19 research outputs found

    Evaluation of anti-estrogenic or estrogenic activities of aqueous root extracts of Gunnera manicata L.

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    Gunnera perpensa (Gunneraceae) is an African plant widely used in traditional medicine. This species is known for its activity involving the female reproductive system, such as inducing or increasing labor, treating female infertility, expelling the placenta and/or preventing post-partum hemorrhage. These properties are probably due to (z)-venusol, a majoritary compound, and its action in conjunction with substances in the whole extract and other natural products. In southern Brazil, a native species Gunnera manicata L. that also belongs to Gunneraceae can be found. In spite of the traditional use of G. perpensa, there is no pharmacological and phytochemical information regarding the South American Gunnera species. Therefore, the aim of this study was to investigate the activity of Brazilian G. manicata aqueous extracts on the reproductive system of immature female Wistar rats through a uterotrophic assay and to verify the presence of (z)-venusol by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). Data were analyzed by analysis of variance (ANOVA) and Bonferroni´s post-hoc test (p< 0.01). Results obtained shown that G. manicata extracts did not present in vivo anti or estrogenic activity. Furthermore, (z)-venusol compound was not found. This study represents the first preliminary screening done on the South American G. manicata species.Gunnera perpensa (Gunneraceae) é uma planta de origem africana extensamente utilizada na medicina tradicional do país. Esta espécie é conhecida por suas atividades no sistema reprodutor feminino, como indução ou aumento do trabalho de parto, tratamento da infertilidade em mulheres, expulsão da placenta e/ou impedimento de hemorragia pós-parto. Tais atividades devem-se, provavelmente, ao sinergismo existente entre o (z)-venusol, composto majoritário, e outros compostos presentes na planta. No sul do Brasil, encontra-se uma espécie nativa, Gunnera manicata L., pertencente à família Gunneraceae. Apesar do uso tradicional de G. perpensa, não há informações farmacológicas e fitoquímicas a respeito da espécie sul Americana de Gunnera. Assim, o objetivo deste estudo foi investigar a atividade de extratos aquosos da espécie brasileira G. manicata no sistema reprodutor de ratas Wistar imaturas através de ensaio uterotrófico e verificar a presença do composto (z)-venusol utilizando-se cromatografia líquida acoplada a espectrômetro de massas em tandem (CL-EM/EM). Para a análise estatística, utilizou-se ANOVA/Bonferroni (

    Alstonine as an Antipsychotic: Effects on Brain Amines and Metabolic Changes

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    Managing schizophrenia has never been a trivial matter. Furthermore, while classical antipsychotics induce extrapyramidal side effects and hyperprolactinaemia, atypical antipsychotics lead to diabetes, hyperlipidaemia, and weight gain. Moreover, even with newer drugs, a sizable proportion of patients do not show significant improvement. Alstonine is an indole alkaloid identified as the major component of a plant-based remedy used in Nigeria to treat the mentally ill. Alstonine presents a clear antipsychotic profile in rodents, apparently with differential effects in distinct dopaminergic pathways. The aim of this study was to complement the antipsychotic profile of alstonine, verifying its effects on brain amines in mouse frontal cortex and striatum. Additionally, we examined if alstonine induces some hormonal and metabolic changes common to antipsychotics. HPLC data reveal that alstonine increases serotonergic transmission and increases intraneuronal dopamine catabolism. In relation to possible side effects, preliminary data suggest that alstonine does not affect prolactin levels, does not induce gains in body weight, but prevents the expected fasting-induced decrease in glucose levels. Overall, this study reinforces the proposal that alstonine is a potential innovative antipsychotic, and that a comprehensive understanding of its neurochemical basis may open new avenues to developing newer antipsychotic medications

    The relationships between exogenous and endogenous antioxidants with the lipid profile and oxidative damage in hemodialysis patients

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    Background: We sought to investigate the relationships among the plasma levels of carotenoids, tocopherols, endogenous antioxidants, oxidative damage and lipid profiles and their possible effects on the cardiovascular risk associated with hemodialysis (HD) patients. Methods: The study groups were divided into HD and healthy subjects. Plasma carotenoid, tocopherol and malondialdehyde (MDA) levels, as well as erythrocyte reduced glutathione (GSH), were measured by HPLC. Blood antioxidant enzymes, kidney function biomarkers and the lipid profiles were analyzed by spectrophotometric methods. Results: Plasma lycopene levels and blood glutathione peroxidase (GPx) activity were significantly decreased in HD patients compared with healthy subjects. Total cholesterol, low-density lipoprotein cholesterol (LDL-c), creatinine, urea, MDA, GSH, superoxide dismutase (SOD) and catalase (CAT) were significantly increased in HD (p < 0.05). Lycopene levels were correlated with MDA (r = -0.50; p < 0.01), LDL-c (r = -0.38; p = 0.01) levels, the LDL-c/HDL-c index (r = -0.33; p = 0.03) and GPx activity (r = 0.30; p = 0.03). Regression models showed that lycopene levels were correlated with LDL-c (β estimated = -31.59; p = 0.04), while gender was correlated with the TC/HDL-c index and triglycerides. Age did not present a correlation with the parameters evaluated. GPx activity was negatively correlated with MDA levels and with the LDL-c/HDL-c and CT/HDL-c indexes. Conclusions: Lycopene may represent an additional factor that contributes to reduced lipid peroxidation and atherogenesis in hemodialysis patients

    Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

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    Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

    Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

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    Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

    Evaluation of anti-estrogenic or estrogenic activities of aqueous root extracts of Gunnera manicata L.

    Get PDF
    Gunnera perpensa (Gunneraceae) é uma planta de origem africana extensamente utilizada na medicina tradicional do país. Esta espécie é conhecida por suas atividades no sistema reprodutor feminino, como indução ou aumento do trabalho de parto, tratamento da infertilidade em mulheres, expulsão da placenta e/ou impedimento de hemorragia pós-parto. Tais atividades devem-se, provavelmente, ao sinergismo existente entre o (z)-venusol, composto majoritário, e outros compostos presentes na planta. No sul do Brasil, encontra-se uma espécie nativa, Gunnera manicata L., pertencente à família Gunneraceae. Apesar do uso tradicional de G. perpensa, não há informações farmacológicas e fitoquímicas a respeito da espécie sul Americana de Gunnera. Assim, o objetivo deste estudo foi investigar a atividade de extratos aquosos da espécie brasileira G. manicata no sistema reprodutor de ratas Wistar imaturas através de ensaio uterotrófico e verificar a presença do composto (z)-venusol utilizando-se cromatografia líquida acoplada a espectrômetro de massas em tandem (CL-EM/EM). Para a análise estatística, utilizou-se ANOVA/Bonferroni (p<0,01). Os resultados obtidos demonstraram que os extratos de G. manicata testados não apresentaram atividade anti ou estrogênica in vivo. Na análise química não foi verificada a presença do composto (z)-venusol. Este estudo representa o primeiro screening realizado com a espécie sul-americana G. manicata.Gunnera perpensa (Gunneraceae) is an African plant widely used in traditional medicine. This species is known for its activity involving the female reproductive system, such as inducing or increasing labor, treating female infertility, expelling the placenta and/or preventing post-partum hemorrhage. These properties are probably due to (z)-venusol, a majoritary compound, and its action in conjunction with substances in the whole extract and other natural products. In southern Brazil, a native species Gunnera manicata L. that also belongs to Gunneraceae can be found. In spite of the traditional use of G. perpensa, there is no pharmacological and phytochemical information regarding the South American Gunnera species. Therefore, the aim of this study was to investigate the activity of Brazilian G. manicata aqueous extracts on the reproductive system of immature female Wistar rats through a uterotrophic assay and to verify the presence of (z)-venusol by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). Data were analyzed by analysis of variance (ANOVA) and Bonferroni´s post-hoc test (p< 0.01). Results obtained shown that G. manicata extracts did not present in vivo anti or estrogenic activity. Furthermore, (z)-venusol compound was not found. This study represents the first preliminary screening done on the South American G. manicata species
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