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1.
Respirar (Ciudad Autón. B. Aires) ; 15(3): [188-199], sept. 2023.
Artigo em Espanhol | LILACS, UNISALUD, BINACIS | ID: biblio-1510766

RESUMO

Resumen Antecedentes: la ingeniería tisular permite obtener órganos como injertos a partir de tejidos descelularizados, regenerados con células autólogas. Objetivo: descelularizar y regenerar tráqueas porcinas. Material y métodos: se descelularizaron tráqueas porcinas colocándolas cada una en el epiplón de cuatro cerdos Yorkshire para su regeneración in vivo. Una tráquea desce-lularizada con tritón (DT), descelularizada con desoxicolato (DD), descelularizada con desoxicolato y reforzada con un polímero y células epiteliales (DDR), y una nativa crio-preservada (NC). Después de 8 días se obtuvieron la DD, NC y DDR; y al día 15, la DT. Se las evaluó mecánica e histológicamente, se realizó el análisis casuístico. Resultados: las tráqueas descelularizadas conservaron la integridad del cartílago, sin diferencias mecánicas, excepto la DDR con mayor rigidez. Las tráqueas regeneradas presentaron menor rigidez, excepto la DDR que además perdió el epitelio y la vascula-ridad. Las DT, DD mostraron epitelio no respiratorio, fibrosis y vasculogénesis con in-flamación. Conclusiones: las matrices conservaron sus características mecánicas. La regenera-ción in vivo ofrece ventajas como la esterilidad, interacción celular, nutrientes; es senci-llo, factible y económico, pero no hay control del crecimiento celular y vascularización, y los tejidos presentaron alteraciones mecánicas e histológicas. El polímero impidió la re-epitelialización y revascularización. Este estudio abre la posibilidad de mejorar las me-todologías de ingeniería tisular aplicadas al tejido traqueal.


Abstract Introduction: tissue engineering makes it possible to obtain organs as grafts from de-cellularized tissues, regenerated with autologous cells.Objective: decellularize and regenerate porcine tracheas.ARTÍCULO ORIGINAL | Respirar, 2023; 15(3): 188-199 | ISSN 2953-3414 | https://doi.org/10.55720/respirar.15.3.5RECIBIDO: 9 agosto 2023ACEP TADO: 31 agosto 2023 Elisa Barrera-Ramírezhttps://orcid.org/0000-0002-2778-0882Rubén Efraín Garrido-Cardonahttps://orcid.org/0000-0001-6083-5403Alejandro Martínez-Martínezhttps://orcid.org/0000-0003-3448-910XLuis Fernando Plenge-Tellecheahttps://orcid.org/0000-0002-1619-5004Edna Rico-Escobarhttps://orcid.org/0000-0002-0933-0220Esta revista está bajo una licencia de Creative Commons Reconocimiento 4.0 Internacional. Respirar 2023; 15 (3): 189ARTÍCULO ORIGINAL / E. Barrera-Ramírez, R.E. Garrido-Cardona, A. Martínez-Martínez, L.F. Plenge-Tellechea, E. Rico-EscobarDescelularización y regeneración de tráqueaISSN 2953-3414Materials and Methods: Porcine tracheas were decellularized by placing each one in the omentum of four Yorkshire pigs for regeneration in vivo. A trachea decellularized with triton (DT), decellularized with deoxycholate (DD), decellularized with deoxycho-late and reinforced with a polymer, and epithelial cells (DDR), and a cryopreserved na-tive (NC). After 8 days, the DD, NC and DDR were obtained; and on day 15, the DT. The evaluation was mechanically and histologically, performing the case analysis.Results: the decellularized tracheas preserved the integrity of the cartilage, with no me-chanical differences, except for the DDR with greater rigidity. The regenerated trache-as presented less rigidity, except the DDR, which also lost the epithelium and vascular-ity. The DT, DD showed non-respiratory epithelium, fibrosis and vasculogenesis with inflammation.Conclusions: the matrices retained their mechanical characteristics, in vivo regenera-tion offers advantages such as sterility, cell interaction, nutrients; it is simple, feasible and economical, but there is no control of cell growth and vascularization, and the tis-sues presented mechanical and histological alterations. The polymer prevented re-epi-thelialization and revascularization. This study opens the possibility of improving tissue engineering methodologies applied to tracheal tissue.


Assuntos
Animais , Masculino , Feminino , Regeneração/fisiologia , Traqueia/anatomia & histologia , Engenharia Tecidual/métodos , Octoxinol , Ácido Desoxicólico , Matriz Extracelular Descelularizada
2.
Rev. Soc. Bras. Med. Trop ; 53: e20180463, 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1057304

RESUMO

Abstract INTRODUCTION: The therapeutic efficacy of daily amphotericin B infusion is related to its maximum concentration in blood; however, trough levels may be useful in intermittent regimens of this antifungal drug. METHODS : High performance liquid chromatography (HPLC) was used to determine the minimum concentration (Cmin) of amphotericin B in the serum of patients receiving deoxycholate (D-Amph) or liposomal amphotericin B (L-AmB) for the treatment of cryptococcal meningitis (n=28), histoplasmosis (n=8), paracoccidioidomycosis (n=1), and leishmaniasis (n=1). RESULTS: Daily use of D-Amph 30 to 50 mg or L-AmB 50 mg resulted in a similar Cmin, but a significant increase ocurred with L-AmB 100 mg/day. The geometric mean Cmin tended to decrease with a reduction in the dose and frequency of intermittent L-AmB infusions: 357 ng/mL (100 mg 4 to 5 times/week) > 263 ng/mL (50 mg 4 to 5 times/week) > 227 ng/mL (50 mg 1 to 3 times/week). The impact on Cmin was variable in patients whose dose or therapeutic scheme was changed, especially when administered the intermittent infusion of amphotericin B. The mean Cmin for each L-AmB schedule of intermittent therapy was equal or higher than the minimum inhibitory concentration of amphotericin B against Cryptococcus isolates from 10/12 patients. The Cmin of amphotericin B in patients with cryptococcal meningitis was comparable between those that survived or died. CONCLUSIONS: By evaluating the Cmin of amphotericin B, we demonstrated the therapeutic potential of its intermittent use including in the consolidation phase of neurocryptococcosis treatment, despite the great variability in serum levels among patients.


Assuntos
Humanos , Anfotericina B/sangue , Ácido Desoxicólico/sangue , Antifúngicos/sangue , Paracoccidioidomicose/tratamento farmacológico , Leishmaniose/tratamento farmacológico , Anfotericina B/administração & dosagem , Anfotericina B/farmacocinética , Cromatografia Líquida de Alta Pressão , Meningite Criptocócica/tratamento farmacológico , Ácido Desoxicólico/administração & dosagem , Ácido Desoxicólico/farmacocinética , Histoplasmose/tratamento farmacológico , Antifúngicos/administração & dosagem , Antifúngicos/farmacocinética
3.
Braz. J. Pharm. Sci. (Online) ; 56: e18094, 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1285510

RESUMO

Ursodeoxycholic acid (UDCA), a secondary bile acid (BA), has been used as a drug to treat various liver diseases. UDCA is synthesised from cholic or chenodeoxycholic acid (CA/CDCA), two primary BAs frequently used as the starting materials. Nowadays, swine, cattle, and poultry bile are the main sources of those BAs. However, other commercial animals could be promising sources as well. We identified two livestock, two poultries, and eight fishes that are commercially cultivated in Indonesia. Four free BAs including CA, CDCA, deoxycholic acid (DCA), and lithocholic acid (LA) were identified for their occurrences using thin-layer chromatography and high-performance liquid chromatography. CA was detected in cow, duck, red tilapia, gourami, the common carp, and grouper, whereas CDCA was only detected in two poultries and the common carp. The occurrence of DCA was common and abundant in most tested animals. In contrast, the presence of LA was found to be very low in all samples. The biliary bile of tilapia has been found to contain a high abundance of free CA (43% of the total bile). A simple extraction was able to purify CA from biliary bile of tilapia. This is a new promising and competitive source of CA.


Assuntos
Animais , Masculino , Feminino , Bile/efeitos dos fármacos , Cromatografia Líquida de Alta Pressão/métodos , Cromatografia em Camada Delgada/métodos , Indonésia/etnologia , Animais , Ácido Ursodesoxicólico , Ácido Ursodesoxicólico/antagonistas & inibidores , Ácidos e Sais Biliares/uso terapêutico , Ácido Quenodesoxicólico , Tilápia/classificação , Ácido Cólico/agonistas , Ácido Desoxicólico , Ácido Litocólico
4.
An. bras. dermatol ; 94(6): 754-756, Nov.-Dec. 2019. graf
Artigo em Inglês | LILACS | ID: biblio-1054889

RESUMO

Abstract A 28-year-old white female patient presented with multiple erythematous-to-violaceous, painful, suppurative nodules on the buttocks and thighs that appeared after two weeks of mesotherapy with deoxycholate, caffeine, sunflower liposomes, and sinetrol for localized fat. She was treated for atypical mycobacteriosis, but with no satisfactory response after antibiotic therapy. Bacterial, mycobacterial, and fungal culture were all negative. Histopathologic examination of the biopsy showed noninfectious suppurative panniculitis. It resolved after treatment with methotrexate, prednisone, and hydroxychloroquine. This report highlights the rarity of this complication, the importance of its early recognition, and differentiation with atypical fast growing mycobacterioses.


Assuntos
Humanos , Feminino , Adulto , Paniculite Nodular não Supurativa/induzido quimicamente , Paniculite Nodular não Supurativa/patologia , Ácido Desoxicólico/efeitos adversos , Mesoterapia/efeitos adversos , Biópsia , Paniculite Nodular não Supurativa/tratamento farmacológico , Resultado do Tratamento , Derme/patologia
5.
Rev. méd. Chile ; 146(12): 1481-1485, dic. 2018. graf
Artigo em Espanhol | LILACS | ID: biblio-991360

RESUMO

We report a 45-year-old male with AIDS who had a Cryptococcus neoformans central nervous system infection. He was treated with amphotericin B deoxycholate subsequently changed to voriconazole due to systemic toxicity of the former. Plasma levels of voriconazole were insufficient with a standard dose (0.7 μg/mL), therefore, the dose was increased thereafter to reach appropriate levels (4.5 μg/mL). Anti-retroviral therapy was started five weeks after voriconazole initiation with non-interacting drugs and he was discharged after a favorable evolution. He was re-admitted three months later due to seizures; a brain magnetic resonance showed new sub-cortical nodules. After excluding alternative causes and demonstrating fungal eradication, an immune reconstitution inflammatory syndrome (IRIS) event was suspected and treated with a short course of steroids. His evolution was satisfactory.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Anfotericina B/efeitos adversos , Meningite Criptocócica/tratamento farmacológico , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Ácido Desoxicólico/efeitos adversos , Síndrome Inflamatória da Reconstituição Imune/induzido quimicamente , Voriconazol/administração & dosagem , Antifúngicos/efeitos adversos , Anfotericina B/administração & dosagem , Meningite Criptocócica/diagnóstico por imagem , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico por imagem , Ácido Desoxicólico/administração & dosagem , Combinação de Medicamentos , Antifúngicos/administração & dosagem
6.
Rev. chil. infectol ; 35(4): 420-423, ago. 2018.
Artigo em Espanhol | LILACS | ID: biblio-978053

RESUMO

Resumen Introducción: La criptococcosis es una infección micótica oportunista grave, Cryptococcus neoformans es la principal especie de importancia médica, pudiendo manifestarse como meningitis, neumonía o criptococcemia. Objetivo: Caracterizar a los pacientes con infección por Cryptococcus sp. entre el 01/01/13 y 30/06/16, en el HCVB. Materiales y Métodos: Se identificaron los cultivos con desarrollo de Cryptococcus sp., y a partir de éstos se obtuvo los registros de los pacientes, los que fueron analizados por dos revisores independientes. Resultados: Se recopiló la información de 13 pacientes, que presentaron 15 casos de infección por C. neoformans. De los 13 pacientes, 11 (84,6%) eran de sexo masculino, con una mediana de edad de 35 años. 11 pacientes (84,6%) padecían infección por VIH, uno (7,7%) tenía el antecedente de leucemia linfática crónica, y uno (7,7%) de etilismo crónico. De los 15 casos, nueve (60%) presentaron infección meníngea; cinco (33,3%) presentaron criptococcemia sin compromiso del LCR; y uno (6,6%) presentó infección pulmonar. De los 13 pacientes, ocho (53,3%) se encontraban fallecidos al año de seguimiento. Conclusiones: La infección por Cryptococcus sp. es una patología que debe ser sospechada en pacientes con inmunodeficiencia de predominio celular. La infección meníngea fue la forma más frecuente de presentación. Persiste presentando una elevada mortalidad.


Background: Cryptococcosis is a severe opportunistic mycotic infection, caused mainly by Cryptococcus neoformans. It can present as meningitis, pneumonia or cryptococcemia. Aim: To characterize patients with Cryptococcus infection between January 1°, 2013 and June 30, 2016, in Hospital Carlos van Buren, Valparaíso, Chile. Methods: We identified retrospectively those cultures with Cryptococcus sp. growth, and then obtained their clinical files which were analyzed by two independent reviewers. Results: We were able to obtain data from 13 of 15 patients who presented with Cryptococcus neoformans infection. Out of all, 11 (84.6%) were males, with a median age of 35 years old. 11 (84,6%) were HIV positive, 1 (7,7%) had chronic lymphocytic leukemia, and 1 (7,7%) refered alcohol abuse. Out of the 15 episodes, 9 (60%) had meningeal infection; 5 (33.3%) were cryptococcemia without meningeal involvement and 1 (6.6%) presented as a pulmonary infection. Eight patients were deceased at one year follow up. Conclusions: Cryptococcus sp. infection must be suspected in patients with cellular immunodeficiencies. Meningeal involvement is the most frequent form of clinical presentation. It still has a high mortality rate.


Assuntos
Humanos , Masculino , Feminino , Adulto , Criptococose/diagnóstico , Linfócitos T CD4-Positivos , Fluconazol/uso terapêutico , Chile , Estudos Retrospectivos , Criptococose/tratamento farmacológico , Cryptococcus neoformans/isolamento & purificação , Ácido Desoxicólico/uso terapêutico
7.
Rev. chil. infectol ; 35(4): 448-452, ago. 2018. graf
Artigo em Espanhol | LILACS | ID: biblio-978057

RESUMO

Resumen Presentamos el caso clínico de un paciente con una leucemia linfoblástica aguda (LLA) que desarrolló una fusariosis diseminada por Fusarium verticillioides durante un episodio prolongado de neutropenia febril post quimioterapia. Fue exitosamente tratado cuando se usó terapia combinada de voriconazol más anfotericina B deoxicolato.


We report a case of a patient with acute lymphoblastic leukemia (ALL), who developed a disseminated infection by Fusarium verticillioides during chemotherapy-induced neutropenia. He was successfully treated only after combination therapy with voriconazole plus amphotericin B deoxycolate was used, but not when these compounds were used in an isolated form.


Assuntos
Humanos , Masculino , Adolescente , Anfotericina B/uso terapêutico , Ácido Desoxicólico/uso terapêutico , Fusariose/tratamento farmacológico , Voriconazol/uso terapêutico , Antifúngicos/uso terapêutico , Neutropenia/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras B/complicações , Leucemia-Linfoma Linfoblástico de Células Precursoras B/microbiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras B/tratamento farmacológico , Combinação de Medicamentos , Quimioterapia Combinada , Fusariose/etiologia , Fusariose/patologia , Neutropenia/etiologia , Neutropenia/patologia
8.
Rev. Nac. (Itauguá) ; 10(1): 17-35, 20180600.
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-914219

RESUMO

Introducción En las últimas décadas, el agente de elección para el tratamiento de la mayoría de las micosis sistémicas ha sido la anfotericina B que, a pesar de los efectos tóxicos, sigue teniendo un papel importante en el tratamiento de las infecciones micóticas. Objetivo Determinar los efectos adversos asociados al empleo de anfotericina B en neonatos del Servicio de Neonatología del Hospital Nacional de Itauguá, en el periodo 2013 - 2015. Materiales y métodos Estudio de serie de casos, retrospectivo, de recién nacidos con tratamiento con anfotericina B. Resultados: Entre 28 recién nacidos tratados con anfotericina B, hubo mayor prevalencia en el sexo masculino. Con respecto a la edad más de la mitad de los recién nacidos fueron pre-término en el grupo estudiado. Hubo predominio de bajo peso al nacer (32,14%). Los factores de riesgo arrojaron que 53,5% no contaba con antecedentes de sepsis. La edad media de inicio de anfotericina fue 19±9 días, más de la mitad de los neonatos utilizó dosis progresiva de 0,5 mg/kp/día a 1 mg/kp/día, en 24 hs.El 96,4% recibió infusión de anfotericina B de 4 horas, 1 caso requirió 6 horas. Entre los efectos secundarios, 35,7% de los pacientes presentó anemia, el disturbio hidroelectrolítico más frecuente fue la hipokalemia, entre los signos se destacaron la taquicardia e hipotensión. Conclusiones Los efectos secundarios más llamativos encontrados durante el tratamiento con anfotericina B fueron la anemia, alteraciones de Sodio y Potasio


Introduction In recent decades, the agent of choice for the treatment of most systemic mycoses has been amphotericin B which, despite the toxic effects, continues to play an important role in the treatment of fungal infections. Objective To determine the adverse effects associated with the use of amphotericin B in neonates of the Neonatology Service of the National Hospital of Itauguá, in the period 2013 - 2015. Materials and methods: retrospective case series study of newborns treated with amphotericin B. Results Among 28 newborns treated with amphotericin B, there was a higher prevalence in males. With regard to age, more than half of the newborns were pre-term in the group studied. There was a predominance of low birth weight (32.14%). The risk factors showed that 53.5% did not have a history of sepsis. The mean age of onset of amphotericin was 19 ± 9 days, more than half of the infants used progressive dose from 0.5 mg / kp / day to 1 mg / kp / day, in 24 hours. 96.4% received infusion of amphotericin B for 4 hours, 1 case required 6 hours. Among the side effects, 35.7% of the patients presented anemia, the most frequent water and electrolyte disturbance was hypokalemia, among the signs were tachycardia and hypotension. Conclusions The most striking side effects found during treatment with amphotericin B were anemia, Sodium and Potassium alterations.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Anfotericina B/efeitos adversos , Ácido Desoxicólico/efeitos adversos , Micoses/tratamento farmacológico , Antifúngicos/efeitos adversos , Recém-Nascido de Baixo Peso , Recém-Nascido Prematuro , Anfotericina B/administração & dosagem , Estudos Retrospectivos , Ácido Desoxicólico/administração & dosagem , Antifúngicos/administração & dosagem
9.
Rev. Soc. Bras. Med. Trop ; 50(5): 712-714, Sept.-Oct. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-897020

RESUMO

Abstract Basidiobolomycosis is an unusual fungal skin infection that rarely involves the gastrointestinal tract. This study reported a 5-year-old boy with gastrointestinal basidiobolomycosis that had been misdiagnosed as gastrointestinal lymphoma. He was treated by surgical resection and a combination of posaconazole and amphotericin B deoxycholate with an acceptable response and no recurrence.


Assuntos
Humanos , Masculino , Pré-Escolar , Doenças do Colo/microbiologia , Zigomicose/patologia , Zigomicose/tratamento farmacológico , Zigomicose/diagnóstico por imagem , Neoplasias Gastrointestinais/diagnóstico , Hepatopatias/microbiologia , Linfoma/diagnóstico , Triazóis/uso terapêutico , Tomografia Computadorizada por Raios X , Anfotericina B/uso terapêutico , Resultado do Tratamento , Doenças do Colo/patologia , Doenças do Colo/diagnóstico por imagem , Ácido Desoxicólico/uso terapêutico , Diagnóstico Diferencial , Combinação de Medicamentos , Neoplasias Gastrointestinais/patologia , Hepatopatias/patologia , Hepatopatias/diagnóstico por imagem , Linfoma/patologia , Antifúngicos/uso terapêutico
10.
Rev. Soc. Bras. Med. Trop ; 50(4): 478-482, July-Aug. 2017. tab
Artigo em Inglês | LILACS | ID: biblio-896990

RESUMO

Abstract INTRODUCTION: The drugs available for visceral leishmaniasis (VL) treatment in Brazil have specific characteristics in terms of operability, effectiveness, toxicity, and cost. The aim of this study was to estimate the direct costs of therapies recommended by the Ministry of Health (MH) for VL treatment in Brazil. METHODS: The analytical perspective used was that adopted by the Brazilian Public Health System. Three drugs and four regimens were included: 1) N-methyl glucamine antimoniate intramuscularly at 20mg per kg per day for 30 days; 2) N-methyl glucamine antimoniate intravenously at 20mg per kg per day for 30 days; 3) amphotericin B deoxycholate at 1mg per kg per day for 21 days; and 4) liposomal amphotericin B at 3mg per kg per day for a 7 days treatment. RESULTS: The estimated direct costs of treatment for an adult patient using N-methylglucamine antimoniate administered via the intramuscular and intravenous routes were USD 418.52 and USD 669.40, respectively. The estimated cost of treatment with amphotericin B deoxycholate was USD 1,522.70. Finally, the estimated costs of treatment with liposomal amphotericin B were USD 659.79, and USD 11,559.15 using the price adopted by the WHO and the Drug Regulation Board, respectively. CONCLUSIONS: This analysis indicates the economic feasibility of replacing N-methyl glucamine antimoniate with liposomal amphotericin B, which allows a shorter treatment period with less toxicity compared with other treatments, provided that the purchase value used by the WHO and transferred to the MH is maintained.


Assuntos
Humanos , Custos de Cuidados de Saúde/estatística & dados numéricos , Leishmaniose Visceral/tratamento farmacológico , Antiprotozoários/economia , Compostos Organometálicos/economia , Compostos Organometálicos/uso terapêutico , Brasil , Anfotericina B/economia , Anfotericina B/uso terapêutico , Protocolos Clínicos , Ácido Desoxicólico/economia , Ácido Desoxicólico/uso terapêutico , Combinação de Medicamentos , Antimoniato de Meglumina , Leishmaniose Visceral/economia , Meglumina/economia , Meglumina/uso terapêutico , Antiprotozoários/uso terapêutico
11.
Rev. Soc. Bras. Med. Trop ; 50(1): 67-74, Jan.-Feb. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-842815

RESUMO

ABSTRACT INTRODUCTION Despite their high toxicity, antimonials and amphotericin B deoxycholate are commonly used for treating visceral leishmaniasis (VL). Few studies showing conflictive data about their efficacy and adverse events in pediatric population are available. This study aimed to evaluate efficacy and safety of amphotericin B deoxycholate vs. that of N-methylglucamine antimoniate in treating pediatric VL in Brazil. METHODS This was a randomized, open-label, 2-arm and controlled pilot clinical trial. Treatment naïve children and adolescents with VL without signs of severe illness were treated with N-methylglucamine antimoniate (20mg/kg/day for 20 days) or amphotericin B deoxycholate (1 mg/kg/day for 14 days). All patients were diagnosed with positive direct examination and/or positive PCR for Leishmania spp. performed in bone marrow samples. The primary efficacy end-point was VL cure determined after 180 days of completion of treatment. The analysis was performed using intention-to-treat (ITT) and per protocol (PP) analyses. RESULTS In total, 101 volunteers were assessed. Efficacy was similar for both groups. The antimonial (n=51) and amphotericin B groups (n=50) had a cure rate of 94.1% and 100%, and 94% and 97.9% according to ITT and PP analyses, respectively. All patients reported adverse events (AE). Serious AE incidence was similar in both groups. Five individuals were excluded from the study because of severe adverse events. CONCLUSIONS N-methylglucamine antimoniate and amphotericin B deoxycholate have similar efficacy and adverse events rate in pediatric patients with VL.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Compostos Organometálicos/uso terapêutico , Anfotericina B/uso terapêutico , Ácido Desoxicólico/uso terapêutico , Leishmaniose Visceral/tratamento farmacológico , Meglumina/uso terapêutico , Antiprotozoários/uso terapêutico , Compostos Organometálicos/efeitos adversos , Projetos Piloto , Anfotericina B/efeitos adversos , Resultado do Tratamento , Ácido Desoxicólico/efeitos adversos , Combinação de Medicamentos , Antimoniato de Meglumina , Meglumina/efeitos adversos , Antiprotozoários/efeitos adversos
12.
Lima; s.n; feb. 2017. tab, ilus.
Não convencional em Espanhol | LILACS, BRISA/RedTESA | ID: biblio-848084

RESUMO

INTRODUCCIÓN: Antecedentes: El presente dictamen expone la evaluación de tecnología de la eficacia y seguridad de las formulaciones lipídicas de amfotericina B para el tratamiento de primera líena de pacientes con diagnóstico de mucormicosis. Aspectos Generales: La mucormicosis es una infección causada por hongos del orden Mucorales (clase Zigomycetes). Esta micosis afecta preferentemente a pacientes inmunocomprometidos o con diabetes mellitus, y se manifiesta por una variedad de síndromes, siendo los más comunes las infecciones de tipo rino-orbital-cerebral y pulmonar. Además, se recnonocen cinco formas clínicas adicionales de la infección: gastrointestinal, cutánea, renal, diseminada y con complicación del sistema central nervioso. Tecnología Sanitaria de Interés: El grupo de las formulaciones lipídicas abarca dos formulaciones disponibles, las cuales fueron desarrolladas para maximizar la utilidad terapéutica de la terapia estándar con amfotericina B y a su vez reducir la frecuencia de eventos adversos. Los compuestos considerados son: Amfotericina B Complejo Lipídico (ABCL/Marca Registrada Abelcet; Enzon Pharmaceuticals); Amfotericina B Liposomal (L-AMB/Marca Registrada AmBisome; Gilead). METODOLOGÍA: Estrategia de Búsqueda: Se realizó una búsqueda de la literatura con respecto a la eficacia y seguridad de la amfotericina B liposomal o la amfotericina B complejo lipídico para el tratamiento de mucormicosis. Esta búsqueda se realizó utilizando los meta-fuscadores: Translating Research into Practice (TRIPDATABASE), National Library of Medicine (Pubmed-Medline) y Health Systems Evidence. RESULTADOS: Sinopsis de la Evidencia: Se llevó a cabo una búsqueda de evidencia científica con respecto a la eficacia y seguridad de amfotericina B liposomal o amfotericina B complejo lipídico para el tratamiento de mucormicosis. CONCLUSIONES: En la presente evaluación de tecnología sanitaria no se encontraron estudios primarios de tipo ensayos clínicos que muestren diferencias entre las formulaicones lipídicas de amfotericina B y amfotericina B desoxicolato en cuanto a la eficacia y seguridad en pacientes con mucormicosis. El Instituto de Evaluación de Tecnologías Sanitarias e Investigación-IETSI, no aprueba el uso de las formulaciones lipídicas de la amfotericina B como primera línea de tratamiento de la mucormicosis.


Assuntos
Humanos , Anfotericina B/uso terapêutico , Mucormicose/terapia , Anfotericina B , Ácido Desoxicólico , Lipídeos , Avaliação da Tecnologia Biomédica , Resultado do Tratamento
13.
Fisioter. Bras ; 18(3): f:349-I:355, 2017000.
Artigo em Português | LILACS | ID: biblio-905901

RESUMO

Desde a primeira publicação a respeito, em 2001, a aplicação de injeções lipolíticas para gordura localizada tornou-se um procedimento amplamente utilizado na clínica. Consiste de múltiplas injeções subcutâneas de compostos lipolíticos, que podem ter diversos mecanismos de ação. O fármaco mais utilizado atualmente, o desoxicolato de sódio, foi descoberto por acaso, em uma associação com fosfatidilcolina em que sua única função era de veículo da fórmula. Conforme estudos foram sendo realizados, concluiu-se que a ação no tecido era devido ao desoxicolato, um sal biliar que emulsiona os lipídios da membrana celular, resultando em lise do adipócito e consequente necrose do tecido adiposo. Seus principais efeitos adversos, muito frequentemente relatados, incluem dor intensa, edema e formação de nódulos fibrosos nos pontos aplicados. Em decorrência de falhas na aplicação, alguns efeitos adversos mais graves podem ocorrer, como injúria do nervo facial e infecções persistentes. Apesar destes, a utilização de desoxicolato de sódio na camada subcutânea apresenta resultados muito positivos, como publicado em diversos ensaios clínicos, inclusive com relação à satisfação do paciente perante o desfecho final, sendo, portanto, uma boa escolha de técnica para contorno corporal e diminuição de depósitos de gordura localizados. (AU)


Since the first paper, in 2001, injection lipolysis for localized fat deposits became a widely used procedure in the clinics. It consists basically of multiple subcutaneous injections of lipolytic compounds, with many different mechanisms of action. The most used drug nowadays is sodium deoxycholate, initially thought to be only the solubilizing vehicle in the phosphatidilcholine formula. As studies were performed, it was concluded that the changes seen in the tissue was due to sodium deoxycholate, a biliary salt which emulsifies membrane lipids, resulting in adipocyte lysis and consequent adipose tissue necrosis. Its main adverse events include pain, oedema and fibrous nodules. Due to poor technique, more serious adverse events may happen, such as nerve injury or persistent infection by mycobacterium. In spite of these, the use of sodium deoxycholate presents great results, as published in many clinical trials, including patient's satisfaction at the end of the treatment, which is of much value in the aesthetics field. Therefore, mesotherapy using sodium deoxycholate is a good choice for body contouring and localized fat deposits. (AU)


Assuntos
Humanos , Feminino , Gorduras , Injeções , Ácido Desoxicólico , Fosfatidilcolinas , Sódio
14.
Acta cir. bras ; 30(9): 624-631, Sep. 2015. tab, ilus
Artigo em Inglês | LILACS | ID: lil-761497

RESUMO

ABSTRACTPURPOSE:To assess whether deoxycholic acid (DOC) and lithocholic acid (LCA) administered in a period of six months in a concentration of 0.25% may have a carcinogenic role in mice colon.METHODS:The study used C57BL6 female mice divided into four groups. The control group received a balanced diet and the others received diets supplemented with 0.25% DOC, 0.25% LCA and 0.125% DOC+0.125% LCA, respectively. After euthanasia, the lesions found in the resected gastrointestinal tracts were stained with hematoxylin-eosin and examined microscopically.RESULTS:No gastrointestinal tract changes were observed in the control group, while hyperplastic Peyer's patches in the small intestine, flat adenomas with mild dysplasia and chronic colitis at the level of the colon were found in all three test groups. The colonic lesions prevailed in the proximal colon. The highest number of flat adenoma lesions (8), hyperplasia of Peyer's patches (25) and chronic colitis (2) were found in mice fed with diet and LCA.CONCLUSION: Precancerous or cancerous pathological lesions could not be identified. Instead, adenomatous colonic injuries occurred in a shorter period of time (six months), compared to the reported data.


Assuntos
Animais , Feminino , Ácidos e Sais Biliares/toxicidade , Carcinógenos/toxicidade , Colagogos e Coleréticos/toxicidade , Colo/efeitos dos fármacos , Ácido Desoxicólico/toxicidade , Ácido Litocólico/toxicidade , Adenoma/induzido quimicamente , Testes de Carcinogenicidade , Colite/induzido quimicamente , Colo/patologia , Neoplasias do Colo/induzido quimicamente , Modelos Animais de Doenças , Fezes/química , Nódulos Linfáticos Agregados/efeitos dos fármacos , Fatores de Tempo
15.
Medicina (B.Aires) ; 72(1): 23-27, feb. 2012. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-639647

RESUMO

El objetivo de este trabajo es presentar la incidencia, frecuencia, características clínicas y evolución de los pacientes con mucormicosis atendidos en el Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, entre los años 1982 y 2010. Durante ese período se diagnosticaron 10 casos de mucormicosis. Los tres primeros entre 1982 y 2004 y los últimos 7 entre 2005 y 2010. La incidencia y frecuencia de esta enfermedad, para el período 1980-2004 fue 0.13 pacientes/año y 0.1 casos/10 000 egresos (IC 95%: 0.00 a 0.3) respectivamente. En el período 2005-2010 la incidencia fue 0.86 pacientes/año y la frecuencia de 1.1 casos/10 000 egresos (IC 95%: 0.5 a 2.4). Hubo nueve casos de mucormicosis rinosinuso-orbitaria, siete en pacientes con diabetes mellitus, uno en una paciente con una hemopatía maligna y neutropenia, y el restante en un paciente con HIV/sida que además estaba neutropénico y con un síndrome hemofagocítico. En una paciente se realizó el diagnóstico post mortem de mucormicosis pulmonar. El diagnóstico se efectuó por la observación de filamentos cenocíticos en los diez casos. Hubo desarrollo de mucorales en los cultivos de 8/9 pacientes; cinco Rhizopus spp y tres Mucor spp. Todos los pacientes recibieron un tratamiento inicial con anfotericina B deoxicolato, que en tres de ellos fue continuado con anfotericina B liposomal, y cirugía. Tres enfermos recibieron además un tratamiento adyuvante con oxigeno hiperbárico. La mortalidad fue 30%.


Mucormycosis is an opportunistic infection caused by fungi of the order Mucorales. It is characterized by rapid progression and high morbidity and mortality in the absence of early diagnosis and prompt treatment. It was an infrequent disease, but in recent years, its incidence appears to have increased. The aim of this paper is to report the cases of mucormycosis diagnosed from 1982 to 2010 at the Hospital de Clinicas José de San Martín, University of Buenos Aires. We diagnosed 10 cases of mucormycosis; the first three between 1982 and 2004 and the last 7 between 2005 and 2010. The incidence from 1980 to 2004 was 0.13 patient-years and the frequency 0.1/10 000 discharges (95% CI 0.00- 0.3). In the period 2005 to 2010, the incidence was 0.86 patients per year with 1.1/10 000 discharges (95% CI 0.5-2.4). There was a pulmonary mucormycosis case (in a patient treated with corticosteroids) and nine rhinocerebral cases, two in neutropenic and seven in diabetic patients. The diagnosis was made by observation of cenocytic hyphae in 10/10 patients. Mucorales were recovered in 8/9 cultures (5 Rhizopus spp and 3 Mucor spp.). In one case diagnosis of pulmonary mucormycosis was made post-mortem. Nine patients were treated with amphotericin B deoxycholate (in 3 patients supplemented with liposomal amphotericin B) and surgery. Three patients underwent hyperbaric chamber. Seven patients had favorable outcome. In conclusion, mucormycosis is a rare disease, but its incidence has increased over the past five years. A good evolution of the patients is linked to early diagnosis and treatment.


Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mucormicose/epidemiologia , Doenças Nasais/epidemiologia , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Argentina/epidemiologia , Combinação de Medicamentos , Ácido Desoxicólico/uso terapêutico , Infecções Oculares Fúngicas/tratamento farmacológico , Infecções Oculares Fúngicas/epidemiologia , Infecções Oculares Fúngicas/microbiologia , Incidência , Pneumopatias Fúngicas/tratamento farmacológico , Pneumopatias Fúngicas/epidemiologia , Pneumopatias Fúngicas/patologia , Mucormicose/tratamento farmacológico , Mucormicose/patologia , Doenças Nasais/tratamento farmacológico , Doenças Nasais/microbiologia , Doenças dos Seios Paranasais/tratamento farmacológico , Doenças dos Seios Paranasais/epidemiologia , Doenças dos Seios Paranasais/microbiologia
16.
Córdoba; s.n; 2012. 88 p. ^c29 cm, ^cCD Texto Completo.
Tese em Espanhol | LILACS | ID: lil-695478

RESUMO

Altas concentraciones de deoxicolato de sodio (DXCS) producen efectos tóxicos en el intestino. Este estudio explora el efecto de concentraciones fisiológicas altas de DXCS sobre la absorción intestinal de Ca2+ y los mecanismos moleculares involucrados. Para ello, se usaron pollos de 4 semanas de edad, los cuales se dividieron en dos grupos: controles y tratados con DXCS en la luz intestinal, a diferentes tiempos y concentraciones. La absorción intestinal de Ca2+ se midió por la técnica del asa intestinal ligada in situ. Se estudió la expresión de genes y de proteínas involucradas en la vía transcelular de la absorción del catión. El contenido de glutatión (GSH) y la actividad de enzimas del sistema antioxidante se evaluaron por espectrofotometría. La producción de ROS se determinó por espectrometría de resonancia de espín y los cambios en la permeabilidad de la membrana interna itocondrial mediante la técnica de swelling. La apoptosis se estudió a través de la localización subcelular de citocromo c por Western blot y la fragmentación del ADN por la técnica de TUNEL. DXCS inhibió la absorción intestinal de Ca+2, efecto que fue dependiente de la concentración de la sal biliar. La expresión del ARNm de la Ca+2- ATPasa disminuyó por el tratamiento con la sal biliar y lo mismo ocurrió con la expresión de las proteínas involucradas en el proceso de absorción del catión: Ca+2- ATPasa, intercambiador Na+/Ca+2 y calbindina D28k. DXCS produjo estrés oxidativo, a juzgar por la generación de ROS, la depleción de glutatión y el swelling mitocondrial. Además, la presencia del antioxidante quercetina en el medio de incubación bloqueó el efecto inhibitorio del DXCS sobre la absorción intestinal de Ca+2.


SUMMARY: High concentrations of sodium deoxycholate (NaDOC) produce toxic effects. This study explores the effect of a single high concentration of NaDOC on the intestinal Ca2+ absorption and the underlying mechanisms. Chicks were divided into two groups: 1) controls, 2) treated with different concentrations of NaDOC in the duodenal loop for variable times. Intestinal Ca2+ absorption was measured as well as the gene and protein expression of molecules involved in the Ca2+ transcellular pathway. Glutathione (GSH) content and the activity of antioxidant enzymes were assessed by spectrophotometry. ROS was determined by spin resonance spectrometry and permeability changes of the internal mitochondrial membrane by the swelling technique. Apoptosis was studied by cytochrome localization through Western blot and DNA fragmentation (TUNEL procedure). NaDOC inhibited the intestinal Ca2+ absorption, which was dose dependent. Ca2+- ATPase mRNA decreased by the ile salt and the same occurred with the protein expression of Ca2+-ATPase, calbindin D28k and Na+/Ca2+ exchanger. NaDOC produced oxidative stress as judged by ROS generation, mitochondrial swelling and glutathione depletion. Furthermore, the antioxidant quercetin blocked the inhibitory effect of NaDOC on the intestinal Ca2+ bsorption. Apoptosis was also triggered by the bile salt, as indicated by the TUNEL staining and the cytochrome crelease from the mitochondria. As a compensatory mechanism, enzyme activities of the antioxidant system were all increased, but the cellular redox state was not normalized. In conclusion, a single high dose of NaDOC inhibits intestinal Ca2+.


Assuntos
Humanos , Masculino , Feminino , Ácido Desoxicólico/administração & dosagem , Ácido Desoxicólico/efeitos adversos , Absorção Intestinal , Fatores Desencadeantes , Argentina
17.
Rev. Soc. Bras. Med. Trop ; 44(1): 26-29, Jan.-Feb. 2011. tab
Artigo em Inglês | LILACS | ID: lil-579826

RESUMO

INTRODUCTION: Histoplasmosis is a systemic mycosis endemic in Brazil, especially in the State of Rio Grande do Sul, where Histoplasma capsulatum was isolated from the soil. H. capsulatum may compromise unusual areas, including the oropharynx, particularly in patients presenting disseminated histoplasmosis; which is associated with a state of immunosuppression, such as AIDS. METHODS: During database analysis of a total of 265 cases of histoplasmosis, the medical records of 11 patients with histological or microbiological diagnoses of oral histoplasmosis (OH) between 1987 and 2008 were retrospectively reviewed. RESULTS: This work reports 11 cases of OH, the majority presenting histopathological or microbiological evidence of disseminated histoplasmosis (DH). In the patients with DH, OH was the first manifestation of histoplasmosis. Five of the 11 patients discussed were HIV-seropositive with clinical and laboratory findings of AIDS. Four patients presented active pulmonary tuberculosis concomitant with histoplasmosis. Treatment was based on the use of itraconazole and amphotericin B deoxycholate. Eight patients responded successfully to therapy after one year, two did not come back for reevaluation and one died despite adequate therapy. CONCLUSIONS: Oral histoplasmosis is closely associated with immunosuppression status, especially in patients presenting AIDS; moreover, in many cases, OH is the first sign of disseminated histoplasmosis.


INTRODUÇÃO: Histoplasmose é uma micose sistêmica, endêmica no Brasil, especialmente no Estado do Rio Grande do Sul, onde Histoplasma capsulatum foi isolado do solo. H. capsulatum pode acometer áreas não-usuais, como cavidade orofaríngea, particularmente em pacientes com histoplasmose disseminada, por sua vez, associada com estado de imunossupressão, como na AIDS. MÉTODOS: A partir de 265 casos de histoplasmose em um banco de dados de um laboratório de micologia, foram analisados retrospectivamente 11 prontuários de pacientes com diagnóstico histológico ou microbiológico de histoplasmose oral (HO) entre 1987 e 2008. RESULTADOS: Reportamos neste trabalho onze casos de HO, a grande maioria com evidências histopatológicas e microbiológicas de histoplasmose disseminada (HD). Nos pacientes com HD, HO foi a primeira manifestação de histoplasmose. Cinco dos onze casos relatados eram portadores do vírus do HIV, todos com diagnóstico clínico e laboratorial de AIDS. Quatro pacientes do total tinham concomitantemente tuberculose pulmonar e histoplasmose. Tratamento foi baseado no uso de itraconazol e anfotericina B principalmente. Oito pacientes tiveram sucesso terapêutico após um ano, dois não retornaram para reavaliação e um faleceu apesar da adequada terapia antifúngica. CONCLUSÕES: Histoplasmose oral está associada muitas vezes com estado de imunossupressão, especialmente em pacientes com AIDS. Em muitos casos pode representar o primeiro sinal indicativo de histoplasmose disseminada.


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Histoplasmose/microbiologia , Orofaringe/microbiologia , Doenças Faríngeas/microbiologia , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Combinação de Medicamentos , Ácido Desoxicólico/uso terapêutico , Histoplasmose/diagnóstico , Histoplasmose/tratamento farmacológico , Itraconazol/uso terapêutico , Cetoconazol/uso terapêutico , Doenças Faríngeas/diagnóstico , Doenças Faríngeas/tratamento farmacológico , Estudos Retrospectivos
18.
Rev. chil. infectol ; 27(1): 25-33, feb. 2010. tab
Artigo em Espanhol | LILACS | ID: lil-537163

RESUMO

Amphotericin B deoxycholate is associated with infusion-related toxicity and renal toxicity. Purpose: To evaluate medical indications of this compound in a tertiary care center, analyze adverse reactions, infusion protocols and outcome of treated patients. Patients and methods: Retrospective analysis of 39 treatments indicated in 33 patients during 2007, exploring indications, infusion protocols and renal protective measures, infusion-related adverse reactions, nephrotoxicity, hypokalemia and outcomes. Results: On average, therapy lasted 12 days (2 to 39) and reached 600 mg of accumulated dose (100 to 1950) respectively. 24-hours infusions were applied in 63.2 percent of prescriptions and 35.9 percent received a 4-6 hour infusion schedule. In addition, 36.8 percent received daily a saline infusion before amphotericin. Adverse reactions were observed in 40 percent of treatments, predominating fever (25 percent). Nonetheless, nephrotoxicity was infrequent (9.4 percent), of low magnitude, only affecting patients without previous renal disease, and not requiring dialysis. Hypokalemia developed in 21.6 percent of treatments. More than half of medical indications were empirical (59 percent), for presumed infections by either filamentous fungi or yeasts. In the subgroup with microbiological information, main indications were invasive aspergillosis (15.4 percent of total), systemic candidiasis (12.8 percent) or meningeal cryptococcosis (10.3 percent). A favorable response was registered in 41 percent, and only 48.5 percent of patients survived. In a multivariate analysis, only age > 60 years remained as an independent factor for developing infusion-related adverse reactions. In the same manner, a SOFA score > 3 and corticosteroids administration at the same time than amphotericin B, were independently associated to a fatal outcome. Conclusion: infusion-related adverse reactions are frequent during amphotericin B deoxycholate therapy, but renal...


Anfotericina B deoxicolato se asocia a reacciones adversas durante la infusión y a nefrotoxicidad. Objetivo: Evaluar las indicaciones de anfotericina B deoxicolato en un hospital universitario, las reacciones adversas asociadas, los protocolos de administración y el desenlace de los pacientes tratados. Pacientes y Métodos: Se efectuó un estudio retrospectivo con el total de tratamientos efectuados durante el año 2007 en el Hospital Clínico de la Universidad de Chile, identificando 39 tratamientos en 33 pacientes. Se analizaron las indicaciones, dosis, protocolos de administración, efectos adversos relacionados a la infusión (fiebre, calofríos, vómitos o flebitis), nefrotoxicidad, hipokalemia y además la evolución de los pacientes. Resultados: La duración promedio del tratamiento fue de 12 días (2-39) con una dosis acumulada promedio de 600 mg totales (100-1.950 mg). Un 63,2 por ciento de los tratados recibió infusiones de 24 horas y 35,9 por ciento, infusiones de 4 a 6 horas. Además, 36,8 por ciento fue sometido a precargas salinas. Un 40 por cientoo de los tratamientos se acompañó de reacciones adversas asociadas a la infusión, predominando la fiebre (25 por ciento). Sin embargo, la nefrotoxicidad fue de baja magnitud (9,4 por cientoo), sólo presente en pacientes sin falla renal previa y en ningún caso determinó el inicio de diálisis. La hipokalemia se presentó en ocho tratamientos (21,6 por ciento). Más de la mitad de las indicaciones fueron empíricas (59 por cientoo), ya fuese para el tratamiento presunto de hongos filamentosos (aspergilosis o mucormicosis) o levaduras (candidiasis sistémica). En el subgrupo con datos micro-biológicos, las principales indicaciones fueron aspergilosis invasora (15,4 por ciento de los 39 tratamientos), candidiasis sistémica (12,8 por ciento) o criptococosis meníngea (10,3 por ciento). Un 41 por cientoo de los pacientes tuvo una respuesta favorable a los tratamientos y sólo 48,5 por cientoo sobrevivió...


Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Anfotericina B/efeitos adversos , Antifúngicos/efeitos adversos , Ácido Desoxicólico/efeitos adversos , Micoses/tratamento farmacológico , Anfotericina B/administração & dosagem , Antifúngicos/administração & dosagem , Chile , Combinação de Medicamentos , Ácido Desoxicólico/administração & dosagem , Hospitais Universitários , Nefropatias/induzido quimicamente , Micoses/classificação , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
19.
Braz. j. infect. dis ; 12(6): 555-557, Dec. 2008. ilus
Artigo em Inglês | LILACS | ID: lil-507465

RESUMO

Meningitis is a common evolution in progressive disseminated histoplasmosis in children, and is asymptomatic in many cases. In leukemia, the impaired of the T cells function can predispose to the disseminated form. The attributed mortality rate in this case is 20 percent-40 percent and the relapse rate is as high as 50 percent; therefore, prolonged treatment may be emphasized. We have described a child with acute myeloid leukemia (AML), that developed skin lesions and asymptomatic chronic meningitis, with a good evolution after prolonged treatment with amphotericin B deoxycholate followed by fluconazole.


Assuntos
Adolescente , Humanos , Masculino , Histoplasmose/diagnóstico , Leucemia Mieloide/imunologia , Meningite Fúngica/diagnóstico , Doença Aguda , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Doença Crônica , Combinação de Medicamentos , Quimioterapia Combinada , Ácido Desoxicólico/uso terapêutico , Fluconazol/uso terapêutico , Histoplasmose/tratamento farmacológico , Hospedeiro Imunocomprometido , Leucemia Mieloide/microbiologia , Meningite Fúngica/tratamento farmacológico , Meningite Fúngica/microbiologia , Resultado do Tratamento
20.
Rev. ciênc. farm. básica apl ; 27(1): 21-26, 2006. graf
Artigo em Inglês | LILACS | ID: lil-458664

RESUMO

O objetivo desse trabalho foi o de desenvolver e avaliar do ponto de vista físico-químico um sistema micelar de penicilina G benzatina (BPG) em desoxicolato de sódio (NaDC).Foram estudadas as características físicoquímicas da BPG quanto à solubilidade em água e em soluções tampões com diferentes pHs, além do coeficiente de partição octanol-água.Foram avaliadas as propriedades da concentração micelar crítica (CMC) das soluções micelares de Desoxicolato de sódio (NaDC) em baixa e alta força iônica provocada pela presença de cloreto de sódio.O estudo da incorporação da BPG em soluções micelares de NaDC usando várias concentrações de NaDC também foi realizado.O aumento da solubilidade da BPG provocada pela presença de micelas de NaDC foi analisada quantitativamente pelo formalismo do modelo de pseudo-fase.Houve indicação da aplicabilidade do sistema micelar estudado quanto à incorporação de penicilina e aumento se sua solubilidade aparente, com taxa de incorporação de até 90 por cento.Espera-se que a formulação micellar de BPG apresente melhor estabilidade, considerando-se que o antibiótico incorporado na região hidrofóbica das micelas está protegido do meio aquoso externo.


Assuntos
Penicilina G Benzatina/administração & dosagem , Penicilina G Benzatina/farmacologia , Ácido Desoxicólico , Estabilidade de Medicamentos , Micelas , Solubilidade
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