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BACKGROUND: The Latarjet procedure is often used to address off-track Hill-Sachs lesions (OFF-HS) in shoulders with anterior instability. There are concerns as to whether the Latarjet procedure is able to convert all OFF-HS into on-track Hill-Sachs lesions (ON-HS) and whether this limitation could explain the cases of recurrent postoperative instability. HYPOTHESIS: Latarjet surgery converts many preoperative OFF-HS lesions, but not all of them, and there is a difference in the failure rate between shoulders with converted lesions and those with persistent OFF-HS lesions. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Patients with anterior shoulder instability and an OFF-HS lesion treated with an arthroscopic classic Latarjet procedure between January 2010 and September 2017 were retrospectively evaluated. Patients with moderate or severe shoulder arthrosis, rotator cuff tears, or age older than 50 years were excluded. Glenoid track (GT), HS, HS interval (HSI), and the difference between HSI and GT (ΔHSI-GT) were measured preoperatively. A postoperative computed tomography scan and a clinical evaluation, including the Rowe and Western Ontario Shoulder Instability scores, were performed at a minimum 1- and 2-year follow-up, respectively. Postoperatively, 2 groups of patients were obtained: (1) patients with postoperative persistent OFF-HS; (2) patients with postoperative ON-HS. Clinical and imaging data were compared between the 2 groups. RESULTS: A total of 51 patients (n = 51 shoulders), with a mean age of 29.8 ± 8.4 years (range, 15-50 years), met the inclusion criteria. Six shoulders (11.8%) still showed OFF-HS lesions despite Latarjet surgery. There were no postoperative dislocations, but 3 patients reported subluxations. The subluxation rate was significantly higher in the postoperative persistent OFF-HS group (2 [33%] vs 1 [2.2%]; P = .033). There was a wider preoperative HSI (29.8 ± 2.4 mm vs 22.9 ± 3.5 mm; P < .001) and a larger preoperative ΔHSI-GT (12.2 ± 3.8 mm vs 4.82 ± 3.2 mm; P < .001) in the persistent OFF-HS group. A receiver operating characteristic curve was performed based on preoperative ΔHSI-GT values. A preoperative ΔHSI-GT value ≥7.45 mm predicted a persistent OFF-HS after Latarjet surgery (sensitivity, 100%; specificity, 87%; positive predictive value, 50%; and negative predictive value, 100%). CONCLUSION: Latarjet surgery converted many preoperative OFF-HS lesions into ON-HS lesions, but not all of them. Six patients (11.8%) retained an OFF-HS and had a statistically significantly higher failure rate after Latarjet surgery compared with those with postoperative ON-HS lesions. Because there were few postoperative OFF-HS lesions and few recurrences, findings are statistically fragile and should be confirmed with larger series.
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Lesões de Bankart , Instabilidade Articular , Luxação do Ombro , Articulação do Ombro , Adolescente , Adulto , Artroscopia , Humanos , Instabilidade Articular/cirurgia , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Luxação do Ombro/etiologia , Luxação do Ombro/cirurgia , Articulação do Ombro/diagnóstico por imagem , Articulação do Ombro/cirurgia , Adulto JovemRESUMO
Nectandra grandiflora Nees (Lauraceae) is a Brazilian native tree recognized by its durable wood and the antioxidant compounds of its leaves. Taking into account that the forest industry offers the opportunity to recover active compounds from its residues and by-products, this study identifies and underlines the potential of natural products from Nectandra grandiflora that can add value to the forest exploitation. This study shows the effect of three different extraction methods: conventional (CE), ultrasound-assisted (UAE) and microwave-assisted (MAE) on Nectandra grandiflora leaf extracts (NGLE) chemical yields, phenolic and flavonoid composition, physical characteristics as well as antioxidant and antifungal properties. Results indicate that CE achieves the highest extraction phytochemical yield (22.16%), but with similar chemical composition to that obtained by UAE and MAE. Moreover, CE also provided a superior thermal stability of NGLE. The phenolic composition of NGLE was confirmed firstly, by colorimetric assays and infrared spectra and then by chromatographic analysis, in which quercetin-3-O-rhamnoside was detected as the major compound (57.75-65.14%). Furthermore, the antioxidant capacity of the NGLE was not altered by the extraction methods, finding a high radical inhibition in all NGLE (>80% at 2 mg/mL). Regarding the antifungal activity, there was observed that NGLE possess effective bioactive compounds, which inhibit the Aspergillus niger growth.
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Antifúngicos/química , Antioxidantes/química , Flavonoides/química , Fenóis/química , Compostos Fitoquímicos/química , Extratos Vegetais/química , Estreptófitas/química , Antifúngicos/farmacologia , Antioxidantes/isolamento & purificação , Antioxidantes/farmacologia , Aspergillus niger/efeitos dos fármacos , Fracionamento Químico , Flavonoides/isolamento & purificação , Flavonoides/farmacologia , Humanos , Fenóis/isolamento & purificação , Fenóis/farmacologia , Compostos Fitoquímicos/isolamento & purificação , Compostos Fitoquímicos/farmacologia , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/farmacologia , Folhas de Planta/química , SolubilidadeRESUMO
Metal phthalocyanines are promising components in photodynamic therapy. Aluminum phthalocyanine chloride (AlClPc) has been used to treat oral cancer in mice, human carious tissue, lung cancer cells and other conditions. To overcome the high hydrophobicity of AlClPc, phthalocyanine is often encapsulated in nanoformulations. Despite increased usage, little is known about the pharmacokinetics and biodistribution of AlClPc. The aim of this study was the development and validation of a UHPLC-MS method for the determination of AlClPc in solution after extraction from nanoformulations and biological matrices such as plasma and tissue. The described method has been assayed as to selectivity, linearity, limits of detection and quantification, precision and recovery. The present study is the first to describe the behavior of AlClPc in biological matrices with mass spectrometry as well as the first to describe the chromatographic behavior of AlClPc contaminants. Molecular mass analysis identified dechlorination of AlClPc by both LC/MS and MALDI-MS and an adduct formation in LC/MS. The parameters observed indicated that the method has applicability and robustness for use in biodistribution studies.
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Cromatografia Líquida de Alta Pressão/normas , Indóis/sangue , Nanoestruturas/química , Compostos Organometálicos/sangue , Fármacos Fotossensibilizantes/sangue , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/normas , Animais , Disponibilidade Biológica , Biotransformação , Óleo de Rícino/química , Sistemas de Liberação de Medicamentos , Emulsões , Humanos , Interações Hidrofóbicas e Hidrofílicas , Indóis/farmacocinética , Indóis/farmacologia , Rim/efeitos dos fármacos , Rim/metabolismo , Limite de Detecção , Fígado/efeitos dos fármacos , Fígado/metabolismo , Pulmão/efeitos dos fármacos , Pulmão/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Nanoestruturas/administração & dosagem , Compostos Organometálicos/farmacocinética , Compostos Organometálicos/farmacologia , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/farmacocinética , Fármacos Fotossensibilizantes/farmacologia , Polietilenoglicóis/química , Baço/efeitos dos fármacos , Baço/metabolismo , Distribuição TecidualRESUMO
Alrededor de 5 % de los tumores del estroma gastrointestinal (GIST) se localizan en el recto. Cuando se encuentran localmente avanzados, el tratamiento neoadyuvante con imatinib ha demostrado buenos resultados para reducir el volumen de este tipo de tumores. Se presenta el caso de un paciente con diagnóstico de GIST rectal gigante, al que se le administró neoadyuvancia con imatinib y, posteriormente, se sometió a resección anterior baja con anastomosis coloanal. Es imprescindible que la evaluación y el tratamiento sean multidisciplinarios en los GIST rectales, para tratar de obtener los mejores resultados ante esta entidad tan poco frecuente, poder evitar la comorbilidad asociada y practicar cirugías menos agresivas tras una buena reacción terapéutica al imatinib
Less than 5% of gastrointestinal stromal tumors (GIST) are located at the rectum. When these tumors are locally advanced, neoadjuvant therapy with imatinib has shown good results, reducing its volume. We present the case of a patient with a giant rectal GIST tumor, who underwent neoadjuvant imatinib therapy, and posterior low anterior resection with coloanal anastomosis. In rectal GIST tumors it is essential the multidisciplinary evaluation and treatment, in order to obtain the best possible results in this rare entity. After a good response to the treatment with imatinib, aggressive surgeries can be avoided, along with the associated morbidity that comes with it
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Humanos , Neoplasias Retais , Tumores do Estroma Gastrointestinal , Mesilato de Imatinib , Oncologia CirúrgicaRESUMO
Background. Activating mutations in the RET gene leads to medullary thyroid carcinoma (MTC). Guidelines encourage performing RET analysis in subjects with hereditary and sporadic disease. Materials and Methods. Design. Observational, case series report study. Patients. Subjects diagnosed with MTC, with a thyroidectomy performed in a single center in Costa Rica between the years 2006 and 2015. Diagnosis and Follow-Up. Pre- and postoperative calcitonin, RET mutation, and neck ultrasound and tomography were obtained. Results. 21 subjects with histological diagnosis of MTC were followed up. The average age at diagnosis was 52.0 ± 15.7 years. The preoperative mean value of calcitonin was 1340 ± 665 pg/mL. Evidence of RET mutation was found in 26.3% of the patients, with only 2 of them grouped in the same kindred. We found statistically significant differences in mean ages between mutated (38.4 ± 20.2 y) versus nonmutated RET gene (54.6 ± 11.8 y, p = 0.04). There were no significant differences regarding tumor size, metastases, and surgical reintervention. Conclusions. We report the results of RET mutation analysis in subjects with MTC in a single center of Costa Rica. The availability of this tool increases the probability of identifying familial MTC, with the benefit of detecting affected subjects and their relatives at an earlier age.
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CONTEXT: Stem and leaves infusion of Chuquiraga spinosa (R&P) Don. (Asteraceae) is used in the Peruvian traditional medicine for its anti-inflammatory properties and for the treatment of vaginal infections. OBJECTIVE: This study evaluated the antioxidant, anti-inflammatory and antifungal activities of C. spinosa for the first time. MATERIALS AND METHODS: Extracts of methanol, 50% methanol and water were obtained from C. spinosa aerial parts. Antioxidant activity of the extracts was evaluated (DPPHË, ABTSË(+) and superoxide radical-scavenging activity). The correlation between these results and total polyphenolic content was determined by Pearson's Correlation Coefficient. Anti-inflammatory activity of 50% methanol extract was evaluated with the rat model of carrageenan-induced acute inflammation and mouse model of TPA-induced acute inflammation. The antifungal activity of the extracts against Cladosporium cucumerinum and Candida albicans was studied by direct bioautography, and antifungal activity against phytopathogenic fungi was performed by culture in potato dextrose agar plates. RESULTS: All the extracts showed high antioxidant activity, and there was correlation between the activity and total polyphenolic compounds. As 50% methanol extract was administered orally, the paw edema in rats was reduced significantly (52.5%). This extract, by topical administration, produced a reduction of 88.07% of the edema TPA-induced in ear of mice. The aqueous and 50% methanol extracts were active against C. albicans (minimum inhibitory concentration of 2.5 and 6.25 µg, respectively). The aqueous extract showed antifungal activity against C. cucumerinum (MIC: 2.5 µg). DISCUSSION AND CONCLUSION: Preliminary phytochemical screening and the analysis of the three extracts by high-performance liquid chromatography diode-array detection showed the majority compounds are flavonoids and phenolic acid derivatives. These compounds may be responsible of the radical-scavenging activity of these extracts as well as responsible of anti-inflammatory effect in vivo of 50% methanol extract. Several authors have demonstrated the antioxidant and anti-inflammatory properties of some flavonoids and phenolic acids. The antifungal activity of the extracts obtained from aerial parts of C. spinosa has been investigated here for the first time. Other studies are necessary to determine the mechanism of action and to identify the bioactive compounds of this plant.
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Anti-Inflamatórios/uso terapêutico , Antifúngicos/farmacologia , Antioxidantes/farmacologia , Asteraceae/química , Inflamação/tratamento farmacológico , Fitoterapia/métodos , Extratos Vegetais/uso terapêutico , Animais , Anti-Inflamatórios/química , Anti-Inflamatórios/farmacologia , Antifúngicos/química , Antioxidantes/química , Candida albicans/efeitos dos fármacos , Carragenina , Cladosporium/efeitos dos fármacos , Modelos Animais de Doenças , Avaliação Pré-Clínica de Medicamentos , Flavonoides/análise , Flavonoides/farmacologia , Inflamação/induzido quimicamente , Masculino , Medicina Tradicional , Metanol/química , Camundongos , Peru , Fenóis/análise , Fenóis/farmacologia , Componentes Aéreos da Planta/química , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Polifenóis , Ratos , Ratos Wistar , Acetato de Tetradecanoilforbol , Água/químicaRESUMO
AIM OF THE STUDY: To collect, analyze and evaluate the ethnopharmacologic knowledge in Nor-Yauyos in order to protect it. This paper reports the results of an ethnopharmacological survey on the uses of medicinal plants by inhabitants of the Andean region Nor-Yauyos, Peru. In this region one surviving ethnic group, the Jaqaru-Quichuas, has been identified. METHODOLOGY: Field work was concluded between October 1999 and March 2000, using semi-structured questionnaire and participant observation as well as transects walks in wild herbal plant collection. Interviews with 68 informants (mean age: 54; 100% men, 0% women) were performed in 12 farmers' communities: Huancaya, Vilca, Vitis, Miraflores, Piños, Carania, San Lorenzo De Alis, Santa Rosa De Tinco, Tomás, Huancachi, Laraos and Huantán. RESULTS: 63 species of plants belonging to 29 families were reported. More than a half of reported plants were native, endemic of the studied area. Leaves and their mixtures were the most (67.26%) commonly used plant part. Most of the remedies were prepared in infusion, and 90.08% were administered orally. Most treated disorders were the gastrointestinal (18.59%) and respiratory ones (18.22%). CONCLUSIONS: 6 species (9.52%) without pharmacological references in international scientific literature, 21 species (33.33%) with 1-2 references, 16 species (25.40%) with 3-6 references, and 20 species (31.75%) that have been already widely studied were found.
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Agricultura , Medicina Tradicional , Fitoterapia , Plantas Medicinais , Idoso , Coleta de Dados , Etnobotânica , Etnofarmacologia , Flores , Humanos , Masculino , Pessoa de Meia-Idade , Peru , Casca de Planta , Extratos Vegetais , Folhas de Planta , Raízes de Plantas , Caules de Planta , Rizoma , Inquéritos e QuestionáriosRESUMO
Se presenta el caso de una paciente asmática de 19 años, con un cuadro de sarampión complicado por neumonitis y sobreinfección por Staphylococcus aureus, que la llevó a la muerte. Este caso hace evidente una de las complicaciones más frecuentes del sarampión; se hace énfasis en la prevención como concepto prioritario en enfermedades infecto-contagiosas. Se insiste en la vacunación sistemática como pilar fundamental para prevenir la enfermedad y sus riesgos