo a transient depolarization, while input resistance increases until day 5 after differentiation induction, then successively decreases. Capacitance declines until day 5, later appearing enhanced. Moreover, with the induction of differentiation, the pattern of functional voltage-dependent ion channels changes. Therefore, during myogenesis, cell maturation is coupled with changes in cell membrane morphological features and functional characteristics.