Assuntos
Fibras na Dieta/efeitos adversos , Fentanila/uso terapêutico , Galactanos/efeitos adversos , Mananas/efeitos adversos , Fosforilcolina , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Doença Crônica , Dietas da Moda , Combinação de Medicamentos/uso terapêutico , Estenose Esofágica/induzido quimicamente , Álcoois Graxos/uso terapêutico , Fentanila/administração & dosagem , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Dor/tratamento farmacológico , Gomas Vegetais , Polietilenoglicóis/uso terapêutico , Surfactantes Pulmonares/uso terapêutico , Estados Unidos , United States Food and Drug AdministrationRESUMO
Antacids show gastroprotective action against various irritants in experimental animals and enhance the healing of chronic gastroduodenal ulcers in humans but the mechanisms of these effects are unknown. The present study was designed to determine whether prostaglandin (PG) and epidermal growth factor (EGF), which also have protective and antiulcer properties, contribute to the action of antacids on rat's stomach. It was found that Maalox 70 and its active component, Al(OH)3, enhance significantly the healing of chronic gastric and duodenal ulcers observed during 7 and 14 days after their induction. Pretreatment with indomethacin caused a significant prolongation of ulcer healing, and this was accompanied by a significant reduction in PG and EGF formation, suggesting that both factors may be involved in ulcer healing. Maalox and Al(OH)3 failed to prevent the suppression of PG by indomethacin but were equally effective in ulcer healing in rats without and with indomethacin administration, suggesting that endogenous PG may not play any important role in the healing process by these drugs. Removal of salivary glands, the major source of EGF, also prolonged ulcer healing but, again, Maalox was as effective in ulcer healing as in rats with intact salivary glands. Our findings that Maalox at pH above 3.0 binds significant amounts of EGF, enhances the binding of EGF to the ulcer area, and stimulates mucosal growth, suggest that EGF may be involved in ulcer healing; however, because antacids are also effective after sialoadenectomy, EGF does not seem to be the major factor in ulcer healing by these drugs.
Assuntos
Hidróxido de Alumínio/uso terapêutico , Antiácidos/uso terapêutico , Fator de Crescimento Epidérmico/fisiologia , Hidróxido de Magnésio/uso terapêutico , Magnésio/uso terapêutico , Úlcera Péptica/tratamento farmacológico , Prostaglandinas/fisiologia , Animais , Combinação de Medicamentos/uso terapêutico , Concentração de Íons de Hidrogênio , Indometacina/farmacologia , Ratos , Fatores de Tempo , Cicatrização/fisiologiaAssuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Catalase/uso terapêutico , Colina O-Acetiltransferase/uso terapêutico , Fibromialgia/tratamento farmacológico , Lipase/uso terapêutico , Lipoxigenase/uso terapêutico , Nucleotidiltransferases/uso terapêutico , Sulfato Adenililtransferase/uso terapêutico , Sulfurtransferases/uso terapêutico , Combinação de Medicamentos/uso terapêutico , HumanosRESUMO
Parkinson's disease continues to be a tragic debilitator of close to half a million Americans. As more is learned about the disease, pharmacological treatment improves. Just recently, deprenyl became a part of our therapeutic armamentarium, and it appears that Sinemet CR will soon be following. It is hoped that these drugs will improve the quality and quantity of life for patients with PD until the disease can be cured.
Assuntos
Antiparkinsonianos/uso terapêutico , Carbidopa/uso terapêutico , Levodopa/uso terapêutico , Doença de Parkinson/tratamento farmacológico , Fenetilaminas/uso terapêutico , Selegilina/uso terapêutico , Idoso , Carbidopa/administração & dosagem , Carbidopa/efeitos adversos , Combinação de Medicamentos/administração & dosagem , Combinação de Medicamentos/efeitos adversos , Combinação de Medicamentos/uso terapêutico , Feminino , Humanos , Levodopa/administração & dosagem , Levodopa/efeitos adversos , Levodopa/farmacologia , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/psicologia , Qualidade de Vida , Selegilina/administração & dosagem , Selegilina/efeitos adversosRESUMO
The aim of this study was to determine whether Fluor Protector, a fluoride varnish, applied to molars before orthodontic banding could prevent white spot formation. In the in vitro study 93 human premolars were used, divided in five different groups, representing different clinical situations. Each tooth was sliced in half, one as a control and the other as a test specimen. All tooth halves were stored in a demineralizing solution, in an attempt to induce white spot formation. In the in vivo study 104 molars (52 controls and 52 tests) of 28 orthodontic patients were involved. The 'split-mouth technique' was used. After evaluation of the results of both studies, it is evident that Fluor Protector is very effective in the prevention of white spot formation under molar bands.
Assuntos
Cárie Dentária/prevenção & controle , Fluoretos Tópicos/uso terapêutico , Dente Molar , Aparelhos Ortodônticos , Poliuretanos/uso terapêutico , Silanos/uso terapêutico , Silício/uso terapêutico , Cimentos Dentários , Materiais Dentários/uso terapêutico , Combinação de Medicamentos/uso terapêutico , Humanos , Técnicas In Vitro , Laca , Higiene Bucal , Distribuição Aleatória , Reprodutibilidade dos Testes , Resinas Vegetais , Propriedades de SuperfícieRESUMO
The hydrochlorothiazide component of Maxzide (Lederle Laboratories, Pearl River, NY) has been shown to be more bioavailable than the hydrochlorothiazide component of Dyazide (Smith, Kline and French Laboratories, Philadelphia, PA). The authors compared the antihypertensive effectiveness of a half-tablet of Maxzide (25 mg of hydrochlorothiazide and 37.5 mg of triamterene) to one capsule of Dyazide (25 mg of hydrochlorothiazide and 50 mg of triamterene) to determine if the difference in bioavailability would be reflected in differences in blood pressure control and metabolic changes. Thirty patients were studied in a randomized open-label crossover design study. There was a significant reduction in systolic blood pressure for both treatments although there was no difference in blood pressures at any time during the study between the two agents. There were no statistically significant differences between Maxzide and Dyazide in terms of metabolic changes for potassium, magnesium, glucose, cholesterol, triglycerides, uric acid, or calcium. Although the hydrochlorothiazide component of Maxzide is more bioavailable than that of Dyazide this did not translate into enhanced hypotensive efficacy.
Assuntos
Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Hidroclorotiazida/uso terapêutico , Hipertensão/tratamento farmacológico , Triantereno/uso terapêutico , Adulto , Idoso , Anti-Hipertensivos/administração & dosagem , Anti-Hipertensivos/farmacocinética , Disponibilidade Biológica , Combinação de Medicamentos/administração & dosagem , Combinação de Medicamentos/farmacocinética , Combinação de Medicamentos/uso terapêutico , Feminino , Humanos , Hidroclorotiazida/administração & dosagem , Hidroclorotiazida/farmacocinética , Hipertensão/sangue , Masculino , Pessoa de Meia-Idade , Distribuição Aleatória , Triantereno/administração & dosagem , Triantereno/farmacocinéticaAssuntos
Alprostadil/análogos & derivados , Antiulcerosos/uso terapêutico , Úlcera Péptica Hemorrágica/prevenção & controle , Úlcera Gástrica/complicações , Estresse Fisiológico/complicações , Alprostadil/uso terapêutico , Hidróxido de Alumínio/uso terapêutico , Antiácidos/uso terapêutico , Combinação de Medicamentos/uso terapêutico , Humanos , Unidades de Terapia Intensiva , Hidróxido de Magnésio/uso terapêutico , Misoprostol , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
The quest for a brighter, more attractive smile has fueled rapid growth in the marketplace for tooth whiteners. With names like BriteSmile, Denta-Lite, Ultra Lite and Whiter Teeth, these products are grabbing the attention of looks-conscious consumers. More than a dozen whiteners have flooded the market recently, most of them available by dentist prescription, a few being sold directly to consumers over the counter. There's no doubt these products work as whiteners, at least on mild to moderate stains. The looming questions is this: are they safe? This article explores that safety question and seeks to provide practicing dentists with some perspective on the issue. We don't pretend to have the definitive answer. As always, it's up to you, doctor, to decide what's best for your patients. It's up to us to provide information that helps you make those crucial decisions. That's our goal.
Assuntos
Dentifrícios/uso terapêutico , Clareamento Dental/métodos , Descoloração de Dente/terapia , Peróxido de Carbamida , Dentifrícios/efeitos adversos , Combinação de Medicamentos/efeitos adversos , Combinação de Medicamentos/uso terapêutico , Humanos , Peróxidos/efeitos adversos , Peróxidos/uso terapêutico , Segurança , Ureia/efeitos adversos , Ureia/análogos & derivados , Ureia/uso terapêuticoAssuntos
Antimaláricos/uso terapêutico , Malária/tratamento farmacológico , Pirimetamina/uso terapêutico , Sulfadoxina/uso terapêutico , Sulfanilamidas/uso terapêutico , Animais , Combinação de Medicamentos/uso terapêutico , Resistência a Medicamentos , Humanos , Lactente , Masculino , Plasmodium falciparumAssuntos
Antimaláricos/uso terapêutico , Malária/tratamento farmacológico , Pirimetamina/uso terapêutico , Sulfadoxina/uso terapêutico , Sulfanilamidas/uso terapêutico , Animais , Combinação de Medicamentos/uso terapêutico , Humanos , Quênia , Plasmodium falciparum/efeitos dos fármacos , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
The treatment of dyspepsia in the emergency department often consists of antacid in combination with viscous lidocaine, even though the specific etiology of the pain is frequently unknown. The efficacy of lidocaine as a component of symptomatic therapy was evaluated in a randomized, patient-blinded protocol. Patients presenting to the ED with dyspeptic symptoms were randomized to receive 30 mL of antacid (Mylanta II), or 30 mL of antacid plus 15 mL of 2% viscous lidocaine (GI cocktail). Patients recorded their pain score on an 11-cm linear analog scale prior to and 30 minutes after treatment. Seventy-six patients were enrolled; three were excluded from analysis due to incomplete data. Thirty-four patients were randomized to receive antacid and 39 to receive GI cocktail. Patients rated their baseline pain at 6.4 +/- 2.8 cm in the antacid group and 6.7 +/- 2.7 cm in the cocktail group (P greater than .50). Improvement in pain score with treatment was 0.9 +/- 2.9 cm in the antacid group compared with 4.0 +/- 3.4 cm in the GI cocktail group (P less than .0001). Assessment of pain relief using a five-point rating scale also indicated greater relief with GI cocktail therapy compared with antacid alone (P = .004). No adverse effects were noted with either treatment. We conclude that a single dose of antacid and viscous lidocaine provides a significantly greater degree of immediate pain relief than antacid alone in patients with dyspepsia.
Assuntos
Hidróxido de Alumínio/administração & dosagem , Antiácidos/administração & dosagem , Dispepsia/tratamento farmacológico , Serviço Hospitalar de Emergência , Lidocaína/administração & dosagem , Hidróxido de Magnésio/administração & dosagem , Magnésio/administração & dosagem , Silicones/administração & dosagem , Simeticone/administração & dosagem , Doença Aguda , Hidróxido de Alumínio/uso terapêutico , Antiácidos/uso terapêutico , Combinação de Medicamentos/administração & dosagem , Combinação de Medicamentos/uso terapêutico , Quimioterapia Combinada , Feminino , Humanos , Lidocaína/uso terapêutico , Hidróxido de Magnésio/uso terapêutico , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Simeticone/uso terapêuticoRESUMO
One hundred febrile episodes in 89 neutropenic patients after cytotoxic chemotherapy were randomized to be treated with either ceftazidime or imipenem as initial monotherapy. The clinical characteristics of the two groups of patients were comparable. The response of the fever in patients who received imipenem was significantly better than that in those who received ceftazidime (77 versus 56%, respectively; P = 0.04), especially in those with microbiologically documented infection (81 versus 33%, respectively; P = 0.02). The in vitro susceptibilities and the clinical responses suggested that, with the possible exception of Pseudomonas spp., imipenem was more effective than ceftazidime in treating neutropenic infections caused by both gram-positive and -negative organisms. An additional 23 and 21% of the patients in the ceftazidime and imipenem groups, respectively, responded to the addition of cloxacillin and amikacin following failure of monotherapy. The majority of the treatment failures, relapses, and superinfections were related to resistant infective organisms such as methicillin-resistant Staphylococcus spp. and Pseudomonas spp. or disseminated fungal infections.
Assuntos
Agranulocitose/complicações , Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Ceftazidima/uso terapêutico , Cilastatina/uso terapêutico , Febre/complicações , Imipenem/uso terapêutico , Neutropenia/complicações , Adolescente , Adulto , Idoso , Antineoplásicos/efeitos adversos , Bactérias/efeitos dos fármacos , Infecções Bacterianas/complicações , Infecções Bacterianas/microbiologia , Combinação Imipenem e Cilastatina , Combinação de Medicamentos/uso terapêutico , Quimioterapia Combinada/uso terapêutico , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Neutropenia/induzido quimicamente , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
A new surgical technique for treating type A aortic dissections is described. It consists of the exclusive and extensive use of surgical glue without replacing a segment of the ascending aorta. Since 1984, 21 patients were operated on using this technique. No operative mortality occurred and one reoperation for redissection was required. The technique is simple and safe and yields excellent short-term and long-term results.
Assuntos
Aneurisma Aórtico/cirurgia , Dissecção Aórtica/cirurgia , Formaldeído/uso terapêutico , Gelatina/uso terapêutico , Resorcinóis/uso terapêutico , Adesivos Teciduais/uso terapêutico , Dissecção Aórtica/classificação , Aorta/cirurgia , Aneurisma Aórtico/classificação , Combinação de Medicamentos/administração & dosagem , Combinação de Medicamentos/uso terapêutico , Formaldeído/administração & dosagem , Gelatina/administração & dosagem , Humanos , Resorcinóis/administração & dosagem , Técnicas de Sutura , Adesivos Teciduais/administração & dosagemRESUMO
The treatment of cyclophosphamide-induced hemorrhagic cystitis has been difficult, with overall poor results using intensive and costly therapy. The authors evaluated the treatment of this problem in four patients with prostaglandin intravesical therapy. Each patient had failed to respond to conservative management. Carboprost tromethamine (Hemabate) was instilled into the bladder, with dwell times ranging from 45 to 60 minutes, three to four times a day for 4 to 5 days. Two of the patients required a second course with carboprost tromethamine at an increased concentration. A third patient's treatment was stopped after the first 5-day course because of intractable bladder spasms and persistent hematuria. In the three patients who completed the full course of therapy the hematuria resolved completely. The only side effect noted was bladder spasms, which were controlled in three of the four patients with oxybutynin chloride. This preliminary evaluation suggests that carboprost tromethamine may be a safe and effective bedside treatment of cyclophosphamide-induced hemorrhagic cystitis.
Assuntos
Carboprosta/uso terapêutico , Ciclofosfamida/efeitos adversos , Cistite/prevenção & controle , Hematúria/prevenção & controle , Hemorragia/prevenção & controle , Prostaglandinas F Sintéticas/uso terapêutico , Trometamina/uso terapêutico , Adulto , Criança , Combinação de Medicamentos/uso terapêutico , Avaliação de Medicamentos , Feminino , Humanos , MasculinoAssuntos
Ventrículos Cerebrais/anatomia & histologia , Meios de Contraste , Imageamento por Ressonância Magnética , Meglumina/uso terapêutico , Compostos Organometálicos/uso terapêutico , Ácido Pentético/uso terapêutico , Sorbitol/análogos & derivados , Adulto , Combinação de Medicamentos/uso terapêutico , Feminino , Gadolínio/uso terapêutico , Gadolínio DTPA , HumanosAssuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Fibromialgia/tratamento farmacológico , Lipase/uso terapêutico , Lipoxigenase/uso terapêutico , Catalase/uso terapêutico , Colina O-Acetiltransferase/uso terapêutico , Método Duplo-Cego , Combinação de Medicamentos/uso terapêutico , Fibromialgia/diagnóstico , Humanos , Sulfato Adenililtransferase/uso terapêutico , Sulfurtransferases/uso terapêuticoAssuntos
Vacina contra Sarampo/uso terapêutico , Vacina contra Caxumba/uso terapêutico , Vacina contra Rubéola/uso terapêutico , Vacinas Virais/uso terapêutico , Anticorpos Antivirais/análise , Vacina contra Varicela , Criança , Pré-Escolar , Combinação de Medicamentos/uso terapêutico , Feminino , Política de Saúde , Herpesvirus Humano 3/imunologia , Humanos , Esquemas de Imunização , Lactente , Masculino , Vacina contra Sarampo-Caxumba-Rubéola , Vacinas Atenuadas/efeitos adversos , Vacinas Virais/imunologiaRESUMO
A multicenter study was performed in 919 hypertensive patients, 780 of whom could be evaluated. Patients in group I (n = 482) were treated with Aldactazine alone (altizide + spironolactone, 2 tablets per day). The other 298 patients (group II) were treated with 1 or 2 tablets per day of Aldactazine plus a conventional antihypertensive agent, e.g., a beta blocker, alpha-methyldopa or clonidine. After 45 days of treatment with Aldactazine alone, mean systolic and diastolic blood pressure (BP) decreased by 15 and 14%, respectively, vs baseline values. The addition of the other antihypertensive agent decreased BP further; however, the best results were obtained with the combination of Aldactazine and clonidine. With this combination, systolic and diastolic BP decreased by 16.6 and 18%, respectively, vs baseline. In terms of adverse effects, a few cases of gastrointestinal disturbances and orthostatic hypotension were reported.