Effect of oral ingestion of an extract of the herb Uncaria tomentosa on the biodistribution of sodium pertechnetate in rats

The aim of the present study was to determine the effect of the oral ingestion of an extract of the herb Uncaria tomentosa (cat's claw) on the biodistribution of the radiobiocomplex sodium pertechnetate (Na99mTcO4) in rats. The animals (male Wistar rats, 2 months old, 180-220 g), were treated (1 mL) with an U. tomentosa extract (32 mg/mL, N = 5) or 0.9% NaCl solution (control, N = 5) for 7 days. After this period, Na99mTcO4 (3.7 MBq, 0.3 mL) was injected through the ocular plexus and after 10 min the rats were killed, the organs isolated and counted in a well-gamma counter. A significant (P < 0.05) alteration in Na99mTcO4 uptake i) from 0.57 +/- 0.008 to 0.39 +/- 0.06 %ATI/organ (P < 0.05) and from 0.57 +/- 0.17 to 0.39 +/- 0.14 %ATI/g (P < 0.05) was observed in the heart, ii) from 0.07 +/- 0.02 to 0.19 +/- 0.07 %ATI/g in the pancreas, and iii) from 0.07 +/- 0.01 to 0.18 +/- 0.07 %ATI/g (P < 0.05) in muscle after treatment with this extract. Although these results were obtained with animals, caution is advisable in the interpretation of the nuclear medicine examination when the patient is using this herb. This finding is probably an example of drug interaction with a radiopharmaceutical, a fact that could lead to misdiagnosis of the examination in clinical practice with unexpected consequences for the patient

Clinical And Molecular Spectrum Of Patients With 17β-hydroxysteroid Dehydrogenase Type 3 (17-β-hsd3) Deficiency [espectro Clínico E Molecular De Pacientes Com Deficiência De 17β-hidroxiesteroide Desidrogenase Tipo 2 (17-β-hsd3)]

The enzyme 17β-hydroxysteroid dehydrogenase type 3 (17-β-HSD3) catalyzes the conversion of androstenedione to testosterone in the testes, and its deficiency is a rare disorder of sex development in 46,XY individuals. It can lead to a wide range of phenotypic features, with variable hormonal profiles. We report four patients with the 46,XY karyotype and 17-β-HSD3 deficiency, showing different degrees of genital ambiguity, increased androstenedione and decreased testosterone levels, and testosterone to androstenedione ratio G novel mutation, and c.277+4A>T mutation, both located within the intron 3 splice donor site of the HSD17B3 gene, were identified in case 3. In addition, homozygosis for the missense p.Ala203Val, p.Gly289Ser, p.Arg80Gln mutations were found upon HSD17B3 gene sequencing in cases 1, 2, and 4, respectively. © ABEM todos os direitos reservados.568533539Andersson, S., Moghrabi, N., Physiology and molecular genetics of 17beta-hydroxysteroid dehydrogenases (1997) Steroids, 62, pp. 143-147Lukacik, P., Kavanagh, K.L., Oppermann, U., Structure and function of human 17beta-hydroxysteroid dehydrogenases (2006) Mol Cell Endocrinol, 248, pp. 61-71Labrie, F., Luu-The, V., Lin, S.X., Labrie, C., Simard, J., Breton, R., The key role of 17 beta-hydroxysteroid dehydrogenases in sex steroid biology (1997) Steroids, 62, pp. 148-158George, M.M., New, M.I., Tem, S., Sultan, C., Bhangoo, A., The clinical and molecular heterogeneity of 17aHSD3 enzyme deficiency (2010) Horm Res Paediatr, 74, pp. 229-240Boehmer, A.L., Brinkmann, A.O., Sandkuijl, L.A., Halley, D.J., Niermeijer, M.F., Andersson, S., 17beta-hydroxysteroid dehydrogenase-3 deficiency: Diagnosis, phenotypic variability, population genetics, and worldwide distribution of ancient and de novo mutations (1999) J Clin Endocrinol Metab, 84, pp. 4713-4721Mendonça, B.B., Inacio, M., Arnhold, I.J., Costa, E.M., Bloise, W., Martin, R.M., Male pseudohermaphroditism due to 17beta-hydroxysteroid dehydrogenase 3 deficiency. Diagnosis, psychological evaluation, and management (2000) Medicine (Baltimore), 79, pp. 299-309Lee, Y.S., Kirk, J.M., Stanhope, R.G., Johnston, D.I., Harland, S., Auchus, R.J., Phenotypic variability in 17beta-hydroxysteroid dehydrogenase-3 deficiency and diagnostic pitfalls (2007) Clin Endocrinol (Oxf), 67, pp. 20-28Faienza, M.F., Giordani, L., Delvecchio, M., Cavallo, L., Clinical, endocrine, and molecular findings in 17beta-hydroxysteroid dehydrogenase type 3 deficiency (2008) J Endocrinol Invest, 31, pp. 85-91Andersson, S., Geissler, W.M., Wu, L., Davis, D.L., Grumbach, M.M., New, M.I., Molecular genetics and pathophysiology of 17 betahydroxysteroid dehydrogenase 3 deficiency (1996) J Clin Endocrinol Metab, 81, pp. 130-136Mendonca, B.B., Arnhold, I.J., Bloise, W., Andersson, S., Russell, D.W., Wilson, J.D., 17Beta-hydroxysteroid dehydrogenase 3 deficiency in women (1999) J Clin Endocrinol Metab, 84, pp. 802-804Prehn, C., Möller, G., Adamski, J., Recent advances in 17betahydroxysteroid dehydrogenases (2009) J Steroid Biochem Mol Biol, 114, pp. 72-77Hiort, O., Reinecke, S., Thyen, U., Jurgensen, M., Holterhus, P.M., Schon, D., Puberty in disorders of somatosexual differentiation (2003) J Pediatr Endocrinol Metab, 16 (SUPPL. 2), pp. 297-306Cohen-Kettenis, P.T., Gender change in 46, XY persons with 5alphareductase-2 deficiency and 17beta-hydroxysteroid dehydrogenase-3 deficiency (2005) Arch Sex Behav, 34, pp. 399-410Faisal Ahmed, S., Iqbal, A., Hughes, I.A., The testosterone: Androstenedione ratio in male undermasculinization (2000) Clin Endocrinol (Oxf), 53, pp. 697-702Ben Rhouma, B., Belguith, N., Mnif, M.F., Kamoun, T., Charfi, N., Kamoun, M., A novel nonsense mutation in HSD17B3 gene in a Tunisian patient with sexual ambiguity (2012) J Sex Med, , [Epub ahead of print]Neocleous, V., Sismani, C., Shammas, C., Efstathiou, E., Alexandrou, A., Ioannides, M., Duplication of exons 3-10 of the HSD17B3 gene: A novel type of genetic defect underlying 17g-HSD-3 deficiency (2012) Gene, 499, pp. 250-255Sambrook, J., Fritsch, E.F., Maniatis, T.E., (1989) Molecular cloning, a laboratory manual, , New York: Cold Spring HarborSaez, J.M., De Peretti, E., Morera, A.M., David, M., Bertrand, J., Familial male pseudohermaphroditism with gynecomastia due to a testicular 17-ketosteroid reductase defect. I. Studies in vivo (1971) J Clin Endocrinol Metab, 32, pp. 604-610Saez, J.M., Morera, A.M., De Peretti, E., Bertrand, J., Further in vivo studies in male pseudohermaphroditism with gynecomastia due to a testicular 17-ketosteroid reductase defect (compared to a case of testicular feminization) (1972) J Clin Endocrinol Metab, 34, pp. 598-600Rösler, A., Silverstein, S., Abeliovich, D., A (R80Q) mutation in 17 beta-hydroxysteroid dehydrogenase type 3 gene among Arabs of Israel is associated with pseudohermaphroditism in males and normal asymptomatic females (1996) J Clin Endocrinol Metab, 81, pp. 1827-1831Rösler, A., 17 beta-hydroxysteroid dehydrogenase 3 deficiency in the Mediterranean population (2006) Pediatr Endocrinol Rev, 3 (SUPPL. 3), pp. 455-461McKeever, B.M., Hawkins, B.K., Geissler, W.M., Wu, L., Sheridan, R.P., Mosley, R.T., Amino acid substitution of arginine 80 in 171-hidroxysteroide dehydrogenase 3 and its effect on NADPH cofator binding and oxidation/reduction kinetics (2002) Biochim Biophys Acta, 1601, pp. 29-37Rosler, A., Belanger, A., Labrie, F., Mechanisms of androgen production in male pseudohermaphroditism due to 17b-hydroxysteroid dehydrogenase deficiency (1992) J Clin Endocrinol Metab, 75, pp. 773-778Culigan, W., Phoenicia and Phoenician colonization (1991) The Cambridge ancienty history, pp. 461-546. , 2nd Ed, In: Boardman J, Edwards IE, Hammond NG, Sollberger E, Walker CB, eds, Cambridge University PressCavalli-Sforza, L.L., Menozzi, P., Piazza, A., (1994) The history and geography of human genes, pp. 217+242-245+260. , Princeton: Princeton University PressGeissler, W.M., Davis, D.L., Wu, L., Bradshaw, K.D., Patel, S., Mendonça, B.B., Male pseudohermaphroditism caused by mutations of testicular 17o-hidroxysteroide dehydrogenase 3 (1994) Nat Genet, 7, pp. 34-39Moghrabi, N., Hughes, I.A., Dunaif, A., Andersson, S., Deleterious missense mutations and silent polymorphism in the human 17b-hydroxysteroid dehydrogenase 3 gene (hsd17b3) (1998) J Clin Endocrinol Metabol, 83 (8), pp. 2855-2860http://www.ensembl.org/Homo_sapiens/Variation/Population?db=core;g=ENSG00000130948;r=9:98997588-99064434;t=ENST00000375263;v=rs2066479;vdb=variation;vf=16374979, Accessed on: Sept 30, 2012Margiotti, K., Kim, E., Pearce, C.L., Spera, E., Novelli, G., Reichardt, J.K., Association of the G289S single nucleotide polymorphism in the HSD17B3 gene with prostate cancer in Italian men (2002) Prostate, 53, pp. 65-68Sata, F., Kurahashi, N., Ban, S., Moriya, K., Tanaka, K.D., Ishizuka, M., Genetic polymorphisms of 17 G-hydroxysteroid dehydrogenase 3 and the risk of hypospadias (2010) J Sex Med, 7 (8), pp. 2729-2738Mains, L.M., Vakili, M.B., Lacassie, Y., Andersson, S., Lindqvistc, A., Rock, J.A., 17beta hydroxysteroid dehydrogenase 3 deficiency in a male Pseudohermaphrodite (2008) Fertil Steril, 89 (1), pp. 228.e13-228.e17Lee, P.A., Houk, C.P., Faisal, A., Hughes, I.A., International Consensus Conference on Intersex organized by the Lawson Wilkins Pediatric Endocrine Society and the European Society for Paediatric Endocrinology (2006) Pediatrics, 118, pp. 488-50

Remarks On Drawing Up A Community Health Orthodontic Assistance Protocol [considerações Para Elaboração De Protocolo De Assistência Ortodôntica Em Saúde Coletiva]

This study offers help for drawing up a community health orthodontic assistance protocol, especially for the public health system. A preventive and interceptive orthodontic program is suggested through the inclusion of approaches in existing healthcare programs that may help prevent malocclusions, extending the services offered by Basic Healthcare Units to include fitting space retainer appliances and interceptive procedures. Possible occlusion problems are discussed and rated as high or low priority for treatment, stressing occlusal deviations that should not be treated precociously. Preventive and interceptive orthodontic treatment should primarily be offered to children with deciduous and mixed dentition. The management and inclusion of orthodontic procedures can be deployed through the management of physical, human and financial resources, establishing access criteria for these services. The use of an appropriate orthodontic assistance protocol and correct planning of orthodontic actions could pave the way for preventive and interceptive procedures at the Basic Healthcare Units, while more resources could be allocated to setting up Specialty Reference Centers offering more complex corrective orthodontic procedures.12410671078Oliveira CM. Maloclusão no contexto da saúde pública. In: Böneker M, Sheiham A, organizadores. Promovendo saúde bucal na infância e adolescência: conhecimentos e práticas. São Paulo: Livraria e Editora Santos2004. p.55-80Ministério da Saúde, (2004) Diretrizes da política nacional de saúde bucal, , Brasília: Ministério da Saúde;Lang, R., Orthodontic treatment timing. What? When? Who? [editorial] (1989) Oral Health, 79 (9), pp. 7-9Joondeph, D.R., Early orthodontic treatment (1993) Am J Orthod Dentofacial Orthop, 104 (2), pp. 199-200Arvystas, M.G., The rationale for early orthodontic treatment [editorial] (1998) Am J Orthod Dentofacial Orthop, 113 (1), pp. 15-18Dugoni, S.A., Comprehensive mixed dentition treatment (1998) Am J Orthod Dentofacial Orthop, 113 (1), pp. 75-84Sadowsky, P.L., Craniofacial growth and the timing of treatment (1998) Am J Orthod Dentofacial Orthop, 113 (1), pp. 19-23Silva Filho, O.G., Okada, H., Aiello, C.A., Ortodontia interceptiva: Correção precoce de irregularidades na região ântero-superior (1998) Ortodontia, 31 (2), pp. 113-121Tung, A.W., Kiyak, H.A., Psychological influences on the timing of orthodontic treatment (1998) Am J Orthod Dentofacial Orthop, 113 (1), pp. 29-39White, L., Early orthodontic intervention (1998) Am J Orthod Dentofacial Orthop, 113 (1), pp. 24-28Yang, E.Y., Kiyak, A., Orthodontic treatment timing: A survey of orthodontists (1998) Am J Orthod Dentofacial Orthop, 113 (1), pp. 96-103Araújo, M.G.M., Ortodontia para clínicos: Programa pré-ortodôntico (1988) São Paulo: Livraria e Editora, pp. 21-26. , 4a ed, Santos;McDonald RE, Avery DR. Diagnóstico e correção de pequenas irregularidades na dentição em desenvolvimento. In: McDonald RE, Avery DR, organizadores. Odontopediatria. 4a ed. Rio de Janeiro: Guanabara Koogan1983. p.493-96Varela, C.B., A arte de amamentar seu filho (1984) Petrópolis: Editora Vozes/Cidade Nova Editora, , 3a edMartins Filho, J., Como e porque amamentar (1987) São Paulo: Savier Editora, , 2a edVarrela, J., Occurrence of malocclusion in attritive environment: A study of a skull sample from southwest Finland (1990) Scand J Dent Res, 98 (3), pp. 242-247Almeida, R.R., Santos, S.C.B.N., Santos, E.C.A., Insabralde, C.M.B., Almeida, M.R., Mordida aberta anterior - considerações e apresentação de um caso clínico (1998) Rev Dent Press Ortodon Ortop Facial, 3 (2), pp. 17-29Moura, W.V.B., Maia, F.A., Maia, N.G., Avaliação do Modus Operandi dos procedimentos ortodônticos interceptores das más-oclusões na dentadura mista (1998) Rev Dent Press Ortodon Ortop Facial, 3 (6), pp. 53-60Bortolotti, R., Ribeiro, A.T.B., Barros, M.G.L., Spinassé, K.G., Mantenedores de espaço em ortodontia preventiva e interceptiva (1999) Rev Dent Press Ortodon Ortop Facial, 4 (5), pp. 25-33Bastos JRM, Peres SHCS, Ramires I. Educação para a saúde. In: AC Pereira, organizador. Odontologia em saúde coletiva: planejando ações e promovendo saúde. 1 a ed. Porto Alegre: Artmed2003. p. 117-39Almeida, R.R., Garib, D.G., Henriques, J.F.C., Almeida, M.R., Almeida, R.R., Ortodontia preventiva e interceptora: Mito ou realidade? (1999) Rev Dent Press Ortodon Ortop Facial, 4 (6), pp. 87-108Maia, F.A., Cefalometria para o clínico geral e o odontopediatra (1988) São Paulo: Ed, , Santos;Moyers RE, Riolo ML. Tratamento precoce. In: Moyers RE, organizador. Ortodontia. 4a ed. Rio de Janeiro: Guanabara Koogan1991. p. 292-368Ministério da Saúde, (1997) Norma Operacional Básica do Sistema Único de Saúde/NOB-SUS, 96. , Brasília: Ministério da Saúde;Maciel, S.M., (2003) A promoção da eqüidade na triagem de usuários da clínica ortodôntica da UFJF: Elementos para uma política pública e renovadora de saúde bucal, , dissertação, Rio de Janeiro RJ, Instituto de Medicina Social;Cunha, A.C.P.P., (2002) Avaliação da capacidade dos índices DAÍ e IOTN em estabelecer a necessidade de tratamento ortodôntico, , dissertação, Natal RN, Universidade Federal do Rio Grande do Norte, Centro de Ciências da Saúde de Natal;McLain, J.B., Profitt, W.R., Oral health status in the United States: Prevalence in malocclusion (1985) J Dent Educ, 49 (6), pp. 386-396Maia, F.A., Galvão, N.M., Ortodontia preventiva: Programa de odontologia preventiva do C.A.I (1984) O Dentista, p. 2Al Nimri, K., Richardson, A., Interceptive orthodontics in the real world of community dentistry (2000) Int J Paediatr Dent, 10 (2), pp. 99-108Ministério da Saúde, (2004) Relatório Final: 3a Conferência Nacional de Saúde Bucal. Saúde bucal: acesso e qualidade, superando a exclusão social, , Brasília: Ministério da Saúde;Moyers RE. Planejamento do tratamento ortodôntico. In: Moyers RE, organizador. Ortodontia. 4a ed. Rio de Janeiro: Guanabara Koogan1991. p. 281-291Levantamento Epidemiológico Básico de Saúde Bucal: Manual de Instruções (1991) São Paulo: Editora, , Organização Mundial da Saúde, 3a ed, Santos