RESUMEN
RESUMO O objetivo deste trabalho é descrever o conhecimento popular relacionado à espinheira-santa (Maytenus ilicifolia) entre erveiros e feirantes que comercializam a planta no centro de Pelotas, Rio Grande do Sul, Brasil. Foi realizada uma pesquisa de abordagem qualitativa, exploratória e descritiva, de agosto a outubro de 2013. Entrevistas semi-estruturadas, com questões sobre os saberes e práticas relacionados à espinheira-santa, foram aplicadas a cinco erveiros e três feirantes do mercado informal de plantas medicinais. Para a análise dos dados foi utilizada a proposta operativa de Minayo, sendo Capra o referencial teórico para este estudo. Foi verificado que o saber relacionado ao uso da espinheira-santa é transmitido de geração a geração, embora existam outras fontes de conhecimento. As indicações do uso popular da espinheira-santa com finalidade terapêutica estão relacionadas a distúrbios gástricos, cicatrização e depuração do sangue. As diferentes formas dos sujeitos deste estudo interagirem com o ambiente, com sua família e em outras relações interpessoais resultam em diferentes saberes relacionados à espinheira-santa.
ABSTRACT The aim of this study was to describe the popular knowledge related to the espinheira-santa (Maytenus ilicifolia) among herbalists and marketers that sell this plant in the center of Pelotas/Rio Grande do Sul State, Brazil. A qualitative, exploratory and descriptive research was performed between August and July of 2013. Semi-structured interviews, with questions regarding the knowledge and practices related to this plant, were applied to five herbalists and three marketers inserted in the informal market of medicinal plants. The operative proposal by Minayo was used in order to analyze the data, and the theoretical framework by Capra was used in the discussion. The popular knowledge related to the use of espinheira-santa is passed on from generation to generation, although nowadays there are other sources ofinformation. The popular clueswith therapeutic purposes are related to gastric disorders, healing and blood clearance. The study participants have different forms of interaction with the environment, the family and other interpersonal relationships, resulting in different popular knowledges related to this medicinal plant.
Asunto(s)
Humanos , Plantas Medicinales/clasificación , Participación de la Comunidad , Maytenus/metabolismo , Asistencia Médica/clasificaciónRESUMEN
BACKGROUND/AIMS: Endoscopic sclerotherapy is considered a first line therapy to stop bleeding from esophageal varices, but acute variceal bleeding is still associated with high risk of rebleeding and death. We compared the use of octreotide with endoscopic sclerotherapy versus sclerotherapy alone to control acute variceal bleeding and prevent rebleeding in patients with cirrhosis. METHODOLOGY: In a prospective controlled trial, 68 patients with cirrhosis and acute variceal bleeding who underwent emergency sclerotherapy were randomly assigned to receive a continuous infusion of octreotide or placebo for two days. The primary outcome measure was 7-day mortality. RESULTS: After seven days the overall mortality was 19.1%, and the proportion of patients who died in octreotide group (8 of 40, or 20%) was similar to the placebo group (5 of 28, or 17.85%; p = 0.74). Rebleeding occurred in 20.6% (14 of 68 patients), being 20% (8 of 40) in the octreotide group vs. 21.4% (6 of 28) in the placebo group (p = 0.88). The mean number of units of blood transfused after sclerotherapy was 2.05 units in the octreotide group vs. 2.08 units in the placebo group (p = 0.96). Thirty patients needed intensive care support (20 of 40 in the octreotide group vs. 10 of 28 in the placebo group; p = 0.24). The differences remained without statistical significance even after adjustment for hepatic function and endoscopic bleeding stigmata by a linear regression model analysis test. CONCLUSIONS: In patients with cirrhosis, octreotide intravenous per 48h associated with sclerotherapy is not superior to sclerotherapy alone in terms of 7-day mortality, frequency of rebleeding, number of units of packet red blood cell transfusion and length of stay in intensive care setting.
Asunto(s)
Várices Esofágicas y Gástricas/tratamiento farmacológico , Fármacos Gastrointestinales/uso terapéutico , Hemorragia Gastrointestinal/terapia , Hemostasis Endoscópica/métodos , Octreótido/uso terapéutico , Escleroterapia , Várices Esofágicas y Gástricas/etiología , Femenino , Hemorragia Gastrointestinal/etiología , Humanos , Cirrosis Hepática/complicaciones , Masculino , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
Plasmid and chromosomal genes encode determinants of virulence for Yersinia pestis, the causative agent of plague. However, in vitro, Y. pestis genome is very plastic and several changes have been described. To evaluate the alterations in the plasmid content of the cultures in vitro and the impact of the alterations to their pathogenicity, three Y. pestis isolates were submitted to serial subculture, analysis of the plasmid content, and testing for the presence of characteristic genes in each plasmid of colonies selected after subculture. Different results were obtained with each strain. The plasmid content of one of them was shown to be stable; no apparent alteration was produced through 32 subcultures. In the other two strains, several alterations were observed. LD50 in mice of the parental strains and the derived cultures with different plasmid content were compared. No changes in the virulence plasmid content could be specifically correlated with changes in the LD50.
Asunto(s)
Humanos , Animales , Ratones , ADN Bacteriano , Genoma Bacteriano , Inestabilidad Genómica , Plásmidos , Yersinia pestis , Western Blotting , Medios de Cultivo , ADN Bacteriano , Electroforesis en Gel de Agar , Dosificación Letal Mediana , Reacción en Cadena de la Polimerasa , Virulencia , Yersinia pestisRESUMEN
Plasmid and chromosomal genes encode determinants of virulence for Yersinia pestis, the causative agent of plague. However, in vitro, Y. pestis genome is very plastic and several changes have been described. To evaluate the alterations in the plasmid content of the cultures in vitro and the impact of the alterations to their pathogenicity, three Y. pestis isolates were submitted to serial subculture, analysis of the plasmid content, and testing for the presence of characteristic genes in each plasmid of colonies selected after subculture. Different results were obtained with each strain. The plasmid content of one of them was shown to be stable; no apparent alteration was produced through 32 subcultures. In the other two strains, several alterations were observed. LD50 in mice of the parental strains and the derived cultures with different plasmid content were compared. No changes in the virulence plasmid content could be specifically correlated with changes in the LD50.
Asunto(s)
ADN Bacteriano/aislamiento & purificación , Inestabilidad Genómica/genética , Plásmidos/genética , Yersinia pestis/patogenicidad , Animales , Western Blotting , ADN Bacteriano/genética , Electroforesis en Gel de Agar , Genoma Bacteriano , Humanos , Dosificación Letal Mediana , Ratones , Reacción en Cadena de la Polimerasa , Virulencia/genética , Yersinia pestis/genéticaRESUMEN
OBJECTIVE: The term Barrett's esophagus refers to a premalignant condition that is characterized by the replacement of the esophageal squamous mucosa by a columnar-lined one. Preliminary studies have demonstrated reversal of Barrett's mucosa after endoscopic coagulation with different techniques associated with acid inhibition. However, most of these studies have shown that residual Barrett's glands are found underneath the new squamous epithelium in up to 40% of patients. The goal of our study is to verify whether complete restoration of Barrett's mucosa can be achieved by the combination of high power setting argon plasma coagulation and omeprazole. METHODS: A total of 33 patients (mean age: 55.2 yr, range: 21-84 yr; 21 men and 12 women) with histologically demonstrated Barrett's esophagus (mean length: 4.05 cm, range: 0.5-7 cm) were treated. Fourteen cases presented with low-grade dysplasia and one with high-grade dysplasia. All of the extent, or until a maximum of 4 cm, of the Barrett's mucosa was cauterized in each session using argon beam coagulation at a power setting of 65-70 W. All patients received 60 mg omeprazole during the treatment period. RESULTS: Complete restoration of squamous mucosa was obtained in all 33 cases after a mean of 1.96 sessions (range, 1-4). Endoscopic results were histologically confirmed. Nineteen (57.5%) patients experienced moderate to severe chest pain and odyno-dysphagia lasting for 3-10 days after the procedure. Five of these cases experienced high fever and a small volume of pleural effusion, and three patients developed esophageal strictures that needed to be dilated. Another patient developed pneumomediastinum and subcutaneous emphysema without evidences of perforation. After a mean follow-up of 10.6 months there was one endoscopic, as well as histological, recurrence of Barrett's mucosa in a patient with an ineffective laparoscopic fundoplication. CONCLUSIONS: High power setting argon plasma coagulation combined with intensive acid suppression is an effective treatment for the total endoscopic ablation of Barrett's esophagus, at least in the short term. Long-term follow-up of treated patients in whom gastroesophageal reflux is surgically or medically alleviated seems mandatory before drawing definitive conclusions about this therapy.