Phytochemical characterization, and antioxidant and antibacterial activities of the hydroethanolic extract of Anadenanthera peregrina stem bark

The Brazilian Cerrado biome consists of a great variety of endemic species with several bioactive compounds, and Anadenanthera peregrina (L.) Speg is a promising species. In this study, we aimed to perform phytochemical characterization and evaluate the antioxidant and antibacterial activities against Staphylococcus aureus and Escherichia coli of the hydroethanolic extract of A. peregrina stem bark. The barks were collected in the Botanical Garden of Goiânia, Brazil. The hydroethanolic extract was obtained by percolation and subjected to physicochemical screening, total phenolic content estimation, high-performance liquid chromatography (HPLC) fingerprinting, and antioxidant (IC50 values were calculated for the 2,2-diphenyl-1-picrylhydrazyl assay - DPPH) and antibacterial activity determination. The pH of the extract was 5.21 and density was 0.956 g/cm3. The phytochemical screening indicated the presence of cardiac glycosides, organic acids, reducing sugars, hemolytic saponins, phenols, coumarins, condensed tannins, flavonoids, catechins, depsides, and depsidones derived from benzoquinones. The extract showed intense hemolytic activity. The total phenolic content was 6.40 g GAE 100 g-1. The HPLC fingerprinting analysis revealed the presence of gallic acid, catechin, and epicatechin. We confirmed the antioxidant activity of the extract. Furthermore, the extract did not inhibit the growth of E. coli colonies at any volume tested, but there were halos around S. aureus colonies at all three volumes tested. These results contribute to a better understanding of the chemical composition of A. peregrina stem bark and further support the medicinal applications of this species.

Ureteral fibroepithelial polyps in a pregnant woman: case report

CONTEXT

Ureteral fibroepithelial polyps are rare benign nonepithelial tumors, and less than 200 cases have been reported in the literature. We report on a pregnant patient with ureteral fibroepithelial polyps that were successfully treated with laparotomy.

CASE REPORT

A 23-year-old pregnant woman presented with a three-month history of intermittent lumbar pain of low intensity. Abdominal ultrasonography showed that she was 13 weeks pregnant and found severe left-side ureterohydronephrosis and a heterogeneous solid mass measuring 11 x 8 x 7 centimeters in the middle portion of the ureteral topography. The investigation was complemented with magnetic resonance imaging, which confirmed the previous findings. Nephroureterectomy was performed without complications. The specimen revealed three solid tumors in the ureter, of which the largest was around eight centimeters in length. The anatomopathological report confirmed that they were fibroepithelial tumors without malignant components.

In ovo injection of ascorbic acid and higher incubation temperature modulate blood parameters in response to heat exposure in broilers

1. This study analysed whether in ovo injection of ascorbic acid before incubation and at high incubation temperature influenced blood characteristics and performance in broilers reared in different temperature conditions. 2. A total of 3,000 fertile eggs from broiler breeders (Cobb®) were randomly divided into three incubation treatments: no ascorbic acid injection and egg incubation at 37.5°C (control); no ascorbic acid injection and egg incubation at 39°C; in ovo ascorbic acid injection prior to incubation (6 µg AA/100 µl water) and egg incubation at 39°C. 3. Male chicks hatched from the three incubation treatments were submitted to three distinct rearing temperatures (control, cold and hot) from the third week of age onwards (540 chicks were divided into 6 treatments with 5 replicates per treatment). 4. Measurements at 42 d showed that, after egg incubation at 39°C, the haematocrit, haemoglobin values, ionised calcium and glucose concentrations were increased and base excess values were reduced. However, in ovo injection of ascorbic acid normalised all these parameters. 5. Partial CO₂ and O₂ pressure were higher with increased rearing temperature. Blood pH was lower when eggs were incubated at 39°C and injected with ascorbic acid. In ovo injection of ascorbic acid induced leucocytosis due to lymphocytosis and heterophilia, restored basophils rate and led to monocytopoenia. Leucocytosis was triggered by hot rearing temperature due to lymphocytosis, eosinophilia and heterophilia. 6. The results obtained in this study showed that in ovo injection of ascorbic acid before incubation may serve as a long-term stimulator and modulator of the broiler immune system, and that high incubation temperatures induce adaptations in the electrolytic balance, minimising or avoiding the occurrence of respiratory alkalosis under hot rearing temperature.

Histological Variants of Urothelial Carcinoma Predict No Response to Neoadjuvant Chemotherapy

BACKGROUND

Platinum-based neoadjuvant chemotherapy (NAC) in muscle-invasive urothelial bladder cancer (MIBC) has been adopted as a standard of care related to better survival outcomes. However, there is a considerable number of patients who do not respond, experiencing toxicity and delay in the surgical treatment. Our aim is to find biomarkers of response that could be easily adopted in the clinical practice.

METHODS

Between January 2009 and July 2016, 52 patients with MIBC were submitted to radical cystectomy after NAC. A tissue microarray containing 25 cases, who met the inclusion criteria was built for immunohistochemical analysis of Cytokeratins 5/6, 7, and 20, GATA3, Her2, EGFR, p63, p53, Carbonic-anhydrase IX (CAIX), MLH1, MSH2, MSH6, and PMS2. The surgery was performed in a mean time of 58.7 (± 21) days after the end of the NAC. Fisher's exact test was used to analyze the relationship between response (≤pT1) and histopathological and immunohistochemical results and Kaplan-Meier curves were designed for survival analysis.

RESULTS

Ten (40.0%) patients presented response to NAC. Histological variants of the urothelial carcinoma characterized by squamous, sarcomatous/rhabdoid, plasmacytoid, and micropapillary was present in 36.0% and none responded to NAC (P = .002). CAIX was expressed by 53.3% and none responded to NAC (P= .005). Lymph-node metastasis, divergent differentiation, and expression of cytokeratin 5/6 were related to short cancer specific survival.

CONCLUSION

Histological variants and CAIX immune-expression are biomarkers of nonresponse to NAC of MIBC, and might be easily used in the clinical practice to select patients to be submitted to surgery upfront.

Urological complication following aortoiliac graft: case report and review of the literature

CONTEXT

Ureteral stenosis and ureterohydronephrosis may be serious complications of aortoiliac or aortofemoral reconstructive surgery.

CASE REPORT

A 62-year-old female patient presented with a six-month history of left lumbar pain. She was a smoker, and had mild chronic arterial hypertension and Takayasu arteritis. She had previously undergone three vascular interventions. In two procedures, Dacron prostheses were necessary. Excretory urography showed moderate left ureterohydronephrosis and revealed a filling defect in the ureter close to where the iliac vessels cross. This finding was compatible with ureteral stenosis, and the aortoiliac graft may have been the reason for this inflammatory process. The patient underwent laparotomy, which showed that there was a relationship between the ureteral stenosis and the vascular prosthesis. Segmental ureterectomy and end-to-end ureteroplasty with the ureter crossing over the prosthesis anteriorly were performed. There were no complications. The early and late postoperative periods were uneventful. The patient evolved well and the results from a new excretory urogram were normal. We concluded that symptomatic ureterohydronephrosis following aortoiliac graft is a real complication and needs to be quickly diagnosed and treated by urologists.

Validation of the TWIST score for testicular torsion in adults

PURPOSE

The TWIST (Testicular Work-up for Ischemia and Suspected Torsion) score was developed to allow for expedited diagnosis of testicular torsion (TT) in children based on clinical variables: edema (2 points), hard mass (2), absent cremasteric reflex (1), high-riding testis (1) and nausea/vomiting (1). We sought to validate the TWIST Score applied by non-expert physicians for the diagnosis of testicular torsion in an adult population.

METHODS

We prospectively analyzed all consecutive males presenting to a tertiary hospital with acute scrotum. Patients with previous scrotal pathology or trauma were excluded. Physical examination was performed by a general surgeon and variables of TWIST were recorded. All patients underwent Scrotal Doppler Ultrasound. Measures of accuracy of the TWIST score and ROC curves were generated to evaluate its performance in diagnosing TT in adults.

RESULTS

Of 68 patients, 34 had TT (50%). Median age was 24.9 years. According to the original cutoffs of TWIST, 23 patients had a score ≤ 2 among which none had TT. Fifteen patients had a score of 3-4, among which seven had TT. Thirty patients had a score ≥ 5, among which 27 had TT. All 18 patients with a score of 6 or greater had TT (100% PPV). ROC curve revealed an AUC of 0.95.

CONCLUSION

The TWIST Score is valid for the diagnosis of Testicular Torsion in adults, presenting a PPV of 90% for a cutoff of 5 points and 100% for six points. In all patients with a score of 2 or less, the disease could be safely excluded (100% NPV).

Hidradenocarcinoma of the Scrotum

Lesions of the skin and soft tissues of the penis and scrotum may be confusing in urological practice, since rare differential diagnoses can be challenging to providers with limited dermatological experience. Hidradenocarcinoma is one of such diagnoses, a rare and aggressive malignant tumor originating from sweat glands. A 61 year-old man presented with a nodule in the penoscrotal region which had appeared 1 year before consultation. He had no history of penile lesions, sexually transmitted diseases, or other complaints. Surgical resection revealed a hidradenocarcinoma of the scrotum infiltrating subcutaneous tissue.

Calcifying fibrous tumor: A rare spermatic cord presentation

Calcifying fibrous tumor of the tunica vaginalis is a rare fibrous proliferation, which can sometimes mimic a scrotal malignancy prompting surgical intervention. It has been recognized as a benign lesion, and no recurrence has been described after its resection. Its identification is essential to avoid overtreatment and unnecessary orchiectomy. We herein describe a rare case of calcifying fibrous tumor of the tunica vaginalis in a young patient and review the clinical features of inguinal and scrotal calcifying fibrous tumors to help clinical decisions and encourage a testis sparing surgery.

Evaluation of the antimicrobial potential of extracts Myrciaria cauliflora in strains of Staphylococcus aureus ATCC and Staphylococcus aureus BLAC

Bacteria of medical interest have increasingly acquired resistance to available antimicrobials over the years. This resistance makes these microorganisms a challenge for conventional medicine treatments, and new research is focusing on herbal medicine to fight these pathogens. The present work aimed to evaluate the cytotoxic activity of Myrciaria cauliflora and Genipa americana extracts, considering an in vitro bacterial inhibition, using a modified antibiogram technique, the extracts were studied in strains of Staphylococcus aureus ATCC 29213 and Staphylococcus aureus BLAC, where inhibition was observed in the two strains studied by the extract. This study observed that the M. cauliflora bark extract has antimicrobial potential when tested in vitro on S. aureus ATCC 29213 and S. aureus BLAC strains, indicating it is a potential herbal medicine for infections by this pathogen.