Individualized multidisciplinary therapy for vulvodynia.

OBJECTIVE: The main objective of this review was to develop strategies for individualizing multidisciplinary therapy for vulvodynia. METHODS: We conducted two literature searches; the first one focused on clinical trials assessing vulvodynia treatments published after the recommendations of the expert committee of the Fourth International Consultation on Sexual Medicine. The second search targeted studies identifying predictive factors and mediators of vulvodynia treatments, published from the earliest date to October 2022. RESULTS: Based on data from 55 relevant studies, we developed models of individualized multidisciplinary therapy targeting groups of women less responsive to multidisciplinary therapy (characterized by women with higher vulvar pain intensity, impaired sexual functioning, and vulvodynia secondary subtype) and to physical therapy, as an isolated treatment (characterized by women with increased pelvic floor muscle tone and vulvodynia primary subtype). Each individualized multidisciplinary therapy model comprises three components: psychotherapy, medical care, and physical therapy. These components provide distinct therapeutic modalities for distinct subgroups of women with vulvodynia; the women subgroups were identified according to the characteristics of women, the disease, partners, and relationships. Additionally, for women with provoked vestibulodynia who exhibit less benefits from vestibulectomy (such as those with higher levels of erotophobia, greater vulvar pain intensity, and the primary subtype) and encounter resistance to individualized multidisciplinary therapy, we suggest additional conservative treatments before performing vestibulectomy. CONCLUSION: Our study is a pioneer in the development of models that allow the individualization of multidisciplinary therapy for vulvodynia and represents a significant advance in the clinical practice of gynecologists, physiotherapists, and psychologists.

Lambs supplemented with Amazonian oilseed co-products: Meat quality and fatty acid profile.

The Amazon has a wide variety of oilseeds that generate a huge amount of co-products with potential for use in animal nutrition. The objective was to use alternative resources (oilseed cakes) in the feeding of lambs to assign a sustainable destination to this biomass, and evaluate its influence on the quality and fatty acid (FA) profile of the meat. Twenty-four lambs, male, castrated, crossbred Dorper × Santa Inês, weighing 30 ± 1.3 kg of initial body weight, were distributed in a completely randomized design in 4 treatments (diets) with six replications (animals). The control diet (Control) contained corn and soybean meal as main ingredients, which were partially replaced in the other diets by cupuassu cake diet (Cup), palm kernel cake diet (Palm) and tucuma cake diet (Tuc). The inclusion of Amazon cakes influences the lipid (P = 0.02) and protein (P < 0.01) composition of meat (longissimus lumborum); reduces cooking losses (P < 0.01); influences the colors (L, a, b), chroma, and Hue Angle (P < 0.01); promotes changes in total FA composition and FA profile (P < 0.05); reduces hypocholesterolemic FA (h) (P = 0.01), but does not influence hypercholesterolemic (H) and indices h:H, AI and TI (P > 0.05). The inclusion of oilseed cakes influences the chemical composition, physical parameters, composition and fatty acid profile of the meat, but does not influence the indicators of atherogenicity, thrombogenicity and cholesterolemia.

Fluconazole and propolis co-encapsulated in chitosan nanoparticles for the treatment of vulvovaginal candidiasis in a murine model.

Vulvovaginal candidiasis (VVC) is a fungal infection caused mainly by Candida albicans. The treatment of VVC with azoles has been impaired due to the increased cases of resistance presented by this pathogen. The aim of the present study was to investigate the antifungal activity of mucoadhesive chitosan nanoparticles encapsulating both green propolis and fluconazole for topical use in the treatment of VVC. The nanoparticles were prepared by the ionic gelation method, resulting in a size of 316.5 nm containing 22 mg/kg of green propolis and 2.4 mg/kg of fluconazole. The nanoparticles were non-toxic in vitro using red blood cells or in vivo in a Galleria mellonella toxicity model. The treatment of female BALB/c mice infected by C. albicans ATCC 10231 with topical nanoparticles co-encapsulating fluconazole and green propolis was effective even using a fluconazole amount 20 times lower than the amount of miconazole nitrate 2% cream. Considering that the mucoadhesive property of chitosan, which is known to allow a prolonged retention time of the compounds at the mucous epithelia, the antifungal potential of the phenols and flavonoids present in green propolis may have favored the effectiveness of this treatment. These results indicate that this formulation of topical use for fluconazole associated with green propolis can be used as a promising approach to therapy for the treatment of VVC, thus contributing to reducing the development of resistance to azoles.

Vulvovaginal candidiasis is a fungal infection for which we search for alternatives for its treatment. Thus, a nanoparticle formulation based on fluconazole and green propolis was developed. These nanoparticles were tested, and we obtained adequate results in laboratory tests.

Evaluation of the effects of SPONDIAS MOMBIN extract as an alternative antimicrobial drug

The extract of Spondias mombin has constituents which may improve psychiatric disorders, in addition to having antiviral, antifungal, and antimicrobial activity. But despite having several benefits, it is necessary to assess whether the extract may interfere with cell metabolism so furthermore its microbicide potential can be explored. Fifteen Wistar rats were used, divided into four groups (control group; control with extract; hyperlipidemic diet; hyperlipidemic diet and extract). For 12 weeks, the animals were weighed and their blood glucose was assessed. Afterwards, they were euthanized, and the biological material was collected. The evaluation confirmed the efficacy of the extract of S. mombin against cell metabolism of rats, without negatively altering cell viability; the group of rats with an hyperlipidemic diet showed an increase in body weight; however, in the individual assessment of the organs, there were no significant changes. The glycemic index, liver parameters, lipids, and mineral ions did not show changes. Furthermore, the antimicrobial potential of S. mombin extract was observed against Staphylococcus aureus ATCC 29213 and Staphylococcus aureus BLACC. The results suggest that S. mombin extract did not interfere with cell viability, did not show cytotoxicity to cells that were exposed to it, nor did it interfere with the metabolism, organs, and biochemical indices of rats with a standard or hyperlipidemic diet. Considering such characteristics and the potential activities observed in this present study, additional evaluation should be conducted to further assess the role of S. mombin extract as a source of new alternative antimicrobial drug as well as its possible beneficial activity to the cardiovascular system.

HPLC Method Validated for Quantification of Fluconazole Co-Encapsulated with Propolis Within Chitosan Nanoparticles.

Considering the cases of fungal resistance to classic antifungals, it is necessary to develop more efficient and innovative therapies capable of reversing this situation. Fluconazole is an antifungal frequently used in the treatment of mycosis and some fungi developed resistance to its mechanism of action. In this work, fluconazole and green propolis were co-encapsulated in chitosan nanoparticles to be explored in order to promote a synergistic effect to enhance its therapeutic efficacy. However, because of the complexity of the chemical composition of green propolis, it was necessary to develop a simple and precise methodology to quantify fluconazole in the formulation. High Efficiency Liquid Chromatography methodology was developed and validated following the Brazilian regulatory guidelines (ANVISA, RDC 166/2017) for the separation of co-eluted peaks of fluconazole and green propolis in the nanoparticle supernatant. Applying the method developed, it was possible to quantify fluconazole in the same sample containing propolis. Thus, the results allow to affirm that it is a specific test, effective, precise and robust, which helped to determine the efficiency of association of the compounds within the nanoparticle. The method can be applied to quantify compounds that have similar chromatographic retention times. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12088-021-00954-2.

HPLC-PDA method validated for the determination of hibalactone in Hydrocotyle umbellata subterraneous parts and its ultrasound-assisted extraction optimization

ABSTRACT In this work, we developed and validated a HPLC-PDA method for the quantification of hibalactone in Hydrocotyle umbellata L., Araliaceae, subterraneous parts extracts and optimized its ultrasound-assisted extraction. Chromatographic separations were carried out with an isocratic mobile phase of acetonitrile/methanol/water (10:65:25), a flow of 0.8 ml min−1, detection at 290 nm and C18 column (250 × 4.6 mm, 5 µm). The method validation parameters were determined according to Brazilian legislation. The optimization of the hibalactone ultrasound-assisted extraction was performed using Box-Behnken design and response surface methodology. The HPLC method for hibalactone quantification proved to be selective, linear, precise, accurate and robust, being useful for the analysis of hibalactone in H. umbellata subterraneous parts extracts. The optimal ultrasound-assisted extraction conditions were obtained with solid-to-liquid ratio of 1:5 g ml−1, ethanolic strength of 70% (v/v) and temperature of 65 °C. The results can provide support of the quality control and standardization of raw materials from H. umbellata.

Computed Tomographic Angiography for Cerebral Aneurysms in Spontaneous Subarachnoid Hemorrhage

Computed tomographic angiography (CTA) has recently gained popularity as an initial imaging test for spontaneous subarachnoid hemorrhage (SAH). This study evaluated 59 patients presenting aneurysmal SAH who underwent microsurgical clipping based on CTA findings alone and digital subtraction angiography (DSA) at postoperative follow-up. Multiple aneurysms were identified by CTA in 27% of patients and in 10% of patients, DSA identified aneurysms in addition to those diagnosed with CTA. The time between CTA and surgical treatment ranged from 0­4 days. Postoperative DSA revealed that 24% of patients had residual neck. The use of CTA alonemay not be enough to detect small unruptured aneurysms in patients with multiple lesions or aneurysm remnants adjacent to an aneurysm clip. However, the advantages of CTA compared with DSA include its rapidity, reduced invasiveness, and lower cost, which allow us to proceed to ruptured aneurysm repair entirely on the basis of good-quality CTA studies.

Angiotomografia computadorizada (ATC) ganhou popularidade como exame de imagem inicial na hemorragia subaracnoide (HSA). Este estudo retrospectivo, descritivo e observacional, avaliou 59 pacientes com HSA aneurismática. Todos foram submetidos à clipagem microcirúrgica apenas com base na ATC e no seguimento realizou-se avaliação com angiografia digital (AD). Em 27% dos pacientes encontramos múltiplos aneurismas na ATC e 10% tinham outros diferentes aneurismas diagnosticados pela AD. O intervalo entre ATC e tratamento cirúrgico variou de 0­4 dias. AD pós-operatória mostrou 24% dos pacientes com colo residual. A detecção de pequenos aneurismas não rotos em pacientes com múltiplos aneurismas e colo residual pós clipagem cirúrgica continuam a ser um problema quando a ATC é realizada isoladamente. No entanto, as vantagens da ATC incluem sua rapidez, menor invasão e custo, o que nos permite realizar o tratamento cirúrgico de aneurismas rotos apenas com os achados da ATC de boa qualidade.

Influence of environmental factors on the composition of essential oils from leaves of Myrcia tomentosa (Aubl) DC / Influencia de los factores ambientales sobre la composición de los aceites esenciales de hojas de Myrcia tomentosa (Aubl) DC

The leaves of Myrcia tomentosa were collected from five sites and four different months in the Brazilian Cerrado and their essential oils were obtained by hidrodistillation and analyzed by GC/MS. The aim of this work was to evaluate the influence of environmental factors on essential oils composition in the leaves of M. tomentosa. The results were submitted to stepwise Multiple Regression and Canonical Correlation Analysis that indicated a relationship between compounds in essential oils and some environmental factors (foliar nutrients, soil nutrients and climatic data). Cluster Analysis indicated a high chemovariability in the essential oils from different sites, also showed that the collection time had a minor effect on oil composition.

Las hojas de Myrcia tomentosa se obtuvieron de cinco sitios diferentes y cuatro meses en el Cerrado brasileño y sus aceites esenciales fueron obtenidos por hidrodistillation y analizados por GC/MS. El objetivo de este trabajo fue evaluar la influencia de los factores ambientales sobre la composición de los aceites esenciales en las hojas de M. tomentosa. Los resultados fueron sometidos a múltiples etapas de regresión y análisis de correlación canónica indicó que la relación entre los compuestos en los aceites esenciales y algunos factores ambientales (nutrientes foliares, fertilizantes y datos climáticos). El análisis de agrupamiento indicó chemovariability un alto en los aceites esenciales de diferentes sitios, también mostró que el equipo de recolección tuvo un efecto menor sobre la composición del aceite.

Environmental factors affecting the concentration of phenolic compounds in Myrcia tomentosa leaves

Myrcia tomentosa (Aubl.) DC., Myrtaceae, found in Central Brazilian Cerrado and popularly known as "goiaba-brava", belongs to the Myrcia genus, which has several species with medicinal properties such as: hypoglycemic, diuretic, hypotensive, antidiarrheal, antimicrobial and antitumor. The present study aimed to analyzed the environmental influence on concentrations of phenolic metabolites in M. tomentosa leaves. Compounds assayed in the leaves were: total phenols, tannins by protein precipitation, hydrolysable tannins and total flavonoids and mineral nutrients, while soil fertility was also analyzed, all over during one year. The results were submitted to Pearson Correlation Analysis and stepwise Multiple Regression Analysis to investigate the relationship between phenolics and environment data. Analysis of variance and Cluster Analysis allowed indicated a high variability in samples from different sites. The results obtained suggests that content of phenolics from M. tomentosa leaves are influenced by environmental factors, particularly some foliar nutrients (N1, Ca1 and Mn1), soil nutrients (Ca s and Ks) and Rainfall.

Chemical variability of the essential oils from fruits of Pterodon emarginatus in the Brazilian Cerrado

Pterodon emarginatus Vogel, Fabaceae, is a tree species commonly known as "sucupira-branca". It is a popular medicinal plant in the Brazilian cerrado (Savanna). This study investigates the chemical variability of the essential oils from fruits of P. emarginatus. The fruits were collected from five sites in the Brazilian Cerrado and their essential oils were analyzed by GC/MS. The results obtained by Principal Component and Cluster Analysis identified two groups: cluster I containing β-caryophyllene and δ-elemene and cluster II containing α-copaene, β-cubebene, allo-aromadendrene, α-cubebene and γ-muurulene. The Canonical Discriminant Analysis was used to differentiate between clusters on the basis of essential oil composition. The results showed high variability in the composition of the essential oils from fruits of P. emarginatus, contributing to studies of domestication of this species.

Phytochemical Analysis and Antimicrobial, Antinociceptive, and Anti-Inflammatory Activities of Two Chemotypes of Pimenta pseudocaryophyllus (Myrtaceae).

Preparations from Pimenta pseudocaryophyllus (Gomes) L.R. Landrum (Myrtaceae) have been widely used in Brazilian folk medicine. This study aims to evaluate the antimicrobial activity of the crude ethanol extracts, fractions, semipurified substances, and essential oils obtained from leaves of two chemotypes of P. pseudocaryophyllus and to perform the antinociceptive and anti-inflammatory screening. The ethanol extracts were purified by column chromatography and main compounds were spectrally characterised (1D and 2D (1)H and (13)C NMR). The essential oils constituents were identified by GC/MS. The broth microdilution method was used for testing the antimicrobial activity. The abdominal contortions induced by acetic acid and the ear oedema induced by croton oil were used for screening of antinociceptive and anti-inflammatory activities, respectively. The phytochemical analysis resulted in the isolation of pentacyclic triterpenes, flavonoids, and phenol acids. The oleanolic acid showed the best profile of antibacterial activity for Gram-positive bacteria (31.2-125 µg mL(-1)), followed by the essential oil of the citral chemotype (62.5-250 µg mL(-1)). Among the semipurified substances, Ppm5, which contained gallic acid, was the most active for Candida spp. (31.2 µg mL(-1)) and Cryptococcus spp. (3.9-15.6 µg mL(-1)). The crude ethanol extract and fractions from citral chemotype showed antinociceptive and anti-inflammatory effects.

Involvement of 5-HT1A in the anxiolytic-like effect of dichloromethane fraction of Pimenta pseudocaryophyllus.

ETHNOPHARMACOLOGICAL RELEVANCE: Medicinal applications of Pimenta pseudocaryophyllus infusion as a diuretic and aphrodisiac agent as well as tranquilizer in the form of tea for the treatment of emotional tension in Brazilian folk medicine has been in practice since time immemorial. Despite its popular therapeutic acceptance and claims, there are scanty scientific reports to corroborate its central biological activities. AIM: To characterize anxiolytic-like effect of the dichloromethane fraction (DF) obtained from ethanolic leaf extract of the Pimenta pseudocaryophyllus and identify mechanisms of action involved while seeking to support its popular use as a soothing agent. MATERIAL AND METHODS: Mice (25-35 g) were treated orally with DF obtained from ethanolic leaf extract of Pimenta pseudocaryophyllus and were submitted to light-dark box (LDB) and elevated plus maze (EPM) tests. Different groups of mice were treated with flumazenil and NAN-190 to identify mechanisms of action involved in the anxiolytic-like effect of DF. RESULTS: Treatment with DF increased number of transitions and time spent in the light compartment of the LDB while the time spent and numbers of entries in the open arm of the LCE were significantly increased. Pre-treatment of the animal with flumazenil (2 mg/kg, i.p.--competitive antagonist of benzodiazepine site of GABA(A) receptor) did not block this effect, thereby excluding participation of benzodiazepine site of the GABA(A) receptor. However, anxiolytic-like effect of DF was reversed by pre-treatment with NAN-190 (0.5 mg/kg, i.p.--an antagonist of the 5-HT(1A) receptor) thereby suggesting involvement of 5-HT(1A) receptor. The thin layer chromatography and high-performance liquid chromatography analysis indicated the predominance of (E)-methyl isoeugenol and oleanolic acid in DF. CONCLUSION: These results support the popular use of Pimenta pseudocaryophyllus as a calming agent and suggest the involvement of 5-HT(1A) receptor.

Dissolution test of herbal medicines containing Passiflora sp.

The dissolution test is an essential tool to assess the quality of herbal medicines in the solid dosage form for oral use. This work aimed to evaluate the dissolution behavior of three herbal medicines in the form of capsules and tablet containing Passiflora, produced with powder or dried extract. Assay of total flavonoids and dissolution methods were validated and obtained results allowed the quantification of flavonoids with precision, accuracy and selectivity. The percentage of total flavonoids found was 2 percent for capsule A (containing only powder), 0.97 percent for capsule B (containing only dried extract) and 5.5 percent for tablet. Although the content was lower, the release of flavonoids present in the capsule containing dried extract was 12 percent higher over 30 min, with dissolved percentage values of 87 and 75, for the capsules containing extract and powder, respectively. The tablet containing dried extract presented dissolution of 76 percent, despite the higher content of flavonoids, which may be due to pharmacotechnical problems. Obtained data demonstrated the need to implement these tests in the quality control of herbal medicines, confirming the release of the active ingredients that underlie the pharmacological action of these medicines.

Dissolution test of herbal medicines containing Paullinia cupana: validation of methods for quantification and assessment of dissolution / Ensaio de dissolução de medicamentos fitoterápicos contendo Paullinia cupana: validação de métodos de quantificação e avaliação de dissolução

"Guaraná" (Paullinia cupana) is used as a physical activity enhancer and stimulator due to its methylxanthines and condensed tannins. The aim of this work was to evaluate the dissolution behavior of five herbal medicines in the form of capsules and tablets containing guaraná. Assay and dissolution methods were validated and results obtained allowed simultaneous marker quantification with precision, accuracy, selectivity and robustness. Findings showed that 100 percent of the herbal medicinal products analyzed did not provide satisfactory results concerning the presence of four markers, 60 percent had three markers (caffeine, catechin and epicatechin), while 40 percent had only caffeine at tested dosage forms. In addition, after 30 minutes, only capsule A showed at least 80 percent of the dissolved markers. In other capsules, marker dissolution did not exceed 60 percent whereas 60 percent of the samples had some characteristic pharmacotechnical problems. These results evidence the need for rigorous quality control to help ensure the therapeutic action of these drugs. To this end, dissolution studies are an essential tool for quality assurance of herbal medicines.

Guaraná (Paullinia cupana) é utilizado como revigorante e estimulante devido à presença de metilxantinas e taninos condensados. Este trabalho visou avaliar o comportamento de dissolução de cinco fitoterápicos, na forma de cápsulas e comprimidos, contendo guaraná. O método de quantificação e de dissolução foram validados e os resultados obtidos permitiram a quantificação dos marcadores simultaneamente, com precisão, exatidão, seletividade e robustez. Foi verificado que 100 por cento dos fitoterápicos analisados encontravam em desacordo quanto à presença dos quatro marcadores, sendo que 60 por cento apresentaram três marcadores (cafeína, catequina e epicatequina) e 40 por cento apresentaram somente a cafeína. Além disso, após o tempo de 30 minutos de ensaio foi possível observar que somente a cápsula A apresentou pelo menos 80 por cento dos marcadores dissolvidos. Nas demais cápsulas o comportamento de dissolução apresentado pelos marcadores não ultrapassou 60 por cento e, além disso, 60 por cento das amostras apresentaram alguns problemas farmacotécnicos característicos. Frente aos resultados obtidos torna-se evidente a necessidade de um rigoroso controle de qualidade que contribua para assegurar a ação terapêutica desses medicamentos e, nesse sentido, o estudo de dissolução constitui uma ferramenta essencial para a garantia de qualidade dos fitoterápicos.

Determinação de taninos e metilxantinas no guaraná em pó (Paullinia cupana Kunth, Sapindaceae) por cromatografia líquida de alta eficiência / Determination of tannins and methylxanthines in powdered guarana (Paullinia cupana Kunth, Sapindaceae) by high performance liquid chromatography

As sementes de guaraná (Paullinia cupana Kunth, Sapindaceae) são utilizadas como estimulante e os principais constituintes químicos são as metilxantinas e os taninos, tais como catequina e epicatequina. Este trabalho teve por objetivo investigar um método por cromatografia líquida de alta eficiência (CLAE) para quantificar, simultaneamente, cafeína, teofilina, teobromina, catequina e epicatequina em pó de guaraná. Os valores obtidos foram comparados com os resultados encontrados no método espectrofotométrico da Farmacopéia Brasileira IV ed. Pelo método cromatográfico, os teores de metilxantinas e taninos totais foram de 4,04 por cento e 1,48 por cento, respectivamente. Os teores de metilxantinas e taninos totais, obtidos pelo método espectrofotométrico, foram de 4,88 por cento e 4,05 por cento, respectivamente. Acredita-se que, nas condições experimentais empregadas, o método espectrofotométrico não foi específico, quantificando outras substâncias fenólicas presentes no guaraná. Portanto, sugere-se o emprego desse método cromatográfico no controle de qualidade do guaraná em pó, por ser preciso, sensível, específico e rápido.

The seeds of Paullinia cupana Kunth, Sapindaceae, are used as a stimulant and the main chemical constituents are the methylxanthines and tannins, as catechin and epicatechin. This study aimed to investigate a method by high performance liquid chromatography (HPLC) to quantify both caffeine, theophylline, theobromine, catechin and epicatechin in powdered of P. cupana. The values obtained were compared with the results of the spectrophotometric method of the Brazilian Pharmacopoeia IV ed. For the chromatographic method, the levels of methylxanthines and total tannins were 4.04 percent and 1.48 percent, respectively. The levels of methylxanthines and total tannins obtained by the spectrophotometric method, were 4.88 percent and 4.05 percent, respectively. It is believed that, under our experimental conditions, the spectrophotometric method was not specific and quantified others phenolic substances present in the P. cupana. Therefore we suggest the use of this chromatographic method in quality control of P. cupana powder, to be accurate, sensitive, specific and fast.

Assessment of intra-arterial injected autologous bone marrow mononuclear cell distribution by radioactive labeling in acute ischemic stroke.

OBJECTIVE: To evaluate the feasibility of monitoring the autologous mononuclear bone marrow (ABMMN) cells implanted into the brain after acute ischemic stroke by the technique of labeling with Tc-99m-HMPAO. CASE REPORT: A 37-year-old man presented with aphasia, right-side hypoesthesia, and right homonymous hemianopsia after an acute ischemic stroke of the left middle cerebral artery. He was included in an autologous bone marrow mononuclear cell-based therapy research protocol about the safety of intra-arterial autologous bone marrow mononuclear cell transplantation for acute ischemic stroke. Nine days after the stroke he received 3.0 x 10(7) ABMMN cells delivered into the left cerebral middle artery via a balloon catheter. Approximately 1% of these cells were labeled with 150 MBq (4 mCi) Tc-99m by incubation with hexamethylpropylene amine oxime (HMPAO). RESULTS: Brain perfusion images with Tc-99m ECD demonstrated hypoperfusion in the left temporal and parietal regions. The perfusion brain images were compared with tomographic views of the brain obtained 8 hours after ABMMN-labeled cell delivery, revealing intense accumulation of the ABMMN-labeled cells in the ipsilateral hemisphere. A whole-body scan was done and showed left brain, liver, and spleen uptake. CONCLUSIONS: Our results showed that Tc-99m HMPAO can be used to label ABMMN cells for in vivo cell visualization, and that brain SPECT imaging with labeled ABMMN cells is a feasible noninvasive method for studying the fate of transplanted cells in vivo. Additionally, our findings demonstrate the localization of these intra-arterially injected cells.

Avaliação in vivo da distribuição das células autólogas mononucleares da medula óssea no tecido miocárdico infartado através da marcação com 99mTc-HMPAO / In vivo evaluation of the distribution of the autologous bone marrow mononuclear cells the post infarct myocardium through labeling witch 99mTc-HMPAO

Objetivos: Demonstrar a fixação das células autólogas mononucleares da medula óssea (CAMMO) no miocárdio, após a sua injeção intravascular. Quantificar a proporção da fixação das células em relação ao corpo inteiro e sua taxa de claramento. Métodos: Foram selecionados 20 pacientes na fase aguda do infarto do miocárdio; 19 foram submetidos à marcação de uma fração das células (10 à sexta potência de células) com o 99mTC hexametil propilenoaminaoxime(99mTc-HMPAO). Foram adquiridas imagens precoces e tardias de corpo inteiro e imagens tomográficas do tórax. Resultados: Os pacientes apresentaram em média 29,9 maior ou menor que 14 por cento da área infartada nas imagens de perfusão miocárdica. A taxa de captação na área cardíaca foi 12,1 maior ou menor que 8,25 por cento nas imagens precoces e 7,8 maior ou menor que 6,31 por cento nas imagens tardias. A taxa de clareamento foi de 35,3 maior ou menor que 15,94 por cento. A captação das células não apresentou correlação com o tamanho do infarto miocárdico (r igual a 0,271) e o clareamento não apresentou correlação com o tamanho do infarto miocárdico nem com o intervalo entre as aquisições das imagens (r igual a 0,22 e r igual a 0,000024). Conclusão: A marcação das CAMMO com 99mTc-HMPAO permite demonstrar a sua fixação na área infartada, quantificando a sua proporção em relação à sua distribuição no corpo inteiro.