A circulação extracorpórea com hipotermia (CEC-H) é um procedimento comumente utilizado em cirurgias cardíacas, que representa um fator de risco para o paciente por promover extensa hemodiluição e profundas alterações fisiológicas. Nestas cirurgias, utiliza-se a cefuroxima como antimicrobiano para profilaxia de infecções, estando sua concentração inibitória mínima (CIM90) na faixa de 4 a 16 µg/mL dependendo da espécie e cepa bacteriana. Vários esquemas posológicos tem sido propostos para a profilaxia com este antimicrobiano. Assim, o objetivo do presente estudo foi investigar a farmacocinética e a disponibilidade sistêmica da cefuroxima, administrada I.V., bolus, na dose de 1,5g a 17 pacientes submetidos à cirurgia cardíaca com ou sem CEC-H. Desenvolveu-se método analítico simples seletivo e sensível em CLAE-UV para determinar a cefuroxima no plasma e tecido subcutâneo destes pacientes. Os resultados evidenciaram que independente das alterações causadas pela CEC-H, obtiveram-se baixas concentrações plasmáticas, inferiores ao CIM90, a partir da 9a hora após a administração da medicação nos dois grupos de pacientes investigados. Esta baixa disponibilidade sistêmica da cefuroxima após administração de 1,5 g pode favorecer o desenvolvimento de infecções pós-cirúrgicas e o desenvolvimento de cepas bacterianas resistentes. Por outro lado, a disposição cinética da cefuroxima foi alterada pela CEC-H, evidenciando-se ligeiro mas significativo prolongamento da meia vida biológica e redução da depuração plasmática nos pacientes submetidos a este procedimento. A ausência de alterações no volume de distribuição está de acordo com a penetração do antibiótico no tecido, uma vez que a quantidade de cefuroxima presente no subcutâneo foi comparável em ambos os grupos de pacientes investigados. Os dados obtidos permitem recomendar mudanças no regime posológico para manter níveis plasmáticos adequados e garantir a profilaxia com cefuroxima. / Cardiopulmonary bypass and hypothermia (HCPB) is a procedure commonly used during heart surgery, representing a risk factor for the patient by promoting extensive hemodilution and profound physiological changes. Cefuroxime is used for the prophylaxis of infection after heart surgery and its minimum inhibitory concentration (MIC90) may vary from 4 to 16 µg/mL depending on the bacterial species and strain. Several dose schemes have been suggested for prophylaxis with this antimicrobial agent. Thus, the objective of the present study was to assess in a comparative manner the systemic availability of cefuroxime administered intravascularly at the dose of 1.5 g in bolus to 17 patients submitted to heart surgery with or without HCPB. An improved, simple, selective and sensitive micromethod based on HPLC-UV is described to determine cefuroxime in plasma and fat tissue. Despite the differences recorded during the study period as a consequence of HCPB, antibiotic concentrations lower than MIC90 were obtained as early as after the 9th h for the surgical patients of the two groups of patients investigated. Thus, the low systemic availability of cefuroxime after the administration of a 1.5 g dose may be the factor responsible for postoperative infections and may favor the development of resistant bacterial strains. By the other hand, cefuroxime kinetic disposition was altered by HCPB showing a slight prolongation of biological half-life e reduction of plasma clearance. Unchanged apparent volume of distribution was according antibiotic tissue penetration since in both groups of patients the amount of cefuroxime obtained was comparable. The data obtained permit us to recommend a change in the dose scheme in order to maintain adequate plasma levels of the drug and thus guarantee prophylaxis with cefuroxime.

Background: Hibernomas are rare benign soft-tissue tumours arising from brown fat tissue. Although imaging characteristics are not specific certain imaging features, common locations and patient demographics may suggest hibernoma as a differential diagnosis. Case presentation: We report on two 48-year-old male patients with hibernoma. The tumour presented with local swelling of the inguinal region in the first patient and was an incidental imaging finding in the second patient. Imaging included magnetic resonance imaging in both patients and computed tomography as well as 18 F-fluorodeoxyglucose positron emission tomography-computed tomography in the second patient. In both cases histological diagnosis was initially based on excisional and needle core biopsy, respectively. Complete surgical resection confirmed the diagnosis of hibernoma thereafter. Conclusion: In soft tissue tumours with fatty components hibernoma may be included into the differential diagnosis. Because of the risk of sampling errors in hibernoma-like tissue components of myxoid and well-differentiated liposarcoma, complete resection is mandatory. This article also reviews the current imaging literature of hibernomas.

A circulação extracorpórea com hipotermia (CEC-H) é um procedimento comumente utilizado em cirurgias cardíacas, que representa um fator de risco para o paciente por promover extensa hemodiluição e profundas alterações fisiológicas. Nestas cirurgias, utiliza-se a cefuroxima como antimicrobiano para profilaxia de infecções, estando sua concentração inibitória mínima (CIM90) na faixa de 4 a 16 µg/mL dependendo da espécie e cepa bacteriana. Vários esquemas posológicos tem sido propostos para a profilaxia com este antimicrobiano. Assim, o objetivo do presente estudo foi investigar a farmacocinética e a disponibilidade sistêmica da cefuroxima, administrada I.V., bolus, na dose de 1,5g a 17 pacientes submetidos à cirurgia cardíaca com ou sem CEC-H. Desenvolveu-se método analítico simples seletivo e sensível em CLAE-UV para determinar a cefuroxima no plasma e tecido subcutâneo destes pacientes. Os resultados evidenciaram que independente das alterações causadas pela CEC-H, obtiveram-se baixas concentrações plasmáticas, inferiores ao CIM90, a partir da 9a hora após a administração da medicação nos dois grupos de pacientes investigados. Esta baixa disponibilidade sistêmica da cefuroxima após administração de 1,5 g pode favorecer o desenvolvimento de infecções pós-cirúrgicas e o desenvolvimento de cepas bacterianas resistentes. Por outro lado, a disposição cinética da cefuroxima foi alterada pela CEC-H, evidenciando-se ligeiro mas significativo prolongamento da meia vida biológica e redução da depuração plasmática nos pacientes submetidos a este procedimento. A ausência de alterações no volume de distribuição está de acordo com a penetração do antibiótico no tecido, uma vez que a quantidade de cefuroxima presente no subcutâneo foi comparável em ambos os grupos de pacientes investigados. Os dados obtidos permitem recomendar mudanças no regime posológico para manter níveis plasmáticos adequados e garantir a profilaxia com cefuroxima. / Cardiopulmonary bypass and hypothermia (HCPB) is a procedure commonly used during heart surgery, representing a risk factor for the patient by promoting extensive hemodilution and profound physiological changes. Cefuroxime is used for the prophylaxis of infection after heart surgery and its minimum inhibitory concentration (MIC90) may vary from 4 to 16 µg/mL depending on the bacterial species and strain. Several dose schemes have been suggested for prophylaxis with this antimicrobial agent. Thus, the objective of the present study was to assess in a comparative manner the systemic availability of cefuroxime administered intravascularly at the dose of 1.5 g in bolus to 17 patients submitted to heart surgery with or without HCPB. An improved, simple, selective and sensitive micromethod based on HPLC-UV is described to determine cefuroxime in plasma and fat tissue. Despite the differences recorded during the study period as a consequence of HCPB, antibiotic concentrations lower than MIC90 were obtained as early as after the 9th h for the surgical patients of the two groups of patients investigated. Thus, the low systemic availability of cefuroxime after the administration of a 1.5 g dose may be the factor responsible for postoperative infections and may favor the development of resistant bacterial strains. By the other hand, cefuroxime kinetic disposition was altered by HCPB showing a slight prolongation of biological half-life e reduction of plasma clearance. Unchanged apparent volume of distribution was according antibiotic tissue penetration since in both groups of patients the amount of cefuroxime obtained was comparable. The data obtained permit us to recommend a change in the dose scheme in order to maintain adequate plasma levels of the drug and thus guarantee prophylaxis with cefuroxime.

Background: Hibernomas are rare benign soft-tissue tumours arising from brown fat tissue. Although imaging characteristics are not specific certain imaging features, common locations and patient demographics may suggest hibernoma as a differential diagnosis. Case presentation: We report on two 48-year-old male patients with hibernoma. The tumour presented with local swelling of the inguinal region in the first patient and was an incidental imaging finding in the second patient. Imaging included magnetic resonance imaging in both patients and computed tomography as well as 18 F-fluorodeoxyglucose positron emission tomography-computed tomography in the second patient. In both cases histological diagnosis was initially based on excisional and needle core biopsy, respectively. Complete surgical resection confirmed the diagnosis of hibernoma thereafter. Conclusion: In soft tissue tumours with fatty components hibernoma may be included into the differential diagnosis. Because of the risk of sampling errors in hibernoma-like tissue components of myxoid and well-differentiated liposarcoma, complete resection is mandatory. This article also reviews the current imaging literature of hibernomas.

Nigella sativa ou cumin noir est une plante et un condiment populaires. Les graines de N. sativa sont très utilisées en médecine traditionnelle des pays nord africains pour le traitement du diabète. Cependant, les mécanismes d'actions cellulaires et moléculaires via lesquels cette plante exerce son effet euglycémiant restent encore mal compris. Le but de notre étude est d'examiner l’effet de N. sativa sur la sécrétion d’insuline, le transport de glucose et sur les voies de signalisation impliquées dans l’homéostasie et le métabolisme de glucose, en utilisant des essais biologiques sur des cultures cellulaires murines (cellules β pancréatiques βTC, myoblastes C2C12, hépatocytes H4IIE et adipocytes 3T3-L1) et des études in vivo chez le rat normoglycémique et le Meriones shawi (rongeur) diabétique. Chez les cellules β pancréatiques, N. sativa a augmenté leur prolifération ainsi que la sécrétion basale et gluco-stimulée de l’insuline. N. sativa a augmenté aussi la prise de glucose de 50% chez les cellules musculaires alors que chez les cellules graisseuses, la prise de glucose est augmentée jusqu’au 400%. Les expériences d’immunobuvardage de type western ont montré que N. sativa stimule les voies de signalisation de l’insuline (Akt et ERKs) et aussi celle insulino-indépendante (AMPK) chez les cellules C2C12. Par contre, chez les 3T3-L1, l’augmentation de transport de glucose est plutôt reliée à une activation de la voie de peroxisome proliferator activated receptor γ (PPARγ). Chez les hépatocytes, N. sativa augmente la stimulation des protéines intracellulaires Akt et 5' adenosine monophosphate-activated protein kinase (AMPK). Cette activation de l’AMPK est associée à un effet découpleur de la plante au niveau de la phosphorylation oxydative mitochondriale. Par ailleurs, chez les Meriones shawi diabétiques, N. sativa diminue graduellement la glycémie à jeun ainsi que la réponse glycémique (AUC) à une charge orale en glucose (OGTT) pour atteindre des valeurs semblables aux animaux témoins après quatre semaines de traitement. Une amélioration du profile lipidique est observée autant chez les Meriones shawi diabétiques que chez les rats normaux. Au niveau moléculaire, N. sativa augmente le contenu musculaire en glucose transporter 4 Glut4 et la phosphorylation de l’acetyl-coenzyme A carboxylase ACC dans le muscle soléaire et le foie chez les Mériones shawi diabétiques. Par contre, chez le rat normal, on assiste à une stimulation des voies de signalisation de l’insuline (Akt et ERK) au niveau hépatique. En conclusion, nous avons confirmé l’action insulinotropique de N. sativa au niveau des cellules β pancréatiques et mis en évidence un effet proliférateur pouvant potentiellement s’avérer utile pour contrecarrer la perte de masse cellulaire observée chez les diabétiques. Notre étude a également mis en évidence pour la première fois que N. sativa exerce son activité antidiabétique par une combinaison d’effets insulino-mimétiques et insulino-sensibilisateurs directs permettant ainsi d’augmenter le transport de glucose des tissus périphériques. Cette action de N. sativa est liée à une stimulation des voies de signalisation intracellulaires insulinodépendantes et -indépendantes (AMPK) chez le muscle squelettique et le foie alors qu’elle passe par la voie des PPARγ au niveau du tissu adipeux. Finalement, l’étude in vivo vient confirmer l’effet antidiabétique de N. sativa. Notre apport novateur se situe au niveau de la démonstration que l’activité antidiabétique de N. sativa chez le Meriones shawi diabétique est la résultante des mêmes activités que celles déterminées au niveau de l’étude in vitro. En effet, N. sativa active la voie de l’AMPK, améliore la sensibilité à l’insuline et augmente l’insulinémie. Notre étude montre aussi que N. sativa possède une activité antilipidémiante. Ces résultats confirment le bien-fondé de l'utilisation ethnopharmacologique de N. sativa comme traitement du diabète et des perturbations du métabolisme lipidique qui y sont associées. De plus, les actions pléiotropiques de N. sativa en font un traitement alternatif ou complémentaire du diabète très prometteur qui encouragent à présent la tenue d’études cliniques de bonne qualité. / Nigella sativa or black cumin is a medicinal plant and a popular condiment. The seeds of N. sativa are widely used in the traditional medicine of North African countries for the treatment of diabetes. However, the cellular and molecular mechanisms of action through which the plant exerts its hypoglycemic effect remain unclear. The aim of our study is to determine the effect of N. sativa on insulin secretion, glucose transport and signaling pathways involved in the regulation of glucose homeostasis and metabolism. We carried out in vitro murine cell-based bioassays (βTC pancreatic β cells, C2C12 myoblasts, H4IIE hepatocytes and 3T3-L1 adipocytes) and in vivo studies in normoglycemic rats and diabetic Meriones shawi (rodent). In pancreatic β cells, N. sativa increased cell proliferation as well as basal and glucose stimulated insulin secretion. It also enhanced glucose uptake in muscle cells by 50%. Moreover, the increase of glucose uptake in fat cells reached levels up to 400%. The experiments using Western immunoblot analysis showed that N. sativa stimulated insulin-dependent (Akt and ERK) as well as -independent (AMPK) pathways in C2C12 cells. In 3T3-L1 cells, the increase of glucose uptake was attributed to the activation of the peroxisome proliferator activated receptor γ (PPARγ) pathway. Similarly to C2C12 cells, N. sativa activated Akt and 5' adenosine monophosphate-activated protein kinase (AMPK) in hepatocytes. This activation of AMPK was associated with an uncoupling effect on mitochondrial oxidative phosphorylation. In diabetic Meriones, N. sativa gradually decreased fasting blood glucose and the glycemic response to an oral glucose load (OGTT) to values similar to normal animals at the end of treatment. Improved lipid profile is observed in both animal models. At the molecular level, N. sativa increased muscle glucose transporter 4 (Glut4) content and acetyl-coenzyme A carboxylase (ACC) phosphorylation in soleus muscle and liver in diabetic Meriones shawi. In normal rats, the plant extract induced a stimulation of insulin signaling pathways (Akt and ERK) in the liver. In conclusion, N. sativa has an insulinotropic effect on pancreatic β cells. Our study has revealed for the first time that N. sativa exerts its antidiabetic activity by a combination of insulino-mimetic and insulin-sensitizing effects, thereby increasing glucose uptake in peripheral tissues. This effect of N. sativa is linked to the stimulation of insulin-dependent and -independent (AMPK) pathway in skeletal muscle and liver, while in adipose tissue, the effect was attributed to the activation of PPARγ. Finally, the in vivo study confirms the antidiabetic and antihyperlipidemic effects of N. sativa. Our original contribution lies in the demonstration that the in vivo antidiabetic action of N. sativa is exerted though the same mechanisms identified by our in vitro studies. These data support the soundness of the ethnobotanical use of this plant for the treatment of diabetes and its associated dyslipidemia. Moreover, the pleiotropic actions of N. sativa make it a very promising alternative or complementary treatment for diabetes, which calls for immediate high quality clinical trials.

No description available.

Nigella sativa ou cumin noir est une plante et un condiment populaires. Les graines de N. sativa sont très utilisées en médecine traditionnelle des pays nord africains pour le traitement du diabète. Cependant, les mécanismes d'actions cellulaires et moléculaires via lesquels cette plante exerce son effet euglycémiant restent encore mal compris. Le but de notre étude est d'examiner l’effet de N. sativa sur la sécrétion d’insuline, le transport de glucose et sur les voies de signalisation impliquées dans l’homéostasie et le métabolisme de glucose, en utilisant des essais biologiques sur des cultures cellulaires murines (cellules β pancréatiques βTC, myoblastes C2C12, hépatocytes H4IIE et adipocytes 3T3-L1) et des études in vivo chez le rat normoglycémique et le Meriones shawi (rongeur) diabétique. Chez les cellules β pancréatiques, N. sativa a augmenté leur prolifération ainsi que la sécrétion basale et gluco-stimulée de l’insuline. N. sativa a augmenté aussi la prise de glucose de 50% chez les cellules musculaires alors que chez les cellules graisseuses, la prise de glucose est augmentée jusqu’au 400%. Les expériences d’immunobuvardage de type western ont montré que N. sativa stimule les voies de signalisation de l’insuline (Akt et ERKs) et aussi celle insulino-indépendante (AMPK) chez les cellules C2C12. Par contre, chez les 3T3-L1, l’augmentation de transport de glucose est plutôt reliée à une activation de la voie de peroxisome proliferator activated receptor γ (PPARγ). Chez les hépatocytes, N. sativa augmente la stimulation des protéines intracellulaires Akt et 5' adenosine monophosphate-activated protein kinase (AMPK). Cette activation de l’AMPK est associée à un effet découpleur de la plante au niveau de la phosphorylation oxydative mitochondriale. Par ailleurs, chez les Meriones shawi diabétiques, N. sativa diminue graduellement la glycémie à jeun ainsi que la réponse glycémique (AUC) à une charge orale en glucose (OGTT) pour atteindre des valeurs semblables aux animaux témoins après quatre semaines de traitement. Une amélioration du profile lipidique est observée autant chez les Meriones shawi diabétiques que chez les rats normaux. Au niveau moléculaire, N. sativa augmente le contenu musculaire en glucose transporter 4 Glut4 et la phosphorylation de l’acetyl-coenzyme A carboxylase ACC dans le muscle soléaire et le foie chez les Mériones shawi diabétiques. Par contre, chez le rat normal, on assiste à une stimulation des voies de signalisation de l’insuline (Akt et ERK) au niveau hépatique. En conclusion, nous avons confirmé l’action insulinotropique de N. sativa au niveau des cellules β pancréatiques et mis en évidence un effet proliférateur pouvant potentiellement s’avérer utile pour contrecarrer la perte de masse cellulaire observée chez les diabétiques. Notre étude a également mis en évidence pour la première fois que N. sativa exerce son activité antidiabétique par une combinaison d’effets insulino-mimétiques et insulino-sensibilisateurs directs permettant ainsi d’augmenter le transport de glucose des tissus périphériques. Cette action de N. sativa est liée à une stimulation des voies de signalisation intracellulaires insulinodépendantes et -indépendantes (AMPK) chez le muscle squelettique et le foie alors qu’elle passe par la voie des PPARγ au niveau du tissu adipeux. Finalement, l’étude in vivo vient confirmer l’effet antidiabétique de N. sativa. Notre apport novateur se situe au niveau de la démonstration que l’activité antidiabétique de N. sativa chez le Meriones shawi diabétique est la résultante des mêmes activités que celles déterminées au niveau de l’étude in vitro. En effet, N. sativa active la voie de l’AMPK, améliore la sensibilité à l’insuline et augmente l’insulinémie. Notre étude montre aussi que N. sativa possède une activité antilipidémiante. Ces résultats confirment le bien-fondé de l'utilisation ethnopharmacologique de N. sativa comme traitement du diabète et des perturbations du métabolisme lipidique qui y sont associées. De plus, les actions pléiotropiques de N. sativa en font un traitement alternatif ou complémentaire du diabète très prometteur qui encouragent à présent la tenue d’études cliniques de bonne qualité. / Nigella sativa or black cumin is a medicinal plant and a popular condiment. The seeds of N. sativa are widely used in the traditional medicine of North African countries for the treatment of diabetes. However, the cellular and molecular mechanisms of action through which the plant exerts its hypoglycemic effect remain unclear. The aim of our study is to determine the effect of N. sativa on insulin secretion, glucose transport and signaling pathways involved in the regulation of glucose homeostasis and metabolism. We carried out in vitro murine cell-based bioassays (βTC pancreatic β cells, C2C12 myoblasts, H4IIE hepatocytes and 3T3-L1 adipocytes) and in vivo studies in normoglycemic rats and diabetic Meriones shawi (rodent). In pancreatic β cells, N. sativa increased cell proliferation as well as basal and glucose stimulated insulin secretion. It also enhanced glucose uptake in muscle cells by 50%. Moreover, the increase of glucose uptake in fat cells reached levels up to 400%. The experiments using Western immunoblot analysis showed that N. sativa stimulated insulin-dependent (Akt and ERK) as well as -independent (AMPK) pathways in C2C12 cells. In 3T3-L1 cells, the increase of glucose uptake was attributed to the activation of the peroxisome proliferator activated receptor γ (PPARγ) pathway. Similarly to C2C12 cells, N. sativa activated Akt and 5' adenosine monophosphate-activated protein kinase (AMPK) in hepatocytes. This activation of AMPK was associated with an uncoupling effect on mitochondrial oxidative phosphorylation. In diabetic Meriones, N. sativa gradually decreased fasting blood glucose and the glycemic response to an oral glucose load (OGTT) to values similar to normal animals at the end of treatment. Improved lipid profile is observed in both animal models. At the molecular level, N. sativa increased muscle glucose transporter 4 (Glut4) content and acetyl-coenzyme A carboxylase (ACC) phosphorylation in soleus muscle and liver in diabetic Meriones shawi. In normal rats, the plant extract induced a stimulation of insulin signaling pathways (Akt and ERK) in the liver. In conclusion, N. sativa has an insulinotropic effect on pancreatic β cells. Our study has revealed for the first time that N. sativa exerts its antidiabetic activity by a combination of insulino-mimetic and insulin-sensitizing effects, thereby increasing glucose uptake in peripheral tissues. This effect of N. sativa is linked to the stimulation of insulin-dependent and -independent (AMPK) pathway in skeletal muscle and liver, while in adipose tissue, the effect was attributed to the activation of PPARγ. Finally, the in vivo study confirms the antidiabetic and antihyperlipidemic effects of N. sativa. Our original contribution lies in the demonstration that the in vivo antidiabetic action of N. sativa is exerted though the same mechanisms identified by our in vitro studies. These data support the soundness of the ethnobotanical use of this plant for the treatment of diabetes and its associated dyslipidemia. Moreover, the pleiotropic actions of N. sativa make it a very promising alternative or complementary treatment for diabetes, which calls for immediate high quality clinical trials.

The aim of this thesis is to optimize the design of the Fat-IBC-based communication of a novel neuroprosthetic system in which a brain-machine interface is used to control a prosthetic arm. Fat-based intra-body communication (Fat-IBC) uses the fat tissue inside the body of the bearer as a transmission medium for low-power microwaves. Future projects will use the communication system and investigate ways to control the prosthetic arm directly from the brain. The finished system was able to individually control all movable joints of multiple prosthesis prototypes using information that was received wirelessly through Fat-IBC. Simultaneous transmission in the other direction was possible, with the control data then being replaced by sensor readings from the prosthesis. All data packets were encoded with the COBS/R algorithm and the wireless communication was handled by Digi Xbee 3 radio modules using the IEEE 802.15.4 protocol at a frequency of 2.45 GHz. The Fat-IBC communication was evaluated with the help of so-called "phantoms" which emulated the conditions of the human body fat channel. During said testing, packet loss measurements were performed for various combinations of packet sizes and time intervals between packets. The packet loss measurements showed that the typical amount of transmitted data could be handled well by the fat channel test setup. Although the transmission system was found to be well-functioning in its current state, increasing the packet size to achieve a higher granularity of the movement was perceived to be viable considering the findings from the packet loss measurements.