Tricobezoar de estómago / Gastric Trichobezoar Rapunzel Syndrome

Trichobezoars are an unusual pathology that appears generally in young adolescents associated with psychiatric disorders. The clinical presentation is very varied. The diagnosis is suspected by the clinical records of teen agers with trichophagia and trichotillomania and the digestive disorders are confirmed by the results of the endoscopy, the same as with images toward the therapeutic management. Undowbtly the treatment is surgical, and continuation with the psychiatric treatment is essential to avoid a recidival of the disease. Bezoar is a concretion formed in the alimentary tract, and according to the substances forming the ball, we find trichobezoar (foodball). The Rapunzel syndrome is an unusual complication of individual bezoar. When the trichobezoar located in the stomach extends through the pylorus into the small intestine and the right colon, is known as Rapunzel syndrome, that is an extremely rare gastric condition in humans. It is a rare form of trichobezoar, occurring in psychiatric patients with the trichobezoar (hairball) located in the stomach. The syndrome is named after the long haired girl Rapunzel in the fairy tale of the brothers Grimm. Most bezoars in teen agers are trichobezoars from swallowed hair. A 28-year-old patient is presented, with abdominal pain and vomiting, on the general physical examination the patient revealed a severe weight loss. Later on, through a gastrostomy, appeared the trichobezoar, being removed with good postsurgical resullts

Linking stable isotopes and biochemical responses in Balanus glandula under sewage influence.

In the present study, we analyzed the influence of untreated sewage exposure on carbon (δ13C) and nitrogen (δ15N) isotopic composition and several biochemical responses in the barnacle Balanus glandula. The main objective was to evaluate whether changes in stable isotopes signature do reflect biochemical sub-lethal effects in a sewage influence gradient. Stable isotopes analysis showed differences in isotope signatures between close sewage influence and distant sites, being δ13C signatures stronger than that of δ15N. Regarding biochemical effects, although organisms close to the effluent would be clearly exposed to contaminants (increased GST activity) the oxidative stress would not be too evident (peroxidases and ACAP not affected). The most affected physiological aspect was the digestive one, reflected in increased alkaline proteases and lipases activities. A clear relation between δ15N and GST activity was found, showing to δ15N as an indicator of potential exposure to chemical contaminants.

An internally validated new clinical and inflammation-based prognostic score for patients with advanced hepatocellular carcinoma treated with sorafenib.

BACKGROUND: Sorafenib is a standard treatment for patients (pts) with advanced hepatocellular carcinoma (aHCC), although the clinical benefit is heterogeneous between different pts groups. Among novel prognostic factors, a low baseline neutrophil-to-lymphocyte ratio (bNLR) and early-onset diarrhoea have been linked with a better prognosis. PURPOSE: To identify prognostic factors in pts with aHCC treated with 1st-line sorafenib and to develop a new prognostic score to guide management. MATERIALS AND METHODS: Retrospective review of 145 pts bNLR, overall toxicity, early toxicity rates and overall survival (OS) were assessed. Univariate and multivariate analysis of prognostic factors for OS was performed. The prognostic score was calculated from the coefficients found in the Cox analysis. ROC curves and pseudoR2 index were used for internal validation. Discrimination ability and calibration were tested by Harrel's c-index (HCI) and Akaike criteria (AIC). RESULTS: The optimal bNLR cut-off for the prediction of OS was 4 (AUC 0.62). Independent prognostic factors in multivariate analysis for OS were performance status (PS) (p < .0001), Child-Pugh (C-P) score (p = 0.005), early-onset diarrhoea (p = 0.006) and BNLR (0.011). The prognostic score based on these four variables was found efficient (HCI = 0.659; AIC = 1.180). Four risk groups for OS could be identified: a very low-risk (median OS = 48.6 months), a low-risk (median OS = 11.6 months), an intermediate-risk (median OS = 8.3 months) and a high-risk group (median OS = 4.4 months). CONCLUSIONS: PS and C-P score were the main prognostic factors for OS, followed by early-onset diarrhoea and bNLR. We identified four risk groups for OS depending on these parameters. This prognostic model could be useful for patient stratification, but an external validation is needed.

Antibacterial and leishmanicidal activity of Bolivian propolis.

UNLABELLED: The antimicrobial activity of Bolivian propolis was assessed for the first time on a panel of bacteria and two endemic parasitic protozoa. Ten samples of Bolivian propolis and their main constituents were tested using the micro-broth dilution method against 11 bacterial pathogenic strains as well as against promastigotes of Leishmania amazonensis and L. braziliensis using the XTT-based colorimetric method. The methanolic extracts showed antibacterial effect ranging from inactive (MICs > 1000 µg ml(-1) ) to low (MICs 250-1000 µg ml(-1) ), moderate (62·5-125 µg ml(-1) ) and high antibacterial activity (MIC 31·2 µg ml(-1) ), according to the collection place and chemical composition. The most active samples towards Leishmania species were from Cochabamba and Tarija, with IC50 values of 12·1 and 7·8, 8·0 and 10·9 µg ml(-1) against L. amazonensis and Leishmania brasiliensis respectively. The results show that the best antibacterial and antiprotozoal effect was observed for some phenolic-rich propolis. SIGNIFICANCE AND IMPACT OF THE STUDY: Propolis is used in Bolivia as an antimicrobial agent. Bolivian propolis from the main production areas was assessed for antibacterial and leishmanicidal effect and the results were compared with the propolis chemical composition. The active antibacterial propolis samples were phenolic-rich while those containing mainly triterpenes were devoid of activity or weakly active. A similar picture was obtained for the effect on Leishmania, with better effect for the phenolic-rich samples. As propolis is used for the same purposes regardless of the production area and composition, our findings indicate the need for the standardization of this natural product as antimicrobial.

Characterization, feasibility and optimization of Agaricus subrufescens growth based on chemical elements on casing layer.

The aim of this study was to analyze yields, biological efficiency, earliness (expressed as days to first harvest), and precociousness and establish models for the mushroom growing according to these parameters. The experiment followed a double factorial design with four sources of calcium (calcitic limestone, calcitic limestone + gypsum, dolomitic limestone and dolomitic limestone + gypsum) and 2 application times (25 days before casing and at the moment of casing), with 4 replicates for each treatment. Different calcium sources influenced differently Agaricus subrufescens production, especially as regards earliness, which showed significantly higher values when dolomitic limestone with gypsum was applied. Yield and biological efficiency were negatively correlated with H + AL, organic matter and Mg amount. Furthermore, earliness was positively correlated with H + Al, organic matter, and the amount of Mg and Fe. Finally, negative correlations were observed between precociousness and the amount of Ca, SB (sum of base), CEC (cation exchange capacity) and V% (percentage of base saturation). The models presented in this work are extremely important for predicting the agronomic performance of Agaricus subrufescens on the basis of chemical analysis provided by the casing soil.

Intradermal injection of Bothrops cotiara venom in mice in an experimental wound model

Bothropic envenomation induces hemorrhage, coagulant disturbances and necrosis. Regarding therapies against the local damage caused by the venom, there is little information on tissue changes until the complete healing. In the current study, local damage was evaluated by examination of morphological inflammatory alterations, mast cell count, and analysis of collagen deposition. Bleeding was evident four hours after inoculation. After 24 hours, a large area of injury appeared presenting disorganized tissue, significant hemorrhage and acute inflammation. After three days, the damaged area was extensive, with a large amount of inflammatory cells and the presence of scab. In seven days, healing and reepithelization process started. And, 21 days later, the epithelium showed less infiltration and no skin appendages. The number of mast cells was similar to control after four hours, with a drop of 50 percent at 24 hours, followed by an increase until the 21st day. No differences of collagen deposition were observed among experimental groups. Taken together, wound healing after intradermal injection of Bothrops cotiara venom in mice follows similar parameters to wounds caused by other bothropic venoms. The present work reveals the importance of experimental wound models to the study of neutralizing agents against venom toxins.(AU)

Intradermal injection of Bothrops cotiara venom in mice in an experimental wound model

Bothropic envenomation induces hemorrhage, coagulant disturbances and necrosis. Regarding therapies against the local damage caused by the venom, there is little information on tissue changes until the complete healing. In the current study, local damage was evaluated by examination of morphological inflammatory alterations, mast cell count, and analysis of collagen deposition. Bleeding was evident four hours after inoculation. After 24 hours, a large area of injury appeared presenting disorganized tissue, significant hemorrhage and acute inflammation. After three days, the damaged area was extensive, with a large amount of inflammatory cells and the presence of scab. In seven days, healing and reepithelization process started. And, 21 days later, the epithelium showed less infiltration and no skin appendages. The number of mast cells was similar to control after four hours, with a drop of 50 percent at 24 hours, followed by an increase until the 21st day. No differences of collagen deposition were observed among experimental groups. Taken together, wound healing after intradermal injection of Bothrops cotiara venom in mice follows similar parameters to wounds caused by other bothropic venoms. The present work reveals the importance of experimental wound models to the study of neutralizing agents against venom toxins.

Evaluation of antinociceptive effects of Galipea longiflora alkaloid extract and major alkaloid 2-phenylquinoline.

The present study evaluated the antinociceptive properties of an alkaloid extract and 2-phenylquinoline obtained from the bark of Galipea longiflora Krause (Rutaceae) against different models of pain in mice. The results demonstrate that the alkaloid extract caused a pronounced antinociceptive effect with the main alkaloid detected, 2-phenylquinoline, exhibiting moderate activity. The alkaloid extract had a calculated ID50 value of 20.3 mg/kg i.p. and less than 50 mg/kg p.o. against the writhing test which proved to be more effective than the reference drugs when administered by both routes. The ID50 of 2-phenylquinoline was 52.8 mg/kg i.p. with an inhibition of 24.5% when administered orally at 100 mg/kg. In the formalin test the alkaloid extract, but not 2-phenylquinoline, significantly inhibited both phases of pain (neurogenic and inflammatory) at 10 mg/kg i.p. with inhibitions of 37.4% and 58.3%, respectively. The alkaloid extract and 2-phenylquinoline caused only a modest effect in the capsaicin and glutamate tests. In the hot plate test, the alkaloid extract increased the latency time by 25.6% at 10 mg/kg i.p. compared to 2-phenylquinoline which was less effective. It appears that the antinociceptive effects of this plant may be attributed, at least in part, to the presence of some antinociceptive alkaloids in minor concentrations.

An alkaloid extract of Evanta, traditionally used as anti-Leishmania agent in Bolivia, inhibits cellular proliferation and interferon-gamma production in polyclonally activated cells.

Traditional medicine and scientific studies have shown that the raw extract of Evanta [Galipea longiflora, Angostura longiflora (Krause) Kallunki] exhibits anti-leishmanial activity. We hypothesized that the healing observed when using this plant might not only be due to the direct action on the parasite, but possibly to a parallel effect on the host immune response to the parasite involved in the healing process. We show here that an alkaloid extract of Evanta (AEE) directly killed the parasite already at a dose of 10 microg/ml, but at this low concentration, AEE did not have a major effect on viability and proliferation of eukaryotic cells. The whole extract was also found to be stronger than 2-phenylquinoline, the most prominent alkaloid in AEE. AEE was not directly stimulating B or T cells or J774 macrophages. However, it interfered with the activation of both mouse and human T cells, as revealed by a reduction of in vitro cellular proliferation and interferon-gamma (IFN-gamma) production. The effect was more evident when the cells were pretreated with AEE and subsequently stimulated with the polyclonal T-cell activators Concanavalin A and anti-CD3. Taken together, our results suggest that Evanta have a direct leishmanicidal effect and due to the effect on IFN-gamma production it might contribute to control the chronic inflammatory reaction that characterize Leishmania infection pathology, but in vivo studies are necessary to corroborate this finding.

Antimalarial activity of some Colombian medicinal plants.

Antimalarial activity of 10 vegetal extracts (9 ethanolic extracts and 1 crude alkaloid extract), obtained from eight species traditionally used in Colombia to treat malaria symptoms, was evaluated in culture using Plasmodium falciparum chloroquine resistant (FcB2) strain and in vivo on rodent malaria Plasmodium berghei. The activity on ferriprotoporphyrin biomineralization inhibition test (FBIT) was also assessed. Against Plasmodium falciparum, eight extracts displayed good activity Abuta grandifolia (Mart.) Sandwith (Menispermaceae) leaves, Acacia farnesiana (L.) Willd. (Mimosaceae) leaves, Acnistus arborescens (L.) Schltdl. (Solanaceae) aerial part, Croton leptostachyus Kunth (Euphorbiaceae) aerial part, Piper cumanense Kunth (Piperaceae) fruits and leaves, Piper holtonii C. DC. (Piperaceae) aerial part and Xylopia aromatica (Lam.) Mart. (Annonaceae) bark with IC(50) values ranging from <1 to 2.1 microg/ml, while in the in vivo model only Abuta grandifolia alkaloid crude extract exhibits activity, inhibiting 66% of the parasite growth at 250 mg/kg/day. In the FBIT model, five extracts were active (Abuta grandifolia, Croton leptostachyus, Piper cumanense fruit and leaves and Xylopia aromatica).

In vitro immunomodulatory activity of plants used by the Tacana ethnic group in Bolivia.

One hundred and seventy-eight ethanolic plant extracts from the pharmacopoeia of the Tacana, an ethnic group from Bolivia, were screened for immunomodulatory activity using complement cascade inhibition and ADP-induced platelet aggregation inhibition assays. Six impaired both complement pathways (classical and alternative): stem bark from Astronium urundeuvea (Anacardiaceae), Cochlospermum vitifolium (Cochlospermaceae), Terminalia amazonica (Combretaceae), Triplaris americana (Polygonaceae), Uncaria tomentosa (Rubiaceae) and Euterpe precatoria (Arecaceae) roots. Inhibition of complement cascade was independent of essential ion complexation, and was not due to direct hemolytic activity on target red blood cells. For A. urundeuvea, C. vitifolium, and T. amazonica, anti-inflammatory activity relied on cyclo-oxygenase inhibition. Four of these species (A. urundeuva, T. americana, U. tomentosa and E. precatoria) are used traditionally to treat inflammatory processes.

A search for natural bioactive compounds in Bolivia through a multidisciplinary approach. Part VI. Evaluation of the antimalarial activity of plants used by Isoceño-Guaraní Indians.

Seventy-seven plant extracts (corresponding to 62 different species) traditionally used by the Isoceño-Guaraní, a native community living in the Bolivian Chaco, were screened for antimalarial activity in vitro on Plasmodium falciparum chloroquine sensitive strain (F32), and on ferriprotoporphyrin (FP) IX biocrystallisation inhibition test (FBIT). Among these extracts, seven displayed strong in vitro antimalarial activity, and 25 were active in the FBIT test. Positive results on both tests were recorded for six extracts: Argemone subfusiformis aerial part, Aspidosperma quebracho-blanco bark, Castela coccinea leaves and bark, Solanum argentinum leaves and Vallesia glabra bark. Results are discussed in relation with Isoceño-Guaraní traditional medicine. Further studies to be undertaken in relation with these results are also highlighted.

Consumer acceptability versus trained sensory panel scores of powdered milk shelf-life defects.

The objective of the present work was to correlate consumer panel acceptability versus trained sensory panel scores for appearance and flavor defects likely to appear during storage of whole milk powder. Descriptors selected for the study were: acid, caramel, cooked, dark color, lipolysis, and oxidized. For each descriptor a set of nine samples with different intensities were measured for acceptability and likelihood to consume by a 50-member consumer panel and for sensory intensity by a trained panel. Linear correlations between sensory acceptability and trained sensory panel scores were used to determine the sensory failure cut-off point for each descriptor, except caramel and cooked, which were not critical from the consumer's point of view. Differences in acceptability were found between Argentine and Uruguayan consumers for oxidized samples, while for lipolysis flavor, Argentine and Costa Rican consumers behaved similarly. For the color descriptor, significant changes in acceptability measured on a hedonic scale did not mean that consumers refused to consume the product. In contrast, for flavor descriptors, as soon as a significant decrease in acceptability occurred approximately 30% of the consumers said they would not consume the product. The sensory failure cut-off points presented in this paper can be used as a guide in future studies on the shelf life of MP and can also be of value in establishing sensory specifications for quality control programs. The methodology of correlating consumer acceptability to sensory panel scores and, thus, defining sensory failure is an improvement over more arbitrary criteria presented in most shelf-life studies.

Digestive proteinases of Artemesia longinaris (Decapoda, Penaeidae) and relationship with molting.

Digestive proteinase activities of Artemesia longinaris were assayed at different stages of the molting cycle. Total proteolytic activity in the hepatopancreas was highest during postmolt. Trypsin and chymotrypsin activities were highest during intermolt. Specific inhibitors and zymograms of A. longinaris hepatopancreas extracts showed four trypsins (14.79, 15.49, 16.60, 17.38 kDa, respectively) and three chymotrypsins (21.38, 22.91, 27.54 kDa, respectively). Our results suggest that proteolytic activity in the hepatopancreas of A. longinaris is influenced by the molting cycle. Types and activity of prawn digestive enzymes constitute background information to further study the digestive abilities of these organisms and will lead to understanding their nutritional needs and feeding ecology.

A non-radiolabelled ferriprotoporphyrin IX biomineralisation inhibition test for the high throughput screening of antimalarial compounds.

Intraerythrocytic malaria parasites produce large amounts of toxic ferriprotoporphyrin IX (FP) during their digestion of host cell haemoglobin. The inhibition of biomineralisation of FP to haemozoin (or beta-haematin) by antimalarial drugs underlies their mode of action. We have developed an in vitro microassay for testing the inhibition of biomineralisation by drugs. It is based on the detection by optical density measurement of solubilised beta-haematin remaining after contact with drugs. The assay uses a 192-microM haemin chloride solution in dimethyl sulfoxide, 96-well filtration microplates as well as normal microplates; it lasts 18-24h and requires a spectrophotometer. We determined by this assay the IC(50) of chloroquine phosphate (28microM) and quinine base (324microM) and showed that unlike previous methods it is insensitive to inorganic anions. We also determined the activity of synthetic dyes and plant extract to determinate the interference of coloured compounds on the accuracy of the test. We found that methylene blue, thionine (IC(50) 38 and 87microM, respectively), and an extract of plants that contains quinoline derivatives, inhibited the biomineralisation of FP regardless of their intrinsic colour.

Digestive proteinases of red shrimp Pleoticus muelleri (Decapoda, Penaeoidea): partial characterization and relationship with molting.

The present study describes the activity and some characteristics of proteinases in the hepatopancreas of red shrimp Pleoticus muelleri during the different stages of the molting cycle. Proteolytic activity was highest between pH 7.5 and 8. The hepatopancreatic protein content in the premolt stage was higher than in the other stages of the molting cycle (P<0.05). No significant differences were found in total proteolytic activity in the hepatopancreas when comparing molting stages. The proteolytic activity of the P. muelleri hepatopancreas enzyme preparations is the main responsibility of serine proteinases. TLCK, a trypsin inhibitor, reduced azocasein hydrolysis between 26% (intermolt) and 37% (premolt). TPCK, a chymotrypsin inhibitor, did not decrease hydrolytic activity, except for in postmolt. Low trypsin and chymotrypsin activities were found during intermolt, and increased in postmolt. The electrophoretogram of the enzyme extracts shows 12 bands of activity during intermolt (from 16.6 to 53.1 kDa). Some fractions were not detected in the postmolt and premolt stages. Three low molecular weight trypsin forms (17.4, 19.1 and 20 kDa) were found in all molting stages. One band of chymotrypsin (21.9 kDa) was observed in all molting stages. High molecular mass active bands (66-205 kDa) could not be characterized with inhibitors. Comparison of the protease-specific activity of the hepatopancreas of some species indicated a relationship between digestive enzyme activity and feeding habits of the shrimp. Omnivorous shrimp, such as Penaeus vannamei (syn: Litopenaeus vannamei) and Penaeus monodon, showed higher protease activity than the carnivorous shrimp, Penaeus californiensis (syn: Farfantepenaeus californiensis) and P. muelleri. In fact, the enzymatic activity in the hepatopancreas of P. muelleri showed variations in relation to feeding habit and molting cycle.

Molecular analysis of p53 tumor-suppressor gene and microsatellites in preneoplastic and neoplastic lesions of the colon and esophagus.

Mutations in exons 4-8 of the p53 gene by the PCR-SSCP analysis in preneoplastic and neoplastic lesions of the colon (n=11) and esophagus (n=18) were screened. p53 overexpression by immunohistochemistry in 11 colonic lesions and 13 microsatellites, in all the patients (n=29), were also studied. A positive result concordancy between the three techniques was found in 1 adenoma and 2 adenocarcinomas of the colon, each with loss of heterozygocity of microsatellites. Metaplastic lesions of esophagus showed biallelic mutations and low frequency of microsatellite alterations. The relationship between genetic alterations in p53, microsatellites and type of colon and esophageal lesions is discussed.

Medicinal plants uses of the Tacana, an Amazonian Bolivian ethnic group.

We present the results of an ethnopharmacological investigation of a Bolivian lowland ethnic group, the Tacana. The Tacana have a long tradition of exchange with highland communities. Though facing rapid acculturation, highlighted by the loss of the Tacana language among the younger generations, the knowledge and uses of medicinal plants are still alive. Of the approximately 450 different plant species collected during this survey, 33% had medicinal uses. We present an overview of the traditional Tacana ethnomedicine and pharmacopoeia.

A search for natural bioactive compounds in Bolivia through a multidisciplinary approach. Part I. Evaluation of the antimalarial activity of plants used by the Chacobo Indians.

Thirty extracts of plants traditionally used by the Chacobos, a native community living in the Amazonian part of Bolivia, were screened in vitro and/or in vivo for antimalarial activity. Two of the four species designated as antimalarial, Geissospermum laeve and Maquira coriacea, displayed rather good activity, corroborating their traditional uses. However, they did show a rather high toxicity in vivo. Among twelve species used to cure symptoms relevant to malaria, five showed good activity: Apuleia leiocarpa, Bauhinia guianensis, Nectandra cuspidata, Sparattanthelium amazonum, Tanaecium jaroba. Two species, Qualea paraensis and Sclerolobium aff. guianense, used to treat scabies, showed interesting antimalarial activity in vivo; three other species (Iryanthera laevis, Prunus amplifolia, Pterocarpus aff. amazonum) used for various medicinal purposes, apparently not related with a Plasmodium infection, also showed antimalarial activity. Finally, one species (Derris amazonica) used as a piscicide displayed good in vitro activity, in the same way as one Annonaceae, Guatteria aff. schomburgkiana, used for construction purposes.

Purification, properties, and N-terminal amino acid sequence of a kallikrein-like enzyme from the venom of Lachesis muta rhombeata (Bushmaster).

Pit viper venoms contain multiple proteinases which cause considerable damage in tissues and systemic effects after envenomation. A proteinase, kallikrein-like enzyme, belonging to the serine group must play a very important role on systemic effects. The corresponding enzyme from Lachesis muta rhombeata venom was purified to homogeneity by a combination of isoelectrofocusing fractionation followed by one step of gel filtration HPLC. The enzyme focused with pI 5.0-6.5, it had a molecular mass of 32 kDa by gel filtration HPLC, had edematogenic activity, and induced a hypotensic effect in anesthetized rats. It exhibited strong N-alpha-tosyl-L-Arg methyl esterase (955.38 units/mg) and N-Bz-DL-Arg-pNA amidolytic (233.02 units/mg) activities, hydrolyzed tripeptide nitroanilide derivatives weakly or not at all, and cleaved selectively the A-alpha and B-beta chains of fibrinogen, apparently leaving the Y-chain unaffected. The 30 N-terminal amino acid sequence of the L. m. rhombeata protein showed greatest identity (74% in 26 amino acids) with Crotalus viridis kallikrein-like protein, but significant similarities in sequence were observed with enzymes from other snake venoms and pig pancreatic kallikrein.