Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.312
Filtrar
1.
Sci Rep ; 14(1): 17621, 2024 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-39085322

RESUMO

Plantar fasciitis is the most common cause of heel pain in adults with an overall prevalence of 0.85% in the adult population of the US, affecting over 2 million adults annually. Most current treatment modalities are not supported by sufficient evidence to recommend one particular strategy over another. Topical application of analgesics for soft tissue pain is well established, however the plantar fascia presents challenges in this regard due to thick skin, fibrotic tissue, and an often thickened fat pad. Sixty-two patients with plantar fasciitis were randomized to a placebo controlled trial testing the efficacy of a topical solution of plant terpenes containing camphor, menthol, eugenol, eucalyptol, and vanillin. Skin permeation of the mixture was enhanced with 15% dimethylsulfoxide (DMSO), 1% limonene, and rosemary oil. One ml of solution was applied topically twice daily, and pain scores evaluated on Day 0, Day 1, Day 3, and Day 10. Using the validated foot function index 78.1% of patients reported an 85% or greater decrease in their total pain score by day 10 while placebo treatment was without effect (One Way ANOVA, P < 0.01). This study adapts the treatment modality of topical analgesia for soft tissue pain to a problematic area of the body and shows therapeutic promise.ClinicalTrials.gov Identifier: NCT05467631.


Assuntos
Dimetil Sulfóxido , Fasciíte Plantar , Humanos , Feminino , Masculino , Fasciíte Plantar/tratamento farmacológico , Pessoa de Meia-Idade , Adulto , Dimetil Sulfóxido/uso terapêutico , Dimetil Sulfóxido/administração & dosagem , Dimetil Sulfóxido/química , Terpenos/uso terapêutico , Resultado do Tratamento , Idoso , Mentol/administração & dosagem , Mentol/uso terapêutico , Benzaldeídos/administração & dosagem , Benzaldeídos/uso terapêutico , Benzaldeídos/química , Eugenol/uso terapêutico , Eugenol/administração & dosagem , Eugenol/farmacologia , Cânfora/uso terapêutico , Cânfora/administração & dosagem , Medição da Dor , Óleos Voláteis
2.
Laryngoscope ; 134(8): 3568-3571, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38747477

RESUMO

Onyx is a safe and effective embolic agent to utilize in the treatment paradigm of JNA. We present a tandem approach that combines trans-arterial embolization (TAE) with direct puncture embolization (DPE) with Onyx to limit blood loss and facilitate safe resection. Laryngoscope, 134:3568-3571, 2024.


Assuntos
Dimetil Sulfóxido , Embolização Terapêutica , Polivinil , Humanos , Embolização Terapêutica/métodos , Polivinil/uso terapêutico , Dimetil Sulfóxido/uso terapêutico , Punções/métodos , Masculino , Pessoa de Meia-Idade , Feminino , Resultado do Tratamento , Terapia Combinada
3.
Neurosurg Rev ; 47(1): 217, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38736006

RESUMO

Dural Arteriovenous Fistulas (dAVFs) of the anterior cranial fossa (ACF) are uncommon but carry a high risk of hemorrhage and pose substantial treatment challenges. Recent advancements in endovascular treatment (EVT), including the introduction of novel liquid embolic agents, have markedly bolstered EVT's role in managing ACF-dAVFs, with notable series published in the last five years. We aimed to assess the feasibility, safety, and efficacy of EVT for ACF-dAVFs. We searched Medline, Scopus, Web of Science, and Cochrane Library databases following PRISMA guidelines. Eligible studies included those with ≥ 5 patients undergoing embolization of ACF-dAVFs, detailing both angiographic and clinical outcomes. We used single proportion analysis with 95% confidence intervals under a random-effects model, I2 to assess heterogeneity, and Baujat and sensitivity analysis to address high heterogeneity. Publication bias was assessed by funnel-plot analysis and Egger's test. Outcomes included complete occlusion following embolization, unsuccessful endovascular embolization attempts, incomplete occlusion following embolization, symptom resolution or clinical improvement following embolization, recurrence; procedure-related complications, morbidity, and mortality. Additionally, a subanalysis for studies exclusively utilizing Onyx™ embolic system was done. Eighteen studies comprising 231 ACF-dAVF were included. Unsuccessful endovascular embolization attempts rate was 2%. Complete occlusion rate was 85%, with 4% of complications. Incomplete occlusion rate was 10%. Successfully embolized patients experienced either symptom resolution or clinical improvement in 94% of cases. Morbidity and mortality rates were 1% and 0%, respectively. Onyx subanalyses showed an overall rate of 0% for unsuccessful attempts, 95% for complete occlusion, and 5% for incomplete occlusion. Symptom resolution or clinical improvement was 98% and recurrence rate was 0%. EVT for ACF-dAVF is highly feasible, effective, and safe, with a low rate of complications, morbidity, and mortality. The subanalyses focusing on Onyx embolizations revealed superior efficacy and safety outcomes compared to the findings of the primary analyses involving all included studies.


Assuntos
Malformações Vasculares do Sistema Nervoso Central , Fossa Craniana Anterior , Embolização Terapêutica , Procedimentos Endovasculares , Polivinil , Humanos , Malformações Vasculares do Sistema Nervoso Central/terapia , Embolização Terapêutica/métodos , Procedimentos Endovasculares/métodos , Polivinil/uso terapêutico , Resultado do Tratamento , Dimetil Sulfóxido/uso terapêutico , Estudos de Viabilidade
4.
Neuroradiol J ; 37(5): 587-592, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38557275

RESUMO

OBJECTIVE: Intracranial intracranial dural arteriovenous fistulas (DAVFs) are mainly treated with an endovascular approach and various embolic agents. The aim of this study was to investigate the efficacy and safety of Onyx embolization in the treatment of DAVFs and characterize the factors as sociated with complete obliteration. METHODS: This retrospective study was based on 62 patients with DAVFs who underwent endovascular treatment with Onyx alone or in combination with coils at our institution. Clinical and imaging data were collected and analyzed. RESULTS: A total of 62 patients with 64 DAVFs were treated with endovascular embolization. The most common primary symptom was ophthalmological signs with a rate of 37.1%. Cognard type III was the most commonly seen subtype (32.8%). The immediate complete occlusion and follow-up rate was 92.2% and 93.5%, respectively. Transvenous balloon-assisted sinus protection was used in 12 patients (18.8%). The pressure cooker technique was used in eight patients (12.5%). Complications were seen in five patients including intracerebral hemorrhage (n = 2), venous thrombotic events (n = 2), and glued microcatheter (n = 1). CONCLUSIONS: Endovascular Onyx alone or in combination with coils embolization is a safe and effective therapy for DAVFs. Favorable angiographic and clinical outcomes can be achieved using different endovascular approaches. Transvenous balloon-assisted sinus protection and the pressure cooker technique may help achieve complete occlusion of DAVFs.


Assuntos
Malformações Vasculares do Sistema Nervoso Central , Dimetil Sulfóxido , Embolização Terapêutica , Polivinil , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Polivinil/uso terapêutico , Estudos Retrospectivos , Malformações Vasculares do Sistema Nervoso Central/terapia , Malformações Vasculares do Sistema Nervoso Central/diagnóstico por imagem , Embolização Terapêutica/métodos , Dimetil Sulfóxido/uso terapêutico , Idoso , Adulto , Resultado do Tratamento , Procedimentos Endovasculares/métodos , Angiografia Cerebral
5.
J Orthop Res ; 42(7): 1527-1535, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38316633

RESUMO

Posttraumatic ankle osteoarthritis (PTAO) causes severe ankle and adjacent joint morbidity. We aimed to compare the treatment efficacy of previously tried and still applied intra-articular injections and oral methylsulfonylmethane (MSM) at functional and histopathological level in PTAO animal model. Thirty-two adult female Sprague-Dawley rats were divided into four groups (Group 1: Control, Group 2: 0.06 g/kg/day MSM, Group 3: 0.04 mg/µL methylprednisolone [MP], Group 4: 0.04 mg/µL hyaluronic acid [HA]). MSM was started orally between Day 0 to the end of 8 weeks. Intra-articular injections were applied to the right ankles of the subjects after surgery. All subjects were killed after radiological evaluation at the 8th week. Subsequently, functional (range of motion) and histopathological evaluation was performed. Radiological evaluation showed better results of the MP (p < 0.001) and MSM (p < 0.001) groups than the control group. Severity of osteoarthritis (OA) in the MP group was significantly less than in the HA group (p = 0.032). When the total Osteoarthritis Research Society International score was compared, the severity of OA was higher in the KS and HA groups than in the control group (p < 0.001). No significant statistical difference was found in the histopathological comparison of MSM and control group (p = 0.466). There was no difference between the groups in range of motion measurement according to the contralateral ankle joint. The radiological progression of OA was slowed in the MSM and MP groups, but significant histopathological worsening was found in the MP and HA applied groups. We suggest that the treatment methods used in daily practice need to be reviewed.


Assuntos
Articulação do Tornozelo , Dimetil Sulfóxido , Ácido Hialurônico , Metilprednisolona , Osteoartrite , Ratos Sprague-Dawley , Sulfonas , Ácido Hialurônico/uso terapêutico , Ácido Hialurônico/administração & dosagem , Animais , Feminino , Osteoartrite/tratamento farmacológico , Metilprednisolona/uso terapêutico , Metilprednisolona/administração & dosagem , Injeções Intra-Articulares , Dimetil Sulfóxido/uso terapêutico , Dimetil Sulfóxido/administração & dosagem , Articulação do Tornozelo/patologia , Ratos , Sulfonas/uso terapêutico , Amplitude de Movimento Articular
6.
J Vet Sci ; 25(1): e6, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38311321

RESUMO

BACKGROUND: Chronic bovine mastitis is linked to biofilm-producing Staphylococcus aureus (bp-Sa) or Staphylococcus coagulase-negative (bp-Scn). OBJECTIVES: Bp-Sa and bp-Scn were treated with intramammary preparations of either enrofloxacin HCl·2H2O-dimethyl-sulfoxide-chitosan (enro-C/DMSO/chitosan) or enro-C alone. Their potential to inhibit and degrade biofilm formation in vitro was also assessed. METHODS: Milk samples were obtained from the affected quarters in a herd. Phenotypical and genotypical identifications as biofilm-producing Staphylococcus species were carried out. Enro-C/DMSO/chitosan and enro-C alone were assessed to determine their in vitro efficacy in interfering with biofilm formation and their bactericidal effects. A prolonged eight-day treatment with a twice-daily intramammary insertion of 10 mL of enro-C/DMSO/chitosan or enro-C alone was set to evaluate the clinical and bacteriological cures on day 10 in 15 cows per group and the biofilm-inhibiting ability. RESULTS: Fifty-seven percent of the isolates were identified as Staphylococcus spp., of which 50% were bp-Sa, 46% bp-Scn, and 4% Staphylococcus pseudintermedius. One hundred percent of the S. aureus isolated and 77% of Staphylococcus coagulase-negative were biofilm producers. In both groups, the icaA and icaD biofilm-producing genes were identified. The experimental preparation could inhibit biofilm formation, degrade mature biofilms, and have well-defined microbicidal effects on planktonic and biofilm bacteria. The respective clinical and bacteriological cure rates were 100% and 80% for enro-C/DMSO/chitosan and 41.7% and 25% for enro-C alone. CONCLUSIONS: Enro-C/DMSO/chitosan eliminates bp-Sa and bp-Scn from cases of chronic bovine mastitis.


Assuntos
Doenças dos Bovinos , Quitosana , Mastite Bovina , Infecções Estafilocócicas , Feminino , Animais , Bovinos , Staphylococcus aureus/genética , Enrofloxacina/uso terapêutico , Coagulase/uso terapêutico , Mastite Bovina/tratamento farmacológico , Mastite Bovina/microbiologia , Quitosana/uso terapêutico , Dimetil Sulfóxido/uso terapêutico , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/veterinária , Infecções Estafilocócicas/microbiologia , Biofilmes , Leite/microbiologia
7.
J Clin Neurosci ; 120: 147-153, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38244529

RESUMO

BACKGROUND: Head and Neck Paragangliomas are characterized by having a rich blood supply. Presurgical embolization with Onyx as a neoadjuvant treatment is not a consensus regarding its efficacy and safety. Our study aimed to answer this matter through a single-arm meta-analysis. METHODS: We systematically reviewed 4 databases. Sixteen studies were described and suitable papers were selected for meta-analysis of estimated intraoperative blood loss (EBL), percentage of tumor devascularization, and complications associated with embolization. RESULTS: The study identified 198 patients with 203 tumors, aged between 8 and 70 years. Commonly reported symptoms included neck mass perception and cranial nerve impairment. Carotid Body Tumors were most prevalent (127, 62.5 %), followed by jugular (48, 23.6 %), or vagal (29, 14.2 %) tumors. Eight studies reported estimated intraoperative blood loss (EBL) averaging 261.89 ml (95 %CI: 128.96 to 394.81 ml). In an analysis of 9 studies, 99 % (95 %CI: 96 to 100 %) achieved 70 % or more devascularization, and 79 % (95 %CI: 58 to 100 %) achieved 90 % or more devascularization. Complications from endovascular procedures were observed in 3 % (95 %CI: 0 to 8 %) of 96 patients across 10 studies, including 4 facial nerve deficits. Eighteen postoperative neurological deficits were reported across 15 articles. CONCLUSION: Despite acknowledged limitations, with refined indications, EVOH, especially Onyx embolization may significantly bolster patient safety, decreasing EBL and easing surgical resection. Further research with larger studies will refine criteria, optimize techniques, and improve patient care and treatment outcomes in the management of head and neck paragangliomas.


Assuntos
Embolização Terapêutica , Neoplasias de Cabeça e Pescoço , Paraganglioma , Humanos , Embolização Terapêutica/métodos , Embolização Terapêutica/efeitos adversos , Neoplasias de Cabeça e Pescoço/terapia , Paraganglioma/terapia , Paraganglioma/diagnóstico por imagem , Polivinil/uso terapêutico , Adulto , Adulto Jovem , Adolescente , Dimetil Sulfóxido/uso terapêutico , Resultado do Tratamento , Pessoa de Meia-Idade , Idoso
8.
J Magn Reson Imaging ; 59(2): 575-584, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37218596

RESUMO

BACKGROUND: Breast cancer treatment response evaluation using the response evaluation criteria in solid tumors (RECIST) guidelines, based on tumor volume changes, has limitations, prompting interest in novel imaging markers for accurate therapeutic effect determination. PURPOSE: To use MRI-measured cell size as a new imaging biomarker for assessing chemotherapy response in breast cancer. STUDY TYPE: Longitudinal; animal model. STUDY POPULATION: Triple-negative human breast cancer cell (MDA-MB-231) pellets (4 groups, n = 7) treated with dimethyl sulfoxide (DMSO) or 10 nM of paclitaxel for 24, 48, and 96 hours, and 29 mice with MDA-MB-231 tumors in right hind limbs treated with paclitaxel (n = 16) or DMSO (n = 13) twice weekly for 3 weeks. FIELD STRENGTH/SEQUENCE: Oscillating gradient spin echo and pulsed gradient spin echo sequences at 4.7 T. ASSESSMENT: MDA-MB-231 cells were analyzed using flowcytometry and light microscopy to assess cell cycle phases and cell size distribution. MDA-MB-231 cell pellets were MR imaged. Mice were imaged weekly, with 9, 6, and 14 being sacrificed for histology after MRI at weeks 1, 2, and 3, respectively. Microstructural parameters of tumors/cell pellets were derived by fitting diffusion MRI data to a biophysical model. STATISTICAL TESTS: One-way ANOVA compared cell sizes and MR-derived parameters between treated and control samples. Repeated measures 2-way ANOVA with Bonferroni post-tests compared temporal changes in MR-derived parameters. A P-value <0.05 was considered statistically significant. RESULTS: In vitro experiments showed that the mean MR-derived cell sizes of paclitaxel-treated cells increased significantly with a 24-hours treatment and decreased (P = 0.06) with a 96-hour treatment. For in vivo xenograft experiments, the paclitaxel-treated tumors showed significant decreases in cell size at later weeks. MRI observations were supported by flowcytometry, light microscopy, and histology. DATA CONCLUSIONS: MR-derived cell size may characterize the cell shrinkage during treatment-induced apoptosis, and may potentially provide new insights into the assessment of therapeutic response. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 4.


Assuntos
Neoplasias da Mama , Neoplasias de Mama Triplo Negativas , Humanos , Animais , Camundongos , Feminino , Paclitaxel/farmacologia , Paclitaxel/uso terapêutico , Neoplasias de Mama Triplo Negativas/diagnóstico por imagem , Neoplasias de Mama Triplo Negativas/tratamento farmacológico , Dimetil Sulfóxido/uso terapêutico , Linhagem Celular Tumoral , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Imageamento por Ressonância Magnética/métodos , Tamanho Celular
9.
Neurochem Int ; 171: 105641, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37952830

RESUMO

Among diseases of the central nervous system (CNS), spinal cord injury (SCI) has a high fatality rate. It has been proven that P2Y G protein-coupled purinergic receptors have a neuroprotective role in apoptosis and regeneration inside the damaged spinal cord. The P2Y12 receptor (P2Y12R) has recently been linked to peripheral neuropathy and stroke. However, the role of P2Y12R after SCI remains unclear. Our study randomly divided C57BL/6J female mice into 3 groups: Sham+DMSO, SCI+DMSO, and SCI+MRS2395. MRS2395 as a P2Y12R inhibitor was intraperitoneally injected at a dose of 1.5 mg/kg once daily for 7 days. We showed that the P2Y12R was markedly activated after injury, and it was double labeled with the microglial and neuron. Behavioral tests were employed to assess motor function recovery. By using immunofluorescence staining, the NeuN expression level was detected. The morphology of neurons was observed by hematoxylin-eosin and Nissl staining. P2Y12R, Bax, GFAP, PCNA and calbindin expression levels were detected using Western blot. Meanwhile, mitochondria and myelin sheath were observed by transmission electron microscopy (TEM). Our findings demonstrated that MRS2395 significantly enhanced motor function induced by SCI and that was used to alleviate apoptosis and astrocyte scarring. NeuN positive cells in the SCI group were lower than in the therapy group, although Bax, GFAP, PCNA and calbindin expression levels were considerably higher. Moreover, following MRS2395 therapy, the histological damage was reversed. A notable improvement in myelin sheath and mitochondrial morphology was seen in the therapy group. Together, our findings indicate that activation of P2Y12R in damaged spinal cord may be a critical event and suggest that inhibition of P2Y12R might be a feasible therapeutic strategy for treating SCI.


Assuntos
Doenças Desmielinizantes , Traumatismos da Medula Espinal , Ratos , Camundongos , Feminino , Animais , Ratos Sprague-Dawley , Antagonistas do Receptor Purinérgico P2Y/uso terapêutico , Recuperação de Função Fisiológica , Dimetil Sulfóxido/uso terapêutico , Antígeno Nuclear de Célula em Proliferação/metabolismo , Antígeno Nuclear de Célula em Proliferação/uso terapêutico , Proteína X Associada a bcl-2/metabolismo , Camundongos Endogâmicos C57BL , Traumatismos da Medula Espinal/tratamento farmacológico , Traumatismos da Medula Espinal/patologia , Medula Espinal/metabolismo , Apoptose , Calbindinas
10.
Adv Sci (Weinh) ; 10(29): e2302658, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37555802

RESUMO

Topical chemotherapy approaches are relevant for certain skin cancer treatments. This study observes that cabazitaxel (CTX), a broad-spectrum second-generation taxane cytotoxic agent, can be dissolved in α-tocopherol at high concentrations exceeding 100 mg mL-1 . 2D nuclear magnetic resonance (NMR) analysis and molecular dynamics (MD) are used to study this phenomenon. The addition of 30% dimethyl sulfoxide (DMSO) to the α-tocopherol/CTX solution improves its working viscosity and enhances CTX permeation through human skin in vitro (over 5 µg cm-2 within 24 h), while no detectable drug permeates when CTX is dissolved in α-tocopherol alone. In a transepidermal water loss assay, the barrier impairment induced by CTX in 30% DMSO in α-tocopherol, but not in pure DMSO, is reversible 8 h after the formulation removal from the skin surface. Antitumor efficacy of the topical CTX formulation is evaluated in nude mice bearing A431 human squamous carcinoma skin cancer xenografts. With topical application of concentrated CTX solutions (75 mg mL-1 ), tumor growth is significantly suppressed compared to lower concentration groups (0, 25, or 50 mg mL-1 CTX). Taken together, these findings show that topical delivery of CTX using a DMSO and α-tocopherol solvent warrants further study as a treatment for skin malignancies.


Assuntos
Neoplasias Cutâneas , alfa-Tocoferol , Camundongos , Animais , Humanos , alfa-Tocoferol/química , Dimetil Sulfóxido/uso terapêutico , Camundongos Nus , Taxoides , Neoplasias Cutâneas/tratamento farmacológico
11.
Res Vet Sci ; 160: 11-17, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37210872

RESUMO

Poisoning in small animals represents an ongoing hazard and therapeutic problem in veterinary medicine. Therapeutic induction of emesis in time enables a fast elimination of a toxic compound resulting in a shortened course of poisoning and a higher safety level thereafter, which decisively improves prognosis and treatment. Lycorine is a reliable emetic drug in beagle dogs without serious side effects thought to be more beneficial in tolerability and efficacy than the rarely used apomorphine. Therefore, this study investigates efficacy and tolerability of differently composed potential drug formulations of lycorine hydrochloride for s.c. administration in dogs as an emetic principle. By emesis response analysis four dimethyl sulfoxide (DMSO)-based active pharmaceutical ingredient (API) formulations were favored. Two of them (F5 and F6) qualified for further drug development. Both formulations ensure a safe pharmacologically induced emesis within about 30 min after injection, suitable for use as an in time decontaminant in acute poisoning of dogs. DMSO-based formulations were well tolerated and offer a novel promising strategy for treatment of poisoning.


Assuntos
Dimetil Sulfóxido , Eméticos , Cães , Animais , Eméticos/efeitos adversos , Dimetil Sulfóxido/uso terapêutico , Preparações Farmacêuticas , Vômito/induzido quimicamente , Vômito/tratamento farmacológico , Vômito/veterinária
12.
J Neurointerv Surg ; 15(10): 1055, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36944494

RESUMO

Paracavernous dural arteriovenous fistulas (pdAVFs) are extremely rare and can mimic carotid cavernous fistulas (CCFs) in both clinical presentation and imaging characteristics. Access to the venous pouch often presents the greatest challenge in the treatment of pdAVFs. Here we present a novel access technique utilizing an endoscopic endonasal transsphenoidal approach, where we directly puncture the venous pouch under both stereotactic guidance and endoscopic visualization, thereby completely embolizing a pdAVF with no alternate access (video 1). neurintsurg;15/10/1055/V1F1V1Video 1Technical video demonstrates the complete embolization of a pdAVF using an endoscopic endonasal transsphenoidal approach.


Assuntos
Fístula Carótido-Cavernosa , Seio Cavernoso , Malformações Vasculares do Sistema Nervoso Central , Embolização Terapêutica , Humanos , Fístula Carótido-Cavernosa/terapia , Embolização Terapêutica/métodos , Malformações Vasculares do Sistema Nervoso Central/diagnóstico por imagem , Malformações Vasculares do Sistema Nervoso Central/cirurgia , Veias , Polivinil/uso terapêutico , Dimetil Sulfóxido/uso terapêutico , Resultado do Tratamento
13.
Neurourol Urodyn ; 42(3): 615-622, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36747494

RESUMO

INTRODUCTION AND HYPOTHESIS: The primary aim of this study was to compare the effect of bladder instillations using dimethyl sulfoxide (DMSO) with triamcinolone versus bupivacaine, triamcinolone, and heparin (BTH) in women with newly diagnosed interstitial cystitis/painful bladder syndrome. The primary outcome was improvement in symptoms measured using the O'Leary-Sant Interstitial Cystitis Symptoms Index (ICSI) score. Secondary comparisons included changes in urinary frequency, nocturia, and bladder capacity. MATERIALS AND METHODS: This was a prospective, randomized study. Patients with a recent diagnosis of interstitial cystitis/painful bladder syndrome (IC/PBS) were randomized 1:1 to treatment with either 6 weekly bladder instillations of DMSO with triamcinolone or BTH. During follow-up visits, patients completed the ICSI questionnaire, and bladder capacity was determined through the retrograde filling of the bladder. The χ2 test or Student's t test were used for data analysis. RESULTS: A total of 83 patients were randomized, and final analysis included 70 participants who completed the 6 weekly instillations (42 DMSO, 28 BTH). The groups were similar in baseline demographics and clinical characteristics, except for cystometric maximum capacity (DMSO 338.62± 139.44 mL, BTH 447.43 ± 180.38 mL, p = 0.01). In the DMSO group, 63% of patients had a greater than 29.5% reduction in total ICSI score versus 43% in the BTH group (p = 0.15). Nocturia and pain were significantly reduced in the DMSO group. There was a significant increase from baseline in bladder capacity for both groups. CONCLUSION: In women with newly diagnosed IC/PBS, bladder instillations with DMSO and triamcinolone provide greater improvement in pain and nocturia compared to BTH.


Assuntos
Cistite Intersticial , Noctúria , Humanos , Feminino , Cistite Intersticial/terapia , Dimetil Sulfóxido/uso terapêutico , Triancinolona/uso terapêutico , Heparina/uso terapêutico , Bupivacaína/uso terapêutico , Noctúria/tratamento farmacológico , Estudos Prospectivos , Dor/tratamento farmacológico , Administração Intravesical , Resultado do Tratamento
14.
Pediatr Neurosurg ; 58(1): 45-52, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36780879

RESUMO

INTRODUCTION: Brain arteriovenous malformations (AVMs) are increasingly being treated with Onyx liquid embolic agent (Onyx, Medtronic, Inc.). The phenomenon of delayed Onyx migration is not well documented in the literature. Moreover, the clinical presentation associated with Onyx migration is not well understood. CASE PRESENTATION: A pediatric patient with a history of neonatal seizures was referred to our institution upon experiencing daily headaches with photophobia, phonophobia, and sleep disturbance. Cerebral angiography revealed an AVM of the medial left cerebellar hemisphere. Preoperative embolization with Onyx liquid embolic achieved 25% closure of the AVM nidus. Upon developing worsening headaches the following day, new perinidal parenchymal edema was revealed on MRI, and urgent angiography demonstrated delayed migration of Onyx into the venous drainage. The patient underwent emergency resection of the AVM due to the risk of hemorrhage resulting from venous outflow obstruction. CONCLUSION: Our report and literature review demonstrate that while the delayed, unexpected migration of Onyx embolic material has been alluded to in a handful of papers, this phenomenon is not well documented. Future research is needed to understand the frequency of delayed Onyx migration from brain AVMs and the possible clinical presentations to look for. The sudden development of headaches and other signs of perilesional edema, in particular, should prompt repeat angiographic examination due to the possibility of delayed liquid embolic migration.


Assuntos
Embolização Terapêutica , Malformações Arteriovenosas Intracranianas , Recém-Nascido , Humanos , Criança , Malformações Arteriovenosas Intracranianas/complicações , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Malformações Arteriovenosas Intracranianas/terapia , Polivinil/uso terapêutico , Dimetil Sulfóxido/uso terapêutico , Embolização Terapêutica/efeitos adversos , Embolização Terapêutica/métodos , Angiografia Cerebral , Resultado do Tratamento
15.
Drug Dev Ind Pharm ; 49(1): 52-61, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36803490

RESUMO

Long-term treatment with finasteride (FIN) for androgenic alopecia is restricted due to its systemic side effects. To address this problem, DMSO-modified liposomes were prepared in the present study to improve the topical delivery of FIN. DMSO-liposomes were prepared by a modification of the ethanol injection method. It was hypothesized that the permeation-enhancing property of DMSO could promote drug delivery to deeper skin layer where hair follicles are present. Liposomes were optimized by quality by design (QbD) approach and biologically evaluated in a rat model of testosterone-induced alopecia. Optimized DMSO-liposomes were spherical and had mean vesicle size, zeta potential, and entrapment efficiency of 330.1 ± 1.5, -14.52 ± 1.32, and 59.02 ± 1.12%, respectively. Biological evaluation on testosterone-induced alopecia and skin histology shows that follicular density and anagen/telogen (A/T) ratio were increased in rats treated with DMSO-liposomes as compared to FIN-liposomes without DMSO and an alcoholic solution of FIN applied topically. DMSO-liposomes could be promising skin delivery vehicles for FIN or similar drugs.


Assuntos
Finasterida , Lipossomos , Ratos , Animais , Finasterida/farmacologia , Lipossomos/farmacologia , Dimetil Sulfóxido/farmacologia , Dimetil Sulfóxido/uso terapêutico , Pele , Alopecia/tratamento farmacológico , Administração Cutânea
16.
Interv Neuroradiol ; 29(6): 696-701, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35611508

RESUMO

BACKGROUND: Liquid embolic systems (LES) such as n-butyl cyanoacrylate-based TRUFILL® and ethylene vinyl-alcohol copolymer-based OnyxTM are widely used for the embolization of brain arteriovenous malformations (bAVMs). The purpose of this study was to compare hospital cost and length of stay (LOS) among unruptured bAVM patients undergoing embolization procedures with TRUFILL versus Onyx LES. METHODS: Adult patients with unruptured bAVMs undergoing endovascular embolization with TRUFILL or Onyx LES between January 1, 2010 and June 30, 2020 were identified from the Premier Healthcare Database. Baseline covariates among the two groups were balanced using propensity score matching. Outcomes including total procedure cost, supply cost, and LOS were examined. A Generalized Estimating Equation model was used to assess outcomes in the matched cohorts. RESULTS: A total of 1072 patients were included in the study; 140 embolized with TRUFILL (mean age 47.06 [15.72] years, 45.70% male) and 932 embolized with Onyx (mean age 46.80 [16.65] years, 52.30% male). In the post-match cohort, the total procedure costs were lower for the TRUFILL (n = 130) versus Onyx (n = 333) group, though not significantly ($36,798 vs. $40,988; odds ratio [OR] = 0.90, 95% confidence interval [CI]: 0.73-1.10; p = 0.30). However, supply cost was significantly lower for hospitalizations with TRUFILL compared to Onyx use ($13,281 vs. $16,371, OR = 0.81, 95% CI: 0.68, 0.98; p = 0.026). Hospital LOS was similar in these two groups (TRUFILL: 4.05 vs. Onyx: 4.06 days; OR = 1.00, 95% CI: 0.70, 1.42; p = 0.99). CONCLUSIONS: In a large, multi-center, real-world sample of patients undergoing bAVM embolization, TRUFILL use was associated with significantly lower supply cost compared to Onyx use.


Assuntos
Embolização Terapêutica , Malformações Arteriovenosas Intracranianas , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Resultado do Tratamento , Estudos Retrospectivos , Malformações Arteriovenosas Intracranianas/terapia , Malformações Arteriovenosas Intracranianas/complicações , Encéfalo , Embolização Terapêutica/métodos , Polivinil/uso terapêutico , Hospitais , Dimetil Sulfóxido/uso terapêutico
17.
Arch Dermatol Res ; 315(6): 1465-1472, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36459193

RESUMO

Dimethyl sulfoxide (DMSO) is a clear, odorless liquid, inexpensively produced as a by-product of the wood pulp industry. DMSO's unique chemical properties allow for its broad applications in a wide variety of cutaneous challenges. Widely available in the USA as a solvent, DMSO is FDA-approved only for the treatment of interstitial cystitis and for use as a preservative for organ transplant. DMSO readily penetrates and diffuses through biological membranes. At low concentrations, DMSO exhibits anti-inflammatory, analgesic, diuretic, vasodilator, anti-platelet aggregation, radio-protective, and muscle-relaxing properties. DMSO is also a vigorous scavenger of hydroxyl free radicals, which may explain its observed beneficial effects on skin rejuvenation and recovery from thermal injury. DMSO has a relatively low level of toxicity. DMSO has shown promise in the off-label treatment of basal cell carcinoma, pressure ulcers, scleroderma, herpes simplex, cutaneous fungal infections, and amyloidosis. The potential of DMSO to serve as an independent or adjuvant topical treatment for these conditions is explored in this review.


Assuntos
Queimaduras , Dimetil Sulfóxido , Humanos , Dimetil Sulfóxido/uso terapêutico , Solventes , Pele
18.
Drug Des Devel Ther ; 16: 4311-4323, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36573068

RESUMO

Purpose: In search of new potent treatment of herpes simplex keratitis (HSK), inhibitory effect of oridonin (Ori) on herpes simplex virus type 1 (HSV-1) was validated by experiments. Methods: For evaluating inhibitory effect of oridonin on herpes simplex virus type 1, a series of in-vivo and in-vitro studies were carried out. Mouse HSV-1 infection model was used in the in-vivo experiments. Experimental mice were classified in five different groups: Mock (mock-infected), HSV-1+ DMSO, HSV-1+ Ori, HSV-1+ ACV, combined Ori and ACV+HSV-1. Corneas of Mock, HSV-1+ DMSO, HSV-1+ Ori group were sent for mRNA-sequencing after 3 days post infection (dpi). The expression of virus and host-related genes was evaluated by quantitative real-time polymerase chain reaction (qPCR). Vero cells HSV-1 infection models were used in the in-vitro experiments. Results: The application of ACV, Oridonin alone or a combination of both could alleviate HSV-1 severity and inhibit HSV-1 virus replication in C57BL/6 mice models. qPCR showed that compared with mock group, the expression of interleukin-6 (il-6), interleukin-1α (il-1α), and Tumor-necrosis factor-alpha (tnf-α) was up-regulated in DMSO+HSV-1 group and suppressed in other three group. Moreover, the expression of nod-like receptor protein (nlrp3), caspase 1 and interleukin-1ß (il-1ß) were depressed in the oridonin-treated group. Oridonin significantly inhibits HSV-1 replication, HSV-1 related gene expression, and the production of progeny HSV-1 viruses in vitro. Besides, oridonin affect the replication phase but not HSV-1 entry or penetration and cannot inactivate HSV-1. Conclusion: Oridonin alleviates herpes simplex keratitis infection in mouse, which may be attributed to inhibition of the NLRP3-inflammasome-IL-1ß pathway. Our study illustrates that Oridonin has potential promise for application in treating HSK and other diseases caused by HSV-1 infection.


Assuntos
Herpes Simples , Herpesvirus Humano 1 , Ceratite Herpética , Chlorocebus aethiops , Animais , Camundongos , Antivirais/farmacologia , Antivirais/uso terapêutico , Células Vero , Dimetil Sulfóxido/farmacologia , Dimetil Sulfóxido/uso terapêutico , Proteína 3 que Contém Domínio de Pirina da Família NLR , Camundongos Endogâmicos C57BL , Herpes Simples/tratamento farmacológico , Ceratite Herpética/tratamento farmacológico
19.
AJNR Am J Neuroradiol ; 43(12): 1749-1755, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36357152

RESUMO

BACKGROUND AND PURPOSE: Endovascular embolization using liquid embolic agents is a safe and effective treatment option for AVMs and fistulas. Because reliable visibility of these liquid embolic agents is essential for intraprocedural visual control to prevent complications, novel angiographic systems are equipped with material-specific roadmap modes. The aim of this study was the systematic in vitro comparison of conventional and material-specific roadmap modes regarding the visibility of the most used liquid embolic agents. MATERIALS AND METHODS: A recently introduced in vitro model, resembling cerebral vessels, was embolized with Onyx 18, Squid 18, PHIL 25%, and n-BCA mixed with iodized oil (n = 4 for each liquid embolic agent), as well as with contrast medium and saline, both serving as a reference. Imaging was performed in conventional and material-specific roadmap modes. The visibility of the liquid embolic agents in both modes was compared quantitatively and qualitatively. RESULTS: Significant differences between conventional and material-specific roadmap modes regarding the visibility of the liquid embolic agents were observed for all study groups. All liquid embolic agents were better visible in the material-specific roadmap modes compared with the conventional mode in qualitative and quantitative analyses (eg, Onyx in conventional-versus-material-specific modes along the 1.0-mm sector: mean contrast-to-noise ratio, 5.69 [SD, 0.85] versus 47.18 [SD, 5.72]; P < .001, respectively). CONCLUSIONS: In this in vitro study, we demonstrated a better visibility of all investigated liquid embolic agents by using material-specific roadmap modes compared with the conventional roadmap technique. Especially in complex anatomic situations, these novel roadmap modes could improve the visual control and thus the safety and efficacy of embolization procedures in clinical practice.


Assuntos
Embolização Terapêutica , Malformações Arteriovenosas Intracranianas , Humanos , Dimetil Sulfóxido/uso terapêutico , Embolização Terapêutica/métodos , Resultado do Tratamento , Malformações Arteriovenosas Intracranianas/terapia , Polivinil/uso terapêutico , Angiografia
20.
Hum Exp Toxicol ; 41: 9603271221132140, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36198566

RESUMO

Herbacetin (HBN) is a glycosylated flavonoid, which possesses numerous pharmacological properties. Cyclophosphamide (CYC) is a chemotherapeutic drug that adversely affects the kidneys. The present investigation aimed to evaluate the curative potential of HBN against CYC-induced nephrotoxicity. Sprague Dawley rats (n = 48) were randomly divided into four groups: control (0.1% DMSO + food), CYC (150 mg/kg b.wt.), CYC+HBN (150 + 40 mg/kg b.wt.), and HBN (40mg/kg b.wt.). CYC treatment significantly decreased the activities of antioxidant enzymes such as catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx), and glutathione reductase (GSR) while elevating the concentration of reactive oxygen species (ROS) and malondialdehyde (MDA). Treatment with HBN significantly recovered the activity of CAT, SOD, GPx, and GSR while reducing the concentrations of ROS and MDA. Moreover, an increase in the level of renal functional markers, including Urea, creatinine, kidney injury molecule-1 (KIM-1), and neutrophil gelatinase-associated lipocalin (NGAL), and a decrease in creatinine clearance after CYC administration was recovered to control values by HBN treatment. Furthermore, HBN treatment normalized the increased levels of inflammatory markers such as nuclear factor kappa-B (NF-κB), tumor necrosis factor-α (TNF-α), interleukin-1ß (IL-1ß), interleukin-6 (IL-6), inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) after CYC administration. Besides, HBN administration increased the expression of anti-apoptotic markers (Bcl-2) while decreasing the apoptotic markers (Bax and Caspase-3). Furthermore, HBN decreased the activities of tricarboxylic acid (TCA) cycle enzymes (ICDH, αKGDH, SDH, and MDH) as well as renal mitochondrial respiratory-chain complexes (I-IV) and repolarized mitochondrial membrane potential (ΔΨm). Additionally, HBN administration significantly protected against renal histological damage induced by CYC. In conclusion, CYC-induced toxicity was effectively ameliorated by the HBN administration. These results indicate that HBN might be considered as a potential protective agent against nephrotoxicity. The observed protection may be due to its antioxidant, anti-inflammatory, and anti-apoptotic potential.


Assuntos
NF-kappa B , Fator de Necrose Tumoral alfa , Animais , Anti-Inflamatórios/farmacologia , Antioxidantes/metabolismo , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Apoptose , Caspase 3/metabolismo , Catalase/metabolismo , Creatinina/metabolismo , Ciclo-Oxigenase 2/metabolismo , Ciclofosfamida/uso terapêutico , Ciclofosfamida/toxicidade , Dimetil Sulfóxido/metabolismo , Dimetil Sulfóxido/farmacologia , Dimetil Sulfóxido/uso terapêutico , Flavonoides/farmacologia , Glutationa Peroxidase/metabolismo , Glutationa Redutase/metabolismo , Inflamação/induzido quimicamente , Inflamação/tratamento farmacológico , Inflamação/metabolismo , Interleucina-1beta/metabolismo , Interleucina-6/metabolismo , Rim , Lipocalina-2 , Malondialdeído/metabolismo , Mitocôndrias/metabolismo , NF-kappa B/metabolismo , Óxido Nítrico Sintase Tipo II/metabolismo , Estresse Oxidativo , Ratos , Ratos Sprague-Dawley , Espécies Reativas de Oxigênio/metabolismo , Superóxido Dismutase/metabolismo , Ácidos Tricarboxílicos/metabolismo , Ácidos Tricarboxílicos/farmacologia , Ácidos Tricarboxílicos/uso terapêutico , Fator de Necrose Tumoral alfa/metabolismo , Ureia , Proteína X Associada a bcl-2/metabolismo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...