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BACKGROUND: Citrus fruits are a rich source of valuable molecules, and their industrial processing produces bagasses, little explored to generate important by-products. These Citrus residues, including seeds and peels, also contain numerous pharmacologically important substances. To reduce the impact of these Citrus by-products, young, harvested fruits could be used as a functional supplemental food while another part is grown until maturity for industrial production. This study therefore aims to valorize rangpur (Citrus limonia) in the first 3 months of its growth by investigating and comparing its monthly chemical profiles using ultra-performance liquid chromatography-electrospray mass spectrometry (UPLC-ESI-MS) and its anti-inflammatory and antiplatelet activity. RESULTS: Extracts obtained from the fruits harvested in November, December, and January, 2017 and 2018 (L221117, L161217, and L160118) showed different UPLC-ESI-MS profiles. Twenty-five of the 26 detected metabolites were identified as cyclitol, pyrrolidine betaine, aryl propanoyl esters, chlorogenic acids, flavonoids, coumarins, and limonoids. Quantification studies indicated an increased concentration of hesperidin from the younger fruits to the older fruits of the series. L160118 reduced nitrogen oxide (NOx), tumor necrosis factor alpha (TNF-α), and interleukin 6 (IL-6) levels more than other extracts. Their activity followed the same trends as the hesperidin concentration in each fruit. In contrast, the most promising antiplatelet activity was observed with the extracts from the two youngest fruits. This suggests combined effects of the chemical components found in these fruits' extracts. CONCLUSION: The extracts obtained from these young fruits showed considerable anti-inflammatory and antiplatelet activity. Overall, young rangpur could be used as raw material to produce functional foods without producing any waste. © 2022 Society of Chemical Industry.

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ETHNOPHARMACOLOGICAL RELEVANCE: Extracts of several Asteraceae species in Brazil are popularly used as anti-inflammatory. Some of these species are popularly recognizes as "arnica" because of the morphological and sensorial analogy with the traditional European Arnica montana. These used species in Brazil were identified as Calea uniflora Less, Chaptalia nutans (L.) Polák, Lychnophora ericoides Mart. Lychnophora pinaster Mart. Lychnophora salicifolia Mart. Porophyllum ruderale (Jacq.) Cass, Pseudobrickellia brasiliensis (Spreng.) R. M. King & H. Rob. Sphagneticola trilobata (L.) Pruski and Solidago chilensis Meyen. However, the comparative chemical profile of these so-called "arnicas" has never been reported in the literature. AIM OF THE STUDY: This work aimed to compare the main plants recognized as "arnica" in Brazil by using metabolomic analysis, based on UPLC-ESI-QTof-MS2 data and multivariate statistical analysis. MATERIALS AND METHODS: The metabolites profiling of 10 "arnica" species were established by UPLC-ESI-QTof-MS2. Three tinctures of each species (dry leaves) were produced and one aliquot of each tincture was injected and analyzed three times by UPLC-ESI-QTof-MS2. Data were acquired both in negative and positive modes and processed by MassLynx®, MarkerLynx® and Matlab® softwares. Principal component analysis (PCA) was used to reduce dimensionality and data redundancy; hierarchical trees helped to identify and eliminate contaminated or misplaced injections/samples. To achieve the objectives both hierarchical and k-means clustering techniques were employed to group similar samples or species. RESULTS: Diagnostic analysis of MS data allowed the identification of 54 metabolites. The identification was supported with the use of an external standard, fragmentation pattern and data from the literature. The main classes of identified compounds included phenolic acids, coumarin, flavonoids, heterosides, terpenoids and nitrogen compounds. Cluster analysis revealed that Sphagneticola trilobata, Solidago chilensis and Lychnophora pinaster have some chemical features similar to those of Arnica montana. In contrast, the same statistical analysis also showed that Pseudobrickellia brasiliensis, Porophyllum ruderale and Chaptalia nutans are chemically diverse from Arnica montana. The variability of the samples relied principally on nitrogenated compounds (confidence level 4) found in P. brasiliensis and P. ruderale, three phenolic compounds (level 2) detected in P. brasiliensis and in C. nutans and triterpenes (level 3) found in L. salicifolia and L. pinaster. CONCLUSIONS: In summary, the mass spectrometry technique in conjunction with multivariate statistical analysis proved to be an excellent tool to identify correlated compounds, as well as to verify the chemical similarity among evaluated species. This methodology was successfully used to establish important correlations in medicinal preparations of so-called "arnicas" used in Brazil.

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Abstract The "arnicas" found in Brazil are examples of different species of the family Asteraceae used in popular medicine for its attributed anti-inflammatory action. Among the species known and used as "arnica" we selected: Calea uniflora Less., Chaptalia nutans (L.) Polák, Lychnophora ericoides Mart., Lychnophora pinaster Mart., Lychnophora salicifolia Mart., Lychnophora diamantinana Coile & S.B.Jones, Porophyllum ruderale (Jacq.) Cass., Pseudobrickellia brasiliensis (Spreng.) R.M.King & H.Rob., Sphagneticola trilobata (L.) Pruski, and Solidago chilensis Meyen, due to their extensive use. This research provides new information on leaf morphology and anatomy and on chemistry of the major metabolites found in these species through histochemical tests and phytochemical review. The results revealed anatomical characters for the differentiation and quality control of the vegetal drugs, being these: distinctive epidermal attachments, epidermis cells, parenchymal cells of the mesophyll, vascular bundles, midvein patterns and secretory structures of exudation of secondary metabolites. The review of chemical profiles showed differences in the chemical composition of the species, as different skeletons of sesquiterpene lactones in the species evaluated in addition to other chemical classes such as terpenes, flavonoids, chromenes and phenolic acids derivate. Based on the results obtained in this work it is important to emphasize that the information about the ten species of arnica generate subsidies for differentiation and identification of characteristic markers and for the diagnosis of the species and it can be applied in the "arnicas" quality control.

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OBJECTIVE: To summarize current evidence regarding testosterone treatment for women with low sexual desire. MATERIALS AND METHODS: The Female Endocrinology and Andrology Department of the Brazilian Society of Endocrinology and Metabolism invited nine experts to review the physiology of testosterone secretion and the use, misuse, and side effects of exogenous testosterone therapy in women, based on the available literature and guidelines and statements from international societies. RESULTS: Low sexual desire is a common complaint in clinical practice, especially in postmenopausal women, and may negatively interfere with quality of life. Testosterone seems to exert a positive effect on sexual desire in women with sexual dysfunction, despite a small magnitude of effect, a lack of long-term safety data, and insufficient evidence to make a broad recommendation for testosterone therapy. Furthermore, there are currently no testosterone formulations approved for women by the relevant regulatory agencies in the United States, Brazil, and most other countries, and testosterone formulations approved for men are not recommended for use by women. CONCLUSION: Therefore, testosterone therapy might be considered if other strategies fail, but the risks and benefits must be discussed with the patient before prescription. Arch Endocrinol Metab. 2019;63(3):190-8.

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ABSTRACT Objective To summarize current evidence regarding testosterone treatment for women with low sexual desire. Materials and methods The Female Endocrinology and Andrology Department of the Brazilian Society of Endocrinology and Metabolism invited nine experts to review the physiology of testosterone secretion and the use, misuse, and side effects of exogenous testosterone therapy in women, based on the available literature and guidelines and statements from international societies. Results Low sexual desire is a common complaint in clinical practice, especially in postmenopausal women, and may negatively interfere with quality of life. Testosterone seems to exert a positive effect on sexual desire in women with sexual dysfunction, despite a small magnitude of effect, a lack of long-term safety data, and insufficient evidence to make a broad recommendation for testosterone therapy. Furthermore, there are currently no testosterone formulations approved for women by the relevant regulatory agencies in the United States, Brazil, and most other countries, and testosterone formulations approved for men are not recommended for use by women. Conclusion Therefore, testosterone therapy might be considered if other strategies fail, but the risks and benefits must be discussed with the patient before prescription. Arch Endocrinol Metab. 2019;63(3):190-8

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Stem barks of Drimys brasiliensis (Winteraceae) are consumed by the population in the form of a condiment. It is widely used to treat gastric and stomach problems and also to treat cancer. The extracts have demonstrated antiproliferative, antileishmanial and antimicrobial activities assigned to drimane sesquiterpenes. This study aimed to optimize the extraction conditions of the drimanes sesquiterpenes identified as 1-ß-(p-coumaroyloxy)-polygodial 1, drimanial 2 and 1-ß-(p-methoxycinnamoyl)-polygodial 3 in stem bark extracts. The HPLC-DAD method was developed and validated for the quantification of drimanes 1-3. The cytotoxic activity of these drimanes in human cancer cells, and the toxicological effects of the hydroethanolic extract, were determined. The extracts were prepared using different extractive conditions (solvents, plant: solvent ratio and time). The cytotoxicity effect was evaluated against leukemia, lymphomas, carcinomas and sarcomas cells using the tetrazolium assay (MTT). Furthermore, the acute toxicity was determined by measuring the biochemical parameters and by histopathological analysis. The hemolytic activity and micronucleus test were also performed. The method was linear, sensitive, precise and accurate for both drimanes 1-3. The best condition for extraction was using dichloromethane with plant: solvent proportion 1:10 (w/v) for six hours under dynamic maceration. Isolated drimanes exhibited cytotoxic effects with IC50 values ​​ranging from 0.13 to 112.67 µM. Compound 1 demonstrated significant results for acute promyelocytic leukemia (NB4) and Burkitt's lymphoma (RAMOS) cells while driamane 3 for Burkitt's lymphoma (RAJI) and acute T cell leukemia (MOLT4) cells. No signs of toxicity was observed and neither was mutagenicity or hemolytic activity.

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OBJETIVO: Avaliar a sensibilidade insulínica e o perfil metabólico em portadoras de SOP com peso normal e sobrepeso/obesas. MATERIAL E MÉTODOS: Foram avaliadas, retrospectivamente, 49 pacientes, entre 18 e 45 anos, divididas em 2 grupos, conforme o índice de massa corporal (IMC): grupo 1 (18,5-24,9 kg/m²) e grupo 2 (25-40 kg/m²). Dados coletados: pressão arterial sistólica (PAS) e diastólica (PAD); valores basais e após TOTG da glicose, insulina, e da relação glicose/insulina; área sob a curva para glicose e insulina; HOMA-IR, HOMA-beta; perfil lipídico; testosterona total (T) e livre (TL). RESULTADOS: Maiores médias de níveis pressóricos, insulina, triglicerídeos, TL e índices de resistência insulínica, além de menores níveis de HDL, foram encontrados no grupo 2. Não houve correlação entre o IMC com nenhum dos dados, nem da TL e dos índices de RI com o perfil lipídico. CONCLUSÕES: A obesidade está associada a maior prevalência de RI e DM na SOP, independentemente da história familiar de DM. A ausência de correlação entre os índices de RI e da TL com o perfil lipídico sugerem que outros fatores, como os ácidos graxos livres (AGL), possam estar envolvidos na patogênese da dislipidemia na SOP.

OBJECTIVE: To evaluate insulin sensitivity and the metabolic features in normal weight and overweight/obese patients with PCOS. SUBJETS AND METHODS: Forty-nine (49) patients from 18 to 45 years were retrospectively evaluated and divided into 2 groups, according to the body mass index (BMI): group 1 (18.5-24.9 kg/m²) and group 2 (25-40 kg/m²). Colected data: systolic and dyastolic blood pressure; fasting and after OGTT glucose, insulin and glucose/insulin ratio; area under the curve for glucose and insulin; HOMA-IR and HOMA-beta; lipidic profile; free (FT) and total testosterone (T) levels. RESULTS: Greater averages of pressoric levels, insulin resistance (IR) indices, triglycerides and the FT levels, in adition to lower HDL levels, were found in group 2. Neither correlation between the IMC with none of data nor of the FT and IR indices with the lipid profile were found. CONCLUSIONS: Obesity is associated with insulin resistance and diabetes mellitus in PCOS, independently on familiar history of DM. The absence of correlation between the IR indices and the FT with the lipidic profile suggests that other factors, such as the free fatty acids, can be involved in the pathogenesis of dyslipidemia in PCOS.

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OBJECTIVE: To evaluate insulin sensitivity and the metabolic features in normal weight and overweight/obese patients with PCOS. SUBJECTS AND METHODS: Forty-nine (49) patients from 18 to 45 years were retrospectively evaluated and divided into 2 groups, according to the body mass index (BMI): group 1 (18.5-24.9 kg/m(2)) and group 2 (25-40 kg/m(2)). Collected data: systolic and diastolic blood pressure; fasting and after OGTT glucose, insulin and glucose/insulin ratio; area under the curve for glucose and insulin; HOMA-IR and HOMA-beta; lipidic profile; free (FT) and total testosterone (T) levels. RESULTS: Greater averages of pressoric levels, insulin resistance (IR) indices, triglycerides and the FT levels, in addition to lower HDL levels, were found in group 2. Neither correlation between the IMC with none of data nor of the FT and IR indices with the lipid profile were found. CONCLUSIONS: Obesity is associated with insulin resistance and diabetes mellitus in PCOS, independently on familiar history of DM. The absence of correlation between the IR indices and the FT with the lipidic profile suggests that other factors, such as the free fatty acids, can be involved in the pathogenesis of dyslipidemia in PCOS.

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Após os estudos clínicos randomizados produzirem impacto e questionamentos sobre terapia hormonal da menopausa (THM) na comunidade médica, o Departamento de Endocrinologia Feminina e Andrologia da SBEM reuniu um grupo de especialistas para formular um documento informativo, crítico e de posicionamento que pudesse servir de orientação aos que praticam ou opinam sobre tratamento da menopausa. THM está indicada para alívio dos sintomas motores, conservação do trofismo vaginal, preservação de massa óssea e colágeno, melhora do bem estar e sexualidade. Os estudos sobre prevenção cardiovascular primária não são conclusivos, portanto insuficientes para indicar ou deixar de indicar THM com este objetivo. Esquemas e tipos de associação devem ser individualizados. Sempre que possível deve-se optar pelas menores doses eficazes de 17-beta estradiol, associado a progesterona natural ou seus derivados nas mulheres com útero. A duração do tratamento é vinculada a seus objetivos, devendo ser reavaliada periodicamente através de um balanço individual entre indicação e contra-indicação. Orientação quanto a um estilo de vida mais saudável, com eliminação de tabagismo, alimentação adequada em cálcio e pobre em gorduras e atividade física regular são fundamentais como cuidados associados durante a menopausa.

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After randomized clinical trials produced impact and questions at the medical community on menopause hormonal therapy (MHT), the Department of Female Endocrinology and Andrology of the Brazilian Society of Endocrinology convened a group of specialists to produce an informative, critical and position paper, offering guidelines for those who practice or are called to express their opinion on menopause therapy. MHT is indicated for relief of vasomotor symptoms, maintenance of vaginal tropism, bone mass and collagen preservation, sexual and general well-being. Studies on primary cardiovascular prevention are not conclusive, and thus insufficient to indicate or not MHT for this purpose. Schemes and forms of association should de individualized. Whenever possible, one should use 17-beta estradiol, associated to natural progesterone or its derivatives in women with an intact uterus, at the lowest effective doses. Duration of therapy depends on its aims, and should be periodically re-evaluated through an individual indication/contra-indication balance. Orientation toward a healthier lifestyle, with smoking cessation, adequate calcium intake and a low fat diet, together with regular physical activity is fundamental during menopause.

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Para avaliar a utilidade dos fitoestrogênios (FE) na terapia de reposição hormonal da menopausa (TRHM), o Departamento de Endocrinologia Feminina da SBEM reuniu um grupo de especialistas para fazer uma revisão bibliográfica e selecionar trabalhos nos quais a metodologia adotada demonstrasse rigor científico. Os FE têm ações estrogênicas e antiestrogênicas, predominantemente sobre os receptores de estrogênios (E) ß, com potência estrogênica muito inferior à do estradiol. O conteúdo de FE nas suas fontes vegetais é variável, dependendo da forma de cultivo, safra, armazenamento e industrialização. Também a conversão dos precursores em fitormõnios ativos no organismo humano tem grande variabilidade individual. A maior parte das pesquisas com FE é realizada in vitro ou com animais de laboratório, nem sempre podendo ser extrapoladas para humanos. Com relação à síndrome do climatério, alguns estudos sugerem discreta melhora dos fogachos, sem modificação do ressecamento vaginal ou das alterações do humor. No metabolismo lipídico, alimentação rica em soja, mas não isoflavonas isoladamente, promove redução do colesterol total, do LDL-col e dos triglicerídeos, mas não elevam o HDL-col, como os E, e podem causar aumento da lipoproteína (a), que os E contribuem para diminuir. Embora alguns estudos de curta duração sugiram aumento da densidade mineral óssea com uso de isoflavonas, não há demonstração de redução de fraturas. Conclui-se que não há evidências convincentes que justifiquem o uso de FE ou alimentação rica em soja como alternativa para a TRHM.

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O transexualismo masculino é uma condiçäo que exige a atuaçäo de profissionais de diversas áreas para o diagnóstico e tratamento. De vital importância é o correto diagnóstico, uma vez que o tratamento cirúrgico é irreversível e, se incorretamente indicado, pode levar até ao suicídio. Os elementos diagnósticos säo essencialmente clínicos e um período-teste de observaçäo de dois anos é recomendado antes da realizaçäo da cirurgia. Nesse período säo utilizados recursos psicoterápicos e prescrita medicaçäo anti-androgênica e estrogênica para adequaçäo dos caracteres sexuais secundários. No presente artigo de revisäo säo abordados os conceitos necessários à conduta nos casos de transexualismo, bem como as opçöes terapêuticas disponíveis.

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