Effects of hecogenin and its possible mechanism of action on experimental models of gastric ulcer in mice

This study investigates the gastroprotective effects of hecogenin, a steroid saponin isolated from Agave sisalana, on experimental models of gastric ulcer. Male Swiss mice were used in the models of ethanol-and indometacin-induced gastric ulcer. To clarify the hecogenin mechanism of action, the roles of nitric oxide (NO), sulfhydryls (GSH), K-ATP(+) channels and prostaglandins were also investigated, and measurements of lipid peroxidation (TBARS assay) and nitrite levels in the stomach of hecogenin-treated and untreated animals were performed. Furthermore, the effects of hecogenin on myeloperoxidase (MPO) release from human neutrophils were assessed in vitro. Our results showed that hecogenin (3.1, 7.5, 15, 30, 60 and 90 mg/kg, p.o.) acutely administered, before ethanol or indomethacin, exhibited a potent gastroprotective effect. Although the pretreatments with L-NAME, an iNOS inhibitor, and capsazepine, a TRPV1 receptor agonist, were not able to reverse the hecogenin effect, this was reversed by glibenclamide, a K-ATP(+) blocker, and indomethacin in the model of ethanol-induced gastric lesions. the hecogenin pretreatment normalized GSH levels and significantly reduced lipid peroxidation and nitrite levels in the stomach, as evaluated by the ethanol-induced gastric lesion model. the drug alone increased COX-2 expression and this effect was further enhanced in the presence of ethanol. It also decreased MPO release and significantly protected the gastric mucosa. in conclusion, we showed that hecogenin presents a significant gastroprotective effect that seems to be mediated by K-ATP(+) channels opening and the COX-2/PG pathway. in addition, its antioxidant and anti-inflammatory properties may play a role in the gastroprotective drug effect. (C) 2012 Elsevier B. V. All rights reserved.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Univ Fed Ceara, Dept Physiol & Pharmacol, BR-60431270 Fortaleza, Ceara, BrazilUniv Fed Ceara, Dept Pharm, BR-60431270 Fortaleza, Ceara, BrazilUniv Fed Paraiba, Dept Pharmaceut Sci, BR-58100000 Joao Pessoa, Paraiba, BrazilUniv Fed Ceara, Dept Morphol, BR-60431270 Fortaleza, Ceara, BrazilUniversidade Federal de São Paulo, Dept Pharmacol, BR-04044020 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pharmacol, BR-04044020 São Paulo, BrazilWeb of Scienc

Gastroplastia Endoscópica Vertical (GEV): nova técnica de cirurgia bariátrica minimamente invasiva para o tratamento da obesidade e seus desafios quanto à anatomia gastroesofágica: Endoscopic Sleeve Gastroplasty (ESG): a new minimally invasive bariatric surgery technique for the treatment of obesity and its challenges as to gastroesophageal anatomy

INTRODUÇÃO: Na medicina, técnicas cada vez menos invasivas são desenvolvidas para o tratamento de doenças. A gastroplastia endoscópica é uma nova alternativa terapêutica da obesidade, antes tratada basicamente por medicamentos e bypass gástrico (NETO, 2018). Esse procedimento ocorre sem a realização de cortes, diminuindo as complicações operatórias (HUBERTY, 2018). O estômago, então, tem seu volume reduzido através da aplicação do sistema de sutura endoscópica OverStitch, sendo de extrema importância o conhecimento anatômico do segmento gastroesofágico (SOWIER, 2018). OBJETIVO: Apresentar a técnica da GEV e compará-la com o bypass gástrico realizado por via laparoscópica, abordando a importância de conhecer-se a anatomia gástrica para a realização da gastroplastia. METODOLOGIA: Consistiu na revisão bibliográfica das principais bases de dados virtuais, como SciElo e PubMed. DISCUSSÃO E RESULTADOS: A GEV, utilizando o sistema de sutura endoscópica OverStitch, objetiva a redução da luz gástrica por meio da sua tubulização; acoplado a um endoscópio, permite a realização de pontos totais com a utilização de uma agulha curva e fio de polipropoleno 2-0. O primeiro ponto é dado ao nível da incisura angular, sendo realizados pontos em “U” na ordem: parede anterior -> grande curvatura -> parede posterior, com repetição em sentido contrário, sendo todo o procedimento realizado em 2h (NETO, 2018). Nota-se que, diferentemente da técnica do bypass gástrico, não ocorre nenhuma alteração anatômica irreversível na cavidade gástrica, permitindo reintervenção para alcançar resultados duradouros (NAVA, 2016). Vale ressaltar que é de extrema importância que o cirurgião conheça bem a anatomia interna do estômago, uma vez que a cirurgia é realizada por essa via. CONCLUSÃO: A GEV é, atualmente, a alternativa mais segura dentre outras cirurgias bariátricas. Em comparação ao bypass gástrico, essa nova cirurgia é menos invasiva, com curto tempo de procedimento, o que diminui riscos no pós-operatório, sendo possível tratar a obesidade de um modo mais seguro e rápido, além de realizar uma alteração anatômica reversível no estômago

The Bacterium Endosymbiont of Crithidia deanei Undergoes Coordinated Division with the Host Cell Nucleus

In trypanosomatids, cell division involves morphological changes and requires coordinated replication and segregation of the nucleus, kinetoplast and flagellum. In endosymbiont-containing trypanosomatids, like Crithidia deanei, this process is more complex, as each daughter cell contains only a single symbiotic bacterium, indicating that the prokaryote must replicate synchronically with the host protozoan. In this study, we used light and electron microscopy combined with three-dimensional reconstruction approaches to observe the endosymbiont shape and division during C. deanei cell cycle. We found that the bacterium replicates before the basal body and kinetoplast segregations and that the nucleus is the last organelle to divide, before cytokinesis. In addition, the endosymbiont is usually found close to the host cell nucleus, presenting different shapes during the protozoan cell cycle. Considering that the endosymbiosis in trypanosomatids is a mutualistic relationship, which resembles organelle acquisition during evolution, these findings establish an excellent model for the understanding of mechanisms related with the establishment of organelles in eukaryotic cells

CÂNCER DE PELE: INCIDÊNCIAS, DIAGNÓSTICO E CIRURGIA DE MOHS

Skin cancer poses a global concern due to its significant prevalence. With subtypes such as basal cell carcinoma, squamous cell carcinoma, and melanoma, its incidence is linked to chronic sun exposure, especially in regions with high levels of ultraviolet radiation. Early detection is critical for effective intervention. Mohs surgery stands out as a highly precise approach. This micrographic technique enables the gradual removal of lesions, allowing meticulous preservation of the healthy tissue surrounding them. However, in Brazil, although recognized as an effective technique, the availability of Mohs surgery may face access challenges, limiting its application to a portion of the population.O câncer de pele é uma preocupação global devido à sua prevalência significativa. Com        subtipos como carcinoma basocelular, espinocelular e melanoma, sua incidência está         associada à exposição solar crônica, especialmente em regiões com altos níveis de radiação      ultravioleta. Essa condição exige detecção precoce para intervenção eficaz. A cirurgia de             Mohs destaca-se como uma abordagem altamente precisa. Essa técnica micrográfica               possibilita a remoção gradual de lesões, permitindo a preservação cuidadosa do tecido       saudável ao redor. No entanto, no Brasil, apesar de reconhecida como uma técnica eficaz, a               disponibilidade da cirurgia de Mohs pode enfrentar desafios de acesso, limitando sua         aplicação a uma parcela da população

Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry

Background. Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry. Methods. This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March–June 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time ≥ 12 h and door-to-balloon ≥ 30 min) and in-hospital or 30-day mortality. Results. We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825–0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31–2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96–1.34], p = 0.12). Conclusions. The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females. Trial registration number: NCT 04412655

Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry

Background. Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry. Methods. This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March–June 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time ≥ 12 h and door-to-balloon ≥ 30 min) and in-hospital or 30-day mortality. Results. We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825–0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31–2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96–1.34], p = 0.12). Conclusions. The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females. Trial registration number: NCT 04412655

Results of the ISACS-STEMI COVID-19 Registry

Publisher Copyright: © 2023 by the authors.Background. Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry. Methods. This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March–June 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time ≥ 12 h and door-to-balloon ≥ 30 min) and in-hospital or 30-day mortality. Results. We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825–0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31–2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96–1.34], p = 0.12). Conclusions. The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females. Trial registration number: NCT 04412655.publishersversionpublishe

Impact of chronic obstructive pulmonary disease on short-term outcome in patients with ST-elevation myocardial infarction during COVID-19 pandemic: insights from the international multicenter ISACS-STEMI registry

Background: Chronic obstructive pulmonary disease (COPD) is projected to become the third cause of mortality worldwide. COPD shares several pathophysiological mechanisms with cardiovascular disease, especially atherosclerosis. However, no definite answers are available on the prognostic role of COPD in the setting of ST elevation myocardial infarction (STEMI), especially during COVID-19 pandemic, among patients undergoing primary angioplasty, that is therefore the aim of the current study. Methods: In the ISACS-STEMI COVID-19 registry we included retrospectively patients with STEMI treated with primary percutaneous coronary intervention (PCI) between March and June of 2019 and 2020 from 109 high-volume primary PCI centers in 4 continents. Results: A total of 15,686 patients were included in this analysis. Of them, 810 (5.2%) subjects had a COPD diagnosis. They were more often elderly and with a more pronounced cardiovascular risk profile. No preminent procedural dissimilarities were noticed except for a lower proportion of dual antiplatelet therapy at discharge among COPD patients (98.9% vs. 98.1%, P = 0.038). With regards to short-term fatal outcomes, both in-hospital and 30-days mortality occurred more frequently among COPD patients, similarly in pre-COVID-19 and COVID-19 era. However, after adjustment for main baseline differences, COPD did not result as independent predictor for in-hospital death (adjusted OR [95% CI] = 0.913[0.658–1.266], P = 0.585) nor for 30-days mortality (adjusted OR [95% CI] = 0.850 [0.620–1.164], P = 0.310). No significant differences were detected in terms of SARS-CoV-2 positivity between the two groups. Conclusion: This is one of the largest studies investigating characteristics and outcome of COPD patients with STEMI undergoing primary angioplasty, especially during COVID pandemic. COPD was associated with significantly higher rates of in-hospital and 30-days mortality. However, this association disappeared after adjustment for baseline characteristics. Furthermore, COPD did not significantly affect SARS-CoV-2 positivity. Trial registration number: NCT 04412655 (2nd June 2020)