Irinotecan-based regimens are commonly used for treatment of colorectal cancer, which is limited by mucositis and non-alcoholic steatohepatitis (NASH). Silymarin (SIL) prevents fatty liver disease in the clinical setting and in models of liver damage induced chemically. This study investigated the possible effect of SIL on irinotecan (IRI)-induced NASH. Swiss female mice were injected with saline (SAL 5ml/kg i.p.), IRI (50mg/kg i.p.), SIL (150mg/kg p.o.) or IRI (50mg/kg i.p.)+(SIL 1.5, 15 or 150mg/kg p.o.) thrice/week/7weeks. On the seventh week, blood samples were collected for transaminases assay and livers were collected for histopathology, measurement of the total lipids, malondyadehyde (MDA), non-protein sulfhydryl groups (NPSH), cytokines (IL-1β, IL 6 and IL-10), 3-nitrotyrosine (N-Tyr) and toll-like receptor 4 (TLR4) immunoexpression, quantification of NF-kB, α-smooth muscle actin (α-SMA), and Escherichia coli 16S rRNA gene (RRS) expression. IRI increased liver transaminases, neutrophil infiltration, lipid accumulation, MDA, IL-1β and IL-6 levels, N-Tyr and TLR4 immunostaining, NF-kB, α-SMA expression and RRS versus the SAL group (p<0.05). Additionally, SIL (1.5mg/kg) improved these parameters (p<0.05), except neutrophil infiltration and RSS versus the IRI group. Furthermore, the SIL (15mg/kg) only improved the inflammatory parameters, the expression of α-SMA and RRS versus the IRI group (p<0.05). The higher dose of SIL (150mg/kg) was even more deleterious than the intermediate dose. Therefore, silymarin showed a dual effect on liver damage induced by IRI. Hepatoprotection seems to involve the inhibition of oxidative stress and protein nitrosylation, preventing activation of hepatic fibrosis mechanisms.

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Background: Ischemic heart disease is an important death cause in Brazil. The Acute Coronary Syndrome is a subset of signs and symptoms which represents an acute complication of ischemic heart disease. Many of these patients have common risk factors, including renal dysfunction. The analysis of the importance of this commitment in the event of outcomes is still little explored in our midst. Objective: To study the associantion betweent renal dysfunction and the occurrence of deaths in patients with Acute Coronary Syndrome, Methods: This is a analytical study, with patients admitted to the Coronary Care Unit of a Tertiary Hospital (Salvador / BA) diagnosed with acute coronary syndrome, in the period from 2011 to 2014. The patients were divided into three groups according to renal function and two groups according to clinical diagnosis. Results: We identified six hundred seventy-four (n = 674) individuals. Mean age was 69.6 ± 12.4 years and 50.7% (n = 342) were male. Regarding the clinical diagnosis, 49% of patients (n = 331) were diagnosed with Unstable Angina and 50.9% (n = 342) with Acute Myocardial Infarction. The average value of creatinine clearence rate was 63.2 ± 29.3 ml / min (p = 0.001). Conclusion: The severe renal dysfucntion is an important prognostic factor for development of coronary artery disease and was associated with bad prognosis of patients with ACS. The variables DM, hypertension and dyslipidemia were often associated in theses patients.

Objectives: The aim of this study is to establish the profile of individuals with suspected white coat hypertension (WCH) submitted to ambulatory blood pressure monitoring (ABPM), assessing gender, age and pressure behavior during monitoring. Material and method: Between May 2007 and May 2014, a total of 14216 ABPM tests were performed in our department. Of this total, the indication for evaluation of suspected white coat hypertension occurred in 262 tests, which constitute the study sample. The oscillometric method with Dyna-MAPA equipment was used in the study. We have used in statistics: chi-square test of equal proportions and Analysis of Variance (ANOVA). Results: The sample consists of 262 patients, 121 (46.2%) men and 141 (53.8%) women. The mean age of male patients was 41.9 years and of females, 52.5 years. The largest group of patients was the one with abnormal results (113 patients, 43.2%). For patients with abnormal report, the proportion of men is significantly higher than that of women. For patients with normal reports, the proportion of women is significantly higher than men. There is no difference in proportion among genders in the group of patients with borderline report. The mean age of the patients classified as normal (49.9) or borderline (49.6) is significantly older than that of patients diagnosed as abnormal (44.7). Conclusions: 1) Most patients with suspected WCH actually had persistent hypertension at the ABPM; 2) A little over a third of patients with suspected WCH had the diagnosis confirmed by ABPM; 3) The standard patient with WCH in our sample was female and mean age of 50 years.

Suicide constitutes an important global public health issue. The World Health Organization (WHO) estimates that global suicide mortality increased about 60% in the last 45 years. In Brazil, the suicide rate increased 29.5% from 1980 to 2006. Among all 27 Brazilian states, Ceará occupies the 9th position in rates of suicide and Fortaleza, its state capital, had the 4th highest suicide rate among Brazilian capitals, between entre 2004 and 2006. The aim of PRAVIDA (Programa de apoio à vida - Program to support life) is to prevent suicide through therapeutic assistance, dissemination of information and research about suicide. PRAVIDA was created in Fortaleza (CE), in 2004. This program is part of the Federal University of Ceará constitute by medical doctors, professors of psychiatry and psychology, as well as students undergraduates of medicine and psychology. The objective of this work is to present the pioneering experience of PRAVIDA regarding the therapeutic care of patients with suicidal ideation or attempted suicide, as well as to present other suicide prevention strategies used in the program. PRAVIDA follow up subjects for at least three months - 345 people with a history of suicide attempts we followed from 2010 to 2013. No cases of suicide occurred during this thee month period. Furthermore, there is a need of expansion of the program activities in other institutions to allow for a more representative range of their interventions in the city of Fortaleza. Therefore, PRAVIDA intends to establish partnerships to facilitate new strategies to prevent suicide and improve the knowledge on the topic, stimulating appreciation of life, the host and the listening subject who seek medical treatment in the program.RESUMOO suicídio constitui um importante problema de saúde pública no mundo. A Organização Mundial da Saúde (OMS) estima que a mortalidade global de suicídio aumentou cerca de 60% nos últimos 45 anos. No Brasil, a taxa de suicídio cresceu 29,5% entre 1980 e 2006. Entre os 27 estados brasileiros, o Ceará ocupa a 9ª posição nos índices de suicídio, e Fortaleza, capital do estado, teve a 4ª maior taxa de suicídio entre as capitais brasileiras, entre 2004 e 2006. O objetivo do PRAVIDA (Programa de Apoio à Vida) é prevenir o suicídio por meio de assistência terapêutica, divulgação de informações e pesquisas sobre o tema. O PRAVIDA foi criado em Fortaleza (CE), em 2004, e faz parte da Universidade Federal do Ceará, sendo constituído por médicos, professores de psiquiatria e psicologia, bem como alunos de graduação de medicina e psicologia. O objetivo deste trabalho é apresentar a experiência pioneira de PRAVIDA sobre o cuidado terapêutico de pacientes com ideação suicida ou tentativa de suicídio, além de apresentar outras estratégias utilizadas no programa. O PRAVIDA acompanhou, por no mínimo três meses, 345 pessoas com histórico de tentativa de suicídio de 2010 a 2013, não ocorrendo casos de suicídio durante esse período. Existe ainda a necessidade de expansão das atividades do programa em outras instituições para permitir uma ação mais representativa na cidade de Fortaleza. Portanto, o PRAVIDA pretende estabelecer parcerias para facilitar novas estratégias de prevenção do suicídio e melhorar o conhecimento sobre o tema, estimulando a valorização da vida, o acolhimento e a escuta do sujeito que busca atendimento no Programa.