Toxicological and pharmacological evaluation of Discaria americana Gillies & Hook (Rhamnaceae) in mice

Medicinal plants (e.g. Discaria americana) have been used by populations for centuries. However, popular use is not enough to validate these plants as safe and effective medicinal products. The present study sought to evaluate the acute and subacute toxicity as well as the anxiolytic and antinociceptive effects of D. americana root bark and aerial parts extracts in mice. In acute toxicity studies, mice were treated with single intraperitoneal doses of the aforementioned extracts. Subacute toxicity studies were performed by oral administration of the extracts over 14 days. Anxiolytic studies consisted of the elevated plus maze method, and antinociceptive studies were based on the hot plate test. The LD50 value for D. americana aerial parts extract was established at >500 mg/kg, and for the root bark extract, 400 mg/kg. D. americana aerial parts extract produced anxiolytic (250 mg/kg) and antinociceptive effects (125, 200 and 250 mg/kg). Conversely, D. americana root bark extract showed neither anxiolytic nor antinociceptive effects in mice.As plantas medicinais (i. e. Discaria americana) têm sido utilizadas pela população por séculos, entretanto, o conhecimento popular não é suficiente para validá-las como medicamentos seguros e/ou efetivos. Assim, o presente estudo teve por objetivo avaliar a toxicidade aguda e subaguda, bem como o efeito ansiolítico e antinociceptivo dos extratos da casca da raiz e das partes aéreas da D. americana em camundongos. A toxicidade aguda foi avaliada pela administração dos extratos, via intraperitoneal. Para o estudo da toxicidade subaguda os animais foram tratados oralmente com os extratos por 14 dias. O efeito ansiolítico dos extratos foi determinado através do modelo do labirinto em cruz elevado e o efeito antinociceptivo, mediante o teste da placa quente. O valor da DL50 para o extrato das partes aéreas da D. americana foi definido como > 500 mg/kg, enquanto que para o extrato da casca da raiz foi estabelecido em 400 mg/kg. O extrato das partes aéreas da D. americana apresentou atividade ansiolítica (250 mg/kg) e antinociceptiva (125, 200 e 250 mg/kg). O extrato da casca da raiz da D. americana não apresentou efeito ansiolítico nem antinociceptivo

Diagnosis and treatment of recurrent laryngeal cancer following initial nonsurgical therapy.

Surgery is the preferred modality for curative treatment of recurrent laryngeal cancer after failure of nonsurgical treatments. Patients with initial early-stage cancer experiencing recurrence following radiotherapy often have more advanced-stage tumors by the time the recurrence is recognized. About one third of such recurrent cancers are suitable for conservation surgery. Endoscopic resection with the CO(2) laser or open partial laryngectomy (partial vertical, supracricoid, or supraglottic laryngectomies) have been used. The outcomes of conservation surgery appear better than those after total laryngectomy, because of selection bias. Transoral laser surgery is currently used more frequently than open partial laryngectomy for treatment of early-stage recurrence, with outcomes equivalent to open surgery but with less associated morbidity. Laser surgery has also been employed for selective cases of advanced recurrent disease, but patient selection and expertise are required for application of this modality to rT3 tumors. In general, conservation laryngeal surgery is a safe and effective treatment for localized recurrences after radiotherapy for early-stage glottic cancer. Recurrent advanced-stage cancers should generally be treated by total laryngectomy