Manejo Terapêutico do Paciente com Gangrena de Fournier: Revisão de Literatura

This Fournier syndrome, known as Fournier Gangrene, is a serious polymicrobialinfection that mainly affects the perineum and genital region. The research, anintegrative review between 2020 and 2024, resulted in the analysis of 41 articles, ofwhich 6 were selected. The incidence is higher in men, with an increase after the age of50. The results point to several sources of technology, highlighting skin, urological andgastrointestinal. The pathophysiology involves endarteritis obliterans, ischemia andthrombosis, leading to necrosis. The progression of the disease is divided into fourphases, with the third phase characterized by general signs and severe infectioussyndrome, which can lead to septic shock. Treatment includes broad-spectrumantibiotics, surgical debridement and, in severe cases, superficial scrotal debridement.Hyperbaric oxygen therapy is considered an adjuvant, periodic at the request ofmicroorganisms and stimulating healing. It concludes by highlighting the urgency ofearly diagnosis and multidisciplinary treatment, given the rapid progression of necrosisand high rates of morbidity and mortality associated with Fournier syndrome. Theresearch contributes to clinical understanding and highlights the importance ofimproving knowledge for a correct diagnosis and improving treatment conditions.A síndrome de Fournier, conhecida como Gangrena de Fournier, é uma infecçãopolimicrobiana grave que afeta principalmente a região do períneo e genital. Apesquisa, uma revisão integrativa entre 2020 e 2024, resultou na análise de 41 artigos,dos quais foram selecionados 6. A incidência é maior em homens, com aumento apósos 50 anos. Os resultados apontam diversas fontes de infecção, destacando pele,urológicas e gastrointestinais. A fisiopatologia envolve endarterite obliterante,isquemia e trombose, levando à necrose. A progressão da doença é dividida em quatrofases, com a terceira fase caracterizada por sinais gerais e síndrome infecciosa grave,podendo levar ao choque séptico. O tratamento abrange antibióticos de amploespectro, desbridamentos cirúrgicos e, em casos graves, reconstrução escrotal. Aoxigenioterapia hiperbárica é considerada adjuvante, reduzindo a proliferação demicro-organismos e estimulando a cicatrização. Conclui-se ressaltando a urgência dodiagnóstico precoce e tratamento multidisciplinar, dado o rápido avanço da necrose ealtas taxas de morbimortalidade associadas à síndrome de Fournier. A pesquisacontribui para a compreensão clínica e destaca a importância de aprimorar oconhecimento para um diagnóstico correto e melhorar as condições de tratamento

Hormonal response to L-arginine supplementation in physically active individuals

Background: Nutritional supplements based on the amino acid L-arginine have been hypothesized to improve exercise performance by increasing levels of insulin and growth hormone (GH). Changes of these parameters in response to L-arginine supplementation may clarify the mechanisms underlying its putative physiological effects on physical performance. Objective: The aim of the study was to evaluate the effect of L-arginine supplementation on serum insulin, GH, Growth Factor Insulin-like (IGF-1), and cortisol in response to exercise. Exercise performance was also evaluated. Design: Fifteen trained runners were divided into groups supplemented with 6 g of L-arginine (ARG) or placebo (PLA). Blood samples were collected before supplementation (T0), immediately after the first exercise session (T1), after the second exercise session (T2), and after 20 min of rest (T3). The exercise consisted of two bouts of 5 km time-trial running test. Results: There was a significant increase in serum GH (T0: 3.28±0.95 vs. 3.21±0.5 ng/mL; T1: 4.35±0.23 vs. 4.17±0.13 ng/mL; T2: 4.22±0.25 vs. 4.17±0.09 ng/mL; T3: 4.14±0.29 vs. 4.13±0.18 ng/mL) and cortisol (T0: 198.71±53.77 vs. 207.57±69.51 nmol/L; T1: 458.16±116.12 vs. 433.26±101.77 nmol/L; T2: 454.61±125.21 vs. 431.88±74.82 nmol/L; T3: 311.14±102.91 vs. 362.26±110.42 nmol/L) after T1, T2, and T3, with no significant difference between the ARG and PLA groups, respectively. There was also no significant difference observed in the variables of IGF-1, insulin, and total running time between the ARG and PLA groups. Conclusions: The supplementation of L-arginine did not appear to stimulate the production of insulin, GH, and IGF-1 and, thus, provided no benefit in hormonal response or exercise performance in trained runners

Increasing the Power of Polyphenols through Nanoencapsulation for Adjuvant Therapy against Cardiovascular Diseases

Polyphenols play a therapeutic role in vascular diseases, acting in inherent illness-associate conditions such as inflammation, diabetes, dyslipidemia, hypertension, and oxidative stress, as demonstrated by clinical trials and epidemiological surveys. The main polyphenol cardioprotective mechanisms rely on increased nitric oxide, decreased asymmetric dimethylarginine levels, upregulation of genes encoding antioxidant enzymes via the Nrf2-ARE pathway and anti-inflammatory action through the redox-sensitive transcription factor NF-κB and PPAR-γ receptor. However, poor polyphenol bioavailability and extensive metabolization restrict their applicability. Polyphenols carried by nanoparticles circumvent these limitations providing controlled release and better solubility, chemical protection, and target achievement. Nano-encapsulate polyphenols loaded in food grade polymers and lipids appear to be safe, gaining resistance in the enteric route for intestinal absorption, in which the mucoadhesiveness ensures their increased uptake, achieving high systemic levels in non-metabolized forms. Nano-capsules confer a gradual release to these compounds, as well as longer half-lives and cell and whole organism permanence, reinforcing their effectiveness, as demonstrated in pre-clinical trials, enabling their application as an adjuvant therapy against cardiovascular diseases. Polyphenol entrapment in nanoparticles should be encouraged in nutraceutical manufacturing for the fortification of foods and beverages. This study discusses pre-clinical trials evaluating how nano-encapsulate polyphenols following oral administration can aid in cardiovascular performance

Betanin, a Natural Food Additive: Stability, Bioavailability, Antioxidant and Preservative Ability Assessments

Betanin is the only betalain approved for use in food and pharmaceutical products as a natural red colorant. However, the antioxidant power and health-promoting properties of this pigment have been disregarded, perhaps due to the difficulty in obtaining a stable chemical compound, which impairs its absorption and metabolism evaluation. Herein, betanin was purified by semi-preparative HPLC-LC/MS and identified by LC-ESI(+)-MS/MS as the pseudomolecular ion m/z 551.16. Betanin showed significant stability up to −30 °C and mild stability at chilling temperature. The stability and antioxidant ability of this compound were assessed during a human digestion simulation and ex vivo colon fermentation. Half of the betanin amount was recovered in the small intestine digestive fluid and no traces were found after colon fermentation. Betanin high antioxidant ability was retained even after simulated small intestine digestion. Betanin, besides displaying an inherent colorant capacity, was equally effective as a natural antioxidant displaying peroxy-radical scavenger ability in pork meat. Betanin should be considered a multi-functional molecule able to confer an attractive color to frozen or refrigerated foods, but with the capacity to avoid lipid oxidation, thereby preserving food quality. Long-term supplementation by beetroot, a rich source of betanin, should be stimulated to protect organisms against oxidative stress

Physicochemical, nutritional, and sensory analyses of a nitrate-enriched beetroot gel and its effects on plasmatic nitric oxide and blood pressure

Background: Beetroot (Beta vulgaris L.) is a dietary source of natural antioxidants and inorganic nitrate (NO3–). It is well known that the content of antioxidant compounds and inorganic nitrate in beetroot can reduce blood pressure (BP) and the risk of adverse cardiovascular effects. Objective: The aim of the present study was to formulate a beetroot gel to supplement dietary nitrate and antioxidant compounds able to cause beneficial health effects following acute administration. Design and subjects: A beetroot juice produced from Beta vulgaris L., without any chemical additives, was used. The juice was evaluated by physicochemical and microbiological parameters. The sample was tested in five healthy subjects (four males and one female), ingesting 100 g of beetroot gel. Results: The formulated gel was nitrate enriched and contained carbohydrates, fibers, saponins, and phenolic compounds. The formulated gels possess high total antioxidant activity and showed adequate rheological properties, such as high viscosity and pleasant texture. The consumer acceptance test for flavor, texture, and overall acceptability of beetroot gel flavorized with synthetic orange flavor had a sensory quality score >6.6. The effects of acute inorganic nitrate supplementation on nitric oxide production and BP of five healthy subjects were evaluated. The consumption of beetroot gel increased plasma nitrite threefold after 60 min of ingestion and decreased systolic BP (−6.2 mm Hg), diastolic BP (−5.2 mm Hg), and heart rate (−7 bpm)

Chondrosarcoma metastasis simulating a primary stomach tumor: a case report

Gastric tumors are an important cause of cancer deaths. The main type is the primary gastric adenocarcinoma, and rarely secondary metastatic implants can be present. A 79-years-old woman sought medical attention due to a complaint of epigastralgia, unintentional weight loss, two cases of melena in the past two months, and a prior history of a chondrosarcoma of the thigh treated 13 years before. A neoplastic lesion was detected at the stomach during evaluation, and a gastrectomy was opted as a treatment. The immunohistochemical evaluation was compatible with a chondrosarcoma metastatic implant on the stomach. The patient obtained a survival superior to 5 years after surgery. Only one case of gastric metastasis from chondrosarcoma was described in the literature. We observed a great benefit in the use of surgical resection of the gastric lesion, showing that surgery may be considered in selected individuals with chondrosarcoma metastasis

Short-Term Betanin Intake Reduces Oxidative Stress in Wistar Rats

Oxidative stress is a common condition described in risk factors for cardiovascular disease. Betanin, a bioactive pigment from red beetroot demonstrates anti-inflammatory and antioxidant properties. The main aim of this study was to evaluate the short-term intake of betanin against oxidative stress in a rodent model, a common condition described in several risk factors for cardiovascular disease. Oxidative stress was induced in Wistar rats by a hyperlipidemic diet for 60 days, followed by betanin administration (20 mg·kg−1) through oral gavage for 20 days. Plasma biochemical parameters and antioxidant enzyme activities were evaluated. Lipid peroxidation and histopathological changes were determined in the liver. The hyperlipidemic diet caused hyperglycemia, hyperinsulinemia, insulin resistance, and increases in alanine transaminase and aspartate transaminase levels. Oxidative stress status was confirmed by reduction of antioxidant enzyme activities, increased lipid peroxidation, and liver damage. Purified betanin regulated glucose levels, insulin, and insulin resistance. Hepatic damage was reversed as evidenced by the reduction in alanine transaminase and aspartate transaminase levels and confirmed by histological analyses. Betanin reduced hepatic malondialdehyde and increased superoxide dismutase, catalase, and glutathione peroxidase activities. Short-term betanin intake modulated biochemical parameters, reversed hepatic tissue damage, and attenuated oxidative stress in Wistar rats