206 resultados para PERITONITIS


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ABSTRACT: Mikania lindleyana DC., Asteraceae (sucuriju), grows in the Amazon region, where is frequently used to treat pain, inflammatory diseases and scarring. This study was carried out to investigate phytochemical profile accompanied by in vivo antinociceptive and anti-inflammatory screening of n-hexane (HE), dichloromethane (DME) and methanol (ME) extracts obtained from the aerial parts of the plant. The oral administration of ME (0.1, 0.3, 1 g/kg) caused a dose-related reduction (16.2, 42.1 e 70.2%) of acetic acid-induced abdominal writhing while HE and DME (1 g/kg, p.o.) were ineffective. In the hot plate test, ME (300 mg/kg, p.o.) increased the latency of heat stimulus between 30 and 120 min and inhibited the first (45%) and second (60%) phases of nociception in the formalin test. The antinociception induced by ME or positive control fentanyl (150 µg/kg, s.c.) in hot plate and formalin tests was prevented by naloxone (3 mg/kg, s.c.). When submitted to the carrageenan-induced peritonitis test, ME (0.5, 1.0, 2.0 g/kg, p.o.) impaired leukocyte migration into the peritoneal cavity by 46.8, 59.4 and 64.8% respectively, while positive control dexamethasone (2 mg/kg, s.c.), inhibited leukocyte migration by 71.1%. These results indicate that the antinociception obtained after oral administration of methanol extract of M. lindleyana involves anti-inflammatory mechanisms accompanied with opioid-like activity which could explain the use of the specie for pain and inflammatory diseases.

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Croton pullei var. glabrior Lanj. (Euphorbiaceae) é uma liana, amplamente distribuída na Floresta Amazônica. Na medicina popular, diversas plantas do gênero Croton têm sido utilizadas com fins terapêuticos em patologias que envolvem dor e inflamação, o que justifica este trabalho. O objetivo deste estudo foi investigar as atividades antinociceptiva e do extrato metanólico das folhas de C. pullei (MECP). O MECP reduziu, de forma dose-dependente, o número de contorções abdominais (1,2 %) em camundongos, sugerindo uma atividade antinociceptiva da planta. Por outro lado, o MECP não alterou significativamente a reatividade ao estímulo térmico no teste da placa quente e a reatividade à estimulação química na primeira fase do teste da formalina, indicando um mecanismo não-opioidérgico. O MECP reduziu a nocicepção na segunda fase do teste da formalina, inibiu o edema de orelha induzido pelo óleo de croton e reduziu a migração leucocitária no teste da peritonite induzida por carragenina, indicando uma atividade antiinflamatória. Apesar dos mecanismos responsáveis pelos efeitos da planta ainda não estarem completamente esclarecidos, estes resultados parecem justificar o uso medicinal potencial de Croton pullei var. glabrior Lanj. em patologias que envolvam dor e inflamação.

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Euterpe oleracea Mart. é uma típica palmeira da Amazônia, que cresce espontaneamente nos estados do Pará e Amapá, apreciada por sua atrativa beleza e valor nutricional. O fruto de Euterpe oleracea, comumente conhecido como açaí, tem demonstrado exibir significante capacidade anti-oxidante in vitro, o que pode ter benefícios à saúde. Estudos químicos revelaram a presença de ácidos graxos, antocianinas e esteroides. O objetivo deste trabalho foi caracterizar fitoquimícamente o óleo fixo dos frutos desta espécie (OEO) e avaliar em modelos inflamatórios e hiperalgésicos in vivo, o possível envolvimento dos compostos nas respostas inflamatória e analgésica. Para tanto, os modelos experimentais usados foram: teste de contorção induzida por ácido acético, edema de pata de rato, teste do granuloma em ratos, permeabilidade vascular em ratos, migração leucocitária em ratos e eritema de orelha induzida por óleo de cróton em camundongos. Doses orais de 500, 1000 e 1500 mg/kg de OEO inibiu o número de contorções em 33,67%, 45,88% e 55,58, respectivamente. O OEO produziu efeito dose-dependente, e a dose média efetiva encontrada foi de 1226,8mg/kg. Com a administração oral da dose de 1226,8 mg/kg, o OEO inibiu o processo inflamatório em 29,18% quando comparado ao grupo controle. A administração diária de OEO por 6 dias inibiu a formação do tecido granulomatoso em 36,66%. No eritema de orelha por óleo de cróton, o OEO provocou efeito inibitório significativo em 37,9%. No teste de permeabilidade vascular, o OEO inibiu a permeabilidade vascular em 54,5%. Na peritonite induzida por carragenina, o OEO reduziu o número de neutrófilos quando comparado ao grupo controle (inibição de 80,14%). A partir dos resultados obtidos, sugere-se que o OEO apresenta atividade anti-inflamatória, sobre os processos inflamatórios agudo e crônico, e atividade antinociceptiva, provavelmente de origem periférica.

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Endopleura uchi (Huber) Cuatrec. (Humiriaceae), uma planta da Amazônia brasileira, comumente conhecida como “uxi” é utilizada na medicina popular para o tratamento de diversas patologias, como artrite. Bergenina, um dos constituintes químicos das cascas do caule de E. uchi, tem várias atividades biológicas, incluindo antiinflamatória e antinociceptiva. Visando a obtenção de um derivado mais potente que a bergenina decidiu-se acetilar esta substância. Acetilbergenina foi testada em modelos de nocicepção e de inflamação. Bergenina foi isolada a partir do fracionamento por cromatografia por via úmida do extrato aquoso das cascas do caule de E. uchi e acetilbergenina a partir da acetilação da bergenina. As substâncias foram identificadas com base na análise espectral de RMN 1H, RMN 13C, DEPT e COSY, e comparação com dados da literatura. Nos modelos de nocicepção foram realizados os testes de contorção abdominal, placa quente e formalina. Enquanto que nos modelos de inflamação foram realizados os testesdermatite induzida pelo óleo de cróton, edema de pata induzido por carragenina e dextrana e peritonite induzida por carragenina. Além disso, para avaliar o potencialulcerogênico de acetilbergenina foi utilizado o modelo de úlcera gástrica induzida por estresse. No teste de contorção abdominal induzida por ácido acético 0,6%, acetilbergenina nas doses de 1, 5, 10, 15 e 25 mg/kg bloqueou o número de contorções abdominais em 28,2%, 52,7%, 61,1%, 68,3% e 95,0%, respectivamente, e de maneira dose-dependente quando comparada ao grupo controle. DE50 calculada foi de 6,8 mg/kg. No teste da placa quente (55 ºC), acetilbergenina (6,8 mg/kg) não induziu alterações no tempo de latência quando comparada ao grupo controle. No teste da formalina, acetilbergenina (6,8 mg/kg) inibiu em 88,3% o estímulo álgico na 2ª fase (inflamatória) quando comparada ao grupo controle. Além disso, a naloxona reverteu o efeito de acetilbergenina nessa 2ª fase do teste. Na dermatite induzida por óleo de cróton, acetilbergenina (6,8 mg/kg) provocou efeito inibitório de 75,60% em relação ao grupo controle. No edema de pata induzido por carragenina, acetilbergenina (6,8 mg/kg) foi capaz de reduzir o desenvolvimento do edema da 2ª à 5ª hora em comparação ao grupo controle. No edema de pata induzido por dextrana, acetilbergenina (6,8 mg/kg) reduziu o edema em todos os tempos. Na peritonite induzida por carragenina, acetilbergenina (6,8 mg/kg) bloqueou em 70% o número de neutrófilos quando comparada ao grupo controle. No ensaio de úlcera gástrica, acetilbergenina bloqueou em 78,55% a geração de lesões gástricas por estresse quando comparada ao grupo indometacina. Os resultados sugerem que acetilbergenina apresenta atividade antinociceptiva e atividade antiinflamatória, provavelmente, de origem periférica.

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The oil of the fruits of Euterpe oleracea Mart., Arecaceae (OEO), was evaluated in models of inflammation and hyperalgesia in vivo to study its effects on these conditions. The experimental models contained the writhing test in mice, rat paw edema, granuloma test in rats, vascular permeability in rats, cell migration to the peritoneal cavity in rats and ear erythema induced by croton oil in mice. Doses of 500, 1000 and 1500 mg/kg of OEO were administered orally. The observed number of writhes was inhibited by 33.67, 45.88 and 55.58%, respectively. OEO produced a dose-dependent effect, with linear correlation coefficient R=0.99 (y=0.0219x+23.133), and the median effective dose found was 1226.8 mg/kg. The oral administration of 1226.8 mg/kg of OEO inhibited carrageenan-induced edema by 29.18% (p<0.05) when compared to the control group. The daily administration of OEO for six days inhibited the formation of granulomatous tissue by 36.66% (p<0.01). In ear erythema induced by croton oil, OEO presented a significant inhibition (37.9%). In the vascular permeability test, treatment with OEO decreased the response to histamine, inhibiting vascular permeability by 54.16%. In carrageenan-induced peritonitis, OEO reduced the number of neutrophils migrating compared to the control group by 80.14%. These results suggested that OEO has anti-inflammatory and antinociceptive activities, probably of peripheral origin and linked to prostaglandin biosynthesis inhibition.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Lower gastrointestinal tract neoplasms are rare in domestic animals, representing 3% of all biopsies and necropsies. Our objective is to describe the histopathological and B-mode ultrasound findings in a case of duodenal adenocarcinoma in a dog, since it commonly occurs in the large intestine. On ultrasound examination, there was transmural wall thickening in the duodenum with loss of layer structure, focal peritonitis and adenopathy. Histopathological examination of the intestinal mass revealed a malignant epithelial neoplasm, densely cellular and infiltrative, extending through the lamina propria, submucosa, muscle and hypodermis, characterizing a duodenal adenocarcinoma. We conclude that adenocarcinomas may be included in the differential diagnosis of transmural lesions in the duodenum in B-mode ultrasound examinations, but a laparotomy and biopsy are required for definitive diagnosis.

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Peritoneal dialysis (PD) should be considered a suitable method of renal replacement therapy in acute kidney injury (AKI) patients. This study is the largest cohort providing patient characteristics, clinical practice, patterns and their relationship to outcomes in a developing country. Its objective was to describe the main determinants of patient and technique survival, including trends over time of PD treatment in AKI patients. This was a Brazilian prospective cohort study in which all adult AKI patients on PD were studied from January/2004 to January/2014. For comparison purposes, patients were divided into 2 groups according to the year of treatment: 2004-2008 and 2009-2014. Patient survival and technique failure (TF) were analyzed using the competing risk model of Fine and Gray. A total of 301 patients were included, 51 were transferred to hemodialysis (16.9%) during the study period. The main cause of TF was mechanical complication (47%) followed by peritonitis (41.2%). There was change in TF during the study period: compared to 2004-2008, patients treated at 2009-2014 had relative risk (RR) reduction of 0.86 (95% CI 0.77-0.96) and three independent risk factors were identified: period of treatment at 2009 and 2014, sepsis and age>65 years. There were 180 deaths (59.8%) during the study. Death was the leading cause of dropout (77.9% of all cases) mainly by sepsis (58.3%), followed cardiovascular disease (36.1%). The overall patient survival was 41% at 30 days. Patient survival improved along study periods: compared to 2004-2008, patients treated at 2009-2014 had a RR reduction of 0.87 (95% CI 0.79-0.98). The independent risk factors for mortality were sepsis, age>70 years, ATN-ISS > 0.65 and positive fluid balance. As conclusion, we observed an improvement in patient survival and TF along the years even after correction for several confounders and using a competing risk approach.

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Background and ObjectivesHypokalemia has been consistently associated with high mortality rate in peritoneal dialysis. However, studies investigating if hypokalemia is acting as a surrogate marker of comorbidities or has a direct effect in the risk for mortality have not been studied. Thus, the aim of this study was to analyze the effect of hypokalemia on overall and cause-specific mortality.Design, Setting, Participants and MeasurementsThis is an analysis of BRAZPD II, a nationwide prospective cohort study. All patients on PD for longer than 90 days with measured serum potassium levels were used to verify the association of hypokalemia with overall and cause-specific mortality using a propensity match score to reduce selection bias. In addition, competing risks were also taken into account for the analysis of cause-specific mortality.ResultsThere was a U-shaped relationship between time-averaged serum potassium and all-cause mortality of PD patients. Cardiovascular disease was the main cause of death in the normokalemic group with 133 events (41.8%) followed by PD-non related infections, n=105 (33.0%). Hypokalemia was associated with a 49% increased risk for CV mortality after adjustments for covariates and the presence of competing risks (SHR 1.49; CI95% 1.01-2.21). In contrast, in the group of patients with K < 3.5mEq/L, PD-non related infections were the main cause of death with 43 events (44.3%) followed by cardiovascular disease (n=36; 37.1%). For PD-non related infections the SHR was 2.19 (CI95% 1.52-3.14) while for peritonitis was SHR 1.09 (CI95% 0.47-2.49).ConclusionsHypokalemia had a significant impact on overall, cardiovascular and infectious mortality even after adjustments for competing risks. The causative nature of this association suggested by our study raises the need for intervention studies looking at the effect of potassium supplementation on clinical outcomes of PD patients.

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Background: The prevalence of systemic lupus erythematous (SLE) patients requiring renal replacement therapy (RRT) is increasing but data on clinical outcomes are scarce. Interestingly, data on technique failure and peritoneal-dialysis (PD)-related infections are rarer, despite SLE patients being considered at high risk for infections. The aim of our study is to compare clinical outcomes of SLE patients on PD in a large PD cohort. Methods: We conducted a nationwide prospective observational study from the BRAZPD II cohort. For this study we identified all patients on PD for greater than 90 days. Within that subset, all those with SLE as primary renal disease were matched with PD patients without SLE for comparison of clinical outcomes, namely: patient mortality, technique survival and time to first peritonitis, then were analyzed taking into account the presence of competing risks. Results: Out of a total of 9907 patients, we identified 102 SLE patients incident in PD and with more than 90 days on PD. After matching the groups consisted of 92 patients with SLE and 340 matched controls. Mean age was 46.9 +/- 16.8 years, 77.3% were females and 58.1% were Caucasians. After adjustments SLE sub-hazard distribution ratio for mortality was 1.06 (CI 95% 0.55-2.05), for technique failure was 1.01 (CI 95% 0.54-1.91) and for time to first peritonitis episode was 1.40 (CI 95% 0.92-2.11). The probability for occurrence of competing risks in all three outcomes was similar between groups. Conclusion: PD therapy was shown to be a safe and equally successful therapy for SLE patients compared to matched non-SLE patients.