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2.
J Contemp Dent Pract ; 17(8): 650-3, 2016 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-27659082

RESUMO

AIM: To determine the antimicrobial effect of water extracts of leaves of Annona muricata and Simarouba glauca on Enterococcus faecalis using agar diffusion method. MATERIALS AND METHODS: Dried leaves of A. muricata and S. glauca were powdered and extracted in a soxhlet apparatus. Enterococcus faecalis was grown overnight in Trypticase soy agar plates. About 10 µl of each extract was placed on agar plates and incubated overnight. The zone of inhibition was measured after 24 hours. About 1% sodium hypochlorite and distilled water were used as positive and negative controls. RESULTS: The leaf extract of A. muricata showed similar effectiveness as that of sodium hypochlorite, whereas the leaf extract of S. glauca showed only a slight reduction in growth of E. faecalis. CONCLUSION: Leaf extract of A. muricata can be developed as an alternative to sodium hypochlorite for root canal irrigants. CLINICAL SIGNIFICANCE: Success of endodontic treatment depends on complete disinfection of the root canals. Root canal irrigants have a major role in complete disinfection of the root canals. Chemical root canal irrigants are more or less toxic to the oral environment. In this study, naturally derived leaf extracts of A. muricata and S. glauca are compared with sodium hypochlorite for its effectiveness against E. faecalis - the most common pathogen found in the root canals.


Assuntos
Annona , Antibacterianos/farmacologia , Enterococcus faecalis/efeitos dos fármacos , Extratos Vegetais/farmacologia , Simarouba , Humanos , Folhas de Planta , Irrigantes do Canal Radicular
3.
J Antimicrob Chemother ; 65(10): 2155-7, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20682566

RESUMO

Objectives An analysis of the trough serum concentrations sent to the UK Antimicrobial Reference Laboratory for teicoplanin therapeutic drug monitoring (TDM). Methods All trough concentrations over a 13 year period were analysed and the percentages were calculated for the following: <10 mg/L (a sub-optimal concentration for all); ≥10-<20 mg/L (the target used for ordinary Gram-positive infections); ≥20-<60 mg/L (the target for all severe staphylococcal infections including endocarditis); and ≥60 mg/L (the concentration associated with toxicity). Results The percentage of patients with concentrations of <10 mg/L decreased each year to 13% in 2006. Almost 40% of the samples each year were in the ≥10-<20 mg/L range. In 1996, the percentage of samples in the ≥20-<60 mg/L range reached a study high of ∼70%. That percentage then fell to 30% and increased slowly to 50% at the end of the study. Fewer than 5% of the samples were ≥60 mg/L. Conclusions Our study shows that there is a need to increase the initial dose or extend the number of days that the loading dose is used in a significant number of patients. With such a wide optimal range and a low potential for toxicity, it is unclear why optimal therapy is not achieved in a higher percentage of patients.


Assuntos
Antibacterianos/administração & dosagem , Antibacterianos/farmacocinética , Infecções Bacterianas/tratamento farmacológico , Teicoplanina/administração & dosagem , Teicoplanina/farmacocinética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/análise , Criança , Pré-Escolar , Monitoramento de Medicamentos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Soro/química , Teicoplanina/análise , Fatores de Tempo , Reino Unido , Adulto Jovem
4.
J Antimicrob Chemother ; 63(5): 1050-7, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19299472

RESUMO

OBJECTIVES: The aims of this study were to develop a population pharmacokinetic model of vancomycin in adult patients, to use this model to develop dosage guidelines targeting vancomycin trough concentrations of 10-15 mg/L and to evaluate the performance of these new guidelines. METHODS: All data analyses were performed using NONMEM. A population pharmacokinetic model was first developed from vancomycin dosage and concentration data collected during routine therapeutic drug monitoring in 398 patients, then new vancomycin dosage guidelines were devised by using the model to predict vancomycin trough concentrations in a simulated dataset. Individual estimates of CL and V1 were then obtained in an independent group of 100 patients using the population model and the POSTHOC option. These individual estimates were used to predict vancomycin trough concentrations and steady-state AUC(24)/MIC ratios using the current and new dosage guidelines. RESULTS: The population analysis found that the vancomycin data were best described using a bi-exponential elimination model with a typical CL of 3.0 L/h that changed by 15.4% for every 10 mL/min difference from a CL(CR) of 66 mL/min. V(ss) was 1.4 L/kg. The proposed dosage guidelines were predicted to achieve 55% of vancomycin troughs within 10-15 mg/L and 71% within 10-20 mg/L, which is significantly higher than current guidelines (19% and 22%, respectively). The proportion of AUC(24)/MIC ratios above 400 was also higher, 87% compared with 58%. CONCLUSIONS: New vancomycin dosage guidelines have been developed that achieve trough concentrations of 10-15 mg/L earlier and more consistently than current guidelines.


Assuntos
Antibacterianos/administração & dosagem , Antibacterianos/farmacocinética , Vancomicina/administração & dosagem , Vancomicina/farmacocinética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Monitoramento de Medicamentos , Feminino , Humanos , Masculino , Taxa de Depuração Metabólica , Pessoa de Meia-Idade , Modelos Teóricos , Plasma/química , Vancomicina/uso terapêutico , Adulto Jovem
5.
Int Rev Neurobiol ; 129: 85-110, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27503449

RESUMO

Food addiction (FA) is loosely defined as hedonic eating behavior involving the consumption of highly palatable foods (ie, foods high in salt, fat, and sugar) in quantities beyond homeostatic energy requirements. FA shares some common symptomology with other pathological eating disorders, such as binge eating. Current theories suggest that FA shares both behavioral similarities and overlapping neural correlates to other substance addictions. Although preliminary, neuroimaging studies in response to food cues and the consumption of highly palatable food in individuals with FA compared to healthy controls have shown differing activation patterns and connectivity in brain reward circuits including regions such as the striatum, amygdala, orbitofrontal cortex, insula, and nucleus accumbens. Additional effects have been noted in the hypothalamus, a brain area responsible for regulating eating behaviors and peripheral satiety networks. FA is highly impacted by impulsivity and mood. Chronic stress can negatively affect hypothalamic-pituitary-adrenal axis functioning, thus influencing eating behavior and increasing desirability of highly palatable foods. Future work will require clearly defining FA as a distinct diagnosis from other eating disorders.


Assuntos
Comportamento Aditivo/fisiopatologia , Comportamento Aditivo/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos , Recompensa , Comportamento Aditivo/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico por imagem , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Humanos , Motivação , Neurobiologia , Neuroimagem
6.
Diabetes Care ; 15 Suppl 1: 41-3, 1992 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-1559419

RESUMO

The purpose of this study was to report on current third-party reimbursement coverage for diabetes outpatient education programs. In 1986, the Centers for Disease Control began to collect and analyze information about reimbursement of outpatient diabetes education programs. Data compiled in the Diabetes Outpatient Education Reimbursement Database represented various information sources, including contact people in 42 states, surveys, government publications, the American Diabetes Association, the American Association of Diabetes Educators, and Communicating for Agriculture. The purpose of the data base was twofold: 1) to track national reimbursement trends and 2) to support health-care professional efforts in obtaining third-party reimbursement for education services. This article analyzes the Diabetes Outpatient Education Reimbursement Database. This study is a descriptive analysis of the major carriers that reimburse, legislation for reimbursement of education programs, and state risk-sharing insurance pools. Currently, Medicaid (in 37 states), Medicare (in 49 states), Blue Cross/Blue Shield (in 43 states), and private carriers (in 48 states) reimburse diabetes outpatient education programs. Sixteen states have operational pooled risk health insurance plans. This represents an increase in the number of states that report reimbursement from 1986. Progress has been made in procuring reimbursement coverage for diabetes outpatient education programs. However, progress does not imply that third-party reimbursement is uniform nationwide or effortlessly achieved. Many challenges must be addressed before reimbursement is no longer an issue in the management of diabetes education programs and the provision of essential services for people with diabetes.


Assuntos
Diabetes Mellitus/economia , Reembolso de Seguro de Saúde , Educação de Pacientes como Assunto/economia , Planos de Seguro Blue Cross Blue Shield , Bases de Dados Bibliográficas , Diabetes Mellitus/reabilitação , Humanos , Medicaid , Medicare , Estados Unidos
7.
Eur J Cell Biol ; 26(2): 284-8, 1982 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-7067706

RESUMO

The levator ani (L. A.) muscle, part of the genital apparatus of rodents, atrophies after castration. Changes in end-plate structure in the L. A. muscle of castrated male rats were examined with correlated light and electron microscopic methods. Four months after castration acetylcholinesterase staining reveals, in some muscle fibres, the presence of subneural gutters composed of a succession of cuplets whereas the subneural gutters are continuous and ramified in control muscles. Six months after castration most of the end-plates are further modified. Their terminal arborization, as revealed by silver nitrate staining, is more tortuous and irregular than in controls. At the ultrastructural level, reduced sole-plate and superimposed axonal endings are seen in some end-plates three months after castration. Our findings demonstrate that the changes (reduction of muscular activity and atrophy of muscle) are accompanied by adaptations of the neuromuscular junctions. As receptors for testosterone are known to be present in these motoneurons and muscle fibres, the observed morphological changes might be under the control of testosterone acting on both muscle and motoneurons.


Assuntos
Castração , Genitália Masculina/ultraestrutura , Placa Motora/ultraestrutura , Junção Neuromuscular/ultraestrutura , Acetilcolinesterase/metabolismo , Animais , Genitália Masculina/inervação , Masculino , Microscopia Eletrônica , Ratos
8.
Behav Brain Res ; 140(1-2): 185-93, 2003 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-12644291

RESUMO

We studied the capacity of adrenal medullary transplant to restore the deficits of GABAergic and dopaminergic neurons in mice injected with quinolinic acid (QA), using an open field test as well as pharmacological and immunohistochemical techniques. We analysed behavioural traits-total locomotor activity, peripheral and central activities, grooming, leaning and rearing in the QA-lesioned mice and mice that had undergone adrenal medulla (AM) transplantation. We found that the adrenal transplant recovered a loss of GABAergic neurons. It reduced QA-induced hyperactivity in locomotion and improved emotional indices. In addition, immunohistochemical studies of catecholaminergic markers-tyrosine hydroxylase (TH), dopamine (DA) and neuronal vesicular monoamine transporter type 2- and a single post-trial injection of tetrabenazine (TBZ; 5 mg/kg) indicated that catecholamines-synthesising chromaffin cells in the AM grafts were also involved in the beneficial effects. A likely interpretation of this behavioural pattern of results is that adrenal medullary transplants set into play an interaction between GABAergic and DAergic factors. Our results may contribute to the clarification of the beneficial effects of AM transplants in striatal function.


Assuntos
Medula Suprarrenal/transplante , Dopamina/metabolismo , Locomoção/fisiologia , Proteínas de Membrana Transportadoras , Neurônios/transplante , Neuropeptídeos , Ácido gama-Aminobutírico/metabolismo , Medula Suprarrenal/fisiologia , Inibidores da Captação Adrenérgica/farmacologia , Animais , Corpo Estriado/efeitos dos fármacos , Corpo Estriado/lesões , Corpo Estriado/patologia , Imuno-Histoquímica , Locomoção/efeitos dos fármacos , Masculino , Glicoproteínas de Membrana/metabolismo , Camundongos , Atividade Motora/efeitos dos fármacos , Atividade Motora/fisiologia , Neurônios/metabolismo , Neurônios/fisiologia , Neurotoxinas/toxicidade , Ácido Quinolínico/toxicidade , Tetrabenazina/farmacologia , Tirosina 3-Mono-Oxigenase/metabolismo , Proteínas Vesiculares de Transporte de Aminas Biogênicas , Proteínas Vesiculares de Transporte de Monoamina
9.
Behav Brain Res ; 121(1-2): 29-37, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11275282

RESUMO

Immunohistochemical and behavioral techniques were used to study the effects of adrenal medulla grafts, implanted in striatum after bilateral kainic acid (KA) lesions of this structure, on the open field behavior of mice. KA-induced behavioral changes in leaning, grooming and locomotor activity of the open field test were significantly improved after grafting of the adrenal medulla, and in some respects, fully restored. Immunohistochemical identification showed that grafts contained neuron-like cells with a tyrosine hydroxylase (TH), phenylethanolamine N-methyltransferase, gamma-aminobutyric acid (GABA), choline acetyltransferase (ChAT), and enkephalin-like immunostainings. A likely interpretation of this complex pattern of results is that adrenal medullary grafts may restore the deficits of GABAergic neurons which in turn reverse the abnormalities in emotionality and locomotion. Neurobiologically, these behavioral improvements probably involve GABAergic and catecholaminergic factors of adrenal medulla grafts, although other neuroactive substances, such as acetylcholine and enkephalins, cannot be excluded.


Assuntos
Medula Suprarrenal/transplante , Nível de Alerta/fisiologia , Corpo Estriado/fisiologia , Asseio Animal/fisiologia , Atividade Motora/fisiologia , Meio Social , Animais , Mapeamento Encefálico , Catecolaminas/fisiologia , Colina O-Acetiltransferase/fisiologia , Masculino , Camundongos , Regeneração Nervosa/fisiologia , Neurônios/fisiologia , Fenetilaminas , Feniletanolamina N-Metiltransferase/fisiologia , Tirosina 3-Mono-Oxigenase/fisiologia , Ácido gama-Aminobutírico/fisiologia
10.
Br J Gen Pract ; 51(468): 565-6, 2001 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-11462317

RESUMO

Following the publication of the Chief Medical Officer's report on chlamydial screening, we identified the sexual health of young women as an area for concern. As part of our review we decided to opportunistically search for chlamydial genital infections using a non-invasive technique. Sexually active women under 25 years of age were invited to submit a first void urine sample for polymerase chain reaction analysis. Over the period of a year we found out that 10.9% of sexually active young women tested positive for chlamydia in our practice.


Assuntos
Infecções por Chlamydia/epidemiologia , Chlamydia trachomatis/isolamento & purificação , Programas de Rastreamento/métodos , Doenças Vaginais/epidemiologia , Adolescente , Adulto , Antibacterianos/uso terapêutico , Infecções por Chlamydia/tratamento farmacológico , Infecções por Chlamydia/urina , Busca de Comunicante , Feminino , Humanos , Reação em Cadeia da Polimerase , Reino Unido/epidemiologia , Doenças Vaginais/tratamento farmacológico , Doenças Vaginais/urina
11.
Clin Imaging ; 22(3): 162-79, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9559228

RESUMO

The diagnosis and treatment of breast cancer are dependent upon early detection of the disease by physical examination and mammography. Although mammography is a relatively good and cost-effective method of early breast cancer detection, there are some inherent weaknesses associated with this imaging modality that limit its sensitivity and specificity. Contrast-enhanced MRI of the breasts provides the additional capability to answer questions raised or unanswered with conventional imaging methods. This paper reviews contrast-enhanced breast MRI interpretation guidelines and patient preselection criteria for diagnostic problem cases. Technical aspects using a commercially available three-dimensional (3D) spoiled gradient-echo technique are discussed.


Assuntos
Neoplasias da Mama/diagnóstico , Meios de Contraste , Gadolínio DTPA , Imageamento por Ressonância Magnética , Adulto , Feminino , Gadolínio DTPA/administração & dosagem , Humanos , Processamento de Imagem Assistida por Computador , Injeções Intravenosas , Imageamento por Ressonância Magnética/instrumentação , Mamografia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Sensibilidade e Especificidade
12.
J Obstet Gynecol Neonatal Nurs ; 17(1): 35-42, 1988.
Artigo em Inglês | MEDLINE | ID: mdl-3346763

RESUMO

The risks and benefits of intravenous therapy for neonatal patients have not been adequately evaluated. A study was conducted to assess the duration of life of the Teflon catheter used for intravenous therapy in neonates, the incidence of phlebitis associated with this catheter, and the factors which contribute to catheter life and phlebitis. Seventy-two neonates undergoing intravenous therapy with the Teflon catheter were studied. Study results indicated a mean catheter life of 30.1 hours, with 33 of the 72 catheters lasting less than 24 hours. Erythema occurred in 32 cases and phlebitis occurred in 5 cases. Of 19 predictor variables studied, low level of activity and administration of blood transfusion through the catheter were positively correlated with duration of catheter life. The Teflon catheter offers a reasonable though limited means for intravascular access in neonates.


Assuntos
Cateteres de Demora , Doenças do Prematuro/terapia , Politetrafluoretileno , Tromboflebite/etiologia , Peso ao Nascer , Idade Gestacional , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Sepse/etiologia
13.
J Obstet Gynecol Neonatal Nurs ; 15(1): 39-44, 1986.
Artigo em Inglês | MEDLINE | ID: mdl-3632999

RESUMO

The use of a pectin-based barrier between tape and skin as a method of minimizing epidermal stripping while keeping monitoring equipment and other devices securely attached to infants was evaluated. From 45 subjects, 199 application/removal procedures were recorded. The pectin-based barrier under tape held appliances securely for an average of 5.5 days (range 1-23 days). In 72% of the observations, the barrier was removed for nonadhesive-related reasons. Skin condition remained grossly normal in 97% of the observations after the barrier removal. A pectin-based barrier under tape provides effective adhesion for certain appliances and protects neonatal skin from damage caused by tape removal.


Assuntos
Doenças do Prematuro/enfermagem , Cuidados para Prolongar a Vida/enfermagem , Curativos Oclusivos , Pectinas , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal
14.
Caring ; 12(11): 56-7, 1993 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-10130211

RESUMO

Hospice is an excellent realm of care for helping pediatric patients and their families through the tragedy of life cut short. The commitment in time and resources is great but, as the experience of one agency has shown, a special program for pediatric hospice care can serve an entire community.


Assuntos
Serviços de Saúde da Criança/organização & administração , Hospitais para Doentes Terminais/organização & administração , Pediatria/organização & administração , Arizona , Luto , Criança , Tomada de Decisões , Humanos
17.
Neuropsychologia ; 48(5): 1255-64, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20043932

RESUMO

Children with Attention Deficit Hyperactivity Disorder (ADHD) often show spatial attentional deficits, exhibiting a subtle rightwards bias, possibly due to dysfunction within the right hemisphere fronto-parietal network. Approximately 50% of children with ADHD also show signs of movement dysfunction. The nature of this movement dysfunction and possible interactions with spatial attention difficulties has not been clearly described. This study compared 31 children with and 31 children without ADHD on a movement kinematic task that tested hand-drawing movement precision. Participants used an electronic pen on a digitizing tablet. The pen tip position was sampled as X and Y coordinates at 200Hz. The task was to join targets of either 10 or 20mm diameter that were separated by a distance of 62.5 or 125 mm. Constant error in the X and Y planes, peak absolute velocity and acceleration, movement time, the number of pauses and pause time were analysed. Apart from a significantly increased rate of acceleration across all conditions, the children with ADHD demonstrated no temporal difficulties with the task; rather they showed subtle spatial difficulties, possibly suggestive of cerebellar involvement. The children with ADHD showed difficulties in accuracy of movement towards the right. They were less accurate in the X plane when moving towards the right-sided targets over the long distance. Greater variability in target accuracy was shown when moving towards the small target on the right side. The children with ADHD made significantly more pauses on the left target, when preparing the right movement, than the control group. These results suggest that the subtle spatial bias towards the right that has been demonstrated in ADHD in spatial attention also extends into the continuous movement domain.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Percepção Espacial/fisiologia , Campos Visuais , Percepção Visual/fisiologia , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Feminino , Lateralidade Funcional/fisiologia , Humanos , Masculino , Lobo Parietal/fisiopatologia , Tempo de Reação , Escalas de Wechsler
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