24 research outputs found

    Inhibition of cyclooxygenase-2 in experimental severe acute pancreatitis

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    BACKGROUND: The standard treatment for acute pancreatitis (AP) is still based on supportive care. The search for a new drug that could change the natural history of the disease is a continuing challenge for many researchers. The aim of this study is to evaluate the effect of a cyclooxygenase-2 (COX-2) inhibitor on experimental AP in rats. METHODS: The animals were divided into 2 groups: Group 1 (n = 30)-animals with taurocholate-induced AP treated with parecoxib (40 mg/kg). Group 2 (n = 30)-animals with taurocholate-induced AP that received saline. The COX-2 inhibitor (parecoxib) was injected immediately after AP induction, through the penis dorsal vein. The parameters evaluated were histology, serum levels of amylase, IL-6 and IL-10, and mortality rate. RESULTS: The serum levels of IL-6 and IL-10 in the parecoxib-treated group were lower than the control group. The amylase serum levels and the mortality rate remained unchanged in the treated animals. Histologic morphology also was unaltered, except for fat necrosis, which was higher in parecoxib-treated rats. CONCLUSION: Inhibition of Cox-2 decreases the systemic release of inflammatory cytokines, but has a poor effect on the direct pancreas injury caused by taurocholate.INTRODUÇÃO: O tratamento padrĂŁo para a pancreatite aguda permanece baseado em medidas de suporte. A busca por uma droga que altere a histĂłria natural da doença ainda Ă© um desafio para muitos pesquisadores. O objetivo deste estudo Ă© avaliar o efeito de um inibidor da COX-2 na pancreatite aguda grave experimental (PA) em ratos. MÉTODO: Os animais foram divididos em dois Grupos: Grupo 1 (n=30) - animais com PA induzida por taurocolato e tratados com parecoxib (40mg/Kg). Grupo 2 (n=30) - animais com PA induzida por taurocolato que receberam solução salina. O inibidor de COX-2 (parecoxib) foi injetado imediatamente apĂłs a indução, atravĂ©s da veia dorsal do pĂȘnis. Os parĂąmetros avaliados foram histologia, nĂ­veis sĂ©ricos de amilase, IL-6 e IL-10 e taxa de mortalidade. RESULTADOS: Os nĂ­veis sĂ©ricos de IL-6 e IL-10 foram menores do que no grupo controle. Os nĂ­veis sĂ©ricos de amilase e a taxa de mortalidade permaneceram inalteradas. A anĂĄlise histolĂłgica tambĂ©m nĂŁo mostraram alteraçÔes, exceto pela necrose gordurosa, que foi maior nos animais controle. CONCLUSÃO: A inibição da COX-2 pode reduzir a liberação sistĂȘmica de pelo menos duas citocinas, mas tem pouco efeito na lesĂŁo pancreĂĄtica direta causada pelo taurocolato

    Can COVID-19 impact the natural history of paracoccidioidomycosis? Insights from an atypical chronic form of the mycosis

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    Paracoccidioidomycosis (PCM) is a systemic fungal infection caused by Paracoccidioides spp. It can occur as an acute/subacute form (A/SAF), a chronic form (CF) and rarely as a mixed form combining the features of the two aforementioned forms in an immunocompromised patient. Here, we report a 56-year-old male patient with CF-PCM who presented with atypical manifestations, including the development of an initial esophageal ulcer, followed by central nervous system (CNS) lesions and cervical and abdominal lymphatic involvement concomitant with severe SARS-CoV-2 infection. He was HIV-negative and had no other signs of previous immunodeficiency. Biopsy of the ulcer confirmed its mycotic etiology. He was hospitalized for treatment of COVID-19 and required supplemental oxygen in the intensive unit. The patient recovered without the need for invasive ventilatory support. Investigation of the extent of disease during hospitalization revealed severe lymphatic involvement typical of A/SAF, although the patient`s long history of high-risk exposure to PCM, and lung involvement typical of the CF. Esophageal involvement is rare in non-immunosuppressed PCM patients. CNS involvement is also rare. We suggest that the immunological imbalance caused by the severe COVID-19 infection may have contributed to the patient developing atypical severe CF, which resembles the PCM mixed form of immunosuppressed patients. Severe COVID-19 infection is known to impair the cell-mediated immune response, including the antiviral response, through T-lymphopenia, decreased NK cell counts and T-cell exhaustion. We hypothesize that these alterations would also impair antifungal defenses. Our case highlights the potential influence of COVID-19 on the course of PCM. Fortunately, the patient was timely treated for both diseases, evolving favorably

    Is there a therapeutic window for pentoxifylline after the onset of acute pancreatitis? Existe uma janela terapĂȘutica para a pentoxifilina apĂłs o inĂ­cio da pancreatite aguda?

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    PURPOSE: To investigate the effects of pentoxifylline (PTX) in experimental acute pancreatitis (AP) starting drug administration after the induction of the disease. METHODS: One hundred male Wistar rats were submitted to taurocholate-induced AP and divided into three groups: Group Sham: sham-operated rats, Group Saline: AP plus saline solution, and Group PTX: AP plus PTX. Saline solution and PTX were administered 1 hour after induction of AP. At 3 hours after AP induction, peritoneal levels of tumor necrosis factor (TNF)-&#945;, and serum levels of interleukin (IL)-6 and IL-10 levels were assayed by Enzyme-Linked Immunosorbent Assay (ELISA). Determinations of lung myeloperoxidase activity (MPO), histological analysis of lung and pancreas, and mortality study were performed. RESULTS: PTX administration 1 hour after induction of AP caused a significant decrease in peritoneal levels of TNF-&#945; and in serum levels of IL-6 and IL-10 when compared to the saline group. There were no differences in lung MPO activity between the two groups with AP. A decrease in mortality was observed in the PTX treatment compared to the saline group. CONCLUSIONS: Administration of PTX after the onset of AP decreased the systemic levels of proinflammatory cytokines, raising the possibility that there is an early therapeutic window for PTX after the initiation of AP.<br>OBJETIVO: Investigar os efeitos da pentoxifilina (PTX) na pancreatite aguda (PA) experimental administrando a droga apĂłs a indução da doença. MÉTODOS: Cem ratos machos Wistar foram submetidos Ă  indução da PA atravĂ©s da infusĂŁo de taurocolato de sĂłdio e divididos em trĂȘs grupos: Grupo Sham: sham-operated ratos, Grupo Salina: AP e solução salina, e Grupo PTX: AP e PTX. Solução salina e PTX foram administradas 1 hora apĂłs a indução da PA. TrĂȘs horas apĂłs indução da PA os nĂ­veis de fator de necrose tumoral (TNF)-&#945; no lĂ­quido peritoneal e os nĂ­veis sĂ©ricos de interleucina (IL)-6 e IL-10 foram analisados pelo mĂ©todo de Enzima Imunoensaio (ELISA). A atividade da mieloperoxidase (MPO) foi analisada no pulmĂŁo e foram realizadas anĂĄlises histolĂłgicas do pulmĂŁo e pĂąncreas, alĂ©m do estudo da mortalidade. RESULTADOS: A administração de PTX 1 hora apĂłs a indução da PA reduziu significativamente os nĂ­veis de TNF-&#945; peritoneal e os nĂ­veis sĂ©ricos de IL-6 e IL-10 quando comparado ao grupo salina. Redução na mortalidade foi observado apĂłs o tratamento com PTX comparado ao grupo salina. CONCLUSÃO: A administração de PTX apĂłs a indução da PA diminuiu os nĂ­veis sistĂȘmicos de citocinas prĂł-inflamatĂłrias, sugerindo a possibilidade de que existe uma janela terapĂȘutica para PTX apĂłs o inĂ­cio do PA

    Biliary tract schwannoma: A rare cause of obstructive jaundice in a young patient

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    Schwannoma is a tumor derived from Schwann cells which usually arises in the upper extremities, trunk, head and neck, retroperitoneum, mediastinum, pelvis, and peritoneum. However, it can arise in the gastrointestinal tract, including biliary tract. We present a 24-year-old male patient with obstructive jaundice, whose investigation with computed tomography abdomen showed focal wall thickening in the common hepatic duct, difficult to differentiate with hilar adenocarcinoma. He was diagnosed intraoperatively schwannoma of common bile duct and treated with local resection. The patient recovered well without signs of recurrence of the lesion after 12 mo. We also reviewed the common bile duct schwannoma related in the literature and evaluated the difficulty in pre and intraoperative differential diagnosis with adenocarcinoma hilar. Resection is the treatment of choice for such cases and the tumor did not recur in any of the resected cases. (C) 2012 Baishideng. All rights reserved

    Lymph Node Involvement and Not the Histophatologic Subtype Is Correlated with Outcome After Resection of Adenocarcinoma of the Ampulla of Vater

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    Background Intestinal and pancreaticobiliary types of Vater`s ampulla adenocarcinoma have been considered as having different biologic behavior and prognosis. The aim of the present study was to determine the best immunohistochemical panel for tumor classification and to analyze the survival of patients having these histological types of adenocarcinoma. Method Ninety-seven resected ampullary adenocarcinomas were histologically classified, and the prognosis factors were analyzed. The expression of MUC1, MUC2, MUC5AC, MUC6, CK7, CK17, CK20, CD10, and CDX2 was evaluated by using immunohistochemistry. Results Forty-three Vater`s ampulla carcinomas were histologically classified as intestinal type, 47 as pancreaticobiliary, and seven as other types. The intestinal type had a significantly higher expression of MUC2 (74.4% vs. 23.4%), CK20 (76.7% vs. 29.8%), CDX2 (86% vs. 21.3%), and CD10 (81.4% vs. 51.1%), while MUC1 (53.5% vs. 82.9%) and CK7 (79.1% vs. 95.7%) were higher in pancreatobiliary adenocarcinomas. The most accurate markers for immunohistochemical classification were CDX2, MUC1, and MUC2. Survival was significantly affected by pancreaticobiliary type (p=0.021), but only lymph node metastasis, lymphatic invasion, and stage were independent risk factors for survival in a multivariate analysis. Conclusion The immunohistochemical expression of CDX2, MUC1, and MUC2 allows a reproducible classification of ampullary carcinomas. Although carcinomas of the intestinal type showed better survival in the univariate analysis, neither histological classification nor immunohistochemistry were independent predictors of poor prognosis
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