Flávia Pimenta

Anxiolytic-like activity and GC–MS analysis of (R)-(+)-limonene fragrance, a natural compound found in foods and plants

The traditional use of essential oils in aromatherapy has offered numerous health benefits. However, few scientific studies have been conducted with these oils to confirm their therapeutic efficacy. (+)-Limonene is a chemical constituent of various bioactive essential oils. The present study reports on the anxiolytic-like effects of (+)-limonene in an elevated maze model of anxiety in mice. At concentrations of 0.5% and 1.0%, (+)-limonene, administered to mice by inhalation, significantly modified all the parameters evaluated in the elevated plus maze test. The pharmacological effect of inhaled (+)-limonene (1%) was not blocked by flumazenil. Analysis of (+)-limonene using gas chromatography-mass spectrometry (GC-MS) showed its volatility to be high. These data suggest possible connections between the volatility of (+)-limonene and its anxiolytic-like effect on the parameters evaluated in the elevated plus maze test. The data indicate that (+)-limonene could be used in aromatherapy as an antianxiety agent.

Anxiolytic Effect of Citrus aurantium L. on Patients with Chronic Myeloid Leukemia.

The bone marrow aspiration procedure is used in hematological diseases and consists of a painful, invasive procedure causing anxiety‐associated symptoms. The present study assessed the effect of Citrus aurantium L. essential oil on the treatment of anxiety, in the moment that precedes the collection of medullary material in patients with chronic myeloid leukemia (CML). Volunteers from both sexes were divided into groups receiving either the C. aurantium essential oil through inhalation, diazepam (10 mg), or the placebo. The evaluation was performed through psychometric scales [State‐Trait Anxiety Inventory (STAI)] and physiological measurements (blood pressure and cardiac and respiratory frequency). Inhalation of C. aurantium was associated with a decrease in the STAI‐S scores, suggesting an anxiolytic effect. In support of these results, a change in all the physiological measurements was observed in the group exposed to C. aurantium. In the diazepam group, only the diastolic pressure decreased, and no effect was observed in the placebo group. Therefore, the results showed that C. aurantium exhibits an anxiolytic effect and reduces the signs and symptoms associated with anxiety in patients with CML. Copyright

Prevalence Ratio of HTLV-1 in Nursing Mothers From the State of Paraíba, Northeastern Brazil

The human T-cell lymphotropic virus type 1 (HTLV-1) was the first human retrovirus known as a direct causal agent of a malignant disease. The vertical route of HTLV transmission is the most frequent pathway of the virus contamination. This study was performed to determine the prevalence ratio of HTLV-1 infection among nursing women. From January 2004 to January 2005, blood samples from 1033 nursing mothers from Paraíba, Brazil were evaluated for HTLV antibodies by ELISA and HTLV-1 viral particles confirmed by polymerase chain reaction (PCR). HTLV antibodies were detected in 7 women. The overall seroprevalence ratio was 0.68% and HTLV-1 viral sequences were confirmed by PCR in 2 women. These preliminary data suggest that HTLV screening should be introduced as a mandatory test before breastfeeding and breast milk donation in Paraíba, Brazil. Additionally, counseling programs would help reduce the prevalence ratio of HTLV-1 infected individuals in this Brazilian region. J Hum Lact. 24(3):289-292. El Virus Linfotrópico Humano de Células T tipo 1 (HTLV-1) fue el primer retrovirus que se encontró como agente causal directo de una enfermedad maligna. La transmisión vertical del HTLV es la vía mas frecuente de contaminación. Este estudio determinó la proporción de prevalencia de infección por HTLV-1 en mujeres lactando. De enero del 2004 a enero del 2005, se tomaron muestras de sangre de 1,033 mujeres lactantes en Paraiba, Brasil para medir los anticuerpos de HTLV con pruebas de ELISA y partículas virales de HTLV-1 confirmadas por reacción en cadena de la polimerasa (PCR). Se detectaron anticuerpos de HTLV-1 en siete mujeres. La proporción de seroprevalencia fue de 0.68% y la secuencia viral de HTLV-1 se confirmó con PCR en dos mujeres. Estos datos preliminares sugieren que se debe introducir una prueba mandatoria antes de comenzar la lactancia y de donar leche en Paraiba-Brasil. Además un programa de conserjería puede ayudar a reducir la proporción de prevalencia de individuos infectados con el HTLV -1 en esta región de Brasil.

Doença de Castleman localizada abdominal

Castlemans disease is an uncommon lymphoproliferative disorder. There are three histologic types, hyaline vascular (the most common), plasma cell variant and mixed form. The hyaline vascular variant is typically characterized by a benign clinical course without constitutional symptoms (localized disease). It is usually managed with surgery and/or radiotherapy. Multicentric disease is a systemic disorder. An optimal management is still unknown. We report a case of a 47-year-old man with an abdominal mass and compressive symptom. After partial surgical resection, histopathological and immunohistological studies revealed the hyaline vascular variant of localized Castlemans disease. Because the follicular cells were CD20+ we administered rituximab (anti-CD20 monoclonal antibody). Most of the cases reviewed do not consider this approach, except for HHV-8 and sarcoma of Kaposi associated multicentric Castlemans disease. They usually consider the patient free from disease after surgical resection of localized Castlemans disease, but there is a risk of developing non-Hodgkin lymphoma in the long-term. The purpose of this report is to present this rare case, to stress that Castlemans disease should be included in the differential diagnosis of lymphoid disorders and to discuss the management of this disorder.

Zumbido e ansiedade: uma revisão da literatura

Tinnitus is a sound perceived without external stimulus, and results from the dynamic interaction of the centers in the central nervous system, including non-auditory and auditory ways. The result of this interaction, especially with the limbic system and autonomic nervous system, would be responsible for triggering negative emotional associations and distress in patients with tinnitus. Anxiety, a physiological condition inherent to human beings, when exacerbated, generates a mood disorder, affecting thinking, behavior and physiological activity. If an inner or outer stimulus is interpreted as dangerous or threatening, it may trigger an emotional reaction characterized as a state of anxiety. This work aims to review the relationship between tinnitus and anxiety. The tinnitus sound is perceived can be altered by anxiety, thereby, sharpening the sensitivity in detecting sounds that seem a potential threat, because for many people, tinnitus is synonymous with a serious illness. The etiology for the development of depression and anxiety may be related to tinnitus. Many people acquire this symptom by physical problems and hence develop depression and anxiety. Others with different degrees of distress due to tinnitus acquire emotional problems. Thus, there is a probable link between tinnitus and emotional problems, but it is not always easy to identify which one occurs first. Studies show that patients affected by tinnitus have a greater trend for suicide, depression and anxiety. They also refer to the additive cumulative effects of anxiety and depression on the quality of life of tinnitus sufferers.

ANSIEDADE PATOLÓGICA: BASES NEURAIS E AVANÇOS NA ABORDAGEM PSICOFARMACOLÓGICA

Objective: To present an updated and broad perspective of anxiety concerning its pathological manifestation, neural bases and the progress in its psychopharmacological therapeutic approach. Method: It was conduced a literature review whose source of research was papers indexed by the database Pubmed, Medline and researches from specific books that investigated the anxiety in its pathological aspect. Results: As regards the genesis of anxiety disorders, several neurotransmitters are involved since they participate, in a greater or lesser degree, in the modulation and regulation of defensive behaviors. The evidence obtained so far allows noting the progress achieved in the treatment of anxiety disorders with the use of benzodiazepines and, more recently, antidepressants. New alternatives for the treatment of the anxiety-related disorders involve researches related to the discovery of new antidepressants, to the use of neuroactive peptides such as cholecystokinin (CCK), corticotropin releasing factor (CRH), neuropeptide Y, and antagonists of glutamatergic NMDA receptor. Conclusion: Advances can be observed in the pharmacological treatment of anxiety disorders mainly by using antidepressants. However, there is still a long way to be followed in order to find new therapeutic options for these disorders.

Macroglobulinemia de Waldenström - remissão completa após tratamento com rituximabe

Waldenstroms macroglobulinemia is a rare pathology of B lymphocytes characterized by the production of monoclonal IgM, causing clinical manifestations which may include fatigue, asthenia, weight loss, bleeding of the mucosa and intestinal tract, lymphadenomegaly, hepatosplenomegaly and neurological alterations. The disease is more frequent among elderly patients and its symptoms are a result of the hyperviscosity of blood. Waldenstroms macroglobulinemia presents hypergammaglobulinemia with a monoclonal peak of serum proteins seen by electrophoresis, high IgM levels and other normal or diminished immunoglobulin levels, immunophenotyping with CD19+, CD20+ and CD24+ B lymphocytes aspirated from hypercellular bone marrow and hypercellular bone marrow biopsy with diffuse infiltration of lymphocytes, plasmocytoid lymphocytes and plasmocytes. Currently, monoclonal antibodies are successfully being used in the treatment of Waldenstroms macroglobulinemia. Rituximab, an anti-CD20 monoclonal antibody, has shown excellent results in the treatment of Waldenstroms macroglobulinemia even for individuals who did not obtain satisfactory responses to conventional treatment. This work reports the case of a 78-year-old woman with a history of fatigue, asthenia, anorexia, somnolence, restlessness, urticaria, difficulties in walking, and excessive weight loss (approximately 22 Kg within a period of 5 months) who was successfully treated using rituximab. The objective of this report is to present the case of this patient and to review current clinical and therapeutic aspects of the disease.

Occurrence of Acute Myeloid Leukemia in Young Pregnant Women

Although acute leukaemia is rare in pregnancy its importance lies in its life-threatening potential, both to the child and the mother. The possibility of vertical transmission of leukemic cells increases the attention devoted to these patients and their offspring. Three cases of pregnant young women (15-17 years of age) with AML are presented. This series of cases is the first report where gene abnormalities such as ITD mutations of the FLT3 gene and AML1/ETO fusion genes were screened in pregnant AML patients and their babies, so far. Unfortunately, very poor outcomes have been associated to similar cases described in literature, and the same was true to the patients described herein. Although very speculative, we think that the timing and possible similar exposures would be involved in all cases.

Epidemiological Analysis of Lymphoma Subtypes in a Reference Center in João Pessoa

A gradual increase in diagnosed cases of lymphoma has led to greater dissemination of relevant information and has simultaneously revealed a need to improve understanding of the pathology. The prevalence of lymphomas involves many factors that vary regionally, with regional differences in prognosis indeed playing a role in therapeutic decisions. This observational study aimed to retrospectively evaluate the prevalence of lymphoma subtypes diagnosed between 2011 and 2015 at the Napoleao Laureano Hospital, the largest hematology facility in Paraiba, northeastern Brazil and a state reference for hematological oncology. Immunohistochemistry findings and associated prognostic variables were analyzed, including calculation of prognostic indexes such as the international prognostic index (IPI), age adjusted IPI, National Comprehensive Cancer Network IPI (NCCN-IPI), mantle cell lymphoma IPI (MIPI) and follicular lymphoma IPI (FLIPI). The most noteworthy findings include the large number of young people diagnosed with aggressive disease, with poor prognostic indexes but low mortality rates, confirming the technical strength of the institution as reflected in the improved prognosis associated with the disease. The prevalence of Hodgkin lymphoma was found to be high, contradicting a considerable part of the international literature but in agreement with some studies conducted with pediatric populations in Brazil. In addition, the most prevalent subtypes of non-Hodgkin lymphoma, already well discussed in the international literature, were also represented in the present sample. All cases of lymphoma registered at this center were catalogued, with their prognoses and anatomopathological and immunohistochemical diagnoses being analyzed, consequently providing a better database for this geographical region of Brazil.

Successful Treatment For Chronic Eosinophilic Leukemia (CEL) With Imatinib Mesylate

We report a case of a patient with Chronic Eosinophilic Leukemia (CEL) with mutation in alfa PDGFR gene exhibiting a satisfactory response to treatment with imatinib mesylate. A 25-year-old man presented in a hematology service with a persistent cough and hemogram alterations. His blood count showed a hemoglobin level of 12.5 g/dL and a white blood cell count of 94,030/mm3, eosinophils were 68% of all cells. Bone marrow aspiration and biopsy showed hypercellularity with marked eosinophilia (77%) and erythroid differentiation series was hypocellular with normoblast maturation. The immunohistochemically of the bone biopsy was positive for myeloperoxidase and negative for CD34/CD99, consistent with CEL. Fluorescence in situ hybridization (FISH) for the beta-fraction of platelet-derived growth factor (PDGFRβ) and Philadelphia chromosome (Ph 1) were negative and the alfa PDGFR (Platelet-Derived Growth Factor) was positive and showed heterozygosis in c.2531T>C on 18 Exon and homozygous in C.2562+1G>A at the region of the splicing site at the 18 intron. Treatment was initiated and maintained by administering 400mg/day imatinib mesylate. Laboratory findings returned to normal ranges, with clinical improvement and a hematological response observed after the second month of therapy. Currently, the patient’s blood count shows the white blood cell count (5,400 total leukocytes), eosinophils (8.6/mm3), hemoglobin (15.5 g/dl), hematocrit (45.4%) and platelets (298,000/mm3) within normal ranges. The mutation search was negative in in peripheral blood one year after the initial treatment. Our work corroborates other studies on the efficacy of imatinib mesylate in the treatment of patients with CSF PDGFR alpha positive. We emphasize the importance of molecular studies, considering its relevance for the correct staging of the disease. Since CEL is a rare disease, it is important to define its etiology and anticipate its treatment, thus minimizing the damage induced by the disease.