RESUMO
OBJECTIVE: To determine whether patients with simple chronic otitis media and incomplete ossicular discontinuity should undergo ossicular reconstruction. DESIGN: Prospective, randomised surgical trial comparing no intervention with incus interposition over a 5-year period. SETTING: Tertiary referral hospital. PARTICIPANTS: Seventy-six participants with simple chronic otitis media and erosion of the long process of the incus but apparent good transmission throughout the ossicular chain as tested intra-operatively. Forty-four patients had partial erosion of the incus but still bony contact with the stapes head (Group A-Type I), and 32 had mainly connective tissue binding the incus and stapes (Group B-Type II). Each of these groups was randomised to either leaving the ossicular chain as it was (A1 and B1) or performing an incus interposition (A2 and B2). MAIN OUTCOME MEASURES: Average postoperative air-bone gap and the degree of ABG closure. A postoperative air-bone gap under 20 dB was considered a successful result. RESULTS: In group A, there was no significant difference between no intervention and incus interposition. In group B, patients in the no reconstruction subgroup had a significantly worse hearing result than the incus interposition subgroup (postoperative air-bone gap of 27.5 dB and 31% closure within 20 dB vs 15 dB and 75% closure). CONCLUSIONS: For Type I patients, the postoperative hearing results were similar for the reconstruction and no reconstruction groups. For Type II patients, the results clearly favour reconstruction.
Assuntos
Condução Óssea/fisiologia , Tomada de Decisões , Perda Auditiva Condutiva/cirurgia , Bigorna/cirurgia , Prótese Ossicular , Otite Média/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Adolescente , Adulto , Audiometria de Tons Puros , Doença Crônica , Feminino , Seguimentos , Audição/fisiologia , Perda Auditiva Condutiva/diagnóstico , Perda Auditiva Condutiva/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Otite Média/complicações , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Peritonsillar abscess is the most common deep infection of the head and neck in young adults. It is considered a purulent complication of acute tonsillitis, but other mechanisms have been proposed. There is no consensus as to whether seasonality affects peritonsillar abscess incidence. METHODS: This observational, descriptive, retrospective study explored the epidemiology of peritonsillar abscess and its relationship with seasonality. The cases were selected from the emergency otolaryngology service of a tertiary hospital. RESULTS: The sample comprised 528 patients (42.61 per cent males, mean age = 26.63 years). A moderate positive correlation was found between peritonsillar abscess incidence and monthly average temperature. No associations were found with insolation, precipitation or humidity. CONCLUSION: In this sample, peritonsillar abscess was more likely to occur in warmer months. The findings corroborate the theory that peritonsillar abscess is not a direct complication of acute tonsillitis and may improve understanding of peritonsillar abscess aetiology.
Assuntos
Clima , Abscesso Peritonsilar/epidemiologia , Abscesso Peritonsilar/etiologia , Adolescente , Adulto , Fatores Etários , Idoso , Brasil , Criança , Estudos Transversais , Feminino , Humanos , Umidade , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estatística como Assunto , Temperatura , Clima Tropical , Adulto JovemRESUMO
OBJECTIVES: To study the occurrence of fever and the behaviours of inflammatory blood markers (C-reactive protein - CRP and procalcitonin - PCT) during episodes of otorrhea due to uncomplicated chronic otitis media in immunocompetent and immunocompromised patients. DESIGN: Prospective study of patients presenting with otorrhea over a 36-month period. SETTING: All patients were treated at Bonsucesso General Hospital, a tertiary referral hospital in Rio de Janeiro, Brazil. PARTICIPANTS: A total of 84 participants, of which 50 were immunocompetent and 34 were immunocompromised. Immunocompetent patients had a total of 106 episodes of otorrhea, and immunocompromised patients had 117 episodes of otorrhea. MAIN OUTCOME MEASURES: Occurrence of fever (axillary temperature over 38(°) C) and elevation of C-reactive protein and procalcitonin levels above the normal ranges. RESULTS: In the immunocompetent group, the levels of procalcitonin were elevated in five of 106 episodes of otorrhea. The C-reactive protein levels were above the normal range in nine of 106 episodes, the same number of episodes in which fever was observed. In the immunocompromised group, procalcitonin was elevated in 38 of 117 episodes of otorrhea, C-reactive protein levels were abnormal in 40 episodes, and fever was detected in 37 episodes. Cases of otorrhea with systemic inflammatory response were significantly more common in immunocompromised patients with associated rhinosinusitis. CONCLUSIONS: Otorrhea due to uncomplicated chronic otitis media rarely causes a systemic inflammatory response in immunocompetent patients. Its occurrence in immunocompromised patients seems to be more related to concurrent rhinosinusitis than to the chronic middle ear inflammation itself.
Assuntos
Hospedeiro Imunocomprometido , Otite Média Supurativa/complicações , Síndrome de Resposta Inflamatória Sistêmica/etiologia , Doença Crônica , Humanos , Otite Média com Derrame/etiologia , Estudos ProspectivosRESUMO
BACKGROUND: Geographic tongue (GT) is the most frequent oral lesion in psoriatic patients (PP), and genetic involvement in these conditions has been described. The association of psoriasis with GT is still not clear, and the study of human leucocyte antigen (HLA) may help clarify this relation. OBJECTIVE: The aim of this study was to investigate the association of HLA alleles with psoriasis vulgaris and GT. METHODS: Fifty-eight Brazilian PP, 29 GT patients and 125 healthy controls individuals were selected. Information on demographic and clinical characteristics was collected. All patients underwent an oral examination and blood collection for HLA typing. RESULTS: HLA-A did not show significant differences in frequencies among the groups. HLA-B*57 allele was more frequently found in PP and was not found in GT. HLA-B*58 allele was more frequently found in GT. HLA-C*06 and -C*18 alleles were associated with psoriasis. No significant differences in HLA-DRB1 and HLA-DQB1 were observed. CONCLUSION: HLA-B*58 was associated with GT and HLA-B*57 was possibly associated with psoriasis. This suggested that some GT cases may represent true oral psoriasis and some may represent only GT. Therefore, it is necessary to make this distinction and increase our sample size to improve the correct diagnosis and treatment of these conditions.
Assuntos
Glossite Migratória Benigna/genética , Antígenos HLA/genética , Psoríase/genética , Adolescente , Adulto , Alelos , Estudos de Casos e Controles , Feminino , Glossite Migratória Benigna/imunologia , Antígenos HLA-A/genética , Antígenos HLA-B/genética , Antígenos HLA-C/genética , Cadeias beta de HLA-DQ/genética , Cadeias HLA-DRB1/genética , Humanos , Masculino , Pessoa de Meia-Idade , Psoríase/imunologia , Adulto JovemAssuntos
Dermatite Seborreica/genética , Frequência do Gene/genética , Antígenos HLA-A/genética , Cadeias beta de HLA-DQ/genética , Cadeias HLA-DRB1/genética , Adulto , Brasil , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença/genética , Haplótipos/genética , Humanos , Masculino , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
ABSTRACT The reaction of the yellow passion-fruit cultivars Afruvec and Maguary to Meloidogyne incognita race 2, M. javanica and M. hapla were studied under greenhouse conditions. Three experiments were conducted with similar methodology. The initial population was 5,000 eggs and juveniles of second-stage newly hatched (J2) of M. incognita, M. javanica or M. hapla. The experimental delineations were entirely randomized, with six replications. The evaluated parameters were: gall and egg mass index, roots fresh weight, nematode populations in roots, reproductions factor (FR) and number of nematodes per gram of root. The Afruvec and Maguary cultivars were resistant to Meloidogyne incognita race 2, M. javanica and M. hapla.
RESUMO A reação do maracujá amarelo Afruvec e Maguary aos nematóides de galhas Meloidogyne incognita raça 2, M. javanica e M. hapla foi estudada em experimentos conduzidos separadamente para cada espécie de nematóide, em casa de vegetação. As plantas foram inoculadas com 5.000 ovos e eventuais juvenis infectantes. A avaliação foi realizada 60 dias após a inoculação. Os experimentos seguiram o delineamento inteiramente ao acaso com seis repetições, sendo cada parcela constituída por uma planta em vaso de 2 litros com substrato previamente autoclavado. Os parâmetros analisados foram: índice de galhas, índice de massas de ovos, população final do nematóide no sistema radicular e massa do sistema radicular, fator de reprodução do nematóide (FR = Pf/Pi) e o número total de espécimes por grama de raiz. De acordo com os resultados obtidos tanto o maracujá Afruvec como o Maguary se mostraram resistentes a M. incognita raça 2, M. javanica e M. hapla.
RESUMO
Myrtaceae is a plant family widely used in folk medicine and Syzygium and Eugenia are among the most important genera. We investigated the anti-allergic properties of an aqueous leaf extract of Syzygium cumini (L.) Skeels (SC). HPLC analysis revealed that hydrolyzable tannins and flavonoids are the major components of the extract. Oral administration of SC (25-100 mg/kg) in Swiss mice (20-25 g; N = 7/group) inhibited paw edema induced by compound 48/80 (50% inhibition, 100 mg/kg; P Assuntos
Antialérgicos/farmacologia
, Edema/tratamento farmacológico
, Liberação de Histamina/efeitos dos fármacos
, Pleurisia/tratamento farmacológico
, Syzygium/química
, Animais
, Antialérgicos/isolamento & purificação
, Cromatografia Líquida de Alta Pressão
, Modelos Animais de Doenças
, Edema/induzido quimicamente
, Edema/imunologia
, Ensaio de Imunoadsorção Enzimática
, Eosinófilos/efeitos dos fármacos
, Masculino
, Mastócitos/efeitos dos fármacos
, Mastócitos/imunologia
, Camundongos
, Camundongos Endogâmicos BALB C
, Cavidade Peritoneal/citologia
, Extratos Vegetais/farmacologia
, Folhas de Planta/química
, Pleurisia/induzido quimicamente
, Pleurisia/imunologia
, Ratos
, Ratos Wistar
RESUMO
Myrtaceae is a plant family widely used in folk medicine and Syzygium and Eugenia are among the most important genera. We investigated the anti-allergic properties of an aqueous leaf extract of Syzygium cumini (L.) Skeels (SC). HPLC analysis revealed that hydrolyzable tannins and flavonoids are the major components of the extract. Oral administration of SC (25-100 mg/kg) in Swiss mice (20-25 g; N = 7/group) inhibited paw edema induced by compound 48/80 (50 percent inhibition, 100 mg/kg; P <= 0.05) and, to a lesser extent, the allergic paw edema (23 percent inhibition, 100 mg/kg; P <= 0.05). SC treatment also inhibited the edema induced by histamine (58 percent inhibition; P <= 0.05) and 5-HT (52 percent inhibition; P <= 0.05) but had no effect on platelet-aggregating factor-induced paw edema. SC prevented mast cell degranulation and the consequent histamine release in Wistar rat (180-200 g; N = 7/group) peritoneal mast cells (50 percent inhibition, 1 æg/mL; P <= 0.05) induced by compound 48/80. Pre-treatment of BALB/c mice (18-20 g; N = 7/group) with 100 mg/kg of the extract significantly inhibited eosinophil accumulation in allergic pleurisy (from 7.662 ± 1.524 to 1.89 ± 0.336 x 10(6)/cavity; P <= 0.001). This effect was related to the inhibition of IL-5 (from 70.9 ± 25.2 to 12.05 ± 7.165 pg/mL) and CCL11/eotaxin levels (from 60.4 ± 8.54 to 32.8 ± 8.4 ng/mL) in pleural lavage fluid, using ELISA. These findings demonstrate an anti-allergic effect of SC, and indicate that its anti-edematogenic effect is due to the inhibition of mast cell degranulation and of histamine and serotonin effects, whereas the inhibition of eosinophil accumulation in the allergic pleurisy model is probably due to an impairment of CCL11/eotaxin and IL-5 production.
Assuntos
Animais , Masculino , Camundongos , Ratos , Antialérgicos/farmacologia , Edema/tratamento farmacológico , Eugenia/química , Liberação de Histamina/efeitos dos fármacos , Pleurisia/tratamento farmacológico , Antialérgicos/isolamento & purificação , Cromatografia Líquida de Alta Pressão , Modelos Animais de Doenças , Ensaio de Imunoadsorção Enzimática , Edema/induzido quimicamente , Edema/imunologia , Eosinófilos/efeitos dos fármacos , Camundongos Endogâmicos BALB C , Mastócitos/efeitos dos fármacos , Mastócitos/imunologia , Cavidade Peritoneal/citologia , Extratos Vegetais/farmacologia , Folhas de Planta/química , Pleurisia/induzido quimicamente , Pleurisia/imunologia , Ratos WistarRESUMO
OBJECTIVE: Investigate the role of endothelins in leukocyte recruitment in allergic and non allergic inflammation. METHODS: Pleurisy was induced in mice by intrathoracic injection of ovalbumin (OVA; in sensitized animals), E. coli LPS, carrageenan, Mycobacterium bovis (BCG) or zymosan. Animals were treated with BQ-123 or BQ-788 (1.5-150 pmol/cavity), or intravenously with bosentan (30 mg/kg). RESULTS: None of the ET receptor antagonists modified early neutrophil recruitment (at 4 h) induced by OVA, LPS, carrageenan, BCG or zymosan or plasma leakage caused by carrageenan or zymosan. Mononuclear and eosinophil accumulation triggered by OVA were reduced by BQ-123 (150 pmol/cavity) or bosentan (68 and 43% inhibition of eosinophilia), but unaffected by BQ-788. BQ-123 and bosentan also inhibited LPS increases in neutrophil (by 67 and 40%) and eosinophil (by 63 and 74%) at 24 h. CONCLUSIONS: Endothelins, acting via ETA receptors, play a role in late eosinophil and neutrophil accumulation (24 h), but not in the acute (4 h) neutrophilic response.
Assuntos
Endotelinas/fisiologia , Eosinófilos/fisiologia , Neutrófilos/fisiologia , Pleurisia/patologia , Animais , Antagonistas dos Receptores de Endotelina , Contagem de Leucócitos , Lipopolissacarídeos/farmacologia , Masculino , Camundongos , Infiltração de Neutrófilos , Oligopeptídeos/farmacologia , Ovalbumina , Peptídeos Cíclicos/farmacologia , Piperidinas/farmacologia , Pleurisia/induzido quimicamente , Proteínas/metabolismo , Receptor de Endotelina A , Receptor de Endotelina B , Receptores de Endotelina/efeitos dos fármacos , Receptores de Endotelina/fisiologiaRESUMO
Endothelins participate in different aspects of inflammatory reactions, including edema formation and eosinophil accumulation in allergic reaction. In this study, we demonstrated a role for endogenous endothelins in eosinophil and T lymphocyte recruitment and cytokine secretion in a murine model of allergic inflammation. Intrathoracic stimulation with endothelin-1 triggered a neutrophil accumulation at 4 h, concomitant with an increase of CD4+ and CD8+ T lymphocyte populations. Antigen challenge in sensitized animals leads to an increase in eosinophil and mononuclear cell numbers at 24 h. Treatment with ETA receptor antagonist (BQ123) inhibited antigen-induced eosinophil and mononuclear cell migration, whereas the selective ETB receptor antagonist BQ-788 was ineffective. The latter effect of BQ-123 was due to inhibition of CD4+ and CD8+ T lymphocytes. Treatment with BQ-123 also inhibited interleukin-5 levels in the exudate and plasma as well as intracellular staining of interleukin-4, interleukin-5, and interferon-gamma in CD4+ lymphocytes. These findings suggest that endogenous endothelins contribute to allergic inflammation by modulating lymphocyte recruitment and cytokine production.