RESUMEN
To investigate de effect of PAb gel on the bone tissue of rats submitted to Bisphosphonate-related osteonecrosis of the jaws (BRONJ). Initially, 54 animals were submitted to BRONJ model by Zoledronic Acid (ZA) (0.1 mg/kg 3x/wk for 9 wk, ip), followed by the 1st upper left molar extraction at the 8th wk. After tooth removal, the animals were divided into 3 groups, ZA that received placebo gel or PAb gel that received 1% PAb gel, inside the dental alveolus. The control Group (CONTROL) received 0.1 mg/kg of 0.9% saline and then placebo gel. Three weeks after tooth extraction, the animals were euthanized, and maxillae were colleted for macroscopic, radiographic, histological and Raman spectomery assays. Additionally, GSK3b, beta-catenin, and Runx2 mRNA expressions were determined. Blood samples were collected for the analysis of Bone-specific alkaline phosphatase (BALP) levels. PAb gel improved mucosal healing, increased the number of viable osteocytes, while it reduced the number of empty lacunae, as well as the amount of bone sequestration. Furthermore, PAb gel positively influenced the number and functionality of osteoblasts by stimulating Wnt signaling, thereby inducing bone remodeling. Additionally, PAb gel contributed to improved bone quality, as evidenced by an increase in bone mineral content, a decrease in bone solubility, and an enhancement in the quality of collagen, particularly type I collagen. PAb gel mitigated bone necrosis by stimulating of bone remodeling through Wnt signaling and concurrently improved bone quality. PAb gel emerges as a promising pharmacological tool for aiding in BRONJ therapy or potentially preventing the development of BRONJ.
Asunto(s)
Agaricus , Osteonecrosis de los Maxilares Asociada a Difosfonatos , Conservadores de la Densidad Ósea , Animales , Ratas , Osteonecrosis de los Maxilares Asociada a Difosfonatos/tratamiento farmacológico , Osteonecrosis de los Maxilares Asociada a Difosfonatos/etiología , Osteonecrosis de los Maxilares Asociada a Difosfonatos/patología , Difosfonatos , Maxilar/patología , Extracción Dental , Vía de Señalización Wnt , Ácido ZoledrónicoRESUMEN
Statement of the Problem: Periodontitis is an inflammatory disease that causes bone loss. Some patients do not respond well to the classic treatment and need therapies that minimize bone loss, the main sequel of the disease. Chenopodium ambrosioides L. has stood out due to its anti-inflammatory and anti-oxidative activities. However, no study has yet investigated its effect on periodontitis. Purpose: This study aimed to evaluate the bone protective effect of Chenopodium ambrosioides L. (CAL) extract on ligature-induced periodontitis model in rats. Materials and Method: For this, a pre-clinical assay was performed, using male Wistar rats divided into 3 groups: Naive (N) (n=6), not submitted to any procedure; Saline (SAL) (n=6), submitted to ligature-induced periodontitis and receiving 2 ml/kg of 0.9% saline solution; and CAL extract, which was subdivided into 3 subgroups (n=6/subgroup) receiving the CAL at 3 (CAL3), 10 (CAL10) or 30 mg/kg (CAL30). All agents were given, by oral gavage, 30 min before periodontitis induction and daily until euthanasia (11th day). By then, maxillae were removed for macroscopic, histological, and histometric analyses. Kidneys, liver, and stomach were collected to evaluate the safety of CAL extract. High-performance liquid chromatography (HPLC) assay was used to investigate the flavonoid content in the extract. Results: Chenopodium ambrosioides L. extract at 30mg/kg showed a reduction by 58% in bone loss marked by an increase (+35%) in the number of osteoblasts and a reduction (-51%) on the number of osteoclasts (p< 0.05). No significant alteration in the liver, kidney, or stomach was seen. Rutin was the main flavonoid found. Conclusion: In summary, it was observed that Chenopodium ambrosioides L. extract has shown important anti-inflammatory and bone anabolic and anti-resorptive properties without causing toxicity in the main organs. Rutin, as the main flavonoid of the extract, seems to be responsible for the beneficial effect of this agent.
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Osteonecrosis de los Maxilares Asociada a Difosfonatos , Conservadores de la Densidad Ósea , Osteonecrosis , Animales , Atorvastatina/efectos adversos , Osteonecrosis de los Maxilares Asociada a Difosfonatos/tratamiento farmacológico , Conservadores de la Densidad Ósea/efectos adversos , Difosfonatos/farmacología , Maxilares , Osteonecrosis/inducido químicamente , Osteonecrosis/tratamiento farmacológico , Ratas , Ácido Zoledrónico/efectos adversosRESUMEN
Introdução: O complexo zigomático é a segunda estrutura mais fraturada do esqueleto facial em acidentes motociclísticos, perdendo em incidência, apenas, para fraturas de mandíbula. Fraturas de zigoma podem causar complicações oculares, parestesias na face, perda de projeção ântero-posterior, levando a defeitos ósseos que causam danos estéticos e funcionais ao paciente, se não forem tratados de forma correta. Relato de caso: A vítima de acidente motociclístico com trauma de face apresentou-se com queixas estéticas e funcionais, com diagnóstico conclusivo de fratura em complexo zigomático. Realizou-se um acesso hemicoronal com extensão endaural, o que permitiu a visualização das fraturas do arco zigomático direito e da região da sutura fronto-zigomática direita, acesso transconjutival para abordagem do rebordo infraorbitário e acesso intraoral para o pilar zigomático maxilar. As fraturas foram reduzidas e fixadas com placas e parafusos do sistema 1.5mm. Somente o pilar zigomático foi fixado com placas e parafusos de 2.0mm. Considerações Finais: Fraturas complexas do osso zigomático podem representar um verdadeiro desafio cirúrgico. Planejamento prévio por meio de exames de imagem adequados é fundamental para se definir o tipo de tratamento e os acessos cirúrgicos adequados... (AU)
Introduction: The zygomatic complex is the second part of the facial skeleton that most fracture incidence after motorcycle accidents, in losing only chip fractures of the mandible bone. Zygoma fractures can cause eye complications, paresthesias in the face, loss of anteroposterior projection, leading to bone defects that cause cosmetic and functional damage to the patient, if not treated properly. Case report: The victim of a motorcycle accident with facial trauma presented with aesthetic and functional complaints, with a conclusive diagnosis of fracture in a zygomatic complex. A hemi-coronal approach with endaural extension was performed, which allowed the visualization of fractures of the right zygomatic arch and right fronto-zygomatic suture region, transconjutival access to approach the infraorbital ridge and intraoral access to the zygomatic pillar. jaw. Fractures were reduced and fixed with 1.5mm system plates and screws. Only the zygomatic abutment was fixed with 2.0mm plates and screws. Final Considerations: Complex zygomatic bone fractures can represent a real surgical challenge. Prior planning through appropriate imaging exams is critical to defining the type of treatment and appropriate surgical access... (AU)
Asunto(s)
Humanos , Masculino , Adulto , Cigoma , Fracturas Cigomáticas , Fijación Interna de Fracturas , Maxilares , Fracturas Maxilares , Suturas , Heridas y Lesiones , Huesos , Accidentes de Tránsito , MandíbulaRESUMEN
O cisto periapical tem origem associada à proliferação dos restos epiteliais de Malassez, após um processo inflamatório crônico decorrente de uma extensa lesão cariosa com acometimento pulpar. Quando um cisto periapical passa por um processo de reagudização infecciosa o quadro clínico é denominado de abscesso Fênix. O objetivo deste trabalho é relatar um caso de abscesso Fênix associado à raiz residual do dente 44. Paciente M.R.G, 19 anos, apresentou queixa principal de "espinha no meu queixo". Ao exame clínico, foi observada uma fístula cutânea na região mentual, com drenagem purulenta. Ao exame intraoral, foi observada a raiz residual do dente 44. Ao exame imaginológico, observou-se um cisto periapical associado ao dente 44 que se estendia anteriormente até a região anterior de mandíbula, fenestrando a cortical vestibular (mais espessa) e drenando para a região de mento. O paciente foi então tratado com a enucleção da lesão, seguida de plastia da fístula cutânea. Após exame histopatológico foi confirmado o diagnóstico de cisto periapical com processo de inflamação aguda. O paciente evoluiu bem após o tratamento, sem queixas álgicas. Portanto, é fundamental que o Cirurgião-Dentista conheça a etiopatogenia das lesões odontogênicas para o correto diagnóstico e tratamento em casos atípicos como o relatado
The periapical cyst origin is associated to the proliferation of epithelial cell rests of Malassez after a chronic inflammatory process due to an extensive carious lesion with pulp involvement. When a periapical cyst goes through a process of infectious exudation, clinically, it gets denominated phoenix abscess. The purpose of this study is to report a case of phoenix abscess associated to the residual root of the tooth 44. Patient M.R.G., 19 years old, presenting as main complaint a "pimple on my chin". After the clinical exam it was observed an exudating cutaneous fistula on the mentual region. After the intra-oral exam it was observed a residual root of the tooth 44. Radiographically, it was observed a periapical cyst associated to the tooth 44 wich reaches the anterior region of the jaw penetrating the vestibular cortical and draining on the mentual region. The patient has been treated with an enucleation procedure followed by a fistuloplasty. After hystological exam it was confirmed the diagnostic of periapical cyst with an acute inflammatory process. Patient has evolved well after treatment without any pain complaints. Therefore, it is fundamental that the dentists know the etiopathology of the odontogenics lesions to have a correct diagnostic and treatment of unusual cases as same as the reported.
Asunto(s)
Humanos , Femenino , Adulto , Quiste Radicular , Fístula Cutánea , Infección Focal Dental , AbscesoRESUMEN
A goiaba (Psidium guajava) é uma fruta nativa da América tropical encontrada facilmente no Brasil, possuindo qualidades nutricionais as quais viabilizam seu aproveitamento para a industrialização de alimentos. Com o intuito da redução do desperdício do resíduo do processamento da polpa da goiaba, este estudo teve como objetivo avaliar a composição centesimal e a incorporação da farinha do processamento de polpa de goiaba em biscoitos. Foram desenvolvidas formulações com percentuais de 10, 20, 30 e 40% de farinha do resíduo em substituição parcial a farinha de trigo. A utilização da farinha de resíduo em biscoitos apresentou um rendimento de 4,60mg/100g-1. Conclui-se que o aproveitamento de resíduo de frutas e sua incorporação na formulação em biscoitos é uma alternativa viável em substituição a farinha de trigo, considerando as características nutricionais do produto obtido.
Asunto(s)
Psidium , Aprovechamiento Integral de los Alimentos , BizcochosRESUMEN
OBJECTIVE: Symptomatic pituitary apoplexy is a rare but life-threatening condition caused by sudden hemorrhage or infarction of a pituitary adenoma. In the current study, we aim to evaluate the clinical presentation, management, and clinical outcomes in a cohort of patients who were treated for this condition in our center in the last 16 years. METHODS: We performed a retrospective analysis of all patients who underwent endoscopic endonasal surgery for treatment of symptomatic pituitary apoplexy between 2001 and 2016 in our center. RESULTS: A total of 39 patients were included in the study, mean age of 54.9 years (range, 18-70 years) and mean follow-up 5.1 years (range, 0.6-16 years). Most of the patients had nonfunctioning adenomas (32 patients). Headache (89%), visual impairment (79%), and hypopituitarism (86%) were the most common preoperative findings. Surgical treatment led to gross total resection in 31 patients (79.4%). During follow-up, visual fields and oculomotor improvement was observed in 23 (74.1%) and 21 (67.7%) of the patients, respectively. Intractable headache also improved in all patients. Hypopituitarism was present in 77% of patients after surgery. In this series, no cerebrospinal fluid leak, vascular injury, or infection was observed. There was no postoperative mortality. CONCLUSIONS: The endoscopic endonasal transsphenoidal approach is an effective modality to treat pituitary apoplexy with a high rate of success and minimal risk in selected cases. Although reversion of preoperative visual deficits is often observed, hormonal deficits tend to persist, and require long-term hormonal therapy, even after successful endoscopic endonasal surgical resection.
Asunto(s)
Adenoma/cirugía , Cirugía Endoscópica por Orificios Naturales/métodos , Neuroendoscopía/métodos , Apoplejia Hipofisaria/cirugía , Neoplasias Hipofisarias/cirugía , Adenoma/complicaciones , Adolescente , Adulto , Anciano , Pérdida de Líquido Cefalorraquídeo/epidemiología , Femenino , Humanos , Hipopituitarismo/epidemiología , Masculino , Persona de Mediana Edad , Cavidad Nasal , Apoplejia Hipofisaria/etiología , Neoplasias Hipofisarias/complicaciones , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Hueso Esfenoides , Infección de la Herida Quirúrgica/epidemiología , Lesiones del Sistema Vascular/epidemiología , Adulto JovenRESUMEN
O ameloblastoma é um tumor odontogênico benigno, localmente agressivo, com predileção pela região posterior de mandíbula. Acredita-se que se origina de remanescentes do aparelho de formação dentária, semelhante ao desenvolvimento do órgão do esmalte. Não há clara preferência por gênero, sendo mais prevalente entre a terceira e quinta décadas de vida. O ameloblastoma tem sido classificado em quatro tipos: unicístico, sólido/multicístico, desmoplásico e periférico. O tipo sólido pode apresentar algumas variantes histológicas, sendo as mais comuns a folicular e a plexiforme. Dentre as formas de tratamento, a excisão cirúrgica ampla com margens de segurança é o método de tratamento preferido. Recomenda-se um acompanhamento de mais de 10 anos com intervalos regulares após tratamento cirúrgico apropriado O objetivo deste trabalho é relatar o caso de um paciente portador de extenso ameloblastoma em região posterior de mandíbula, tratado a partir da ressecção da lesão com aposição de uma placa reconstrutiva do sistema lock. No momento, o paciente se encontra em acompanhamento pós-operatório de um ano sem sinais de recidiva. A partir deste trabalho pôde-se concluir que o tratamento realizado se mostrou adequado, no entanto um maior período de acompanhamento se faz necessário para indicar a cura do paciente
Ameloblastoma is a benign odontogenic tumor, locally aggressive being more found in posterior region of mandible. It is believed that it is originated from remnants of the dental formation apparatus, such as the developing enamel organ. There is no clear predilection by gender, being most prevalent between the third and fifth decades of life. Ameloblastoma has been classified into four types: unicystic, solid/multicystic, desmoplastic and peripheral. The solid type can present some histological variants, being most common follicular and plexiform types. Among treatment forms, wide surgical excision with safe margins is the preferred method of treatment. It is recommended a follow of more than 10 years, with regular intervals after the proper treatment. The aim of this study is to report a case of a patient showing large ameloblatoma in posterior region of mandible treated with resection of the lesion and the position of a reconstructive plate of the locking system. At the moment, a year follow up patient showed no signs of recurrence. From this study it could be concluded the performed treatment showed itself suitable, however, a longer period of follow is necessary to indicate the patient's cure
Asunto(s)
Humanos , Masculino , Adulto , Ameloblastoma , Mandíbula , Tumores OdontogénicosRESUMEN
O hemangioma é uma neoplasia benigna que se caracteriza por proliferação endotelial anormal. Acomete a região maxilofacial com predileção pelos lábios, língua e mucosa jugal. O tratamento pode ser realizado por diferentes formas terapêuticas, desde corticoterapia até a excisão cirúrgica. Neste trabalho, descrevemos um caso clínico de hemangioma lingual, no qual se optou pela utilização de oleato de monoetanolamina a 5% - ethamolin®, obtendo-se total involução da lesão em 3 aplicações, além de nenhum sinal de recidiva após 15 meses
The hemangioma is a benign neoplasm characterized by abnormal endothelial proliferation. It affects the maxillofacial region with predilection for the lips, tongue and buccal mucosa. The treatment can be performed by different therapeutics, since steroids to surgical excision. In this work we describe a case of lingual hemangioma, where we opted to use monoethanolamine oleate 5% - ethamolin® to get the total lesion regression in 3 applications, and no sign of recurrence after 15 months
Asunto(s)
Patología Bucal , Hemangioma , Anomalías de la BocaRESUMEN
Rut-bpy is a novel nitrosyl-ruthenium complex releasing NO into the vascular system. We evaluated the effect of Rut-bpy (100 mg/kg) on a rat model of brain stroke. Forty rats were assigned to four groups (Saline solution [SS], Rut-bpy, SS+ischemia-reperfusion [SS+I/R] and Rut-bpy+ischemia-reperfusion [Rut-bpy+I/R]) with their mean arterial pressure (MAP) continuously monitored. The groups were submitted (SS+I/R and Rut-bpy+I/R) or not (SS and Rut-bpy) to incomplete global brain ischemia by occlusion of the common bilateral carotid arteries during 30 min followed by reperfusion for further 60 min. Thirty minutes before ischemia, rats were treated pairwise by intraperitoneal injection of saline solution or Rut-bpy. At the end of experiments, brain was removed for triphenyltetrazolium chloride staining in order to quantify the total ischemic area. In a subset of rats, hippocampus was obtained for histopathology scoring, nitrate and nitrite measurements, immunostaining and western blotting of the nuclear factor- κB (NF-κB). Rut-bpy pre-treatment decreased MAP variations during the transition from brain ischemia to reperfusion and decreased the fractional injury area. Rut-bpy pre-treatment reduced NF-κB hippocampal immunostaining and protein expression with improved histopathology scoring as compared to the untreated operated control. In conclusion, Rut-bpy improved the total brain infarction area and hippocampal neuronal viability in part by inhibiting NF-κB signaling and helped to stabilize the blood pressure during the transition from ischemia to reperfusion.
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Anestesia , Isquemia Encefálica/prevención & control , Precondicionamiento Isquémico/métodos , Donantes de Óxido Nítrico/administración & dosificación , Daño por Reperfusión/prevención & control , Compuestos de Rutenio/administración & dosificación , Anestesia/métodos , Animales , Encéfalo/irrigación sanguínea , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Isquemia Encefálica/metabolismo , Isquemia Encefálica/fisiopatología , Masculino , Fármacos Neuroprotectores/administración & dosificación , Ratas , Ratas Wistar , Especies de Nitrógeno Reactivo/metabolismo , Daño por Reperfusión/metabolismoRESUMEN
PURPOSE: To investigate the effect of alanyl-glutamine dipeptide (L-Ala-Gln) pre-treatment on ischemia-reperfusion (I/R) injury after unilateral testicular torsion-detorsion in a comparative controlled experiment. METHODS: Forty-eight rats (150-200 g) randomly distributed into 4 groups (n=12), and distributed in 2 subgroups (n=6) each, were treated with saline 2.0 ml (G-1, G-3) or L-Ala-Gln 20%, 0.75g/kg dissolved in saline (total volume 2.0 ml) administered in the left saphenous vein 30 minutes before ischemia. Anesthetized rats were subjected to I/R induced by torsion (720°) of the right spermatic cord lasting 1h (G-1, G-2) or 3 hours (G-3, G4). Anesthesia was again applied at the end of ischemia time (T-0) for testis detorsion and 6 hours later (T-6) for orchiectomy. All operations were performed on the right testes through transverse scrotal incisions. Right orchiectomy was carried out at the end of ischemia (T-0), and 6 hours later (T-6) to evaluate the concentrations of malondialdehyde (MDA) and reduced glutathione (GSH) in the testis. RESULTS: Pretreatment with L-Ala-Gln reduced MDA contents in rat testis at the end of ischemia lasting 3 hours. There was significant increase of GSH levels in T-6 time-point after 1 hour of ischemia. GSH levels also increased in T-0 and T-6 time-points in rats subjected to ischemia for 3 hours. CONCLUSION: L-Ala-Gln administered before torsion/detorsion of the spermatic cord decreases lipid peroxidation during ischemia and protects the testis from oxidative stress by upregulating GSH levels during reperfusion.
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Dipéptidos/farmacología , Isquemia/complicaciones , Precondicionamiento Isquémico/métodos , Daño por Reperfusión/prevención & control , Testículo/irrigación sanguínea , Animales , Dipéptidos/sangre , Modelos Animales de Enfermedad , Glutatión/sangre , Masculino , Malondialdehído/sangre , Estrés Oxidativo/efectos de los fármacos , Distribución Aleatoria , Ratas , Ratas Wistar , Torsión del Cordón Espermático/complicaciones , Factores de Tiempo , Resultado del TratamientoRESUMEN
PURPOSE: To determine the effects of oral L-glutamine (L-Gln) and the dipeptide L-alanyl-glutamine (L-Ala-Gln) upon the activity of the malate-aspartate shuttle in the rat distal small intestine following ischemia and reperfusion. METHODS: Seventy-two Wistar rats (350-400g), were randomized in 2 groups (n = 36): group S (Sham) and Group T (Treatment) and divided into 12 subgroups (n = 6): A-A6, and B1-B6. The subgroups A1-A3 were subjected to sham procedures at 30 and 60 minutes. Thirty minutes before the study, rats were treated with calcium caseinate, 0.5g/Kg (subgroups A1, A4, B1, B4), L-Gln, 0.5g / kg (subgroups A2, A5, B2 and B5) or L-Ala-Gln, 0.75g/Kg (subgroups A3, A6, B3, B6), administered by gavage. Ischemia was achieved by clamping the mesenteric vessels, delimiting a segment of bowel 5 cm long and 5 cm apart from the ileocecal valve. Samples were collected 30 and 60 minutes after start of the study for real-time PCR assay of malate dehydrogenases (MDH1-2) and aspartate-aminotransferases (GOT1-2) enzymes. RESULTS: Tissue MDH and GOT mRNA expression in intestinal samples from rats preconditioned with either L-Gln or L-Ala-Gln showed no significant differences both during ischemia and early reperfusion. CONCLUSION: Activation of the malate-aspartate shuttle system appears not to be the mechanism of glutamine-mediated elevation of glucose oxidation in rat intestine during ischemia/reperfusion injury.
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Ácido Aspártico/metabolismo , Glutamina/farmacología , Intestino Delgado/irrigación sanguínea , Malatos/metabolismo , ARN Mensajero/sangre , Daño por Reperfusión/prevención & control , Animales , Aspartato Aminotransferasas/sangre , Aspartato Aminotransferasas/genética , Dipéptidos/farmacología , Modelos Animales de Enfermedad , Intestino Delgado/enzimología , Malato Deshidrogenasa/sangre , Malato Deshidrogenasa/genética , Distribución Aleatoria , Ratas , Ratas Wistar , Reacción en Cadena en Tiempo Real de la Polimerasa , Daño por Reperfusión/enzimología , Factores de TiempoRESUMEN
PURPOSE: To evaluate the metabolic and oxidative effects of sevoflurane and propofol in children undergoing surgery for correction of congenital heart disease. METHODS: Twenty children with acyanotic congenital heart disease, scheduled for elective cardiac surgery with cardiopulmonary bypass, age range 1 day to 14 years were randomly assigned to 2 groups: Group GP, programmed to receive total intravenous anesthesia with propofol and group GS scheduled to use balanced anesthesia with sevoflurane. Exclusion criteria were cyanotic heart disease or complex, association with other malformations, severe systemic diseases, infection or children undergoing treatment and palliative or emergency surgery. Blood samples were collected at three different time-points: T0, after radial artery cannulation, T1, 30 minutes after cardiopulmonary bypass (CPB) launch and T2, at the end of procedure. Parameters analyzed included thiobarbituric acid-reactive substance (TBARS), glutathione (GLN), lactate and pyruvate plasmatic concentrations. RESULTS: TBARS, GSH, lactate and pyruvate concentrations did not change significantly by Friedman´s test. Lactate/pyruvate ratio (L/P) was >10 in both groups. There was a moderate Pearson correlation for TBARS, in T1 (r=0.50; p=0.13) e T2 (r=0.51;p=0.12). Pearson correlation was high between groups during CPB (T1) for lactate (r=0.68; p=0.02), pyruvate (r=0.75; p=0.01) and L/P ratio (r=0.83; p=0.003). CONCLUSION: Anesthetic techniques investigated in this study showed a similar pattern, with no increase in metabolic substrates and oxidative stress during surgical correction of congenital heart defects in non-cyanotic children.
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Anestésicos por Inhalación/farmacología , Anestésicos Intravenosos/farmacología , Cardiopatías Congénitas/cirugía , Éteres Metílicos/farmacología , Propofol/farmacología , Adolescente , Niño , Preescolar , Femenino , Glutatión/sangre , Humanos , Lactante , Recién Nacido , Ácido Láctico/sangre , Masculino , Estrés Oxidativo/efectos de los fármacos , Estudios Prospectivos , Ácido Pirúvico/sangre , Sevoflurano , Sustancias Reactivas al Ácido Tiobarbitúrico/metabolismo , Factores de TiempoRESUMEN
PURPOSE: To evaluate the effects of pre-operative L-alanyl-glutamine (L-Ala-Gln) on blood glucose control in patients with coronary obstruction, selected for myocardial revascularization. METHODS: Twenty-two patients (63±8 years) were randomly assigned to receive 250 ml of L-Ala-Gln 20% plus saline 750 ml (Group L- Ala-Gln, n=11) or saline 1000 ml (Group Saline, n=11) over 3 hours before operation. Pre-operative blood samples were collected 3h before (T-1) and at the beginning of the surgical procedure (T-2). Intra-operative samples were collected immediately before the start (T-3) and the end of extra-corporeal perfusion (T- 4). Post-operative samples were collected 12h (T-12) and 24h later (T-24). RESULTS: Glycemia decreased significantly in L-Ala-Gln treated patients during the intraoperative period. The same effect did not occur in saline patients. As the rate of insulin infusion, administered routinely to patients undergoing surgery with extracorporeal circulation was constant in both groups during surgery, the reduction of blood glucose in group L-Ala-Gln does not seem to be related to exogenous insulin. CONCLUSION: Pre-operative use of L-Ala-Gln improves glycemic control in patients with coronary artery occlusion, submitted to myocardial revascularization.
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Glucemia/efectos de los fármacos , Enfermedad de la Arteria Coronaria/cirugía , Glutamina/farmacología , Revascularización Miocárdica , Anciano , Análisis de Varianza , Enfermedad de la Arteria Coronaria/metabolismo , Método Doble Ciego , Glutamina/administración & dosificación , Humanos , Insulina/sangre , Persona de Mediana Edad , Periodo Preoperatorio , Estudios Prospectivos , Cloruro de Sodio/administración & dosificación , Factores de Tiempo , Resultado del TratamientoRESUMEN
PURPOSE: To evaluate the effects of pre-operative L-alanyl-glutamine (L-Ala-Gln) on blood glucose control in patients with coronary obstruction, selected for myocardial revascularization. METHODS: Twenty-two patients (63±8 years) were randomly assigned to receive 250ml of L-Ala-Gln 20 percent plus saline 750 ml (Group L- Ala-Gln, n=11) or saline 1000 ml (Group Saline, n=11) over 3 hours before operation. Pre-operative blood samples were collected 3h before (T-1) and at the beginning of the surgical procedure (T-2). Intra-operative samples were collected immediately before the start (T-3) and the end of extra-corporeal perfusion (T- 4). Post-operative samples were collected 12h (T-12) and 24h later (T-24). RESULTS: Glycemia decreased significantly in L-Ala-Gln treated patients during the intraoperative period. The same effect did not occur in saline patients. As the rate of insulin infusion, administered routinely to patients undergoing surgery with extracorporeal circulation was constant in both groups during surgery, the reduction of blood glucose in group L-Ala-Gln does not seem to be related to exogenous insulin. CONCLUSION: Pre-operative use of L-Ala-Gln improves glycemic control in patients with coronary artery occlusion, submitted to myocardial revascularization.(AU)
OBJETIVO: Avaliar os efeitos do uso pré-operatório da L-alanil-glutamina (L-Ala-Gln) no controle glicêmico em pacientes, selecionados para a revascularização do miocárdio. MÉTODOS: Vinte e dois pacientes cardiopatas (63±8 anos) foram randomizados para receber 250 ml de L-Ala-Gln 20 por cento em 750 ml de solução salina (Grupo L-Ala-Gln, n=11) ou soro fisiológico 1000 ml (Grupo Salina, n=11). Amostras de sangue foram coletadas no pré-operatório, três horas antes (T-1: basal) e no início do procedimento cirúrgico (T-2); imediatamente antes do início (T-3) e no final da perfusão extra-corpórea (T-4); 12h (T-12) e 24h após a conclusão do procedimento. As infusões, com duração de 3 horas, foram iniciadas 3 h antes do procedimento operatório. RESULTADOS: Houve redução significativa da glicemia nos pacientes tratados com L-Ala-Gln durante o período intra-operatório (T-3 e T-4). O mesmo efeito não ocorreu nos pacientes do grupo salina. Como a taxa de infusão de insulina, administrada rotineiramente aos pacientes submetidos à cirurgia com circulação extracorpórea, foi constante em ambos os grupos durante o período intra-operatório, a redução da glicemia no grupo L-Ala-Gln não parece estar relacionada à insulina exógena. CONCLUSÃO: O uso pré-operatório de L-Ala-Gln melhora o controle glicêmico em pacientes com obstrução coronariana, submetidos à revascularização miocárdica.(AU)
Asunto(s)
Humanos , Perfusión , Cirugía Torácica/métodos , Enfermedad de la Arteria Coronaria , Glucemia , GlutaminaRESUMEN
PURPOSE: To evaluate the metabolic and oxidative effects of sevoflurane and propofol in children undergoing surgery for correction of congenital heart disease. METHODS: Twenty children with acyanotic congenital heart disease, scheduled for elective cardiac surgery with cardiopulmonary bypass, age range 1 day to 14 years were randomly assigned to 2 groups: Group GP, programmed to receive total intravenous anesthesia with propofol and group GS scheduled to use balanced anesthesia with sevoflurane. Exclusion criteria were cyanotic heart disease or complex, association with other malformations, severe systemic diseases, infection or children undergoing treatment and palliative or emergency surgery. Blood samples were collected at three different time-points: T0, after radial artery cannulation, T1, 30 minutes after cardiopulmonary bypass (CPB) launch and T2, at the end of procedure. Parameters analyzed included thiobarbituric acid-reactive substance (TBARS), glutathione (GLN), lactate and pyruvate plasmatic concentrations. RESULTS: TBARS, GSH, lactate and pyruvate concentrations did not change significantly by Friedmanïs test. Lactate/pyruvate ratio (L/P) was >10 in both groups. There was a moderate Pearson correlation for TBARS, in T1 (r=0.50; p=0.13) e T2 (r=0.51;p=0.12). Pearson correlation was high between groups during CPB (T1) for lactate (r=0.68; p=0.02), pyruvate (r=0.75; p=0.01) and L/P ratio (r=0.83; p=0.003). CONCLUSION: Anesthetic techniques investigated in this study showed a similar pattern, with no increase in metabolic substrates and oxidative stress during surgical correction of congenital heart defects in non-cyanotic children.(AU)
OBJETIVO: Avaliar os efeitos metabólicos e oxidativos da anestesia com sevoflurano ou propofol em crianças portadoras de cardiopatia congênita, submetidas à cirurgia eletiva. MÉTODOS: Vinte crianças com cardiopatia congênita acianótica, agendadas para a cirurgia cardíaca eletiva com circulação extracorpórea (CEC), idades 1 dia-14 anos, foram distribuídas aleatoriamente em dois grupos: Grupo GP (anestesia venosa total com propofol) e grupo GS (anestesia balanceada com sevoflurano). Critérios de exclusão foram: doença cardíaca cianótica ou complexa, associação com outras malformações, doença sistêmica grave, infecção ou crianças submetidas a tratamento e cuidados paliativos ou cirurgia de emergência. Amostras de sangue foram coletadas em três horários diferentes: T0, após a canulação da artéria radial, T1, 30 minutos após o início da CEC e T2, no final do procedimento. Parâmetros analisados: substâncias reativas ao ácido tiobarbitúrico (TBARS), glutationa (GLN), lactato e piruvato. RESULTADOS: As concentrações de TBARS, GSH, lactato e piruvato não foram diferentes (teste de Friedman). A razão Lactato/piruvato (L/P) foi >10 em ambos os grupos. Houve uma correlação de Pearson moderada no TBARS, em T1 (r = 0,50, p = 0,13) e T2 (r = 0,51, p = 0,12). A correlação de Pearson foi alta entre os grupos durante a CEC (T1) para lactato (r=0,68, p=0,02), piruvato (r=0,75, p=0,01) e relação L/P (r =0,83, p=0,003). CONCLUSÃO: As técnicas anestésicas investigadas mostraram um padrão semelhante, sem aumento de substratos metabólicos ou do estresse oxidativo durante a correção cirúrgica de cardiopatias congênitas em crianças acianóticas.(AU)
Asunto(s)
Humanos , Estrés Oxidativo , Cardiopatías , Anestésicos Intravenosos , Anestésicos por Inhalación , NiñoRESUMEN
PURPOSE: To determine the effects of oral L-glutamine (L-Gln) and the dipeptide l-alanyl-glutamine (L-Ala-Gln) upon the activity of the malate-aspartate shuttle in the rat distal small intestine following ischemia and reperfusion. METHODS: Seventy-two Wistar rats (350-400g), were randomized in 2 groups (n = 36): group S (Sham) and Group T (Treatment) and divided into 12 subgroups (n = 6): A-A6, and B1-B6. The subgroups A1-A3 were subjected to sham procedures at 30 and 60 minutes. Thirty minutes before the study, rats were treated with calcium caseinate, 0.5g/Kg (subgroups A1, A4, B1, B4), L-Gln, 0.5g / kg (subgroups A2, A5, B2 and B5) or L-Ala-Gln, 0.75g/Kg (subgroups A3, A6, B3, B6), administered by gavage. Ischemia was achieved by clamping the mesenteric vessels, delimiting a segment of bowel 5 cm long and 5 cm apart from the ileocecal valve. Samples were collected 30 and 60 minutes after start of the study for real-time PCR assay of malate dehydrogenases (MDH1-2) and aspartate-aminotransferases (GOT1-2) enzymes. RESULTS: Tissue MDH and GOT mRNA expression in intestinal samples from rats preconditioned with either L-Gln or L-Ala-Gln showed no significant differences both during ischemia and early reperfusion. CONCLUSION: Activation of the malate-aspartate shuttle system appears not to be the mechanism of glutamine-mediated elevation of glucose oxidation in rat intestine during ischemia/reperfusion injury.(AU)
OBJETIVO: Determinar os efeitos da administração oral de L-glutamina (L-Gln) e do dipeptídeo L-alanil-glutamina (L-Ala-Gln) sobre a atividade do ciclo malato-aspartato no intestino delgado distal de ratos após isquemia/reperfusão. MÉTODOS: Setenta e dois ratos Wistar (350-400g) foram randomizados em 2 grupos (n = 36): T grupo S (Sham) e grupo (Tratamento) e distribuídos em 12 subgrupos (n = 6): A-A6, e B1-B6. Os subgrupos A1-A3 foram submetidos a procedimentos "sham" aos 30 e 60 minutos. Trinta minutos antes do estudo, os ratos foram tratados com caseinato de cálcio, 0,5 g/kg (subgrupos A1, A4, B1 e B4), L-Gln, 0,5 g/kg (subgrupos A2, A5, B2 e B5) ou L-Ala -Gln, 0,75g/kg (subgrupos A3, A6, B3, B6), administrado por gavagem. A isquemia foi obtida por pinçamento dos vasos mesentéricos, delimitando um segmento do intestino cinco centímetros de comprimento e 5 cm da válvula ileocecal. Amostras foram coletadas aos 30-60 minutos para ensaio de PCR em tempo real das enzimas malato desidrogenases (MDH1-2), aspartato-aminotransferase (GOT1-2). RESULTADOS: A expressão de MDH e GOT mRNA nas amostras provenientes do intestino delgado de ratos pré-condicionados com L-Gln ou L-Ala-Gln não apresentou diferenças significativas, tanto durante a isquemia como na fase inicial de reperfusão. CONCLUSÃO: Ativação do ciclo malato-aspartato não parece ser o mecanismo de elevação glutamina-mediada da oxidação da glicose no intestino de ratos durante a isquemia / reperfusão.(AU)
Asunto(s)
Ratas , Ratas/clasificación , ARN , Intestinos/anatomía & histología , Isquemia , Malato Deshidrogenasa/genéticaRESUMEN
PURPOSE: To investigate the effect of alanyl-glutamine dipeptide (L-Ala-Gln) pre-treatment on ischemia-reperfusion (I/R) injury after unilateral testicular torsion-detorsion in a comparative controlled experiment. METHODS: Forty-eight rats (150-200 g) randomly distributed into 4 groups (n=12), and distributed in 2 subgroups (n=6) each, were treated with saline 2.0 ml (G-1, G-3) or L-Ala-Gln 20 percent, 0.75g/kg dissolved in saline (total volume 2.0 ml) administered in the left saphenous vein 30 minutes before ischemia. Anesthetized rats were subjected to I/R induced by torsion (720º) of the right spermatic cord lasting 1h (G-1, G-2) or 3 hours (G-3, G4). Anesthesia was again applied at the end of ischemia time (T-0) for testis detorsion and 6 hours later (T-6) for orchiectomy. All operations were performed on the right testes through transverse scrotal incisions. Right orchiectomy was carried out at the end of ischemia (T-0), and 6 hours later (T-6) to evaluate the concentrations of malondialdehyde (MDA) and reduced glutathione (GSH) in the testis. RESULTS: Pretreatment with L-Ala-Gln reduced MDA contents in rat testis at the end of ischemia lasting 3 hours. There was significant increase of GSH levels in T-6 time-point after 1 hour of ischemia. GSH levels also increased in T-0 and T-6 time-points in rats subjected to ischemia for 3 hours. CONCLUSION: L-Ala-Gln administered before torsion/detorsion of the spermatic cord decreases lipid peroxidation during ischemia and protects the testis from oxidative stress by upregulating GSH levels during reperfusion.(AU)
OBJETIVO: Investigar o efeito do pré-tratamento com o dipeptídeo L-alanil-glutamina (L-Ala-Gln) sobre a lesão de isquemia e reperfusão (I/R), induzida por torção/destorção do testículo em um experimento controlado e comparativo. MÉTODOS: Quarenta e oito ratos (150-200 g) divididos em quatro grupos (n=12) e distribuídos em dois subgrupos (n = 6) cada, foram tratados com 2,0 ml de solução salina (G-1, G-3 ) ou L-Ala-Gln 20 por cento, 0,75g/kg dissolvida em solução salina (volume total de 2,0 ml), administrada na veia safena 30 minutos antes da isquemia. Ratos anestesiados foram submetidos à torção (720º) do cordão espermático direito durante 1h (G-1, G-2) ou 3 horas (G-3, G4) para indução da I/R. A anestesia foi reaplicada no final do tempo de isquemia (T-0) para destorção do testículo e 6 horas depois (T-6) para orquiectomia. Todas as operações foram realizadas nos testículos direitos através de incisões escrotais. Orquiectomia direita foi realizada no final de isquemia (T-0), e seis horas depois (T-6) para avaliar as concentrações de malondialdeído (MDA) e glutationa reduzida (GSH) no testículo. RESULTADOS: O pré-tratamento com L-Ala-Gln reduziu os níveis de MDA no testículo de ratos no final da isquemia (3 horas). Entretanto os níveis de GSH aumentaram significativamente no T-6 após 1 hora de isquemia e também no T-0 e T-6 em ratos submetidos à isquemia por 3 horas. CONCLUSÃO: L-Ala-Gln administrada antes da torção/destorção do cordão espermático diminui a peroxidação lipídica na isquemia e protege o testículo contra o estresse oxidativo, promovendo aumento dos níveis de GSH durante a reperfusão.(AU)
Asunto(s)
Ratas , Heridas y Lesiones , Isquemia , Reperfusión , Testículo/anatomía & histología , Estrés OxidativoRESUMEN
PURPOSE: To investigate the effect of alanyl-glutamine dipeptide (L-Ala-Gln) pre-treatment on ischemia-reperfusion (I/R) injury after unilateral testicular torsion-detorsion in a comparative controlled experiment. METHODS: Forty-eight rats (150-200 g) randomly distributed into 4 groups (n=12), and distributed in 2 subgroups (n=6) each, were treated with saline 2.0 ml (G-1, G-3) or L-Ala-Gln 20 percent, 0.75g/kg dissolved in saline (total volume 2.0 ml) administered in the left saphenous vein 30 minutes before ischemia. Anesthetized rats were subjected to I/R induced by torsion (720°) of the right spermatic cord lasting 1h (G-1, G-2) or 3 hours (G-3, G4). Anesthesia was again applied at the end of ischemia time (T-0) for testis detorsion and 6 hours later (T-6) for orchiectomy. All operations were performed on the right testes through transverse scrotal incisions. Right orchiectomy was carried out at the end of ischemia (T-0), and 6 hours later (T-6) to evaluate the concentrations of malondialdehyde (MDA) and reduced glutathione (GSH) in the testis. RESULTS: Pretreatment with L-Ala-Gln reduced MDA contents in rat testis at the end of ischemia lasting 3 hours. There was significant increase of GSH levels in T-6 time-point after 1 hour of ischemia. GSH levels also increased in T-0 and T-6 time-points in rats subjected to ischemia for 3 hours. CONCLUSION: L-Ala-Gln administered before torsion/detorsion of the spermatic cord decreases lipid peroxidation during ischemia and protects the testis from oxidative stress by upregulating GSH levels during reperfusion.
OBJETIVO: Investigar o efeito do pré-tratamento com o dipeptídeo L-alanil-glutamina (L-Ala-Gln) sobre a lesão de isquemia e reperfusão (I/R), induzida por torção/destorção do testículo em um experimento controlado e comparativo. MÉTODOS: Quarenta e oito ratos (150-200 g) divididos em quatro grupos (n=12) e distribuídos em dois subgrupos (n = 6) cada, foram tratados com 2,0 ml de solução salina (G-1, G-3 ) ou L-Ala-Gln 20 por cento, 0,75g/kg dissolvida em solução salina (volume total de 2,0 ml), administrada na veia safena 30 minutos antes da isquemia. Ratos anestesiados foram submetidos à torção (720°) do cordão espermático direito durante 1h (G-1, G-2) ou 3 horas (G-3, G4) para indução da I/R. A anestesia foi reaplicada no final do tempo de isquemia (T-0) para destorção do testículo e 6 horas depois (T-6) para orquiectomia. Todas as operações foram realizadas nos testículos direitos através de incisões escrotais. Orquiectomia direita foi realizada no final de isquemia (T-0), e seis horas depois (T-6) para avaliar as concentrações de malondialdeído (MDA) e glutationa reduzida (GSH) no testículo. RESULTADOS: O pré-tratamento com L-Ala-Gln reduziu os níveis de MDA no testículo de ratos no final da isquemia (3 horas). Entretanto os níveis de GSH aumentaram significativamente no T-6 após 1 hora de isquemia e também no T-0 e T-6 em ratos submetidos à isquemia por 3 horas. CONCLUSÃO: L-Ala-Gln administrada antes da torção/destorção do cordão espermático diminui a peroxidação lipídica na isquemia e protege o testículo contra o estresse oxidativo, promovendo aumento dos níveis de GSH durante a reperfusão.
Asunto(s)
Animales , Masculino , Ratas , Dipéptidos/farmacología , Isquemia/complicaciones , Precondicionamiento Isquémico/métodos , Daño por Reperfusión/prevención & control , Testículo/irrigación sanguínea , Modelos Animales de Enfermedad , Dipéptidos/sangre , Glutatión/sangre , Malondialdehído/sangre , Estrés Oxidativo/efectos de los fármacos , Distribución Aleatoria , Ratas Wistar , Torsión del Cordón Espermático/complicaciones , Factores de Tiempo , Resultado del TratamientoRESUMEN
PURPOSE: To determine the effects of oral L-glutamine (L-Gln) and the dipeptide l-alanyl-glutamine (L-Ala-Gln) upon the activity of the malate-aspartate shuttle in the rat distal small intestine following ischemia and reperfusion. METHODS: Seventy-two Wistar rats (350-400g), were randomized in 2 groups (n = 36): group S (Sham) and Group T (Treatment) and divided into 12 subgroups (n = 6): A-A6, and B1-B6. The subgroups A1-A3 were subjected to sham procedures at 30 and 60 minutes. Thirty minutes before the study, rats were treated with calcium caseinate, 0.5g/Kg (subgroups A1, A4, B1, B4), L-Gln, 0.5g / kg (subgroups A2, A5, B2 and B5) or L-Ala-Gln, 0.75g/Kg (subgroups A3, A6, B3, B6), administered by gavage. Ischemia was achieved by clamping the mesenteric vessels, delimiting a segment of bowel 5 cm long and 5 cm apart from the ileocecal valve. Samples were collected 30 and 60 minutes after start of the study for real-time PCR assay of malate dehydrogenases (MDH1-2) and aspartate-aminotransferases (GOT1-2) enzymes. RESULTS: Tissue MDH and GOT mRNA expression in intestinal samples from rats preconditioned with either L-Gln or L-Ala-Gln showed no significant differences both during ischemia and early reperfusion. CONCLUSION: Activation of the malate-aspartate shuttle system appears not to be the mechanism of glutamine-mediated elevation of glucose oxidation in rat intestine during ischemia/reperfusion injury.
OBJETIVO: Determinar os efeitos da administração oral de L-glutamina (L-Gln) e do dipeptídeo L-alanil-glutamina (L-Ala-Gln) sobre a atividade do ciclo malato-aspartato no intestino delgado distal de ratos após isquemia/reperfusão. MÉTODOS: Setenta e dois ratos Wistar (350-400g) foram randomizados em 2 grupos (n = 36): T grupo S (Sham) e grupo (Tratamento) e distribuídos em 12 subgrupos (n = 6): A-A6, e B1-B6. Os subgrupos A1-A3 foram submetidos a procedimentos "sham" aos 30 e 60 minutos. Trinta minutos antes do estudo, os ratos foram tratados com caseinato de cálcio, 0,5 g/kg (subgrupos A1, A4, B1 e B4), L-Gln, 0,5 g/kg (subgrupos A2, A5, B2 e B5) ou L-Ala -Gln, 0,75g/kg (subgrupos A3, A6, B3, B6), administrado por gavagem. A isquemia foi obtida por pinçamento dos vasos mesentéricos, delimitando um segmento do intestino cinco centímetros de comprimento e 5 cm da válvula ileocecal. Amostras foram coletadas aos 30-60 minutos para ensaio de PCR em tempo real das enzimas malato desidrogenases (MDH1-2), aspartato-aminotransferase (GOT1-2). RESULTADOS: A expressão de MDH e GOT mRNA nas amostras provenientes do intestino delgado de ratos pré-condicionados com L-Gln ou L-Ala-Gln não apresentou diferenças significativas, tanto durante a isquemia como na fase inicial de reperfusão. CONCLUSÃO: Ativação do ciclo malato-aspartato não parece ser o mecanismo de elevação glutamina-mediada da oxidação da glicose no intestino de ratos durante a isquemia / reperfusão.