Tratamiento combinado de Espongostan® y Mepitel® en heridas con pérdida de sustancia y abundante sangrado / Combined treatment of Espongostan® and Mepitel® in wounds with loss of substance and abundant bleeding: a case series

Objetivo: Las heridas por pérdida de sustancia en las yemas de los dedos son dolorosas, incapacitantes y sangran abundantemente. El tratamiento recomendado es a base de Espongostan®, aunque este producto puede combinarse con Mepitel®. La combinación de ambos tratamientos podría reducir el dolor y minimizar el sangrado en curas sucesivas. El objetivo de este estudio es describir la aplicación del tratamiento combinado de Espongostan® y Mepitel®. Además, se describirá la evolución del dolor y el sangrado en estos pacientes. Descripción del caso: Se aplicó el tratamiento combinado a 6 pacientes con heridas de pérdida de sustancia en las yemas de los dedos. Resultados: La escala EVA se mantuvo en valores moderados o se redujo a leve en curas sucesivas. Los pacientes no describen signos de dolor destacables al retirar el Espongostan®. Por otro lado, el sangrado remitió antes de 8 días. La tasa promedio de remisión del sangrado se situó en 1 caso por 4 días. Conclusión: La cura combinada es altamente positiva para minimizar el dolor y el sangrado, reduciendo por consiguiente las molestias derivadas sobre los pacientes. (AU)

Objective: Loss of substance wounds on the pads of the fingers are painful, disabling, and have profuse bleeding. The recommended treatment is based on Espongostan®, although this product may be combined with Mepitel ®. The combination of both treatments could reduce pain and minimize bleeding in successive cures. The objective of this study is to describe the application of the combined treatment of Espongostan® and Mepitel®. In addition, the evolution of pain and bleeding in these patients will be described. Description of the case: We applied the combined treatment to 6 patients with loss of substance wounds on the pads of the fingers. Results: The VAS scale remained at moderate values or was reduced to mild in successive cures. Patients do not describe noticeable signs of pain when removing the Espongostan®. Bleeding subsided before 8 days. The average bleeding remission rate was 1 case per 4 days. Conclusion: The combined cure is highly positive for minimizing pain, bleeding and reducing discomfort caused to patients. (AU)

Síndrome de alfa-gal. Alergia a carne roja y gelatina / Alpha-gal syndrome. Allergy to red meat and gelatin

Introducción El síndrome de alfa-gal es una alergia alimentaria potencialmente grave producido por la presencia de IgE específica para alfa-gal. El objetivo de este estudio es describir nuestra serie de 13 pacientes. Material y métodos Estudio retrospectivo de pacientes diagnosticados entre 2016 y 2017. Se realizaron pruebas cutáneas con extracto comercial y gelaspan así como determinación de IgE específica para alfa-gal y diferentes tipos de carne. Resultados Se analizó a 13 pacientes diagnosticados de síndrome de alfa-gal, 9 de ellos con anafilaxia, de los cuales 6 habían sido diagnosticados de anafilaxia idiopática. Todos presentaron prueba cutánea con gelaspan positiva, y no así con los extractos comerciales, cuyos resultados fueron menos concluyentes. Conclusiones Creemos que la anafilaxia idiopática puede esconder pacientes con síndrome de alfa-gal. La prueba cutánea con gelaspan es más útil que los extractos comerciales (AU)

Introduction Alpha-gal syndrome is a potentially severe food allergy caused by the presence of alpha-gal-specific IgE. The aim of this study is to describe our series of 13 patients. Material and methods This work is a retrospective study of patients diagnosed in 2016 and 2017. Skin tests were performed with commercial extract and gelaspan as well as specific IgE determination for alpha-gal and different types of meat. Results Thirteen patients diagnosed with alpha-gal syndrome were analyzed; 9 of them had anaphylaxis, 6of whom had been diagnosed with idiopathic anaphylaxis. All had a positive skin test with gelaspan, though this was not true with the commercial extracts, whose results were less conclusive. Conclusions We believe that a diagnosis of idiopathic anaphylaxis may prevent the identification of patients with alpha-gal syndrome. The gelaspan skin test is more useful than commercial extracts (AU)

Alpha-gal syndrome. Allergy to red meat and gelatin.

INTRODUCTION: Alpha-gal syndrome is a potentially severe food allergy caused by the presence of alpha-gal-specific IgE. The aim of this study is to describe our series of 13 patients. MATERIAL AND METHODS: This work is a retrospective study of patients diagnosed in 2016 and 2017. Skin tests were performed with commercial extract and gelaspan as well as specific IgE determination for alpha-gal and different types of meat. RESULTS: Thirteen patients diagnosed with alpha-gal syndrome were analyzed; 9 of them had anaphylaxis, 6 of whom had been diagnosed with idiopathic anaphylaxis. All had a positive skin test with gelaspan, though this was not true with the commercial extracts, whose results were less conclusive. CONCLUSIONS: We believe that a diagnosis of idiopathic anaphylaxis may prevent the identification of patients with alpha-gal syndrome. The gelaspan skin test is more useful than commercial extracts.

Efecto del factor de crecimiento fibroblástico dos (FGF-2), en la reducción de la senescencia en células madre mesenquimales aisladas de gelatina de Wharton / Fibroblastic growth factor two (FGF-2), in reducing the senescent effect on mesenchymal stem cell isolated from Wharton ́s jelly

Resumen Introducción. Las células madre mesenquimales han generado interés en la ingeniería de tejidos, debido a sus propiedades proliferativas y capacidad de reparación de tejidos, sin embargo, para un trasplante exitoso, es necesario aumentar el número de células mediante un cultivo in-vitro. Durante este proceso la capacidad proliferativa disminuye, provocando cambios en la morfología y funcionalidad celular y afectando la viabilidad del cultivo, este estado se conoce como senescencia celular y como posibles causales, se ha considerado el estrés oxidativo y la falta de factores de crecimiento. Objetivos: Evaluar el efecto de FGF-2 sobre la senescencia de un cultivo de células madre mesenquimales aisladas de gelatina de Wharton y su papel en la regulación del estrés oxidativo. Metodología. Se añadieron dosis de 3,5 y 7,5 ng de FGF-2 al cultivo. Durante los pasajes 5 y 7, se estimó tanto la senescencia celular como la presencia de ROS (especies reactivas de oxígeno). Resultados.Se obtuvo en el pasaje 5, una diferencia significativa del 99,5% entre el control (+) con respecto a los tratamientos con FGF-2, sin embargo, en el pasaje 7 se observó un aumento en la producción de la enzima ß-galactosidasa y cambios morfológicos, confirmando un estado senescente en el cultivo en todos los tratamientos evaluados. Conclusión. Las dosis utilizadas en este estudio contribuyeron positivamente a disminuir el proceso senescente en el cultivo celular, además se determinó, que el FGF-2 puede prolongar el tiempo de cultivo, retardando parcialmente la concentración de especies reactivas de oxígeno

AbstractIntroduction. Mesenchymal stem cells have been generated interest in tissue engineering, due to their proliferative properties and tissue repair capacity, however, for a successful transplant process, it is necessary to increase the number of cells in a culture expansion process. During this process the proliferative capacity is limited, causing changes in cell morphology and functionality affecting the viability of the culture, this state is known as cell senescence. Oxidative stress and deregulation of growth factors are considered as reasons. Aims. To evaluate the effect of FGF-2 on the senescence of a mesenchymal stem cells culture isolated from Wharton ́s jelly and its role in the regulation of oxidative stress. Methodology: 3,5 and 7,5 ng doses of FGF-2 were added to the culture medium from passage 2, then the senescence of the culture was evaluated and the presence of reactive oxygen species was determined during passages 5 and 7. Results. We observed that in passage 5, there is a significant difference 99.5% between the control (+) concerning the FGF-2 treatments, however, in passage 7, an increase in the production of the enzyme ß-galactosidase was observed and changes in morphology such as: increase in size and elongated shape of the cell, confirming a senescent state on the culture in all the treatments evaluated. Conclusion. The doses used in this study contributed positively to decrease this process in a cell culture, also, the FGF- 2 can prolong the cultivation time, partially decreasing the concentration of reactive oxygen species

Regenerative potential of basic fibroblast growth factor contained in biodegradable gelatin hydrogel microspheres applied following vocal fold injury: Early effect on tissue repair in a rabbit model / Potencial regenerativo do fator básico de crescimento de fibroblastos contido em microesferas biodegradáveis de hidrogel de gelatina aplicadas após lesão de prega vocal: efeito inicial no reparo tecidual em modelo de coelho

Abstract Introduction Postoperative dysphonia is mostly caused by vocal fold scarring, and careful management of vocal fold surgery has been reported to reduce the risk of scar formation. However, depending on the vocal fold injury, treatment of postoperative dysphonia can be challenging. Objective The goal of the current study was to develop a novel prophylactic regenerative approach for the treatment of injured vocal folds after surgery, using biodegradable gelatin hydrogel microspheres as a drug delivery system for basic fibroblast growth factor. Methods Videoendoscopic laryngeal surgery was performed to create vocal fold injury in 14 rabbits. Immediately following this procedure, biodegradable gelatin hydrogel microspheres with basic fibroblast growth factor were injected in the vocal fold. Two weeks after injection, larynges were excised for evaluation of vocal fold histology and mucosal movement. Results The presence of poor vibratory function was confirmed in the injured vocal folds. Histology and digital image analysis demonstrated that the injured vocal folds injected with gelatin hydrogel microspheres with basic fibroblast growth factor showed less scar formation, compared to the injured vocal folds injected with gelatin hydrogel microspheres only, or those without any injection. Conclusion A prophylactic injection of basic fibroblast growth factor -containing biodegradable gelatin hydrogel microspheres demonstrates a regenerative potential for injured vocal folds in a rabbit model.

Resumo Introdução A disfonia pós-operatória é causada principalmente por cicatrizes nas pregas vocais. Tem sido relatado que o manejo cuidadoso da cirurgia das pregas vocais reduz o risco de formação de cicatriz. No entanto, a depender da lesão da prega vocal, o tratamento da disfonia pós-operatória pode ser desafiador. Objetivo Desenvolver uma nova abordagem regenerativa profilática para o tratamento de pregas vocais lesionadas após a cirurgia, com microesferas biodegradáveis de hidrogel de gelatina como sistema de administração de medicamentos para o Fator Básico de Crescimento de Fibroblastos (bFGF). Método A cirurgia laríngea videoendoscópica foi feita para criar lesão nas pregas vocais em 14 coelhos. Imediatamente após esse procedimento, microesferas biodegradáveis de hidrogel de gelatina com bFGF foram injetadas na prega vocal. Duas semanas após a injeção, as laringes foram excisadas para avaliação da histologia das pregas vocais e do movimento da mucosa. Resultados A presença de função vibratória deficiente foi confirmada nas pregas vocais lesionadas. A histologia e a análise de imagem digital demonstraram que as pregas vocais lesionadas injetadas com microesferas de hidrogel de gelatina com bFGF apresentaram menor formação de cicatriz, em comparação com as pregas vocais lesionadas injetadas apenas com microesferas de hidrogel de gelatina ou aquelas sem injeção. Conclusão Uma injeção profilática de microesferas biodegradáveis de hidrogel de gelatina com bFGF demonstra um potencial regenerativo para pregas vocais lesionadas em um modelo de coelho.

[Rotational thromboelastometry assessment of ballanced crystalloid, hydroxyethyl starch and gelatin effects on coagulation: a randomized trial]. / Tromboelastometria rotacional na avaliação dos efeitos de cristaloides balanceados, hidroxietilamido e gelatina na coagulação: estudo randômico.

BACKGROUND AND OBJECTIVES: Modern crystalloid and colloid solutions are balanced solutions which are increasingly used in perioperative period. However, studies investigating their negative effect on whole blood coagulation are missing, and vivid debate is going on about which solution has the minimal coagulopathy effect. The aim of our study was to assess the effect of modern fluid solutions on whole blood coagulation using rotational thromboelastometry. METHODS: Blood samples were obtained from 30 patients during knee arthroscopy before and after administration of 500mL of crystalloid, Hydroxyethyl Starch and gelatin according to the randomization. Rotational thromboelastometry (Extem, Intem and Fibtem tests) was used to assess negative effect of fluid solutions on whole blood coagulation. RESULTS: In Extem test, the initiation phase of fibrin clot formation represented by CT parameter was not influenced by any fluid solution (p>0.05). The speed of clot formation represented by CFT and α angle was impaired by Hydroxyethyl Starch and gelatin but not by crystalloids (p<0.05). The strength of formatted coagulum represented by MCF parameter was impaired both in Extem and Fibtem test by HES and in Fibtem also by crystalloids (p<0.05). Intem test was not negatively influenced by any crystalloid or colloid solution in any parameter (p>0.05). CONCLUSION: Extem test appears to be sensitive to coagulopathy effect of modern colloids and crystalloids. Hydroxyethyl starch has the most obvious negative effect on clot formation followed by gelatin and finally by crystalloids. Intem test seems to be insensitive to adverse effect of modern colloids and crystalloids.

Medicina Regenerativa para Úlceras Crónicas: Aplicación Cutánea de Células Troncales Mesenquimales de Gelatina de Wharton / Regenerative Medicine for Chronic Ulcers: Cutaneous Application of Mesenchymal Stem Cells of Wharton's Jelly

Resumen El empleo de células mesenquimales ha emergido como una parte importante en la medicina regenerativa con efectos positivos en la recuperación de tejidos dañados o perdidos. Las úlceras crónicas incluyen lesiones cutáneas que afectan a una gran parte de la población con diabetes mellitus, (por ejemplo 9.14% desarrollan lesiones por pie diabético según ENSANUT 2016) y representan gastos económicos considerables, debido a la pobre calidad de vida que llevan los pacientes. El tratamiento convencional que se lleva a cabo en estos casos es a largo plazo, y los efectos benéficos generados que se presentan son limitados, ya que las lesiones reinciden por no contar con un tratamiento específico y regenerativo, solo paliativo. Es por ello que en este trabajo se obtuvieron y emplearon células troncales mesenquimales derivadas de gelatina de Wharton (CTM-GW) bajo los criterios propuestos por la Sociedad Internacional de la Terapia Celular. El tratamiento fue aplicado en dos pacientes con úlceras crónicas flebostáticas de diferentes condiciones médicas y se monitoreo a corto plazo, por lo que fue un estudio limitado. Los resultados mostraron que las CTM-GW indujeron la reconstrucción cutánea mediante formación de tejido de granulación, además de disminuir el proceso inflamatorio crónico en la zona de daño, lo que favoreció el índice de cierre de la herida. Por lo anterior, se propone la utilización de CTM-GW en úlceras flebostáticas crónicas como tratamiento en la regeneración de la estructura tisular con resultados a corto plazo.

Abstract Use of mesenchymal cells has emerged as an important part in regenerative medicine with positive effects in the recovery of damaged or lost tissues. Chronic ulcers include skin lesions that affect a large part of the population with diabetes mellitus, (for example, 9.14 develop diabetic foot according to ENSANUT 2016) and represent considerable economic expenses, due to poor quality of life in patients. The conventional treatment that is carried out in these cases is long term, and the generated beneficial effects that are presented are limited, since the injuries recur due to not having a specific and regenerative treatment, only palliative. That is why in this work they were obtained and used mesenchymal stem cells derived from Wharton's jelly (MSC-WJ) under the criteria proposed by the International Society for Cell Therapy. The treatment was applied in two patients with chronic ulcers phlebostatic of different medical conditions and short-term monitoring, so it was a limited study. The results showed that MSC-WJ induced skin reconstruction by tissue formation granulation, in addition to decreasing the chronic inflammatory process in the area of damage, which favored the index of wound healing. Therefore, the use of MSC-WJ in chronic phlebostatic ulcers is proposed as a treatment in the regeneration of the tissue structure with short-term results.

Rotational thromboelastometry assessment of ballanced crystalloid, hydroxyethyl starch and gelatin effects on coagulation: a randomized trial / Tromboelastometria rotacional na avaliação dos efeitos de cristaloides balanceados, hidroxietilamido e gelatina na coagulação: estudo randômico

Abstract Background and objectives Modern crystalloid and colloid solutions are balanced solutions which are increasingly used in perioperative period. However, studies investigating their negative effect on whole blood coagulation are missing, and vivid debate is going on about which solution has the minimal coagulopathy effect. The aim of our study was to assess the effect of modern fluid solutions on whole blood coagulation using rotational thromboelastometry. Methods Blood samples were obtained from 30 patients during knee arthroscopy before and after administration of 500 mL of crystalloid, Hydroxyethyl Starch and gelatin according to the randomization. Rotational thromboelastometry (Extem, Intem and Fibtem tests) was used to assess negative effect of fluid solutions on whole blood coagulation. Results In Extem test, the initiation phase of fibrin clot formation represented by CT parameter was not influenced by any fluid solution (p > 0.05). The speed of clot formation represented by CFT and α angle was impaired by Hydroxyethyl Starch and gelatin but not by crystalloids (p < 0.05). The strength of formatted coagulum represented by MCF parameter was impaired both in Extem and Fibtem test by HES and in Fibtem also by crystalloids (p < 0.05). Intem test was not negatively influenced by any crystalloid or colloid solution in any parameter (p > 0.05). Conclusion Extem test appears to be sensitive to coagulopathy effect of modern colloids and crystalloids. Hydroxyethyl starch has the most obvious negative effect on clot formation followed by gelatin and finally by crystalloids. Intem test seems to be insensitive to adverse effect of modern colloids and crystalloids.

Resumo Justificativa e objetivos Os cristaloides e coloides modernos são soluções balanceadas e cada vez mais utilizadas no período perioperatório. No entanto, não há estudos que avaliem seu efeito negativo na coagulação do sangue total e o intenso debate sobre a solução que cause um efeito mínimo na coagulopatia permanece. O objetivo de nosso estudo foi avaliar o efeito das soluções líquidas modernas na coagulação do sangue total com o uso da tromboelastometria rotacional. Métodos De acordo com a randomização, amostras de sangue foram colhidas de 30 pacientes durante a artroscopia de joelho, antes e após a administração de 500 mL de cristaloides, hidroxietilamido e gelatina. A tromboelastometria rotacional (testes Extem, Intem e Fibtem) foi utilizada para avaliar o efeito negativo das soluções líquidas na coagulação do sangue total. Resultados No teste Extem, a fase de iniciação da formação de coágulos de fibrina representada pelo parâmetro CT não foi influenciada por qualquer solução líquida (p > 0,05). A velocidade da formação de coágulos representada pelo CFT e pelo ângulo α foi prejudicada pelo hidroxietilamido e pela gelatina, mas não pelos cristaloides (p < 0,05). A força do coágulo formatado representado pelo parâmetro MCF foi prejudicada tanto no teste Extem quanto no teste Fibtem pelo HES e no teste Fibtem também pelos cristaloides (p < 0,05). O teste Intem não foi influenciado negativamente por nenhuma solução cristaloide ou coloide em nenhum parâmetro (p > 0,05). Conclusão O teste Extem parece ser sensível ao efeito de coagulopatia dos coloides e cristaloides modernos. O hidroxietilamido apresentou o efeito negativo mais óbvio na formação do coágulo, seguido pela gelatina e finalmente pelos cristaloides. O teste Intem parece ser insensível ao efeito adverso dos coloides e cristaloides modernos.

Aplicação de gelatina de pele de tilápia-do-nilo (Oreochromis niloticus) em mortadela / Application of tilapia (Oreochromis niloticus) skin gelatin in mortadella

Foi extraída gelatina de pele de Tilápia-do-Nilo para substituição total ou parcial do toucinho de mortadela, produto cárneo emulsionado popular e muito consumido. Nas análises realizadas, a gelatina obtida apresentou rendimento razoável (6,2%), alto conteúdo proteico (85,6%), percentual de umidade de 7,25%, teor de lipídeos de 4,18% e teor de cinzas de 2,1%, parâmetros coerentes se comparados a estudos presentes na literatura. Desta forma, foi possível concluir que a extração de gelatina a partir da pele de tilápia é uma boa alternativa à gelatina comum. Os resultados sensoriais e o índice de aceitabilidade demonstraram que a redução de gordura nas formulações de mortadela resultou em um produto viável sensorialmente e tecnologicamente, permitindo uma redução na concentração de gordura do produto em relação ao produto convencional.

Encapsulation of Theophylline in Gelatin A-Pectin Complex Coacervates.

The present study aims at synthesizing gelatin A-pectin complex coacervates and encapsulation of theophylline in the polymer system. Variation and optimization of different reaction parameters such as pH, ratio between the polymers and cross-linker concentration was carried out to attain higher product yield. Relative viscosity, turbidity and UV-visible measurements were done for optimization. The optimum ratio between gelatin A-pectin was fixed at weight ratio 42:8 and pH=3.5. It was further observed that adhesion between the microcapsules decreased by the use of sodium carboxymethyl cellulose (SCMC) to the coacervate. The synthesized microcapsules were characterized by using spectroscopic techniques to assess their formation, drug loading and chemical interaction between theophylline and coacervate. Scanning electron microscopy (SEM) revealed the formation of microcapsules. Study relating to the encapsulation efficiency and swelling of the complex coacervates were also carried out.

Comparación entre Células Troncales Mesenquimales obtenidas de Médula Ósea, Tejido Adiposo y Gelatina de Wharton en base a los Criterios de la ISCT / Comparison between Mesenchymal Stem Cells obtained from Bone Marrow, Adipose Tissue and Wharton Gelatin according to the ISCT Criteria

RESUMEN: Las células troncales mesenquimales (CTM) representan una población heterogénea con capacidad para auto-renovarse y diferenciarse a distintos tipos celulares. Estas fueron descritas en un inicio en médula ósea (MO) a mediados del siglo pasado, desde entonces este tejido se ha convertido en el estándar de oro para la obtención y caracterización de CTM. Actualmente se sabe que este tipo de células se encuentran alojadas en nichos distribuidos por todo el organismo, donde contribuyen a los procesos de regeneración del tejido donde se localizan. No obstante, encontrar una fuente alterna de CTM con las mismas características que las de MO, pero que su extracción no suponga riesgo para el donador es fundamental para su utilización con fines terapéuticos. En este trabajo se aislaron células troncales de médula ósea, y se compararon con tejido adiposo y gelatina de Wharton y caracterizaron de acuerdo a los criterios de la Sociedad Internacional para la Terapia Celular (ISCT). Los resultados mostraron que la morfología, diferenciación osteogénica y adipogénica, así como la expresión de los antígenos de superficie CD90, CD73 y CD105 cumplen con los estándares, señalando a las provenientes de gelatina de Wharton como mejor opción.

ABSTRACT: Mesenchymal stem cells (MSC) represent a heterogeneous population with the capacity to self-renew and differentiate into different cell types. At the middle of the last century these cells initially were described in bone marrow (BM), thence this tissue has become the gold standard for obtaining and characterization of MSC. It is known that these cells are housed in specific areas called niches distributed throughout all body, where they contribute to tissue regeneration processes of self-tissue were they are located. However, finding an alternative source of CTM with the same characteristics that have showed in MO, but its obtention no represent a risk since the donor is essential to their use for therapeutic purposes. In this study we isolated mesenchymal stem cells from bone marrow, adipose tissue and Wharton's jelly and they were compared in their characteristics in according to the standards of the International Society for Cellular Therapy (ISCT). The results showed that the morphology as well as adipogenic and osteogenic differentiation and also the expression of surface antigens (CD90, CD73, and CD105) from all tissues accomplished the standards, although Wharton's jelly represented the best option.

Cierre de la pared abdominal con parche de gelatina de Wharton en neonatos con gastrosquisis / Abdominal wall closure with Wharton's gelatin patch in neonates with gastroschisis

El tratamiento quirúrgico tradicional para la gastrosquisis es el cierre primario de la pared abdominal, pero implica el riesgo de síndrome compartimental abdominal; mientras que el cierre abdominal escalonado con silo, conlleva un mayor tiempo de requerimiento de ventilador. Objetivo Describir la experiencia con el uso del parche de gelatina de Wharton, como una alternativa para el cierre de la pared abdominal en pacientes con gastrosquisis.. Métodos Estudio transversal de prevalencia. Resultados Seis recién nacidos (cinco de sexo femenino) con edad gestacional al nacimiento de 34.5 semanas [rango: 31-36 semanas] fueron intervenidos inmediatamente luego del nacimiento [rango: 180- 825 minutos], sin presentar complicaciones intraoperatorias y con un tiempo de ventilador que varió entre 0 y 72 horas. El inicio de nutrición por vía oral tuvo lugar en una mediana de 17 días, la duración de la nutrición parenteral fue de 30 días y la estadía hospitalaria de 45 días. No hubo casos de infección del sitio quirúrgico ni de otras complicaciones postoperatorias. Al momento del alta el resultado cosmético se consideró excelente. Conclusión El uso de parche de gelatina de Wharton es una solución sencilla para un problema grave y la técnica quirúrgica es fácilmente reproducible, ofreciendo buenos resultados clínicos y estéticos. Un estudio prospectivo en un mayor núm

Embolización portal hepática preoperatoria con lipiodol y gelatina absorbible / Preoperative hepatic portal vein embolisation with lipiodol and absorbable gelatin

Objetivo: Describir los resultados de la embolización portal hepática (EPH) preoperatoria con lipiodol y gelatina absorbible para generar hipertrofia hepática y permitir la hepatectomía derecha en pacientes con tumores hepáticos e hígado remanente futuro insuficiente. Materiales y métodos: Entre marzo de 2002 y abril de 2014, en 18 pacientes candidatos a hepatectomía derecha se realizó EPH con lipiodol y esponja de gelatina absorbible mezclada con contraste yodado. La estimación de los volúmenes hepáticos preembolización se hizo por tomografía computada con contraste endovenoso. Los pacientes fueron abordados mediante punción percutánea bajo guía ecográfica, seguida de angiografía. El control de la hipertrofia con estimación del volumen se realizó a la cuarta semana posembolización y el seguimiento se llevó a cabo ambulatoriamente o mediante historia clínica. Resultados: La mediana de edad fue de 58 años (relación hombre/mujer de 1:0,8) y el volumen hepático total estimado (mediana) de 1587,75 cm³. La estimación previa del volumen hepático y su relación con la porción futura remanente pre-EPH fue de 19,9%, mientras que el promedio absoluto de crecimiento del parénquima hepático remanente futuro pos-EPH se encontró entre los 306,2 y 475,2 cm³, con un 43,5% de aumento. La mediana de incremento de la relación volumen hepático total y la porción remanente pos-EPH fue de 8,5% (p< 0,001). Como complicaciones, se registró un hematoma y una necrosis aséptica. Conclusión: La EPH con lipiodol y esponja de gelatina absorbible es un procedimiento seguro y efectivo, que surge como alternativa a otros materiales de embolización.

Objective: To evaluate outcomes of preoperative hepatic portal vein embolisation with lipiodol and absorbable gelatin in order to generate liver hypertrophy and enable right hepatectomy in selected patients with liver tumours and future insufficient residual liver. Materials and methods: Portal vein embolisation (PVE) with lipiodol and absorbable gelatin sponge mixed with iodine based contrast was performed in 18 patient candidates for right hepatectomy between March 2002 and April 2014. The preembolisation liver volume evaluations were performed by computed tomography with intravenous contrast. Patients underwent an ultrasound-guided percutaneous puncture, followed by angiography. The controls of hypertrophy and volume estimation were performed in the 4 th week after portal embolisation. The patients were followed-up on an outpatient basis or by using their medical records. Results: The median age was 58 years, with a 1:0.8 male: female ratio. The total estimated liver volume, excluding the tumour, of all patients evaluated prior to surgery was 1587.75 cm³ (median). The previous estimated liver volume and its relation to the future remaining portion before PVE was 19.9%. The absolute median growth of future residual liver parenchyma post-PVE was 306.2 to 475.2 cm³, being an increase of 43.5%, and the mean growth of liver volume and remaining portion ratio post-PVE was 8.5% (P<.001). Complications were one haematoma and one aseptic necrosis. Conclusión: The selection of patients is of paramount importance, and PVE with lipiodol and absorbable gelatin in our environment is a safe and effective procedure.

Esponja estéril de gelatina comprimida (GELFOAMMR) simulando tejido tiroideo en ecografía de paciente con tiroidectomía. Reporte de un caso / A compressed sterile gel sponge (GELFOAMMR) simulating thyroid tissue in an ultrasound examination of a patient who underwent a thyroidectomy. Report of a case

El cáncer de tiroides es la neoplasia endocrina más usual, el carcinoma papilar de tiroides el subtipo más prevalente representando el 75 al 80% de los casos. Se presenta por lo general como nódulo tiroideo único, el uso de la ecografía ha aumentado su detección. El tratamiento recomendado es la tiroidectomía total evidenciando menor número de recurrencias y complicaciones. Se presenta el caso de una paciente femenina de 54 años de edad, quien en el control postquirúrgico por tiroidectomia refiere aparición de nódulos en hemicuello izquierdo. Se realiza biopsia sugestiva de respuesta inflamatoria. La evaluación postiroidectomía tiene como objetivo la identificación temprana de las recurrencias, existen diferentes situaciones clínicas que pueden simular una recurrencia, como se evidencia en el caso presentado, donde las imágenes simulantes de tejido tiroideo correspondían al material hemostático GelfoamMR, el cual es ampliamente empleado en el campo quirúrgico, la respuesta nodular corresponde a una hiperplasia linfoide atípica

Thyroid cancer is the most common endocrine neoplasm, and papillary thyroid carcinoma is the most prevalent subtype, representing 75 to 80% of all cases. This condition usually appears as a single thyroid nodule, and the use of ultrasound has increased its detection. The recommended treatment is total thyroidectomy, which leads to fewer recurrences and complications. We present the case of a 54-year old female patient who reported the appearance of nodular structures on the left side of her neck in a control after a thyroidectomy. A biopsy was taken, and it was reported as suggestive of an inflammatory response. The assessment after a thyroidectomy aims to identify early recurrences, as it was described in this case, where the images resembling thyroid tissue corresponded to a hemostatic material (GelfoamTM), which is widely used in the surgical field, and the nodular response described corresponded to a case of atypical lymphoid hyperplasia

Diagnóstico clínico en saliva. Revisión

El odontólogo está llamado a convertirse en un elemento importante en el desarrollo de estudios de fenotipado de poblaciones para impulsar la aplicación de la medicina personalizada y la razón se debe a la saliva, que además de resultar un fluido imprescindible para la conservación de las funciones orales, se perfila con cualidades importantes para el diagnóstico clínico con base genética. Con el desarrollo de potentes técnicas de laboratorio, como el inmunoensayo, electroforesis, fluorescencia, cromatografía (HPLC y CG), espectrometría de masa (EM), la reacción en cadena de la polimerasa (PCR) y pruebas genéticas de fenotipado, se ha podido correlacionar la presencia de ciertos biomarcadores de daño tisular en la saliva con los niveles de esas especies en sangre. Estos biomarcadores constituyen señales del daño tisular o de respuestas del organismo a esas injurias, cuando aun no se pueden observar las evidencias clínicas del mismo. Esta aplicación de la saliva le confiere una importancia especial en lo referente al diagnóstico clínico. Al estudio de los biomarcadores orales se ha unido, de forma más reciente, el desarrollo de protocolos para la obtención de ADN genómico de la saliva que permite, por la viabilidad en la colección de muestras, su conservación y facilidades en su traslado, realizar estudios poblacionales para conocer la funcionalidad de ciertos genes que se relacionan con la biotransformación de los medicamentos, una causa importante de las variaciones interindividuales a los tratamientos farmacológicos. El conocimiento de polimorfismos en genes que expresan las enzimas que metabolizan fármacos específicos, permite realizar cambios en los principios activos o ajustes en las dosis de tratamientos individuales, que es el objetivo de la medicina personalizada o farmacogenética. Estos estudios también permiten conocer la predisposición genética de poblaciones al desarrollo de ciertas enfermedades, tanto orales como sistémicas, lo que propicia el establecimiento de nuevas políticas en la profilaxis y medicina preventiva. El uso de la saliva con estos fines abre nuevas perspectivas en la atención odontológica, y requiere de esfuerzos interdisciplinarios y cooperación en el equipo de salud.

The dentist is called to become an important element in the development of studies phenotyping of populations to advance the implementation of personalized medicine and the reason is because saliva, which besides being a prerequisite for the preservation of oral functions fluid , is emerging with important qualities for clinical diagnosis with genetic basis. With the development of powerful laboratory techniques, such as immunoassay, electrophoresis, fluorescence, chromatography (HPLC and GC), mass spectrometry (MS), polymerase chain reaction (PCR) and genetic testing phenotyping, it has been correlate the presence of certain biomarkers of tissue damage in saliva levels of these species in blood. These biomarkers are signs of tissue damage or agency responses to these injuries, when not even be seen clinical evidence of it. This application saliva attaches special importance with regard to clinical diagnosis. The study of oral biomarkers has joined, more recently, the development of protocols for obtaining genomic DNA from saliva that allows for viability in sample collection, preservation of the same and facilities during transport, conduct population studies to determine the function of certain genes that are related to biotransformation of drugs, a major cause of differences among individuals to drug treatments. Knowledge of polymorphisms in genes that express enzymes that metabolize specific drugs can make changes or adjustments active principles in doses of individual treatments, which is the goal of personalized medicine or pharmacogenetics. These studies also provide insight into the genetic predisposition of populations to the development of certain diseases, both oral and systemic, which favors the establishment of new policies in the prophylaxis and preventive medicine. The use of saliva for this purpose opens new perspectives in care dental and requires interdisciplinary efforts and cooperation in the health team.

Plasma matrix metalloproteinase 9 as an early surrogate biomarker of advanced colorectal neoplasia.

INTRODUCTION: Matrix metalloproteinases (MMPs) are overexpressed at different stages of colorectal carcinogenesis and could serve as early surrogate biomarkers of colorectal neoplasia. OBJECTIVE: To assess the utility of plasma MMP2 and MMP9 levels in the detection of advanced colorectal neoplasia and their correlation with tissue levels. METHODS: We analysed blood and tissue samples from patients with non-advanced adenomas (n=25), advanced adenomas (n=25), colorectal cancer (n=25) and healthy controls (n=75). Plasma and tissue gelatinase levels were determined by Luminex XMAP technology and gelatin zymography. Receiver operating characteristic (ROC) curve analysis was used to calculate the optimum cut-off for the detection of advanced colorectal neoplasia. RESULTS: Plasma MMP2 levels were similar between groups whatever the type of lesion. Plasma MMP9 levels were significantly higher in patients with neoplastic lesions than in healthy controls (median 292.3ng/ml vs. 139.08ng/ml, P<0.001). MMP9 levels were also higher in colorectal cancer than in non-advanced adenomas (median 314.6ng/ml vs. 274.3ng/ml, P=0.03). There was a significant correlation between plasma and tissue levels of MMP9 (r=0.5, P<0.001). The plasma MMP9 cut-off range with the highest diagnostic accuracy was between 173ng/ml and 204ng/ml (AUC=0.80 [95% CI: 0.72-0.86], P<0.001; sensitivity, 80-86% and specificity, 57-67%). CONCLUSION: Plasma MMP9 could be a surrogate biomarker for the early detection of advanced colorectal neoplasia, although its diagnostic performance could be increased by combination with other biomarkers.

Aplicação de gelatina obtida de subproduto animal como substituto parcial de gordura em spread de chocolate / Application of gelatin obtained from animal by-product as a partial fat replacement in chocolate spread

O objetivo do presente estudo foi verificação da viabilidade da aplicação de gelatina de pés de frango em spread de chocolate como substituto parcial de gordura. Inicialmente apresentou-se uma revisão de literatura sobre os principais aspectos que envolvem a pesquisa. Após relatou-se a metodologia de extração e caracterização físico-química da gelatina obtida de pés de frango por meio de análises de composição centesimal, de cor, força de gel e análise de perfil de textura (TPA). Posteriormente abordou-se os efeitos da aplicação de gelatina como substituto de gordura nas propriedades físico-químicas e reológicas de spread de chocolate. Por último investigou-se a influência da concentração de gelatina e substituição de gordura na espalhabilidade, estabilidade (shelf life), custos e propriedades sensoriais dos spreads de chocolate. Para tanto, foi utilizado planejamento experimental Central Composto Rotacional e metodologia de superfície de resposta. Os resultados da extração de gelatina de subproduto de frango indicaram que as peles e tendões dos pés de frango possuem rendimento (7,83 %) e conteúdo mineral (1,92 %), apresentando alto teor proteico (84,96 %) próximo das gelatinas comerciais. Em concentração de 6,67 % a gelatina demonstrou elevada força de gel (294,78 g), comportando-se na análise de perfil de textura como um sólido. Os dados relacionados às formulações de spread de chocolate demonstraram que tanto o nível de substituição de gordura quanto a concentração de gelatina exerceram efeitos significativos (p<0,05) sobre a cor, volume, densidade e comportamento reológico dos produtos, exceto a atividade de água que foi influenciada apenas pelo primeiro fator. Sob a perspectiva reológica apenas a amostra com maior nível de substituição de gordura foi classificada como pseudoplástica. A gelatina contribuiu no aumento do teor proteico das formulações. A consistência foi significativamente (p<0,05) influenciada pelas propriedades da fase de gelatina, apresentando ampla faixa de plasticidade nas diferentes temperaturas (10, 20 e 30 °C). A consistência dos spreads aumentou em todas as temperaturas durante os 90 dias de armazenamento. Observou-se por meio da análise sensorial que os fatores em estudo provocaram alterações nos atributos sensoriais do produto suficiente para a percepção dos provadores. A formulação com 75 % de substituição de gordura seguida pelas formulações com 50 % e 0,8 % de concentração de gelatina apresentaram a maior aceitabilidade. Com o máximo de substituição de gordura chegou-se a 53 % de redução de custos. Contudo, os resultados obtidos sugerem que a aplicação de gelatina de pés de frango pode ser vantajosa, já que contribuiu com a formulação de spreads de chocolate menos calóricos e com propriedades físico-químicas e sensoriais adequadas para uma possível comercialização

The aimed of this study was the verification of the feasibility of application of gelatin chicken feet in chocolate spread as a partial replacement fat. Firstly, it was presented a literature review on the main aspects involved in the research. After it was reported the extraction methodology and physicochemical characterization of chicken feet gelatin through chemical composition, color, gel strength and texture profile analysis (TPA) analysis. Next, the effects of the gelatin application as a fat replacement in physicochemical and rheological properties of chocolate spread were discussed. Finally, the influence of the gelatin concentration and fat replacement in spreadability, stability (shelf life), costs and sensory properties of chocolate spread were investigated. For this purpose, the Central Composite Rotational Design and response surface methodology were used. The results of the chicken feet gelatin extraction indicated that the skins and tendons of chicken feet have yield (7.83%) and mineral content (1.92%), with high protein content (84.96%) close to the commercial gelatins. In concentration of 6.67 % gelatin demonstrated high gel strength (294.78 g), behaving in the texture profile analysis as a solid. Data related to the spread chocolate formulations demonstrated that the level of replacement of fat and gelatin concentration exerted a significant effect (p <0.05) on the color, volume, density and rheological behavior of the products, except water activity which was influenced only by the first factor. Under the theological perspective only the sample with higher levels of fat replacement was classified as shear thinning. Gelatin contributed in increasing the protein content of the formulations. The consistency was significantly (p <0.05) influenced by the properties of the gelatin phase, showing a wide range of plasticity at different temperatures (10, 20 and 30 ° C). The spreads consistency increased at all temperatures during the 90 days of storage. It was observed by means of sensory analysis that the factors under study led to changes in the sensory attributes of the product enough to the perception of tasters. The formulation with 75 % fat replacement followed by 50 % and 0.8 % concentration of gelatin had the highest acceptability. With maximum fat replacement was reached to 53% cost reduction. However, the results suggest that the application of chicken feet gelatin can be advantageous since it contributed to the formulation of lower calorie chocolate spreads, with physicochemical and sensory properties suitable for possible commercialization

Design and preparation of a novel colon-targeted tablet of hydrocortisone

ABSTRACT The objective of this research was to design a new colon-targeted drug delivery system based on chitosan. The properties of the films were studied to obtain useful information about the possible applications of composite films. The composite films were used in a bilayer system to investigate their feasibility as coating materials. Tensile strength, swelling degree, solubility, biodegradation degree, Fourier transform infrared spectroscopy (FTIR), Differential Scanning Calorimetry (DSC), Scanning electron microscope (SEM) investigations showed that the composite film was formed when chitosan and gelatin were jointly reacted jointly. The results showed that a 6:4 blend ratio was the optimal chitosan/gelatin blend ratio. In vitro drug release results indicated that the Eudragit- and chitosan/gelatin-bilayer coating system prevented drug release in simulated intestinal fluid (SIF) and simulated gastric fluid (SGF). However, the drug release from a bilayer-coated tablet in SCF increased over time, and the drug was almost completely released after 24 h. Overall, colon-targeted drug delivery was achieved by using a chitosan/gelatin complex film and a multilayer coating system.

RESUMO O objetivo desta pesquisa foi planejar um novo sistema de liberação de fármacos direcionado ao cólon, utilizando quitosana. Estudaram-se as propriedades dos filmes a fim de obter informações úteis sobre a aplicação desses filmes compósitos. Utilizaram-se os filmes compósitos em sistema de bicamada para investigar a sua viabilidade como materiais de revestimento. Estudos de resistência à tração, grau de intumescimento, solubilidade, grau de biodegradação, no infravermelho por transformada de Fourier (FTIR), de calorimetria diferencial de varredura (DSC) e de microscopia eletrônica de varredura (SEM) mostraram que o filme compósito se formou quando a quitosana e a gelatina reagiram entre si. Os resultados mostraram que a mistura de proporção ótima foi de 6:4 de quitosana:gelatina. Resultados da liberação do fármaco in vitro indicaram que o sistema de revestimento de Eudragit e bicamada de quitosana/gelatina impediu a liberação de fármaco em fluido intestinal simulado (SIF) e em fluido gástrico simulado (SGF). Entretanto, a liberação de fármaco do comprimido revestido em bicamada no SCF aumentou ao longo do tempo e o fármaco foi quase completamente liberado após 24 h. Em geral, se obteve a forma de liberação dirigida ao cólon, utilizando filme complexo de quitosana/gelatina e sistema de revestimento multicamada.

Pharmaceutical films made from the waste material from the preparation of propolis extracts: development and characterization

abstract This study investigated the development and characterized the physicochemical properties of films obtained from by-products (BP) from the preparation of propolis extracts. Films were produced in the presence and absence of a polymeric adjuvant (gelatin or ethylcellulose) and propylene glycol by a solvent casting method. Density, surface topography by scanning electron microscopy, mechanical properties (folding endurance, tensile strength and percentage elongation), water vapour permeability (WVP), moisture uptake capacity, thermogravimetry, differential scanning calorimetry and Fourier transform infrared spectroscopy (FTIR) were determined. The films were a transparent, light greenish-yellow colour, with a uniform surface, and were flexible and easy to handle. The thickness and density of the preparations indicated that the compounds were homogeneously dispersed throughout the film. Mechanical properties were influenced by the film composition; films containing gelatin were more resistant to stress, while those containing ethylcellulose were more flexible. Increasing the adjuvant concentration decreased the elasticity and the rupture resistance, but increased the moisture uptake capacity and WVP of the formulations. BP was thermally stable as were the films. FTIR tests suggested interactions between BP and the adjuvants. This work could contribute to the utilization of BP to prepare films for food and pharmaceutical uses.

resumo Este estudo investigou o desenvolvimento e as características físico-químicas de filmes obtidos com o resíduo (BP), normalmente descartado, advindo da preparação de extratos de própolis. Os filmes foram produzidos com e sem adjuvantes poliméricos (gelatina ou etilcelulose) e propilenoglicol, pelo método de evaporação de solvente. Foram determinadas a densidade, a topografia de superfície usando microscopia eletrônica de varredura, as propriedades mecânicas (resistência à dobra, tensão e elongação), transmissão de vapor de água (WVP), capacidade de absorção de umidade, termogravimetria, calorimetria exploratória diferencial e espectroscopia de infravermelho com transformada de Fourier (FTIR). Os filmes demonstraram coloração verde-amarelada, transparência, uniformidade de superfície, homogeneidade, flexibilidade e fácil manuseio. A espessura e a densidade das preparações indicaram que os compostos estavam dispersos de forma homogênea. As propriedades mecânicas foram influenciadas pela composição dos filmes e aqueles que continham gelatina apresentaram-se mais resistentes enquanto os compostos por etilcelulose demonstraram maior flexibilidade. Com o aumento da concentração polimérica, a resistência e a elasticidade diminuíam, porém aumentou a capacidade de absorção de água e a WVP das formulações. BP apresentou estabilidade térmica assim como os filmes. Os testes de FTIR sugeriram interações entre o BP e os adjuvantes utilizados. Este trabalho pôde contribuir com a utilização de BP na preparação de filmes para uso alimentício e farmacêutico.

Desenvolvimento, avaliação da segurança e eficácia clínica de sistemas nanoparticulados de gelatina contendo rutina / Development, safety assessment and clinical efficacy of rutin nanoparticulate gelatin systems

A associação de filtros solares a compostos bioativos tem sido estudada com ênfase na última década. Contudo, a solubilidade limitada dos compostos naturais, tais como a rutina, restringe o desenvolvimento de preparações cosméticas seguras, funcionais e estáveis. A proposta deste estudo envolveu a obtenção de nanoestruturas de gelatina (contendo ou não rutina) para aplicação em protetores solares. Os objetivos específicos foram: (1) preparar partículas de gelatina; (2) realizar a caracterização física, físico-química, morfológica, térmica e funcional (in vitro); (3) avaliar a citotoxicidade e a penetração/permeação curtânea in vitro dos sistemas; (4) desenvolver fotoprotetores bioativos de eficácia estimada in vitro; e (5) determinar a segurança e eficácia clínica fotoprotetora das preparações contendo as estruturas proteicas. As nanopartículas apresentaram-se esféricas e com diâmetro médio e índice de polidispersividade variando entre 318,9 ± 6,9 (B-NC) a 442,8 ± 4,9 nm (R-NC) e 0,06 ± 0,03 (B-NC) a 0,12 ± 0,01 (R-NC), respectivamente. Os valores do potencial zeta apresentaram-se entre -28,5 ± 0,9 mV (B-NC) e -26,6 ± 0,5 mV (R-NC). R-NC apresentou eficiência de associação equivalente a 51,8 ± 1,4%. Os ensaios de segurança das nanopartículas evidenciaram perfil citotóxico adequado para aplicação cosmética, bem como, a ausente tendência de penetração/permeação cutânea. Tendo em vista os resultados obtidos in vitro, as nanopartículas contendo rutina apresentaram capacidade antioxidante 74% superior à rutina em seu estado livre e contribuíram para o aumento de 48% do fator de proteção solar (FPS) quando associada à avobenzona (butyl methoxydibenzoylmethane), ao p-metoxicinamato de octila (ethylhexyl methoxycinnamate) e ao octil dimetil PABA (ethylhexyl dimethyl PABA). A avaliação da eficácia clínica das formulações evidenciou a influência da nanopartícula, sem adição do flavonoide, na proteção da pele contra a formação do eritema UV induzido. Por meio da avaliação dos aspectos funcionais, foi possível constatar, in vitro e in vivo, que a adição das nanopartículas em sistemas fotoprotetores influenciou seu perfil de transmitância da radiação UV, bem como, seus efeitos sobre o eritema UV induzido. Os resultados obtidos apresentaram perspectivas de aplicação prática no desenvolvimento de produtos cosméticos fotoprotetores associados a substâncias bioativas, por meio de plataforma nanotecnológica

Especially, in the last decade, the association of chemical filters and bioactive compounds has been studied by several authors. However, the limited solubility of natural compounds, such as rutin restricts the development of safe and stable cosmetic preparations. The aim of this work was the development of gelatin nanoparticles (with or without rutin) as an ingredient in sunscreens. The specific goals were: (1) the development of rutin-loaded gelatin nanoparticles; (2) to perform the physical, physical-chemical, morphological, thermal and functional (in vitro) analysis; (3) to assess the cytotoxicity and skin penetration / permeation in vitro of the nanoparticles; (4) to develop bioactive sunscreens and to perform the in vitro photoprotection efficacy assay; and (5) to evaluate the in vivo sun protection factor (SPF) of the formulations. The nanoparticles were spherical with an average size and polydispersive index between 318.9 ± 6.9 nm (B-NC) at 442.8 nm ± 4.9 (R-NC), and 0.06 ± 0, 03 (B-NC) to 0.12 ± 0.01 (R-NC). The zeta potential values were high and negative, ranging from - 28.5 ± 0.9 mV (B-NC) and -26.6 ± 0.5 mV (R-NC). R-NC entrapment efficient was 51.8 ± 1.4%. The nanoparticle safety assessment showed a cytotoxic profile suitable for cosmetic application, as well as the absent trend of penetration/ permeation of the skin. The in vitro results indicated that the rutin-loaded gelatin nanoparticles increased 74% the antioxidant profile in comparison with free rutin and also increased 48% the SPF (in vitro) when combined with butyl methoxydibenzoylmethane, ethylhexyl methoxycinnamate and ethylhexyl dimethyl PABA. The assessment of the clinical efficacy assays showed the influence of blank nanoparticle in the protection of the skin against UV-induced erythema response. It was established in vitro and in vivo that the addition of gelatin nanoparticles in sunscreens influenced its UV transmittance profile, as well as its anti-erythema effects on the skin. The results have practical application in the development of sunscreen with bioactive ingredients and at the design of an innovative ingredient with a chemopreventive profile