RESUMO
Maclura is a plant genus little known and used, species of which have been mainly used in the recovery of soils, for medicinal purposes such as dental infection treatments, and as wood for making furniture and construction. The overexploitation of this genus has placed certain species in endangered extinction status in some countries, such as Brazil. In addition, the scarce research and information limit the development, cultivation, and management of its species regarding their biochemical composition, which includes bioactive compounds such as the phenolic and flavonoid compounds found in some species such as M. pomifera, M. cochinchinensis, and M. tinctoria. The plants' antioxidant, antimicrobial, anticancer, anti-inflammatory, and antiproliferative activities have been attributed to these compounds. Other biochemical components such as ashes, insoluble lignin, holocellulose, and the high content of lipids and carbohydrates have been identified to be used to produce biofuels, with characteristics very similar to fuels derived from petroleum. This review aims to analyze the current knowledge on the plant genus Maclura, exploring its biochemical compounds and potential applications, including as a food additive, antioxidant supplement, in agriculture, for therapeutic purposes, aquaculture, and the cosmetic and industrial sector.
RESUMO
BACKGROUND: Clostridium difficile is an increasingly common source of in-patient morbidity and mortality. We aim to assess the effects of diverting loop ileostomy (DLI) versus total abdominal colectomy (TAC) for Clostridium difficile colitis (CDC), in terms of mortality and morbidity. METHODS: Systematic literature search was performed using PubMed, Embase, Cochrane, and Web of Science databases for randomized and non-randomized studies comparing DLI and TAC for fulminant CDC. Meta-analysis was carried out for mortality and postoperative complications. RESULTS: Five non-randomized studies qualified for inclusion in the quantitative synthesis. In total, 3683 patients were allocated to DLI (n = 733) or TAC (n = 2950). The overall mortality was equivalent (OR 0.73; 95% CI 0.45-1.20; P = 0.22). Regarding secondary outcomes, the pooled analysis revealed the following equivalent rates of postoperative events: thromboembolism (OR 0.45; 95% CI 0.14-1.43; P = 0.18), acute renal failure (OR 1.71; 95% CI 0.91-3.23; P = 0.10), surgical site infection (OR 0.95; 95% CI 0.11-8.59; P = 0.97), pneumonia (OR 0.98; 95% CI 0.36-2.66; P = 0.97), urinary tract infection (OR 0.81; 95% CI 0.26-2.52; P = 0.72), and reoperation (OR 0.95; 95% CI 0.50-1.82; P = 0.78). The ostomy reversal rate was significantly higher in DLI (OR 12.55; 95% CI 3.31-47.55; P = 0.0002). CONCLUSIONS: The overall morbidity and mortality rates between DLI and TAC for the treatment of CDC seemed to be equivalent. Evidence from a randomized controlled trial is needed to clarify the timing and understand the impact of DLI for CDC.
Assuntos
Colectomia/métodos , Enterocolite Pseudomembranosa/mortalidade , Enterocolite Pseudomembranosa/cirurgia , Ileostomia/métodos , HumanosRESUMO
BACKGROUND: Primary hyperparathyroidism is a disease characterised by the autonomous production of parathyroid hormone. The most common cause is an adenoma, followed by hyperplasia, and rarely carcinoma. CLINICAL CASES: Three cases are presented. The first case is associated with a brown tumour that was diagnosed as hyperplasia after study and surgery. The second case was related to pathological fractures, and a lower right adenoma 236 times bigger than a normal parathyroid was excised. The last case presented with abdominal pain and heartburn. Histopathology reported a carcinoma, which was removed using surgery en bloc. All patients have improved. CONCLUSION: Hyperparathyroidism symptoms are very difficult to identify and diagnose, thus a detailed and broad approach is needed when hyperparathyroidism is suspected.