RESUMO
BACKGROUND: Urachal cancer is one of the rarest and aggressive malignant diseases of the bladder; its incidence was 0.2% of all bladder cancers in 2012. It occurs in advanced stages, among stage IV tumors 58% die at 22 months. It is originated from urachal, an embryological structure that is present in 32% of the adult population. OBJECTIVE: To present a case series of urachal cancer in a third level medical facility. METHOD: Case series. Clinical data from patients with of urachal cancer during 2011 to 2019 were analyzed. The variables included were age, gender, smoking, clinical stage, treatment and evolution. Descriptive statistics, measures of central tendency and dispersion were used. RESULTS: There were seven patients; three men and four women; the mean age was 54.4 years. The most frequent histological type was mucinous adenocarcinoma. Partial cystectomy was performed with bilateral pelvic lymphadenectomy in three (42.8%) patients, radical cystectomy plus bilateral pelvic lymphadenectomy in the remaining four (57.2% patients). CONCLUSIONS: Urachal cancer is rare, clinical manifestations occur late. Hematuria is the most frequent clinical sign. The medium term prognosis is bad.
ANTECEDENTES: El cáncer de uraco es una de las enfermedades malignas de la vejiga más raras y agresivas. Su incidencia en 2012 era del 0.2% de todos los cánceres de vejiga. Se presenta en estadios avanzados, con una mortalidad del 58% a 22 meses para el estadio IV. Se origina a partir del uraco, una estructura embriológica que está presente en el 32% de la población adulta. OBJETIVO: Presentar las características clínicas de una serie de casos de cáncer de uraco en una unidad de tercer nivel de atención médica. MÉTODO: Serie de casos. Se analizaron los resultados clínicos obtenidos de pacientes con cáncer de uraco de 2011 a 2019. Las variables incluidas fueron edad, sexo, tabaquismo, estadio clínico, tratamiento y evolución. Se utilizó estadística descriptiva, con medidas de tendencia central y dispersión. RESULTADOS: Fueron siete pacientes, tres hombres y cuatro mujeres, con una edad media de 54.4 años. El tipo histológico más frecuente fue adenocarcinoma tipo mucinoso. Se realizó cistectomía parcial con linfadenectomía pélvica bilateral a tres pacientes (42.8%), y cistectomía radical más linfadenectomía pélvica bilateral en los otros cuatro (57.2%). CONCLUSIONES: El cáncer de uraco es una enfermedad rara. Sus manifestaciones son tardías y el signo clínico principal es la hematuria. El pronóstico es malo a mediano plazo.
Assuntos
Adenocarcinoma , Úraco , Neoplasias da Bexiga Urinária , Adenocarcinoma/epidemiologia , Adenocarcinoma/cirurgia , Cistectomia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Úraco/cirurgia , Neoplasias da Bexiga Urinária/epidemiologia , Neoplasias da Bexiga Urinária/cirurgiaRESUMO
ANTECEDENTES: Las metástasis de mama a uréter son extremadamente raras y la mayoría son asintomáticas. CASO CLÍNICO: Mujer de 67 años, con cáncer de mama derecha EC IA luminal A de 5 años de evolución. Presentó infección de vías urinarias de repetición, hematuria macroscópica total y dolor renal derecho. La tomografía abdominopélvica mostró dilatación del cáliz superior y defecto de llenado en la pelvis renal derechos. Se le realizó nefroureterectomía radical derecha, rodete vesical. El reporte histopatológico fue metástasis de carcinoma infiltrante con afectación de pelvis renal y uréter. CONCLUSIONES: La metástasis tardía del cáncer de mama al uréter y la pelvis es rara. BACKGROUND: Breast metastases to ureter are extremely rare. Most are asymptomatic. CASE REPORT: A 67-year-old woman with 5 years of evolution, with right breast cancer stage IA luminal A. She presented repeated urinary tract infection, total macroscopic hematuria and pain in the right renal fossa. The computed tomography showed dilation of the upper calyx and filling defect in the renal pelvis. A right laparoscopic radical nephroureterectomy was realized; the histopathological report was metastasis of infiltrating carcinoma without specific pattern involving renal pelvis and ureter. CONCLUSIONS: Late metastasis of breast cancer to ureter and pelvis are rare.
Assuntos
Neoplasias da Mama , Ureter , Idoso , Feminino , Humanos , Pelve Renal/diagnóstico por imagemRESUMO
OBJECTIVES: To evaluate changes in cerebral oxygenation by means of near-infrared spectroscopy during respiratory events in children with sleep-disordered breathing (SDB) and associated disorders. STUDY DESIGN: Sixty-five children suspected of having SDB underwent a respiratory polygraphy with simultaneous recording of cerebral oxygenation indices. Respiratory events were analyzed by type of event, duration, variations of pulse oximetry (oxygen saturation [SpO2]), cerebral tissue oxygenation index (TOI), and heart rate. Data were categorized according to the severity of SDB and age. RESULTS: There were 540 obstructive and mixed apneas, 172 central apneas, and 393 obstructive hypopneas analyzed. The mean decreases in SpO2 and TOI were 4.1 ± 3.1% and 3.4 ± 2.8%, respectively. The mean TOI decrease was significantly smaller for obstructive hypopnea compared with apneas. The TOI decrease was significantly less in children with mild SDB as compared with those with moderate-to-severe SDB and in children >7 years as compared with those <7 years old. TOI decreases correlated significantly with SpO2 decreases, duration of event, and age, regardless of the type of event. In a multivariable regression model, predictive factors of TOI decreases were the type of respiratory event, SpO2 decrease, apnea-hypopnea index, and age. CONCLUSIONS: In children with SDB and associated disorders, cerebral oxygenation variations depend on the type of respiratory event, severity of SDB, and age.
Assuntos
Encéfalo/metabolismo , Circulação Cerebrovascular/fisiologia , Transtornos do Neurodesenvolvimento/fisiopatologia , Consumo de Oxigênio/fisiologia , Oxigênio/metabolismo , Síndromes da Apneia do Sono/fisiopatologia , Sono/fisiologia , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Frequência Cardíaca/fisiologia , Humanos , Lactente , Masculino , Transtornos do Neurodesenvolvimento/etiologia , Transtornos do Neurodesenvolvimento/metabolismo , Oximetria , Polissonografia , Estudos Retrospectivos , Síndromes da Apneia do Sono/complicações , Síndromes da Apneia do Sono/metabolismo , Espectroscopia de Luz Próxima ao InfravermelhoRESUMO
Familial combined hyperlipidemia (FCHL) is the most prevalent primary dyslipidemia; however, it frequently remains undiagnosed and its precise definition is a subject of controversy. FCHL is characterized by fluctuations in serum lipid concentrations and may present as mixed hyperlipidemia, isolated hypercholesterolemia, hypertriglyceridemia, or as a normal serum lipid profile in combination with abnormally elevated levels of apolipoprotein B. FCHL is an oligogenic primary lipid disorder, which can occur due to the interaction of several contributing variants and mutations along with environmental triggers. Controversies surrounding the relevance of identifying FCHL as a cause of isolated hypertriglyceridemia and a differential diagnosis of familial hypertriglyceridemia are offset by the description of associations with USF1 and other genetic traits that are unique for FCHL and that are shared with other conditions with similar pathophysiological mechanisms. Patients with FCHL are at an increased risk of cardiovascular disease and mortality and have a high frequency of comorbidity with other metabolic conditions such as type 2 diabetes, non-alcoholic fatty liver disease, steatohepatitis, and the metabolic syndrome. Management usually requires lipid-lowering therapy directed toward reducing cholesterol and triglyceride concentrations along with cardiovascular risk protection. In recent years, the number of research studies on FCHL has been decreasing, mainly due to a lack of recognition of its impact on disease burden and comorbidity and the complexity in identifying probands for studies. This creates areas of opportunity to develop research for FCHL in epidemiology, genetics, pathophysiology, therapeutics, and cardiovascular risk management, which are discussed in depth in this review. (REV INVEST CLIN. 2018;70:224-36).
Assuntos
Doenças Cardiovasculares/prevenção & controle , Hiperlipidemia Familiar Combinada/terapia , Lipídeos/sangue , Animais , Apolipoproteínas B/sangue , Doenças Cardiovasculares/etiologia , Diagnóstico Diferencial , Humanos , Hiperlipidemia Familiar Combinada/complicações , Hiperlipidemia Familiar Combinada/fisiopatologia , Hiperlipoproteinemia Tipo IV/diagnóstico , Fatores de RiscoRESUMO
OBJECTIVES: To determine the toxicity and chemoprotective effect of the alkaloid extract of Melocactus bellavistensis against colon cancer induced in rats using 1,2-dimethylhydrazine (DMH). MATERIALS AND METHODS: The alkaloid extract was obtained from the fleshy part of M. bellavistensis, and an acute toxicity test was then carried out on 30 mice of the Balb C57 strain. To assess its chemoprotective effect, colon cancer was induced in 45 Holtzman rats using DMH according to the following experimental design: one control group received 2 mL/kg sodium polysorbate, and four groups received 20 mg/kg DMH plus 0, 1, 5, or 10 mg/kg M. bellavistensis alkaloid extract. RESULTS: With a sample of 5 g of alkaloid extract, an LD50 greater than 1000 mg/mL was determined in the acute toxicity test. Histological indicators revealed that the 5 and 10 mg/kg doses had significant anti-tumor activity with 100% neoplasia inhibition against DMH- induced colon cancer in rats. CONCLUSIONS: Under experimental conditions, the alkaloid extract of M. bellavistensis has a chemoprotective effect against DMH-induced colon cancer in rats.
Assuntos
Cactaceae , Neoplasias do Colo/prevenção & controle , Fitoterapia , Extratos Vegetais/uso terapêutico , 1,2-Dimetilidrazina/administração & dosagem , Alcaloides/uso terapêutico , Animais , Neoplasias do Colo/complicações , Ratos , Ratos Sprague-DawleyRESUMO
RESUMEN Objetivos Determinar la toxicidad y el efecto quimioprotector del extracto alcaloideo de Melocactus bellavistensis (cactus globoso) sobre el cáncer de colon inducido en ratas con 1,2 dimetilhidrazina (DMH). Materiales y métodos Se obtuvo el extracto alcaloideo de la parte carnosa de Melocactus bellavistensis, posteriormente, se realizó un ensayo de toxicidad aguda en 30 ratones de cepas Balb C57. Para evaluar su efecto quimioprotector se indujo el cáncer de colon en 45 ratas Holtzmann con DMH, según el siguiente diseño experimental: un grupo control con: polisorbato de sodio (PS) a 2 mL/kg y cuatro grupos con DMH 20 mg/kg más 0, 1, 5 y 10 mg/kg de extracto alcaloideo de Melocactus bellavistensis respectivamente. Resultados Con una muestra de 5 g de extracto alcaloideo se determinó una DL50 mayor a 1000 mg/mL en el ensayo de toxicidad aguda del extracto alcaloideo de Melocactus bellavistensis. Los resultados del efecto quimioprotector en los indicadores de estudio histopatológico revelaron que a las dosis de 5 y 10 mg/kg demostraron actividad antitumoral significativa en el cáncer de colon inducido por dimetilhidrazina en ratas con 100% de inhibición de neoplasia. Conclusiones En condiciones experimentales, el extracto de alcaloides de Melocactus bellavistensis demostró tener efecto quimioprotector en cáncer de colon inducido por dimetilhidrazina en ratas.
ABSTRACT Objectives To determine the toxicity and chemoprotective effect of the alkaloid extract of Melocactus bellavistensis against colon cancer induced in rats using 1,2-dimethylhydrazine (DMH). Materials and methods The alkaloid extract was obtained from the fleshy part of M. bellavistensis, and an acute toxicity test was then carried out on 30 mice of the Balb C57 strain. To assess its chemoprotective effect, colon cancer was induced in 45 Holtzman rats using DMH according to the following experimental design: one control group received 2 mL/kg sodium polysorbate, and four groups received 20 mg/kg DMH plus 0, 1, 5, or 10 mg/kg M. bellavistensis alkaloid extract. Results With a sample of 5 g of alkaloid extract, an LD50 greater than 1000 mg/mL was determined in the acute toxicity test. Histological indicators revealed that the 5 and 10 mg/kg doses had significant anti-tumor activity with 100% neoplasia inhibition against DMH- induced colon cancer in rats. Conclusions Under experimental conditions, the alkaloid extract of M. bellavistensis has a chemoprotective effect against DMH-induced colon cancer in rats.
Assuntos
Animais , Ratos , Extratos Vegetais/uso terapêutico , Neoplasias do Colo/prevenção & controle , Cactaceae , Fitoterapia , Ratos Sprague-Dawley , Neoplasias do Colo/complicações , 1,2-Dimetilidrazina/administração & dosagem , Alcaloides/uso terapêuticoRESUMO
Geranium ruizii (Pasuchaca) es una planta medicinal utilizada tradicionalmente como hipoglucemiante en el departamento de Ancash, Perú. Objetivo: Evaluar el efecto hipoglucemiante del extracto etanólico de Geranium ruizii administrada en ratas con hiperglicemia inducida por aloxano. Diseño: Experimental. Institución: Laboratorio de Farmacología Experimental, Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Perú. Material biológico: Planta entera de Geranium ruizii, ratas Holtzman hembras de ocho semanas con 200 ± 20 g de peso corporal. Intervenciones: La hiperglicemia fue inducida con aloxano. Las ratas incluidas en el estudio presentaron una glicemia > 200 mg/dL. Se formaron seis grupos de seis ratas cada uno. El grupo I recibió agua destilada 2 mL; los grupo II, III y IV recibieron Geranium ruizii 50 mg/kg; 150 mg/kg y 300 mg/kg, respectivamente (vía oral); al grupo V se administró glibenclamida 5 mg/kg y al grupo VI insulina 4UI/kg. Principales medidas de los resultados: Glucemia (mg/dL), porcentaje de inhibición del radical DPPH, especies reactivas al ácido tiobarbitúrico (TBARS) (nmoles/mL), estudio histológico de páncreas. Resultados: La dosis de 150 mg/kg de G. ruizii redujo 65,58 por ciento los valores de glicemia a las 2 h post administración (Kruskal Wallis; p<0,001), redujo TBARS en 22,34 por ciento e inhibió el radical DPPH en 23,66 por ciento; el tejido pancreático se mantuvo en buen estado de conservación. Conclusiones: El extracto etanólico de Geranium ruizii (pasuchaca) tuvo efecto hipoglicemiante en ratas con hiperglucemia inducida con aloxano...
Geranium ruizii Hieron. (pasuchaca) is a medicinal plant used by traditional medicine to lower glycemia, in Ancash, Peru. Objective: To determine the hypoglycemic effect of Geranium ruizii ethanolic extract on alloxan-induced hyperglycemia in rats. Design: Experimental. Setting: Laboratorio de Farmacología Experimental, Facultad de Medicina Humana, Universidad San Marcos, Lima, Peru. Biological material: Geranium ruizii, eight weeks female Holtzman rats 200 ± 20 g of body weight. Interventions: Experimental hyperglycemia (>200 mg/dL) was induced with alloxan. Rats were divided into six groups of six rats each. Group I received 2 mL distilled water, groups II, III, IV received respectively Geranium ruizii 50, 150 and 300 mg/kg, group V glibenclamide 5 mg/kg and Group VI insulin 4IU/kg. Main outcome measures: Glycemic level (mg/dL), inhibition of DPPH ( per cent), reduction of reactive species to barbituric acid (TBARS) (nmoles/mL), histopathology study. Results: G. ruizii at 150 mg/kg reduced hyperglycemia 68.58 per cent at 2 h following alloxan induction (Kruskal Wallis; p<0.001), reduced TBARS in vivo 22.34 per cent, and inhibited DPPH 23.66 per cent to 1.0 ug/mL; the pancreas tissue remained in good condition. Conclusion: The Geranium ruizii (pasuchaca) ethanolic extract showed hypoglycemic effect in alloxan-induced hyperglycemia in rats...
Assuntos
Animais , Ratos , Experimentação Animal , Extratos Vegetais , Geranium , Hiperglicemia , Hipoglicemiantes , Plantas Medicinais , Ensaio ClínicoRESUMO
Evaluar el efecto hepatoprotector del extracto hidroetanólico atomizado de Zea mays variedad morado sobre lesiones hepáticas inducidas en ratas. Diseño: Experimental. Institución: Laboratorio de Farmacología Experimental, Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Perú. Material biológico: Extracto hidroetanólico atomizado de maíz morado (EAM). Intervenciones: Se formó seis grupos de ratas machos (n=10, por cada grupo), se les administró fenobarbital a concentración de 0,5 g/L en agua potable ad líbitum por 15 días; posteriormente se administró tetracloruro de carbono (CCl4) a una dosis de 0,2 mL/kg, por vía oral. El diseño experimental fue el siguiente: G1: suero fisiológico (SSF); G2: CCl4 0,2 mL/kg (T); G3: T+ silimarina 25 mg/kg; G4: T + EAM 500 mg/kg; G5: T + EAM 1 000 mg/kg; G6: T + EAM 2 000 mg/kg. Principales medidas de resultados: Perfil hepático, especies reactivas al ácido tiobarbitúrico (TBARS) en suero, índice hepático, observación histológica. Resultados: Se observó aumento significativo (p<0,05) en la actividad de alanina amino transferasa (ALT) entre el grupo G2 y los grupos G3 y G4 (p<0,001). Hubo disminución significativa (p<0,05) de fosfatasa alcalina (FAL) en el grupo G2 con respecto G1. El nivel de TBARS fue menor en el grupo que recibió 1 000 mg/kg de EAM con respecto al control. Las actividades de HDL-C y triglicéridos no mostraron diferencias significativas. Se ha observado la reducción de 60 por ciento de la lesión hepática, evidenciado con menor daño del hepatocito al estudio histológico. Conclusiones: El extracto hidroetanólico atomizado de maíz morado a la dosis de 1 000 mg/kg disminuyó las lesiones hepáticas inducidas en ratas...
To evaluate the hepatoprotector effect of hydroalcoholic extract atomized of Zea mays against hepatic injuries induced in rats. Design: Experimental. Institution: Laboratory of Experimental Pharmacology, Faculty of Human Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru. Biological material: Hydroethanolic extract atomized of purple corn (EAM). Interventions: To six groups of male rats (n = 10, for each group) phenobarbital 0.5 g/L in drinkable water ad libitum was administered for 15 days, followed by carbon tetrachloride 0.2 mL/kg p.o. The experimental design was a follow: G1: normal; G2: CCl4 0.2 mL/kg (T); G3:T+ silimarina 25 mg/kg; G4: T+ EAM 500 mg/kg; G5: T + EAM 1 000 mg/kg; G6 T + EAM 2 000 mg/kg. Main outcome measures: Hepatic profile, reactive species to thiobarbituric acid (TBARS), liver index, and histological observation. Results: Significant increase (p<0.05) in ALT activity was observed between group G2 in comparison to groups G3 and G4 (p<0.001). There was significant decrease (p<0.05) of alkaline phosphatase (AP) in group G2 with respect to G1. TBARS level was less in the group that received 1 000 mg/kg of EAM regarding to control. HDL-C and triglycerides activities did not show significant differences. Reduction in 60 per cent of hepatic injury was observed, evidencing less damage of the hepatocyte by histological study. Conclusions: The purple corn atomized hydroethanolic extract at 1 000 mg/kg dose decreased induced hepatic injuries in rats...
Assuntos
Animais , Ratos , Doença Hepática Induzida por Substâncias e Drogas , Experimentação Animal , Extratos Vegetais , Hepatomegalia/induzido quimicamente , Zea mays , Ensaio ClínicoRESUMO
Introducción: Piper aduncum (matico) es una especie utilizada por sus propiedades medicinales en desórdenes gastrointestinales y genitourinarios. Objetivos: Evaluar el efecto antitumoral del aceite esencial de Piper aduncum (matico) in vitro en siete líneas celulares tumorales humanas y determinar la toxicidad oral en ratones. Diseño: Experimental. Institución: Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú. Material biológico: Líneas celulares tumorales humanas H460, DU-145, ME-180, K562, HT-29, MCF 7, M14, K562; fibroblastos normales de ratón 3T3 y ratones albinos machos Balb/C53. Intervenciones: Las líneas celulares fueron expuestas a cuatro concentraciones del aceite esencial de P. aduncum y 5-fluorouracilo (5-FU). Para la toxicidad oral se utilizó ratones albinos machos Balb C/53 de 40 días post destete, a cinco dosis de tratamiento, evaluándose el número de muertes en cada dosis. Principales medidas de los resultados: Porcentaje de inhibición del crecimiento celular (IC50), dosis letal 50 (DL50). Resultados: El aceite esencial mostró IC50 mayor a 250 ug/mL para las líneas celulares M-14 (r = -0,99; p < 0,01), DU-145 (r = 0,99; p < 0,01), ME-180 (r = -0,99; p < 0,01). Para líneas celulares tumorales H460 (r = -0,99; p < 0,01), MCF-7 (r = -0,99; p < 0,01), K562 (r = -0,99; p < 0,01), HT-29 (r = -0,99; p < 0,01), los niveles de IC50 estuvieron entre 20 ug/mL y 250 ug/mL. DL50 > 2 000 mg/kg. Conclusiones: El aceite esencial de P. aduncum no presentó efecto antitumoral in vitro para las siete líneas celulares tumorales humanas y no fue tóxico.
Introduction: Piper aduncum (matìco) is a medicinal plant used for gastrointestinal and genitourinary disorders. Objectives: To determine the in vitro antitumoral effect of Piper aduncum (matico) essential oil on seven human tumoral cell lines and its oral toxicity in mice. Design: Experimental. Setting: Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru. Biologic material: Human tumoral cell lines HT-29, H-460, MCF-7, M-14, ME-180, DU-145, K-562; and 3T3 fibroblasts and male 40 days post weaning Balb C/53 mice. Interventions: The cell lines HT-29, H-460, MCF-7, M-14, ME-180, DU-145, K-562, and 3T3 were exposed to four different concentrations of Piper aduncum essential oil, and to different 5-fluorouracil concentrations used as a positive control. Cell lines growth inhibition (IC50) was determined using linear regression analysis and DL50 by the number of deaths with each dose. Main outcome measures: Antitumor effect. Results: Piper aduncum essential oil showed cytotoxic activity at IC50 levels > 250 ug/mL on cell lines M-14 (r = -0.99; p < 0.01), DU-145 (r = -0.99; p < 0.01), ME-180 (r = -0.99; p < 0.01). IC50 was between 20 ug/mL and 250 ug/mL on cell lines H-460 (r = -0.99; p < 0.01), MCF-7, (r = -0.99; p < 0.01), K562 (r = -0.99; p < 0.01), HT-29 (r = -0.99; p < 0.01). DL50 was > 2 000 mg/kg. Conclusions: P. aduncum essential oil did not show antitumoral effect on seven human tumoral cell lines and it was non toxic.