Evaluation of toxic/protective effects of the essential oil of Salvia officinalis on freshly isolated rat hepatocytes

For this study the essential oil (EO) of sage (Salvia officinalis L.) was isolated from air-dried vegetative aerial parts of the plants by hydrodistillation and analysed by GC and GC-MS. A total yield of 12.07 mg of EO per g of plant dry mass was obtained and more than 50 compounds identified. The major compounds were cis-thujone (17.4 %), alpha-humulene (13.3 %), 1,8-cineole (12.7 %), E-caryophyllene (8.5 %) and borneol (8.3 %). The EO fraction of sage tea was also isolated by partition with pentane and the respective components identified. The toxic and antioxidant protective effects of S. officinalis EO were evaluated on freshly isolated rat hepatocytes. Cell viability (LDH leakage), lipid peroxidation and glutathione status were measured in experiments undertaken with cells (suspensions of 1x106 cells per millilitre) exposed to EO alone (toxicity of the EO; t-BHP as positive control); and with cells exposed to EO and an oxidative compound (t-BHP) together (in EO protection evaluation; quercetin as positive control) for 30 min. The results show that the EO is not toxic when present at concentrations below 200 nl/ml; it was only at 2000 nl EO/ml that a significant LDH leakage and GSH decrease were observed indicating cell damage. In the range of concentrations tested, the EO did not show protective effects against t-BHP-induced toxicity.Fundação para a Ciência e a Tecnologia (FCT) - SFRH/BD/6942/2001, POCTI/AGR/43482/2001

Hepatotoxicity of an essential oil of Salvia officinalis L.: an in vitro study using freshly isolated rat hepatocytes

Sage (Salvia officinalis L.) is a popular Mediterranean aromatic herb that is cultivated worldwide. It is used since ancient times as a medicinal herb for treating a variety of ailments and has a reputation for memory enhancement [1,2]. It is also commonly used for flavouring and seasoning of foods, most of their properties being due to essential oils [1,3]. Sage extracts have also been reported to have an antioxidant effects and excellent properties in inhibiting lipid peroxidation [1]. Sage derivatives continue to be important components of contemporary phytopharmaceuticals, although their potentially toxic effects have not received much attention. In this study, the hepatotoxicity of an essential oil obtained by hydrodistilled aerial parts of Salvia officinalis L. plants (12 mg/g dry weight) harvested in April 2000, cultivated in Arouca experimental farms in northern Portugal, was investigated in freshly isolated rat hepatocytes. The studied concentrations (0 microL/ml, 0.08 microL/ml, 0.4 microL/ml, 2 microL/ml, and 10 microL/ml) did not induce lipid peroxidation measured by the thiobarbituric acid reactive substances (TBARS) assay. However, it was observed a concentration dependent increase of lactate dehydrogenase leakage of 30 min of incubation with the essential oil (18.1%, 21.4%, 28.0%, 29.4%, and 51.6%). Values of reduced and oxidized glutathione will also be discussed. Tert-butylhydroperoxide (1.0 mM, 30 min), a well-known toxic compound, was used as positive control for cell damage. Our results show that care should be taken when applying essential oils in the food industry or as alternative medicines because of their potentially toxic effects on the liver

2-Styrylchromones as novel inhibitors of xanthine oxidase. A structure-activity study

The purpose of this study was the evaluation of the xanthine oxidase (XO) inhibition produced by some synthetic 2-styrylchromones. Ten polyhydroxylated derivatives with several substitution patterns were synthesised, and these and a positive control, allopurinol, were tested for their effects on XO activity by measuring the formation of uric acid from xanthine. The synthesised 2-styrylchromones inhibited xanthine oxidase in a concentration-dependent and non-competitive manner. Some IC50 values found were as low as 0.55mM, which, by comparison with the IC50 found for allopurinol (5.43 mM), indicates promising new inhibitors. Those 2-styrylchromones found to be potent XO inhibitors should be further evaluated as potential agents for the treatment of pathologies related to the enzyme’s activity, as is the case of gout, ischaemia/ reperfusion damage, hypertension, hepatitis and cancer

Validação do conceito risco de débito cardíaco diminuído

OBJECTIVES: to validate the concept risk for decreased cardiac output. METHOD: Six of the eight steps suggested in the technique developed by Walker & Avant were adopted to analyze the concept of the phenomenon under study and the proposal made by Hoskins was used for content validation, taking into account agreement achieved among five experts. RESULTS: the concept decreased cardiac output was found in the nursing and medical fields and refers to the heart's pumping capacity while the concept risk is found in a large number of disciplines. In regard to the defining attributes, impaired pumping capacity was the main attribute of decreased cardiac output and probability was the main attribute of risk. The uses and defining attributes of the concepts decreased cardiac output and risk were analyzed as well as their antecedent and consequent events in order to establish the definition of risk for decreased cardiac output, which was validated by 100% of the experts. CONCLUSION: The obtained data indicate that the risk for decreased cardiac output phenomenon can be a nursing diagnosis and refining it can contribute to the advancement of nursing classifications in this context.OBJETIVO: Validar el concepto riesgo del débito cardíaco disminuido. MÉTODO: Fue adoptada la técnica de Walker & Avant para analizar la definición del fenómeno enfocado, utilizando seis de las ocho etapas sugeridas y la propuesta de Hoskins para validar el contenido, considerándose la conformidad entre cinco expertos. RESULTADOS: el concepto de debito cardíaco disminuido se encuentra en las áreas enfermería y médica y su atención se centra en la capacidad de bombeo del corazón. Sin embargo, el concepto de riesgo es presente en un gran número de áreas. Las características definitorias de la disminución del gasto cardíaco mostraron como principal atributo deficiencia de la bomba cardiaca y, para el riesgo, el atributo de probabilidad. Analizados los usos y características definidoras de los conceptos débito cardíaco disminuido y riesgo con los hechos anteriores y subsiguientes, fue posible elaborar la definición de riesgo de débito cardíaco disminuido, la cual fue validada por 100% de los expertos. CONCLUSIÓN: Los resultados encontrados permitieron concluir que el fenómeno de riesgo de débito cardíaco disminuido puede constituir un diagnóstico de enfermería y su refinamiento puede contribuir al avance de las clasificaciones de enfermería.OBJETIVO: validar o conceito de risco de débito cardíaco diminuído. MÉTODO: foi adotada a técnica de Walker & Avant para a análise do conceito do fenômeno em foco, com utilização de seis das oito etapas sugeridas, e da proposta de Hoskins para validação de conteúdo, considerando-se a concordância entre cinco especialistas. RESULTADOS: o conceito de débito cardíaco diminuído foi encontrado nas áreas de enfermagem e médica e está centrado na capacidade de bombeamento do coração, embora também esteja presente em um grande número de disciplinas. Em relação aos atributos definidores, o débito cardíaco diminuído teve como atributo principal a deficiência de bombeamento cardíaco e o risco, o atributo de probabilidade. Analisados os usos e os atributos definidores dos conceitos de débito cardíaco diminuído e risco, seus eventos antecedentes e consequentes, construiu-se a definição de risco de débito cardíaco diminuído, que foi validada por 100% dos especialistas. CONCLUSÃO: os dados obtidos permitiram inferir que o fenômeno risco de débito cardíaco diminuído pode se constituir num diagnóstico de enfermagem e, por meio do seu refinamento, contribuir para o avanço das classificações de enfermagem nesse contexto.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de EnfermagemUNIFESP, EPESciEL

Validation of the concept Risk for Decreased Cardiac Output

OBJECTIVES: to validate the concept "risk for decreased cardiac output". METHOD: Six of the eight steps suggested in the technique developed by Walker & Avant were adopted to analyze the concept of the phenomenon under study and the proposal made by Hoskins was used for content validation, taking into account agreement achieved among five experts. RESULTS: the concept "decreased cardiac output" was found in the nursing and medical fields and refers to the heart's pumping capacity while the concept "risk" is found in a large number of disciplines. In regard to the defining attributes, "impaired pumping capacity" was the main attribute of decreased cardiac output and "probability" was the main attribute of risk. The uses and defining attributes of the concepts "decreased cardiac output" and "risk" were analyzed as well as their antecedent and consequent events in order to establish the definition of "risk for decreased cardiac output", which was validated by 100% of the experts. CONCLUSION: The obtained data indicate that the risk for decreased cardiac output phenomenon can be a nursing diagnosis and refining it can contribute to the advancement of nursing classifications in this context.OBJETIVO: Validar el concepto riesgo del débito cardíaco disminuido. MÉTODO: Fue adoptada la técnica de Walker & Avant para analizar la definición del fenómeno enfocado, utilizando seis de las ocho etapas sugeridas y la propuesta de Hoskins para validar el contenido, considerándose la conformidad entre cinco expertos. RESULTADOS: el concepto de debito cardíaco disminuido se encuentra en las áreas enfermería y médica y su atención se centra en la capacidad de bombeo del corazón. Sin embargo, el concepto de riesgo es presente en un gran número de áreas. Las características definitorias de la disminución del gasto cardíaco mostraron como principal atributo deficiencia de la bomba cardiaca y, para el riesgo, el atributo de probabilidad. Analizados los usos y características definidoras de los conceptos "débito cardíaco disminuido" y "riesgo" con los hechos anteriores y subsiguientes, fue posible elaborar la definición de "riesgo de débito cardíaco disminuido", la cual fue validada por 100% de los expertos. CONCLUSIÓN: Los resultados encontrados permitieron concluir que el fenómeno de riesgo de débito cardíaco disminuido puede constituir un diagnóstico de enfermería y su refinamiento puede contribuir al avance de las clasificaciones de enfermería.OBJETIVO: validar o conceito de risco de débito cardíaco diminuído. MÉTODO: foi adotada a técnica de Walker & Avant para a análise do conceito do fenômeno em foco, com utilização de seis das oito etapas sugeridas, e da proposta de Hoskins para validação de conteúdo, considerando-se a concordância entre cinco especialistas. RESULTADOS: o conceito de débito cardíaco diminuído foi encontrado nas áreas de enfermagem e médica e está centrado na capacidade de bombeamento do coração, embora também esteja presente em um grande número de disciplinas. Em relação aos atributos definidores, o débito cardíaco diminuído teve como atributo principal a deficiência de bombeamento cardíaco e o risco, o atributo de probabilidade. Analisados os usos e os atributos definidores dos conceitos de "débito cardíaco diminuído" e "risco", seus eventos antecedentes e consequentes, construiu-se a definição de risco de débito cardíaco diminuído, que foi validada por 100% dos especialistas. CONCLUSÃO: os dados obtidos permitiram inferir que o fenômeno risco de débito cardíaco diminuído pode se constituir num diagnóstico de enfermagem e, por meio do seu refinamento, contribuir para o avanço das classificações de enfermagem nesse contexto

Primary Urethral Carcinoma in a Bitch - Multimodal Treatment

Background: Urethral tumors are uncommon in canines, represented predominantly by transitional cell carcinoma, marked by aggressive behavior associated with short life expectancy. Definitive diagnosis is achieved by histopathological analysis. Surgery associated with chemotherapy is the main therapeutic alternative. The aim of this paper is to report a case of primary transitional cell carcinoma of the urethra in a bitch, submitted to surgical treatment associated with conventional adjuvant chemotherapy and metronomic chemotherapy, achieving survival of 21 months, to date. Case: A 12-year-old bitch mixed breed was admitted at the Veterinary Hospital of Federal Rural University of Rio de Janeiro (UFRRJ), manifesting hematuria and urinary incontinence for one month. Physical examination indicated that vital parameters were within normal limits. Laboratory tests of blood count and serum biochemistry, urinalysis, culture, urinary antibiogram, and abdominal ultrasound were performed. The ultrasound image suggested a neoplastic urethral process. Because of the suspicion of neoplasm, a thoracic X-ray was performed, showing no evidence of metastasis. Computed tomography (CT) of the abdominal region was performed, revealing an expansive lesion in the urethra with loss of definition of the walls and urethral lumen extending to the level of the pelvic floor, measuring about 2.9 x 1.4 x 1.2 cm. After pre-anesthetic exams, the animal underwent resection and surgical anastomosis of the affected urethral region. The sectioned tissue was sent for histopathological analysis, with diagnosis of transitional cell carcinoma. Adjuvant chemotherapy was performed using carboplatin at a dose of 250 mg/m², intravenously, every 21 days for 6 sessions. After completing the protocol, abdominal ultrasonography was performed again, which showed a cicatricial process in the urethral region of the surgical excision, with no sign of tumor recurrence. A metronomic chemotherapy protocol was then started with cyclophosphamide at a dose of 15 mg/m², daily for 6 months, with periodic oncological follow-up. At the end of the period, the animal remained under periodic follow-up with ultrasound exams performed at 2-month intervals, and has been free from recurrence for 21 months until now. Discussion: Urethral neoplasms account for 0.5 - 2% of all canine tumors, and are represented mostly by transitional cell carcinomas. Clinical signs of urinary obstruction and hematuria are the most common, as reported in the patient in question. The definitive diagnosis is by histopathological examination. However, imaging tests such as computed tomography are important in the initial investigation and surgical planning. The indicated treatment is surgical resection of the mass with subsequent adjuvant chemotherapy or radiotherapy. The chemotherapy protocol associating cisplatin and piroxicam can achieve remission rates of 70%, but this association has a high nephrotoxic effect. In the present case, cisplatin was replaced by carboplatin in order to reduce the nephrotoxic effects of chemotherapy. The metronomic protocol using cyclophosphamide was used as maintenance therapy, at the end of the conventional chemotherapy protocol. Survival achieved was longer than that described in the literature in cases of transitional cell carcinomas in the urethral region. Therefore, multimodal therapy using surgery associated with conventional and metronomic chemotherapy, is an option in canines with urethral carcinoma. Keywords: canine, urethral neoplasm, surgery, chemotherapy. Título: Carcinoma uretral primário em uma cadela - tratamento multimodal Descritores: canino, neoplasia uretral, cirurgia, quimioterapia

Pharmacological interventions for COVID-19: Protocol for a Rapid Living Systematic Review with network meta-analysis

CONTEXT AND OBJECTIVE: Coronavirus disease 2019 (COVID-19) has emerged in China in December 2019 and rapidly spread. Although extraordinary efforts have been made on research regarding pharmacological interventions, none have proven effective. This is the protocol for a rapid living systematic review that aims to compare the effectiveness and safety of different pharmacological interventions for the treatment of COVID-19. METHODS: rapid living systematic review methodology with Network Meta-Analysis following the recommendations of Cochrane Handbook. We will include randomized controlled trials (RCT) and quasi-RCTs that evaluate single and/or combined pharmacological interventions at any dose for the treatment of COVID-19. We will search Medline via PubMed, Embase via Elsevier, Cochrane Library - Cochrane Central Register of Controlled Trials (CENTRAL), Portal Regional BVS - LILACS, Scopus and WebofScience to identify potentially eligible studies. No language restrictions will be used in the selection. We will perform the critical appraisal of included studies with the Risk of Bias tool and the certainty of evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE)

PROGNOSTIC FACTORS FOR CLINICAL COURSE OF PATIENTS WITH COVID-19: PROTOCOL FOR A RAPID LIVING SYSTEMATIC REVIEW

CONTEXT AND OBJECTIVE: Determining prognostic factors in a context of health crises such as the COVID-19 scenario may provide the best possible care for patients and optimize the management and the resource utilization of the health system. Thus, we aim to systematically review the prognostic factors for different outcomes of patients with COVID-19. DESIGN AND SETTING: Protocol for a rapid living systematic review methodology following the recommendations proposed by the Cochrane Handbook. METHODS: We will include cohorts and case‐control studies. We will search Medline via PubMed, Embase via Elsevier, Cochrane Library - Cochrane Central Register of Controlled Trials (CENTRAL), Portal Regional BVS- LILACS, Scopus and WebofScience to identify studies. No language restrictions will be applied. We will perform the critical appraisal of included studies with the Quality in Prognosis Studies (QUIPS) tool and the certainty of evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE)

Telehealth interventions in the context of the COVID-19 pandemic: Protocol for a scoping review

CONTEXT AND OBJECTIVE: The current health crisis due to COVID-19 is forcing us to profoundly rethink our social organizations and practices in health. While there is no effective treatment for the virus, staying home and social isolation are the control measures recommended by health authorities. The aim of this study is to perform a scoping review in order to summarize the current evidence in telehealth for COVID-19. METHODS: This study is a protocol to describe the rationale, hypothesis and planned methods of our scoping review. We will include randomized controlled trials (RCTs), observational cohort studies, case-control studies, cross-sectional studies, qualitative studies, and/or case series that describe telehealth interventions applied or developed to respond to COVID-19. We will search Medline via PubMed, Embase via Elsevier, Cochrane Library - Cochrane Central Register of Controlled Trials (CENTRAL), Portal Regional BVS - LILACS, and Scopus. We will include studies performed since December 2019 with no language restrictions. We will use the Risk of Bias tool and the Newcastle-Ottawa Scale to perform the critical appraisal of included studies. We will assess the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE)