RESUMEN

INTRODUCTION: Degenerative lumbar disease (DLE) is a spectrum of pathological changes from disc degeneration, herniated disc, spondylolisthesis and lumbar canal stenosis. The pain associated with it is multifactorial. Muscle cramps are among the most frequent causes. The relationship between muscle degeneration and DLE has already been studied in the past in multiple studies, highlighting the one carried out by Kjaer & cols. OBJECTIVE: to determine the prevalence and severity of fatty degeneration in mutifidus spinae, and to study its relationship with clinical and radiographic factors. MATERIAL AND METHODS: observational and analytical study. Patients diagnosed with: herniated disc, lumbar canal stenosis or degenerative scoliosis were included. They were classified according to the Kjaer scale for paraspinal fatty infiltration in one of three groups. Clinical variables were analyzed: age, smoking, obesity, the presence of axial pain, temporality of pain, severity expressed with a visual analog scale (VAS); and radiographic: number of diseased segments, involved segments, diagnostic imaging and the presence of spondylolisthesis. RESULTS: 56 patients with an average age of 52.5 years (16 to 80) with a predominance of females with 62.5% were included. The diagnoses were nonspecific low back pain (1.8%), herniated disc (42.9%), narrow lumbar duct (46.4%) and lumbar duct with degenerative scoliosis deformity (8.9%). The distribution among the three groups described by Kjaer was as follows: 44.6% were classified with a fat infiltration score of 2. In groups 1 and 0, 39.3% and 16.1% were classified respectively. The variables significantly related to greater fat infiltration were: age > 60 years, diagnoses of lumbar canal stenosis and herniated disc; obesity, spondylolisthesis < 2 vertebral segments involved. Axial pain and VAS > 8 points were not related to greater muscle degeneration. CONCLUSIONS: fatty infiltration is present in all patients with some of the forms of DLE. Most patients > 60 years of age with advanced degenerative processes have a greater severity of infiltration. Other related variables are: obesity, spondylolisthesis and disease of < 2 vertebral segments. There is no relationship between a higher percentage of fatty infiltration and axial pain or higher VAS scores.

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INTRODUCCIÓN: la enfermedad lumbar degenerativa (ELD) es un espectro de cambios patológicos desde la degeneración discal, la hernia discal, la espondilolistesis y el conducto lumbar estrecho. El dolor que se le asocia es multifactorial. Los espasmos musculares son de las causas más frecuentes. La relación que guarda la degeneración muscular y la ELD ya ha sido estudiada en múltiples trabajos, destacando el realizado por Kjaer y colaboradores. OBJETIVO: determinar la prevalencia y severidad de la degeneración grasa en el mutifidus spinae, y estudiar su relación con variables clínicas y radiográficas. MATERIAL Y MÉTODOS: estudio observacional y analítico. Se incluyeron pacientes diagnosticados con: hernia discal, conducto lumbar estrecho o escoliosis degenerativa. Se clasificaron de acuerdo con escala de Kjaer para infiltración grasa paraespinal en alguno de tres grupos. Se analizaron variables clínicas: edad, tabaquismo, obesidad, presencia de dolor tipo axial, temporalidad del dolor, severidad del dolor expresada con escala visual análoga (EVA); y radiográficas: número de segmento enfermos, segmentos involucrados, diagnóstico por imagen y presencia de espondilolistesis. RESULTADOS: se incluyeron 56 pacientes con edad promedio de 52.5 años (rango 16 a 80) con predominio del sexo femenino (62.5%). Los diagnósticos fueron lumbalgia inespecífica (1.8%), hernia discal (42.9%), conducto lumbar estrecho (46.4%) y conducto lumbar con deformidad en escoliosis degenerativa (8.9%). La distribución entre los tres grupos descritos por Kjaer fue la siguiente: 44.6% fueron clasificados con un puntaje de infiltración grasa de 2. En los grupos 1 y 0, se clasificaron 39.3 y 16.1%, respectivamente. Las variables relacionadas con mayor infiltración grasa fueron: edad > 60 años, diagnósticos de conducto lumbar estrecho y hernia discal; obesidad, espondilolistesis < 2 segmentos vertebrales involucrados. El dolor mecánico y EVA > 8 puntos no se relacionaron con mayor degeneración muscular. CONCLUSIONES: la infiltración grasa está presente en todos los pacientes con alguna de las formas de ELD. La mayoría de los pacientes > 60 años con procesos degenerativos avanzados tienen mayor severidad de infiltración. Otras variables relacionadas son: obesidad, espondilolistesis y enfermedad < 2 segmentos vertebrales. No hay relación entre mayor porcentaje de infiltración grasa y dolor axial o puntajes más altos de dolor.

Asunto(s)

Degeneración del Disco Intervertebral , Desplazamiento del Disco Intervertebral , Escoliosis , Espondilolistesis , Femenino , Humanos , Masculino , Persona de Mediana Edad , Constricción Patológica/patología , Degeneración del Disco Intervertebral/diagnóstico por imagen , Degeneración del Disco Intervertebral/etiología , Vértebras Lumbares/diagnóstico por imagen , Obesidad , Dolor , Estudios Retrospectivos , Espondilolistesis/diagnóstico por imagen , Espondilolistesis/etiología

RESUMEN

PURPOSE: To evaluate the preliminary results of the use of 68 Gy EQD2(α/ß=3 Gy) as a dose limit to the lowest dose in the most exposed 2 cm3 of the vagina in order to reduce G2 late vaginal problems in postoperative endometrial carcinoma (EC). METHODS: From November 2016 to October 2019, 69 postoperative EC patients receiving vaginal brachytherapy (VBT) ± external beam radiotherapy (EBRT) were prospectively analyzed. The median EBRT dose was 45 Gy (range: 44-50.4 Gy), 1.8-2 Gy/day, 5 fractions(Fr)/week. VBT was administered with the following schedule: 1Fr of 7 Gy after EBRT and 2 daily Fr × 7.5 Gy in exclusive VBT. The dose was prescribed at 0.5 cm from the applicator surface with an active length of 2.5 cm; 56 patients were treated with vaginal cylinders (49-3.5 cm, 6-3 cm, and 1-2.5 cm) and 13 with the colpostat technique. The overall VBT dose was adjusted to meet the vaginal restriction of < 68 Gy EQD2(α/ß=3 Gy) at 2 cm3. Late toxicity was prospectively assessed using RTOG scores for bladder and rectum, and the objective LENT-SOMA criteria for vagina. RESULTS: With a median follow-up of 31.0 months, no vaginal-cuff recurrences were found. Late toxicity: only 1G1(1.4%) rectal toxicity; 21G1(30.4%) and 3G2(4.3%) vaginal complications. Only one (1.4%) of 3 G2 manifested as vaginal shortening. CONCLUSIONS: In postoperative EC patients treated with VBT, only one developed G2 vaginal stenosis with the use of 68 Gy EQD2(α/ß=3 Gy) as a dose constraint. These preliminary results seem to indicate the value of this dose limit for reducing G2 vaginal stenosis. Nonetheless, these findings should be confirmed in a larger number of patients with longer follow-up.

Asunto(s)

Braquiterapia , Neoplasias Endometriales , Braquiterapia/efectos adversos , Braquiterapia/métodos , Constricción Patológica/etiología , Constricción Patológica/patología , Neoplasias Endometriales/radioterapia , Neoplasias Endometriales/cirugía , Femenino , Humanos , Recto , Vagina/patología

RESUMEN

Maternal consumption of polyphenol-rich foods has been associated with fetal ductus arteriosus constriction (DAC), but safety of chocolate exposure in fetal life has not been studied. This experimental study tested the hypothesis that maternal cocoa consumption in late pregnancy causes fetal DAC, with possible associated antioxidant effects. Pregnant Wistar rats, at the 21st gestational day, received by orogastric tube cocoa (720 mg/Kg) for 12 h, indomethacin (10 mg/Kg), for 8 h, or only water, before cesaren section. Immediately after withdrawal, every thorax was obtained and tissues were fixed and stained for histological analysis. The ratio of the narrowest part of the pulmonary artery to the fetal ductus inner diameter and increased ductal inner wall thickness characterized ductal constriction. Substances reactive to thiobarbituric acid were quantified. Statistical analysis used ANOVA and Tukey test. Cocoa (n = 33) and indomethacin (n = 7) reduced fetal internal ductus diameter when compared to control (water, n = 25) (p < 0.001) and cocoa alone increased ductus wall thickness (p < 0.001), but no change was noted in enzymes activity. This pharmacological study shows supporting evidences that there is a cause and effect relationship between maternal consumption of cocoa and fetal ductus arteriosus constriction. Habitual widespread use of chocolate during gestation could account for undetected ductus constriction and its potentially severe consequences, such as perinatal pulmonary hypertension, cardiac failure and even death. For this reason, dietary guidance in late pregnancy to avoid high chocolate intake, to prevent fetal ductal constriction, may represent the main translational aspect of this study.

Asunto(s)

Chocolate/efectos adversos , Conducto Arterioso Permeable/etiología , Conducto Arterial/anomalías , Efectos Tardíos de la Exposición Prenatal/etiología , Animales , Constricción Patológica/etiología , Constricción Patológica/patología , Conducto Arterial/patología , Conducto Arterioso Permeable/patología , Femenino , Enfermedades Fetales/etiología , Enfermedades Fetales/patología , Feto/anomalías , Feto/patología , Masculino , Exposición Materna/efectos adversos , Embarazo , Efectos Tardíos de la Exposición Prenatal/patología , Ratas , Ratas Wistar

RESUMEN

Estenose de Junção Ureteropélvica (JUP) é uma doença caracterizada pelo bloqueio do fluxo de urina da pelve renal (porção proximal do ureter no rim) ao ureter, tubo que liga o rim à bexiga. Essa formação congênita é uma das maiores causas de dilatação do rim (hidronefrose) em recém-nascidos e, em alguns casos, pode causar danos mais severos ao órgão. A hidronefrose causada pela estenose de JUP pode desaparecer espontaneamente sem perda da função renal, entretanto, é preciso um acompanhamento clínico. Por outro lado, em casos mais severos, onde a dilatação pode causar danos maiores ao rim, um tratamento cirúrgico se faz necessário. Embora existam métodos para o diagnóstico da estenose de JUP, como ultrassonografia, tomografia computadorizada, ressonância e cintilografia, é um grande desafio diferenciar os pacientes que requerem um tratamento cirúrgico e os que necessitam apenas de um acompanhamento convencional. A metabolômica global, que investiga de modo comparativo o conjunto de metabólitos de baixa massa molecular expressos em indivíduos em condições pré-selecionadas, tem o potencial de servir como ferramenta diagnóstica para os pacientes com estenose de JUP e, consequentemente, auxiliar na tomada de decisão entre um acompanhamento clínico ou tratamento cirúrgico. Assim sendo, no presente trabalho, três grupos de pacientes com estenose de JUP, pré-diagnosticados por métodos convencionais, foram investigados sob a perspectiva da metabolômica global, por meio de análises de urina, utilizando cromatografia gasosa e cromatografia líquida, ambas acoplada à espectrometria de massas (GC-MS e RPLC10 MS, respectivamente): pacientes que requerem tratamento cirúrgico (CIR), pacientes que requerem acompanhamento clínico (CLI), e indivíduos sãos (CON). Os resultados mostram que é possível encontrar metabólitos discriminantes entre todas as comparações (CON x CLI, CON x CIR e CLI x CIR); os metabólitos encontrados nas análises multivariada e univariada foram utilizados para construção da curva ROC, para confirmar a possibilidade de utilização desses compostos como biomarcadores. Foram observadas alterações em rotas metabólicas importantes para o bom funcionamento das funções renais, principalmente entre a comparação mais desafiadora (CLI x CIR), como o metabolismo da fenilalanina, da tirosina, da beta-alanina, dos aminoaçúcares e dos nucleotídeos. Há indícios de que o ciclo de Krebs também sofre alteração. Os resultados obtidos podem servir como ponto de partida para uma futura análise alvo e validação biológica

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Ureteropelvic junction (UPJ) stenosis is a disease characterized by the interruption of the flow of urine from the renal pelvis (proximal part of ureter in the kidney) to the ureter, tube that links the kidney to bladder. That congenital formation is one of the main causes of kidney dilation (hydronephrosis) in newborns and, sometimes, can cause more serious damage to the organ. The hydronephrosis caused by UPJ stenosis can disappear spontaneously without compromising renal function, although a clinical follow-up is required. On the other hand, in more serious cases, when dilation can induce larger damage to the kidney, surgery intervention is necessary. Although there are methods to diagnose UPJ stenosis, such as ultrasound, computed tomography, resonance and scintigraphy, it is still a great challenge to distinguish patients that require surgery from those whose a clinical follow-up suffices. Global metabolomics, a method that investigates in a comparative manner the set of low molecular mass metabolites expressed by an individual in pre-selected conditions, has the potential to function as a diagnostic tool for patients with UPJ stenosis to support decisions about patient treatment, i.e., surgery versus clinical follow-up. In this work, three groups of UPJ stenosis patients were investigated with the aid of global metabolomics using urine analysis by gas chromatography and liquid chromatography coupled to mass spectrometry (GC-MS and RPLC-MS, respectively): one group consisted of UPJ stenosis patients requiring clinical follow-up (CLI), other group UPJ stenosis patients requiring surgery intervention (CIR) and a third group comprising healthy individuals, the control group (CON).12 The results show that it was possible to find discriminant metabolites among all pairwise comparisons (CON versus CLI, CON versus CIR and CLI versus CIR). The metabolites found by multivariate and univariate analyses were used to build ROC curves, to confirm whether it is possible to use them as biomarkers. Alterations in metabolic pathways that are important for the good maintenance of kidney functions were found, especially in the most challenged comparison (CLI versus CIR), such as the metabolism of phenylalanine, tyrosine, beta-alanine, amino acids and nucleotides. There are evidences that Krebs cycle was also impacted. The results obtained here can serve as a starting point to future targeted analysis and biological validation

Asunto(s)

Humanos , Masculino , Femenino , Niño , Niño , Constricción Patológica/patología , Metabolómica/clasificación , Fenilalanina/agonistas , Espectrometría de Masas/métodos , Vejiga Urinaria/anomalías , Biomarcadores/química , Tomografía Computarizada por Rayos X/instrumentación , Cromatografía de Gases/métodos , Cromatografía Liquida/métodos

Asunto(s)

Ainhum/genética , Constricción Patológica/genética , Queratodermia Palmoplantar/genética , Mutación Missense/genética , Canales Catiónicos TRPV/genética , Administración Tópica , Adulto , Ainhum/diagnóstico , Ainhum/patología , Biopsia , Constricción Patológica/diagnóstico , Constricción Patológica/patología , Cuba/epidemiología , Femenino , Humanos , Queratodermia Palmoplantar/diagnóstico , Queratodermia Palmoplantar/tratamiento farmacológico , Queratodermia Palmoplantar/patología , Ácido Láctico/administración & dosificación , Ácido Láctico/uso terapéutico , Linaje , Canales Catiónicos TRPV/metabolismo , Urea/administración & dosificación , Urea/uso terapéutico

RESUMEN

Sclerosing mediastinitis (SM), previously named chronic fibrosing mediastinitis, is an inflammatory process that in its end-stage results to sclerosis around the mediastinal structures. SM is quite rare and has been correlated with inflammatory and autoimmune diseases, as well as malignancy. SM may either present in a mild form, with minor symptoms and a benign course or in a more aggressive form with severe pulmonary hypertension and subsequent higher morbidity and mortality. The diagnosis of SM may be difficult and quite challenging, as symptoms depend on the mediastinal structure that is mainly involved; quite often the superior vena cava. However, practically any mediastinal structure may be involved by the fibrotic process, such as the central airways, as well as the pulmonary arteries and veins, leading to obstruction or total occlusion. The latter may be impossible to undergo proper surgical excision of the lesion, and is considered to be a real challenge to the surgeon. We herein report a case of SM that presented with arterial and venous compression. The imaging appearance was that of unilateral pulmonary edema, associated with lung collapse. The case is supplemented by a non-systematic review of the relevant literature.

Asunto(s)

Mediastinitis/complicaciones , Atelectasia Pulmonar/etiología , Edema Pulmonar/etiología , Esclerosis/complicaciones , Adulto , Biopsia , Constricción Patológica/diagnóstico por imagen , Constricción Patológica/patología , Femenino , Atrios Cardíacos/diagnóstico por imagen , Atrios Cardíacos/patología , Humanos , Mediastinitis/diagnóstico por imagen , Mediastinitis/patología , Atelectasia Pulmonar/diagnóstico por imagen , Atelectasia Pulmonar/patología , Edema Pulmonar/diagnóstico por imagen , Edema Pulmonar/patología , Radiografía Torácica , Esclerosis/diagnóstico por imagen , Esclerosis/patología , Tomografía Computarizada por Rayos X

RESUMEN

Abstract Sclerosing mediastinitis (SM), previously named chronic fibrosing mediastinitis, is an inflammatory process that in its end-stage results to sclerosis around the mediastinal structures. SM is quite rare and has been correlated with inflammatory and autoimmune diseases, as well as malignancy. SM may either present in a mild form, with minor symptoms and a benign course or in a more aggressive form with severe pulmonary hypertension and subsequent higher morbidity and mortality. The diagnosis of SM may be difficult and quite challenging, as symptoms depend on the mediastinal structure that is mainly involved; quite often the superior vena cava. However, practically any mediastinal structure may be involved by the fibrotic process, such as the central airways, as well as the pulmonary arteries and veins, leading to obstruction or total occlusion. The latter may be impossible to undergo proper surgical excision of the lesion, and is considered to be a real challenge to the surgeon. We herein report a case of SM that presented with arterial and venous compression. The imaging appearance was that of unilateral pulmonary edema, associated with lung collapse. The case is supplemented by a non-systematic review of the relevant literature.

Asunto(s)

Humanos , Femenino , Adulto , Edema Pulmonar/etiología , Atelectasia Pulmonar/etiología , Esclerosis/complicaciones , Mediastinitis/complicaciones , Edema Pulmonar/diagnóstico por imagen , Atelectasia Pulmonar/patología , Atelectasia Pulmonar/diagnóstico por imagen , Biopsia , Radiografía Torácica , Tomografía Computarizada por Rayos X , Constricción Patológica/patología , Constricción Patológica/diagnóstico por imagen , Atrios Cardíacos/patología , Atrios Cardíacos/diagnóstico por imagen , Mediastinitis/patología , Mediastinitis/diagnóstico por imagen

RESUMEN

Heart failure (HF) is a cardiovascular syndrome characterized by maladaptive changes with an underlying inflammatory mediated pathogenesis. Nevertheless, current therapy is aimed at the heart workload and neurohormonal axis; thus, prognosis remains poor. To continue improving treatment, we rely on murine models for a better understanding of HF pathophysiology. Among them, pressure overload HF (PO-HF) animal models are a common strategy. Development of PO-HF is characterized by monocyte infiltration, which orchestrates a cascade of events leading to sustained inflammation and maladaptive changes. Here, we divide the PO-HF model progression into four phases and describe the inflammatory, structural, and gene expression profiles. This division is relevant due to its similarities with clinical hypertensive heart disease progression to HF. Evidence shows improvement in hemodynamic and other local parameters by altering the inflammatory response in a specific immune response at a specific point of time. Thus, it is relevant to focus on the time-dependent immune response interaction in order to provide more effective therapy. This review summarizes the pathogenesis of PO-HF murine models, highlighting the inflammatory events in a time frame view. By this approach, we expect to provide researchers with a better understanding of the intertwining time-dependent events that occur in PO-HF.

Asunto(s)

Linfocitos B/inmunología , Insuficiencia Cardíaca/inmunología , Hipertensión/inmunología , Monocitos/inmunología , Linfocitos T/inmunología , Angiotensina II/administración & dosificación , Angiotensina II/efectos adversos , Animales , Aorta/inmunología , Aorta/patología , Linfocitos B/patología , Cardiomegalia/inmunología , Cardiomegalia/patología , Movimiento Celular , Constricción Patológica/inmunología , Constricción Patológica/patología , Citocinas/biosíntesis , Citocinas/inmunología , Modelos Animales de Enfermedad , Fibrosis Endomiocárdica/inmunología , Fibrosis Endomiocárdica/patología , Insuficiencia Cardíaca/inducido químicamente , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/patología , Humanos , Hipertensión/complicaciones , Hipertensión/patología , Ratones , Monocitos/patología , Linfocitos T/patología , Factores de Tiempo , Disfunción Ventricular Izquierda/inmunología , Disfunción Ventricular Izquierda/patología

RESUMEN

Oesophageal squamous cell carcinomas (SCCs) may be observed as exophytic masses or ulcerative or infiltrative endophytic neoplasms. However, in cattle, there is also an uncommon gross presentation as an annular stenotic thickening of the oesophageal wall. Thirteen cases of annular stenotic oesophageal SCC in cattle grazing in bracken fern (Pteridium arachnoideum) areas are reported. The lesions consisted of endophytic masses, focally extensive, firm and circumferential (annular) in the oesophageal wall. Pronounced wrinkling of the mucosa, with retracted uneven areas and subsequent luminal narrowing (stenosis), was observed in all cases. Papillomas and squamous intraepithelial lesions also were observed in these cases. The SCCs were graded as well differentiated (n = 7), moderately differentiated (n = 5) or poorly differentiated (n = 1). The neoplastic keratinocytes were surrounded by moderate to abundant fibrous connective tissue (a desmoplastic reaction), that was better demonstrated by Masson's trichrome stain. Picrosirius red-stained sections showed abundant collagen type I fibres, which contributed to the stenosing characteristics of this tumour. Although it might be easily misdiagnosed as oesophageal scar tissue, the oesophageal SCCs of cattle grazing bracken fern may have a distinctive gross appearance that should be included in the differential diagnosis of oesophageal stenosis.

Asunto(s)

Carcinoma de Células Escamosas/veterinaria , Enfermedades de los Bovinos/etiología , Enfermedades de los Bovinos/patología , Neoplasias Esofágicas/veterinaria , Pteridium/efectos adversos , Animales , Bovinos , Constricción Patológica/etiología , Constricción Patológica/patología , Carcinoma de Células Escamosas de Esófago , Femenino

RESUMEN

OBJECTIVE: This study investigated the role of oxidative damage and nitric oxide (NO) synthases in the fetal heart using a model of intrauterine growth restriction induced by uteroplacental circulation restriction (UCR). METHODS: New Zealand white rabbits kept under 12-h light cycles, with food and water provided ad libitum, were subjected at day 25 of pregnancy to 40-50% uteroplacental artery ligation. We analyzed the gene expression of enzymes linked to nitric oxide synthesis (iNOS, eNOS, HO-1, and ARG-2), hypoxia inducible factor 1 alpha (HIF-1α), and the state of oxidative stress (protein carbonyl levels) in fetal heart homogenates. Additionally, we studied the histological morphology of the fetal heart. RESULTS: We found that fetal growth restriction was associated with a significant reduction in heart weight but a normal heart/body weight ratio in UCR animals. Hematoxylin and eosin staining showed normal left and right ventricular thickness but increased vessel dilatation with hyperemia in the hearts of the UCR group. We observed HIF-1α, eNOS, p-eNOS, and iNOS induction concomitant with intensified protein carbonyl levels but observed no changes in HO-1 or ARG-2 expression, suggesting increased NO and oxidative stress in the hearts of UCR animals. CONCLUSION: Uteroplacental circulation restriction increased NO-linked enzymes, oxidative damage, and dilated coronary vessels in fetal hearts. © 2017 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.

Asunto(s)

Retardo del Crecimiento Fetal , Corazón Fetal/metabolismo , Corazón Fetal/patología , Óxido Nítrico Sintasa/genética , Estrés Oxidativo/fisiología , Circulación Placentaria , Animales , Constricción Patológica/genética , Constricción Patológica/metabolismo , Constricción Patológica/patología , Estenosis Coronaria/genética , Estenosis Coronaria/metabolismo , Estenosis Coronaria/patología , Inducción Enzimática , Femenino , Retardo del Crecimiento Fetal/genética , Retardo del Crecimiento Fetal/patología , Regulación del Desarrollo de la Expresión Génica , Embarazo , Conejos

RESUMEN

This review aimed to investigate possible protective or deleterious effects of polyphenol-rich foods (PRF) on chronic diseases, e.g. cardiovascular, and in pregnant women, along with their antioxidant and anti-inflammatory action. A great variety of foods and beverages, such as herbal teas, grape and orange derivatives, dark chocolate, and many others contain high concentrations of flavonoids and are freely consumed by the general population. In humans, PRF consumption reduces lipid peroxidation, and several studies have shown a positive correlation between an increased consumption of PRF and a decrease in the incidence of cardiovascular disease. On the other hand, current studies have suggested that maternal ingestion of PRF, especially during the third trimester of pregnancy, could be associated to fetal ductal constriction (DC). Fetuses exposed to this type of diet show higher ductal velocities and lower pulsatility indexes, as well as larger right ventricles than those exposed to minimal amounts of these substances. The underlying mechanism involved in these conditions has not been entirely elucidated, but it seems to be a result of the antioxidant and anti-inflammatory effects of polyphenols by some pathway. Furthermore, taking into account the deleterious effect in late-pregnancy against the numerous positive effects associated to polyphenols, this dual behavior deserves attention particularly to control the dietary ingestion of PRF during gestation. In this line, same PRF, natural constituents of human diet, may represent risk to fetal in late pregnancy compared to the use of nonsteroidal anti-inflammatory drugs.

Asunto(s)

Antioxidantes , Enfermedades Cardiovasculares , Desarrollo Fetal/efectos de los fármacos , Exposición Materna/efectos adversos , Polifenoles , Antiinflamatorios/efectos adversos , Antiinflamatorios/farmacología , Antioxidantes/efectos adversos , Antioxidantes/farmacología , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Constricción Patológica/inducido químicamente , Constricción Patológica/diagnóstico por imagen , Constricción Patológica/patología , Dieta/efectos adversos , Conducto Arterial/efectos de los fármacos , Conducto Arterial/embriología , Conducto Arterial/patología , Femenino , Análisis de los Alimentos , Humanos , Incidencia , Masculino , Polifenoles/efectos adversos , Polifenoles/farmacología , Embarazo , Fenómenos Fisiologicos de la Nutrición Prenatal , Ultrasonografía Prenatal

RESUMEN

BACKGROUND: Mutant rodent models have highlighted the importance of the ventricular ependymal cells and the subcommissural organ (a brain gland secreting glycoproteins into the cerebrospinal fluid) in the development of fetal onset hydrocephalus. Evidence indicates that communicating and non-communicating hydrocephalus can be two sequential phases of a single pathological phenomenon triggered by ependymal disruption and/or abnormal function of the subcommissural organ. We have hypothesized that a similar phenomenon may occur in human cases with fetal onset hydrocephalus. CASE PRESENTATION: We report here on a case of human fetal communicating hydrocephalus with no central nervous system abnormalities other than stenosis of the aqueduct of Sylvius (SA) that became non-communicating hydrocephalus during the first postnatal week due to obliteration of the cerebral aqueduct. The case was followed closely by a team of basic and clinic investigators allowing an early diagnosis and prediction of the evolving pathophysiology. This information prompted neurosurgeons to perform a third ventriculostomy at postnatal day 14. The fetus was monitored by ultrasound, computerized axial tomography and magnetic resonance imaging (MRI). After birth, the follow up was by MRI, electroencephalography and neurological and neurocognitive assessments. Cerebrospinal fluid (CSF) collected at surgery showed abnormalities in the subcommissural organ proteins and the membrane proteins L1-neural cell adhesion molecule and aquaporin-4. The neurological and neurocognitive assessments at 3 and 6 years of age showed neurological impairments (epilepsy and cognitive deficits). CONCLUSIONS: (1) In a hydrocephalic fetus, a stenosed SA can become obliterated at perinatal stages. (2) In the case reported, a close follow up of a communicating hydrocephalus detected in utero allowed a prompt postnatal surgery aiming to avoid as much brain damage as possible. (3) The clinical and pathological evolution of this patient supports the possibility that the progressive stenosis of the SA initiated during the embryonic period may have resulted from ependymal disruption of the cerebral aqueduct and dysfunction of the subcommissural organ. The analysis of subcommissural organ glycoproteins present in the CSF may be a valuable diagnostic tool for the pathogenesis of congenital hydrocephalus.

Asunto(s)

Acueducto del Mesencéfalo/patología , Hidrocefalia/diagnóstico , Órgano Subcomisural/patología , Constricción Patológica/patología , Femenino , Feto , Glicoproteínas/metabolismo , Humanos , Imagen por Resonancia Magnética , Embarazo

RESUMEN

BACKGROUND: The anterior pretectal nucleus (APtN) activates descending mechanisms of pain control. This study evaluated whether the APtN also controls neuropathic pain in rats. METHODS: The hypersensitivity to mechanical stimulation with an electronic von Frey apparatus and the number of Fos-immunoreactive (Fos-ir) neurons in the APtN were evaluated in rats before and after chronic constriction injury of the sciatic nerve. RESULTS: The tactile hypersensitivity was characterized by an initial phase (the 2 days following the injury) and a maintenance phase (the subsequent 7 days). The injection of 2% lidocaine (0.25 µL) or N-methyl-D-aspartate (2.5 µg/0.25 µL) into the APtN intensified the tactile hypersensitivity observed 2 days after injury but did not alter the tactile hypersensitivity observed 7 and 14 days after injury. The injection of naloxone (10 ng/0.25 µL) or methysergide (40 pg/0.25 µL) but not atropine (100 ng/0.25 µL) into the APtN also intensified the tactile hypersensitivity observed 2 days after the injury. A significant increase in the number of Fos-ir cells was found in the contralateral APtN 2 days but not 7 or 14 days after the injury. Electrical stimulation of the APtN reduced the tactile hypersensitivity at 2, 7 and 14 days after the nerve ligation. CONCLUSION: APtN exerts a tonic inhibitory influence on persistent pain. The results point out to an important role of opioid and serotonergic mediation into the APtN to inhibit hyperalgesia during the initial phase of neuropathic pain.

Asunto(s)

Vías Nerviosas/patología , Neuralgia/patología , Área Pretectal/patología , Anestésicos Locales/administración & dosificación , Anestésicos Locales/farmacología , Animales , Constricción Patológica/complicaciones , Constricción Patológica/patología , Hiperalgesia/fisiopatología , Lidocaína/administración & dosificación , Lidocaína/farmacología , Masculino , Metisergida/farmacología , N-Metilaspartato/administración & dosificación , N-Metilaspartato/farmacología , Naloxona/farmacología , Antagonistas de Narcóticos/farmacología , Neuronas/patología , Dimensión del Dolor/efectos de los fármacos , Estimulación Física , Proteínas Proto-Oncogénicas c-fos/metabolismo , Ratas , Ratas Wistar , Neuropatía Ciática/patología

RESUMEN

OBJECTIVE: To assess the morphological changes of penile vascular structures and the corpus cavernosum area in alloxan-induced diabetic rabbits. MATERIALS AND METHODS: Twenty male rabbits (2 months old) were divided into two groups with 10 rabbits each, the control group (CG) and the diabetic group (DG). The animals from DG received an intravenous injection of alloxan (100mg/kg) to induce the diabetes. Ten weeks after the induction of diabetes, all animals were euthanized. Two fragments of the penile shaft were harvested and samples were processed and paraffin embedded. Sections (5 µm) were cut and stained for histological and immunohistochemical markers. RESULTS: Nuclear protrusion toward the lumen, and cytoplasmic vacuolization were observed in the tunica intima of the dorsal artery of the penis in DG. The thicknesses of the tunica media increased significantly in DG (p = 0.0350). It was also observed a significant increase in the area of the tunica media (p = 0.0179). There was no significant change in smooth muscle cell density in the tunica media of the dorsal artery of the penis (p = 0.0855). The collagen fiber pattern of the tunica adventitia of the dorsal artery of the penis was different between the control and diabetic groups. There was a significant decrease in the area occupied by the cavernous sinuses in DG (p = 0.0013). CONCLUSION: Alloxan-induced diabetes mellitus in rabbits promotes important changes in penile vascular structures, thereby decreasing blood supply and affecting penile hemodynamics, leading to erectile dysfunction.

Asunto(s)

Diabetes Mellitus Experimental/patología , Pene/irrigación sanguínea , Enfermedades Vasculares/patología , Aloxano , Animales , Glucemia/análisis , Constricción Patológica/complicaciones , Constricción Patológica/patología , Diabetes Mellitus Experimental/complicaciones , Disfunción Eréctil/etiología , Hemodinámica , Humanos , Hipertrofia/patología , Inmunohistoquímica , Masculino , Miocitos del Músculo Liso/patología , Erección Peniana , Conejos , Enfermedades Vasculares/complicaciones

RESUMEN

Objective To assess the morphological changes of penile vascular structures and the corpus cavernosum area in alloxan-induced diabetic rabbits. Materials and Methods Twenty male rabbits (2 months old) were divided into two groups with 10 rabbits each, the control group (CG) and the diabetic group (DG). The animals from DG received an intravenous injection of alloxan (100mg/kg) to induce the diabetes. Ten weeks after the induction of diabetes, all animals were euthanized. Two fragments of the penile shaft were harvested and samples were processed and paraffin embedded. Sections (5µm) were cut and stained for histological and immunohistochemical markers. Results Nuclear protrusion toward the lumen, and cytoplasmic vacuolization were observed in the tunica intima of the dorsal artery of the penis in DG. The thicknesses of the tunica media increased significantly in DG (p = 0.0350). It was also observed a significant increase in the area of the tunica media (p = 0.0179). There was no significant change in smooth muscle cell density in the tunica media of the dorsal artery of the penis (p = 0.0855). The collagen fiber pattern of the tunica adventitia of the dorsal artery of the penis was different between the control and diabetic groups. There was a significant decrease in the area occupied by the cavernous sinuses in DG (p = 0.0013). Conclusion Alloxan-induced diabetes mellitus in rabbits promotes important changes in penile vascular structures, thereby decreasing blood supply and affecting penile hemodynamics, leading to erectile dysfunction. .

Asunto(s)

Animales , Humanos , Masculino , Conejos , Diabetes Mellitus Experimental/patología , Pene/irrigación sanguínea , Enfermedades Vasculares/patología , Aloxano , Glucemia/análisis , Constricción Patológica/complicaciones , Constricción Patológica/patología , Diabetes Mellitus Experimental/complicaciones , Disfunción Eréctil/etiología , Hemodinámica , Hipertrofia/patología , Inmunohistoquímica , Miocitos del Músculo Liso/patología , Erección Peniana , Enfermedades Vasculares/complicaciones

RESUMEN

There is accumulating evidence that substance P released from peripheral sensory neurons participates in inflammatory and neuropathic pain. In this study it was investigated the ability of substance P to induce orofacial nociception and thermal and mechanical hyperalgesia, as well as the role of NK1 receptors on models of orofacial inflammatory and neuropathic pain. Substance P injected into the upper lip at 1, 10 and 100 µg/50 µL failed to induce nociceptive behavior. Also, substance P (0.1-10 µg/50 µL) injected into the upper lip did not evoke orofacial cold hyperalgesia and when injected at 1 µg/50 µL did not induce mechanical hyperalgesia. However, substance P at this latter dose induced orofacial heat hyperalgesia, which was reduced by the pre-treatment of rats with a non-peptide NK1 receptor antagonist (SR140333B, 3mg/kg). Systemic treatment with SR140333B (3 mg/kg) also reduced carrageenan-induced heat hyperalgesia, but did not exert any influence on carrageenan-induced cold hyperalgesia. Blockade of NK1 receptors with SR140333B also reduced by about 50% both phases of the formalin response evaluated in the orofacial region. Moreover, heat, but not cold or mechanical, hyperalgesia induced by constriction of the infraorbital nerve, a model of trigeminal neuropathic pain, was abolished by pretreatment with SR140333B. Considering that substance P was peripherally injected (i.e. upper lip) and the NK1 antagonist used lacks the ability to cross the blood-brain-barrier, our results demonstrate that the peripheral SP/NK1 system participates in the heat hyperalgesia associated with inflammation or nerve injury and in the persistent pain evoked by formalin in the orofacial region.

Asunto(s)

Dolor Facial/fisiopatología , Inflamación/fisiopatología , Neuralgia/fisiopatología , Receptores de Neuroquinina-1/efectos de los fármacos , Sustancia P/farmacología , Animales , Conducta Animal/efectos de los fármacos , Conducta Animal/fisiología , Frío , Constricción Patológica/patología , Dolor Facial/inducido químicamente , Dolor Facial/psicología , Aseo Animal/efectos de los fármacos , Calor , Hiperalgesia/fisiopatología , Hiperalgesia/psicología , Inflamación/inducido químicamente , Inyecciones , Labio , Masculino , Neuralgia/inducido químicamente , Neuralgia/psicología , Antagonistas del Receptor de Neuroquinina-1/farmacología , Dimensión del Dolor , Estimulación Física , Ratas , Ratas Wistar , Sustancia P/administración & dosificación , Tropanos/farmacología

RESUMEN

PURPOSE: To evaluate the topical effects of mitomycin C (MMC) in rats, with or without esophageal dilation, in different moments after esophageal caustic injury with NaOH10%. METHODS: Forty eight Wistar rats were divided into six groups: "GS" infusion of 0.9% saline solution in the esophagus; "CG" infusion of 0.9% saline solution in the esophagus, with temporary ligation of the organ; "NTG" induction of a caustic lesion without treatment; "GmmcD0" MMC applied immediately after the caustic injury; "GmmcD14" MMC applied 14 days after the caustic injury; "Gdil+mmcD14" esophageal dilation and application of MMC 14 days after caustic injury. We performed contrast esophagograms of four animals from each group, seven and 21 days after the caustic injury. On day 28, all animals were sacrificed, and histopathological analyses were performed on the esophageal specimens. RESULTS: The contrast images showed total stenosis in NTG and GmmcD0, improving to partial stenosis in GmmcD0. In GmmcD14 and Gdil+mmcD14, two animals of each group improved to partial stenosis. By histopathological analysis, NTG and GmmcD14 presented intermediate damage and GmmcD0 and Gdil+mmcD14 severe damage. CONCLUSION: The use of mitomycin C had beneficial effects specially when applied immediately after the induction of esophageal lesions.(AU)

Asunto(s)

Animales , Mitomicina/análisis , Heridas y Lesiones/complicaciones , Esofagitis , Ratas/clasificación , Constricción Patológica/patología

RESUMEN

Antecedentes: La terapia endovascular neurológica ha evolucionado rápidamente en un período de tiempo relativamente corto. Esta técnica ha pasado de sus propósitos iniciales, enfocados a pacientes en los que la cirugía abierta no representaba una buena opción, a convertirse en una corriente de la práctica cotidiana. Objetivo: Exponer los resultados obtenidos en pacientes con diversas patologías cerebrales abordados por terapia endovascular, durante un período de 24 meses, con la finalidad de analizar los beneficios de este método terapéutico. Metodología: Estudio observacional, retrospectivo, analítico, que incluye como población todos los pacientes con patología cerebral intervenidos mediante terapia endovascular, en el Grupo Hospitalario Kennedy, Centro de Intervencionismo Angio Manabí, Hospital Luis Vernaza y Clínica Guayaquil; durante el período comprendido entre junio de 2010 a mayo de 2012. Resultados: Las patologías más diagnosticadas fueron aneurismas cerebrales con 75 por ciento (n = 175) de los casos, seguido por malformaciones arteriovenosas con 14 por ciento (n = 33). Las complicaciones observadas fueron migración de coil y ruptura de un aneurisma durante su embolización. Se observó una mortalidad total de 2,82 por ciento, relacionada con mal estado clínico y alto grado imagenológico de pacientes con aneurismas cerebrales. Posterior a la intervención, 96,23 por ciento (n = 204) de los pacientes permanecen en grado Rankin 1. Conclusiones: La terapia endovascular neurológica ha obtenido resultados altamente satisfactorios en diversas patologías del sistema nervioso, con bajo índice de complicaciones y morbimortalidad; constituyendo así una excelente elección en el manejo de estas patologías.

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Background: Endovascular therapy has evolved rapidly over a relatively short period of time. This technique has evolved from its initial purposes, to treat patients for whom no good open surgical option existed, to become a mainstream of everyday practice. Objective: To present obtained results in patients with brain diseases approach by endovascular therapy, for a period of 24 months, in order to analyze the benefits of this therapeutic method. Methodology: Observational, retrospective, analytical study, of all patients with brain diseases treated by endovascular therapy at Grupo Hospitalario Kennedy, Centro de Intervencionismo AngioManabí, Hospital Luis Vernaza and Clínica Guayaquil, from June 2010 to May 2012. Results: Conditions most commonly diagnosed were brain aneurysms with 75 percent (n = 175) of cases, followed by arteriovenous malformations with 14 percent (n = 33). Complications observed were coil migration in two cases, and aneurysms rupture during the embolization. There was a total mortality of 2,82 percent, related to poor clinical condition and high imaging grade in patients with intracranial aneurysms. After intervention, 96,23 percent (n = 204) of the patients are in Rankin grade 1. Conclusions: Endovascular therapy has achieved highly satisfactory results in several diseases of the nervous system, with low rate of complications and morbid-mortality, making it an excellent choice in the management of these pathologies.

Asunto(s)

Humanos , Masculino , Adulto , Femenino , Adulto Joven , Persona de Mediana Edad , Anciano de 80 o más Años , Fístula Arteriovenosa , Malformaciones Arteriovenosas , Arterias Cerebrales/patología , Constricción Patológica/patología , Embolización Terapéutica/métodos , Encefalopatías/terapia , Aneurisma Intracraneal , Procedimientos Endovasculares/métodos , Hemorragia Subaracnoidea , Ecuador , Estudios Observacionales como Asunto , Estudios Retrospectivos

RESUMEN

OBJECTIVES: The aim of this study was to test the hypothesis that experimental maternal intake of green tea in late pregnancy causes fetal ductus arteriosus constriction, probably because of prostaglandin inhibition. METHODS AND RESULTS: Twelve fetal lambs (pregnancy > 120 days) were assessed before and after maternal administration of green tea (n = 8) or water (n = 4; controls) as the only source of liquid. After 1 week, echocardiography showed signs of constriction of the ductus arteriosus in all fetuses from mothers ingesting green tea, with increase in mean systolic velocity(from 0.70 ± 0.19 m/s to 0.92 ± 0.15 m/s, 31.4%, p = 0.001) and mean diastolic velocity (0.19 ± 0.05 m/s to 0.31 ± 0.01 m/s, 63.1%, p < 0.001), decrease of pulsatility index (2.2 ± 0.4 to 1.8 ± 0.3, 22.2%, p = 0.003) and increase of mean right ventricular/left ventricular diameter ratio (0.89 ± 0.14 to 1.43 ± 0.23, 60.6%, p < 0.001). In the four control fetuses, there were no significant changes. All lambs exposed to green tea also showed at autopsy dilated and hypertrophic right ventricles, which was not present in control fetuses. Histological analysis showed a significantly larger mean thickness of the medial avascular zone of the ductus arteriosus in fetuses exposed to green tea than in controls (747.6 ± 214.6 µm vs 255.3 ± 97.9 µm, p < 0.001). CONCLUSIONS: This study in fetal lambs shows a cause and effect relationship between experimental maternal exposure of green tea and fetal ductus arteriosus constriction in late pregnancy.

Asunto(s)

Conducto Arterial/embriología , Edad Gestacional , Ovinos/embriología , Té/efectos adversos , Animales , Constricción Patológica/diagnóstico por imagen , Constricción Patológica/patología , Constricción Patológica/veterinaria , Conducto Arterial/diagnóstico por imagen , Conducto Arterial/patología , Femenino , Modelos Animales , Embarazo , Antagonistas de Prostaglandina , Ultrasonografía Prenatal/veterinaria

RESUMEN

In this study, we describe the presence of apoptosis, associated with a mitochondrial dysfunction in the hippocampus of animals in an experimental model defined as minimal hepatic encephalopathy (MHE). This experimental model was studied after 10 days of induced portal vein calibrated stricture, leading to portal hypertension and to a moderate hyperammonemia, without the presence of other evident central nervous system changes. The molecular mechanisms here proposed indicate the presence of apoptotic intrinsic pathways that point to hippocampal mitochondria as an important mediator of apoptosis in this experimental model. In this model of MHE, the presence of DNA fragmentation is documented by 2.3-times increased number of TUNEL-positive cells. These findings together with a higher ratio of the Bcl-2 family members Bax/Bcl-xL in the outer mitochondrial membrane of the MHE animals together with 11% of cytochrome c release indicate the presence of apoptosis in this experimental model. A detailed analysis of the hippocampal mitochondrial physiology was performed after mitochondrial isolation. The determination of the respiratory rate in the presence of malate plus glutamate and ADP showed a 45% decrease in respiratory control in MHE animals as compared with the sham group. A marked decrease of cytochrome oxidase (complex IV of the electron transport chain) was also observed, showing 46% less activity in hippocampal mitochondria from MHE animals. In addition, mitochondria from these animals showed less ability to maintain membrane potential (ΔΨ (m)) which was 13% lower than the sham group. Light scattering experiments showed that mitochondria from MHE animals were more sensitive to swell in the presence of increased calcium concentrations as compared with the sham group. In addition, in vitro studies performed in mitochondria from sham animals showed that mitochondrial permeability transition (MPT) could be a mitochondrial mediator of the apoptotic signaling in the presence of NH(4) (+) and calcium.

Asunto(s)

Apoptosis , Encefalopatía Hepática/fisiopatología , Hipocampo/patología , Mitocondrias/metabolismo , Cloruro de Amonio/metabolismo , Cloruro de Amonio/farmacología , Animales , Proteínas Reguladoras de la Apoptosis/metabolismo , Calcio/farmacología , Calcio/fisiología , Constricción Patológica/patología , Fragmentación del ADN , Modelos Animales de Enfermedad , Complejo I de Transporte de Electrón/metabolismo , Complejo II de Transporte de Electrones/metabolismo , Complejo III de Transporte de Electrones/metabolismo , Complejo IV de Transporte de Electrones/metabolismo , Encefalopatía Hepática/complicaciones , Hiperamonemia/etiología , Masculino , Potencial de la Membrana Mitocondrial , Mitocondrias/efectos de los fármacos , Dilatación Mitocondrial , Consumo de Oxígeno , Permeabilidad , Vena Porta/patología , Ratas , Ratas Endogámicas WKY