RESUMO
Synthetic selective modulators of the estrogen receptors (SERMs) have shown to protect neurons and glial cells against toxic insults. Among the most relevant beneficial effects attributed to these compounds are the regulation of inflammation, attenuation of astrogliosis and microglial activation, prevention of excitotoxicity and as a consequence the reduction of neuronal cell death. Under pathological conditions, the mechanism of action of the SERMs involves the activation of estrogen receptors (ERs) and G protein-coupled receptor for estrogens (GRP30). These receptors trigger neuroprotective responses such as increasing the expression of antioxidants and the activation of kinase-mediated survival signaling pathways. Despite the advances in the knowledge of the pathways activated by the SERMs, their mechanism of action is still not entirely clear, and there are several controversies. In this review, we focused on the molecular pathways activated by SERMs in brain cells, mainly astrocytes, as a response to treatment with raloxifene and tamoxifen.
Assuntos
Astrócitos/efeitos dos fármacos , Encefalopatias/tratamento farmacológico , Fármacos Neuroprotetores/farmacologia , Cloridrato de Raloxifeno/farmacologia , Receptores de Estrogênio/metabolismo , Moduladores Seletivos de Receptor Estrogênico/metabolismo , Moduladores Seletivos de Receptor Estrogênico/farmacologia , Tamoxifeno/farmacologia , Animais , HumanosRESUMO
Portal vein thrombosis (PVT) may occur at any time following liver transplantation. We describe our experience with portal vein recanalization in cases of thrombosis after liver transplantation. Twenty-eight children (5%) out of 566 liver transplant recipients underwent portal vein recanalization using a transmesenteric approach. All children received left hepatic segments, developed PVT, and had symptoms or signs of portal hypertension. Portal vein recanalization was performed via the transmesenteric route in all cases. Twenty-two (78.6%) patients underwent successful recanalization and stent placement. They received oral anticoagulants after the procedure, and clinical symptoms subsided. Symptoms recurred due to portal vein restenosis/thrombosis in seven patients. On an intention-to-treat basis, the success rate of the proposed treatment was 60.7%. Only 17 out of 28 children with posttransplant chronic PVT retained stent patency (primary + assisted) at the end of the study period. In cases of portal vein obstruction, the transmesenteric approach via minilaparotomy is technically feasible with good clinical and hemodynamic results. It is an alternative procedure to reestablish the portal flow to the liver graft that can be performed in selected cases and a therapeutic addition to other treatment strategies currently used to treat chronic PVT.
Assuntos
Rejeição de Enxerto/prevenção & controle , Hepatopatias/cirurgia , Regeneração Hepática , Transplante de Fígado/efeitos adversos , Veia Porta/cirurgia , Trombose Venosa/cirurgia , Criança , Pré-Escolar , Feminino , Seguimentos , Rejeição de Enxerto/etiologia , Sobrevivência de Enxerto , Humanos , Lactente , Masculino , Veia Porta/patologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida , Trombose Venosa/etiologiaRESUMO
One case of Intestinal Metaplasia with moderate Dysplasia of the cervix and endometrium associated to leiomyosarcoma is presented. Clinical and Anatomo-Pathological aspects are reviewed.
Assuntos
Colo do Útero/patologia , Endométrio/patologia , Intestinos/patologia , Leiomiossarcoma/patologia , Neoplasias Uterinas/patologia , Feminino , Humanos , Leiomiossarcoma/complicações , Metaplasia/complicações , Pessoa de Meia-Idade , Displasia do Colo do Útero/patologia , Neoplasias Uterinas/complicaçõesRESUMO
Se presenta un caso de metaplasia intestinal con displasia moderada en cuello uterino y endometrio, asociado a leiomiosarcoma. Se revisan aspectos clínicos y anátomo-patológicos