Laparoscopic approach for pancreato-splenic abscess from disseminated melioidosis: Surgical outcome and review of literature
Melioidosis is a severe systemic infection caused by Burkholderia pseudomallei. It commonly affects the lungs, liver and kidneys. Pancreatic and splenic abscess from melioidosis is rare, with few reports in the literature. We present a series of 4 patients with disseminated melioidosis of pancreas and spleen who required surgical intervention. A MEDLINE database review was conducted. Relevant publications were evaluated and demographic data, clinical, radiological findings as well as management options were collected. We found 10 case reports describing this clinical condition. In our series, median age was 57. Median operative time 260 minutes. All four patients failed trial of antibiotic therapy and required surgery. Three underwent distal pancreatosplenectomy and one underwent splenectomy alone. Laparoscopic distal pancreatosplenectomy was successful in two patients. Median length of stay 11.5 days. No post-operative complications and mortality reported. Surgery is indicated in failed medical therapy and laparoscopic approach is safe and feasible.
Infectious diseases are a significant public health challenge due to the increasing recognition of new infectious agents and the resurgence of infections until recently controlled. These infectious illnesses constitute many hospital admissions, mainly respiratory focus, which requires high-cost therapy. One of the strategies to prevent injuries leading to hospitalization is reducing the body’s inflammatory response. Thus, aromatherapy seems to be a useful adjuvant therapeutic tool due to the essential oils’ synergistic action with proven anti-inflammatory and antimicrobial properties. Hence, this study proposes an integrated review of the literature on aromatherapy as a tool to be used in prophylaxis and therapy in respiratory system disorders. After passing the criteria of exclusion and content analysis, a set of 124 articles narrowed to 44 articles that support the anti-inflammatory properties of the sesquiterpenes, such as the farnesol. This substance treats the respiratory system and is present in Cymbopogon nardus, Cymbopogon flexuosus, and Rosa damascena. Caryophyllene and its derivatives are present in Syzygium aromaticum, Rosmarinus officinalis, and Cannabis sativa. Besides, α-bisabolol and chamazulene present in Matricaria recutita and Achillea millefolium. Other oils have antibiotic properties that act against gram-positive and gram-negative bacterias according to their constitution’s complexity and interaction with these microorganisms. In this context, some species such as Cinnamomum zeylanicum, Citrus hystrix, Cymbopogon Citratus, Eucalyptus globulus, Eucalyptus odorata, Juniperus communis, Lavandula angustifólia, Lavandula intermedia, Melaleuca leucadendra, Mentha piperita, Pinus sylvestris, Syzygium aromaticum, and Thymus vulgaris are in the spotlight. Several studies, both in vitro and in vivo, have demonstrated the potential use of essential oils alone or combined with oils from other species as a strategy for the prevention of respiratory diseases and potentiation of standard therapies. This approach is possible due to the synergistic effects of substances with bioactive potential such as sesquiterpenes, monoterpenes, and phenylpropanoids.
Isolated metastasis of hepatocellular carcinoma in the right atrium: a case observed in a university hospital in West Africa (Bouake, Ivory Coast)
Intracardiac metastases from hepatocellular carcinoma (HCC) are rare and have a poor prognosis. We report an observation in a West African university hospital in a 39-year-old black patient admitted with upper gastrointestinal bleeding. Clinical examination noted signs of cirrhosis, namely hepatocellular failure, portal hypertension, melena and signs of right heart failure against a background of deterioration in general condition (WHO-3). The CT scan showed a focal hepatic lesion with arterial enhancement and portal lavage compatible with HCC and a right intracardiac mass taking contrast. Doppler echocardiography confirmed the presence of a large heterogeneous mass occupying almost the entire right atrium. Palliative and symptomatic treatment was instituted in the patient improving his clinical condition. His death occurred two months after his release. The intracardiac localization of HCC, although rare, is not exceptional and of appalling prognosis. It should be sought in the assessment of the extension of HCC, especially in the presence of signs of cardiac involvement.
Astaxanthin: The possible effects of this carotenoid on disease, inflammation and aging control. A meta-analysis
Astaxanthin (ATX), a red pigment that belongs to the xanthophyll subclass of carotenoids, has a strong antioxidant ability and can eliminate singlet oxygen (O2-) as well as hydrogen peroxide (H2O2) and lipid peroxidation. ATX can also prevent mitochondrial dysfunction by permeating and co-localizing within the mitochondria and inhibit the release of cytochrome c resulting from mitochondrial permeabilization and, thus, prevent mitochondrial-mediated apoptotic cell death. Due to its antioxidant capacity and modulating properties of cell signaling, ATX exhibits a variety of beneficial biological activities among them protection against UV damage, anti-inflammatory and immunomodulatory activity, metabolic syndrome (MS) relief, cardioprotective effects, antidiabetic activity, prevention of neuronal damage, anti-aging and anticancer activity. The aim of the present study was to evaluate what has been published about ATX in PubMed/Medline between 2020-2021. The results were distributed in four Tables as follows: Table 1-Publication types; Table 2- Proposal for evaluating the article in vivo; Table 3- Cells markers used in clinical studies in vivo; Table 4- Astaxanthin in human clinical trial. We could observe that the interest of the scientific community has been growing in relation to the benefits of ATX. The results presented in the articles evaluated in this meta-analysis showed us that AXT is already a reality as an option in treatments for various diseases, including glaucoma, heart and vascular injury, type 2 diabetes and fatty liver. We conclude that ATX may not only be a promising nutraceutical as an ally to alternative treatments of the pathologies mentioned above, but also as a powerful prophylactic in elderly individuals in prevention of diseases associated with aging.
Water is considered a finite natural resource and one of the essential elements of life. It is used in various work activities such as agriculture, industry, livestock, public supply, energy generation, among others . According to SPERLING (2006) , only 2.493% of the water on the planet is suitable for the consumption of humans and animals and 0.0007% of the water accessible for consumption is present in the atmosphere, rivers and lakes. It is estimated that more than one billion people worldwide do not have access to treated water, as its supply is not made on an equal basis due to population growth, economic activities and uneven distribution contrasted with different populations. between rural and urban areas [3, 21,33,]. Problems related to water shortages in the metropolitan regions of Brazilian states are increasingly present in everyday life, and can be attributed to factors involving administrative processes, such as the high cost of drinking water treatment, pollution of water tables, increased demand for water. consumption and climatic factors. In this sense, the use of water for poor quality consumption is an alternative for regions experiencing shortages and has a direct impact on the health of individuals, especially workers and students, as about 80% of the infectious and parasitic diseases that affect developing countries are due to poor quality water, directly impacting the individual’s health [10,17,18,28,36,37]. The water potability standards in Brazil are described in Ordinance GM / MS No. 2,914, of December 12, 2011, which portrays the main physical-chemical and microbiological quality control processes aimed at ensuring water safety and quality. for human consumption [5-8,42].In relation to water-borne infectious-parasitic diseases, their main route of transmission is via the oro-fecal route, that is, ingestion of water contaminated by excreta in drinks or food. According to PEIL et al (2015) , the main…
The mouth is a natural reservoir of several microorganisms resulting from various ecological determinants, being conducive to contagion, as it is an open system for contamination, to which the oral health team is exposed. This microbiota, in general, is in harmony with the host and is quite relevant, as it contributes to the development of the mucous immune system. However, local and/or systemic changes can result in imbalance and clinical manifestation of diseases in the mouth, as reported in this chapter, about coronavirus, hepatitis, herpes, varicella-zoster, infectious mononucleosis, cytomegalovirus, ebola, and human immunodeficiency virus (HIV). Oral hygiene is essential to maintain harmony between normal oral microbiota and external contamination, and, as is known, the mouth is part of the digestive and respiratory system and, in this moment of the lethal and quite contagious SARS-VOC 2 pandemic, the dental practice needs to reinforce biosafety care and reduce the vulnerability of staff and patients, in order to favor the good practices of home dental care, outpatient and/or hospital assistance.
Inflammation is a complex process, mediated by cellular and molecular mechanisms caused by a response to a tissue damage from an aggressive agent, whether if biological, chemical or physical origin. This process occurs, ultimately, with the purpose of promoting defense, repair and tissue regeneration. The inflammatory process leads to changes in blood vessels that have their diameter and flow altered, with the objective of leading to increased vascular permeability and consequent leakage of fluids and cells into the extracellular space of the affected tissue. This sequence of events generates the cardinal signs of inflammation, which are: pain, heat, redness, edema, with loss or alteration of function. The process occurs through mechanisms induced by cytokines and that despite having local manifestation, it can lead to systemic responses involving the whole organism with fever, chills, tremors, tachycardia, leukocytosis, sweating, diuresis and blood dyscrasias. In the cascade of events related to inflammation, there is initially a local stimulus that promotes morphological and functional changes in the attacked tissue that trigger the release of signaling molecules, the defensins that have a chemotactic effect on monocytes, neutrophils and lymphocytes, and pro-inflammatory mediators. that are directly involved in the next inflammatory phases. There is, then, the recognition of aggression and the aggressor agent by the receptors of cells of the immune system and release of inflammatory mediators, of the cyclooxygenase pathway that will release prostaglandin, prostacyclins and thromboxanes and by the lipooxygenase pathway that will produce leukotrienes (Figure 1). Then, there is a modification of the local microcirculation promoting vasodilation, initially arteriolar and subsequently of the venules by the action of histamine release by mast cells, and associated with an increase in local blood flow, generate the cardinal flushing and heat signals.
Monitoring Parasitic Contamination of the Beaches Sand and Public Squares of Northeast Brazil: a Comparative Approach
This work aims to evaluate the parasite presence in the sand of two squares and beaches/parks in the metropolitan region of Recife-PE and João Pessoa-PB, to compare the frequencies of the main parasitological species in these locations. The samples were collected in 2014 from three different depths of the soil (surface, 10 cm, and 20 cm), obtaining 96 samples from the metropolitan regions of Recife-PE and 48 samples from João Pessoa-PB. In Recife were detected a high number of positive samples from beaches (70.8%) and squares (25.7%) compared to João Pessoa, which reached 45.8% and 25%, respectively. Twelve parasite species were identified, distributed predominantly in the samples collected in 10 and 20 cm. In Pernambuco, the species Giardia lamblia, Cryptosporidium spp., and Endolimax nana were the most recurrent on the beaches, while Toxocara sp. and Iodamoeba butschilii were more frequent in the parks. In the Paraíba were identified only Cryptosporidium spp. and Entamoeba histolytica/E. dispar on the beaches. While Ancylostoma sp., Cryptosporidium spp, and Entamoeba histolytica/E. dispar were the most recurrent in the Paraíba squares. This study highlights the contamination of parasites in public environments (squares/beaches) to alert the need for actions aimed at combating parasites in these places.
Traditional Chinese Medicine (TCM) is based on the belief of vital energy (qi) within the body and attributes disease with imbalance in energies (yin and yang). The COVID-19 pandemic has necessitated unique physical barriers, including increased physical distancing, use of personal protective equipment (PPE), and telehealth services, which complicate existing efforts to understand alternative health practices. This case report highlights the importance of cultural competency training for healthcare providers, as evident in improved patient care when recognizing and acknowledging TCM customs in association with the COVID-19 pandemic.
Effect of RevX solution adjunct to standard therapy in a patient with metastatic lung adenocarcinoma: A case report
RevX solution is a liquid fermented grain extract obtained through a unique extraction technology, and its ingredients contain phytosterols, sulfonamides, organic acids, and anti-inflammatory substances. The adjunct treatment of RevX for lung adenocarcinoma has not yet been surveyed in vitro or in vivo experiments. A 71-year-old woman was diagnosed with lung adenocarcinoma. She underwent the targeted therapy and continually took the RevX solution (3 to 5 ml per day). Sixteen months after diagnosis and targeted therapy, multiple lung metastases appeared. After the second-line targeted therapy and wedge resection for 16 months, the patient was still alive. The distinct improvement of hypodynamia and fewer complication was found during targeted therapy treatment complemented with the RevX solution for longer than 4 years. Thus, the RevX solution might potentially be an adjuvant therapy for patients with metastatic lung adenocarcinoma.