RESUMO
BACKGROUND: The final decision to fast or not fast for routine lipid profile examination in a standard, healthy population is unclear. Whereas the United States and European protocols state that fasting for regular lipid analysis is unnecessary, the North American and Chinese guidelines still recommend fasting before routine lipid testing. AIM: This study aimed to unravel the contradiction between the different protocols of lipid profile testing worldwide and clarify the effect of diet on lipid profile testing only in a regular, healthy population. METHODS: A literature search was conducted through May 2024. The analyses included studies performed from the date 2000 until now because the contradiction of guidelines for lipid profile testing appeared for the first time in this period. A planned internal validity evaluation was performed using the National Institute of Health (NIH) quality measurement tools for observational cohort, caseâcontrol, controlled interventional, and cross-sectional studies. The data were synthesized according to RevMan 5.3. RESULTS: Eight studies with a total of 244,665 participants were included. The standardized mean difference in cholesterol in six studies showed significant differences in overall effect among fasting and nonfasting states (P < 0.00001), as did high-density lipoprotein cholesterol (P < 0.00001). At the same time, with respect to triglycerides and low-density lipoprotein cholesterol, there were notable variations in the overall effect between the fasted and nonfasted states (P < 0.00001 and P ≤ 0.001, respectively). CONCLUSIONS: This meta-analysis concluded that fasting for lipid profile testing is preferred as a conservative model to reduce variability and increase consistency in patients' metabolic status when sampling for lipid testing.
Assuntos
LDL-Colesterol , Jejum , Triglicerídeos , Humanos , Jejum/sangue , Triglicerídeos/sangue , LDL-Colesterol/sangue , HDL-Colesterol/sangue , Lipídeos/sangue , Feminino , Masculino , AdultoRESUMO
The Al Aziziah area is built on volcanic and granitic rocks. The igneous rocks always contain a high amount of naturally radioactive elements such as uranium, thorium and potassium, which produce gamma rays causing environmental hazards when exceeding the permissible limit. Radon gas is a result from the decomposition of uranium/thorium leaks into enclosed areas (e.g. homes or offices). This leakage is controlled by many conditions, and one of them is the underlining rock type. To work on such an environmental study, a gamma ray spectrometer survey was used. The uranium, thorium and potassium contents, as well as their ratios and the total radiation, were determined and mapped. The radiation dose rate was calculated and mapped in mSv/y and nGy/h units. The radiation contamination of groundwater is detected from the contour map of the dose rate over the artificial drainage lines of rains and floods which move this water to the groundwater wells. The main results are as follows: granitic rocks show an average dose rate of about 2.4 mSv/y, while the deposits of these rocks have an average dose rate of 1.2 mSv/y. A low average dose is recorded over the basalt. The average radiation dose recorded in the study area is 1.08 mSv/y, while its range is from 0.001 to 4.41 mSv/y. The estimated effective doses within the Al Aziziah area and vicinity area were higher than 1 mSv/y, which is the public exposure limit, and lower than the occupational exposure limit of 20 mSv/y. We recommend ventilating homes and offices in these places on an ongoing basis and constant radon measuring in closed places.
Assuntos
Monitoramento de Radiação , Radônio , Urânio , Doses de Radiação , Radônio/análise , Arábia Saudita , Tório/análise , Urânio/análiseRESUMO
A simple and sensitive method was developed for fexofenadine determination in human plasma by liquid chromatography with ultraviolet detection. Satisfactory separation was achieved on a Hypersil® BDS C18 column (250 × 4.6 mm, 5µm) using a mobile phase comprising 20 mm sodium dihydrogen phosphate-2 hydrate (pH adjusted to 3 with phosphoric acid)-acetonitrile at a ratio of 52:48, v/v. The elution was isocratic at ambient temperature with a flow rate of 1.0 mL/min. The UV detector was set at 215 nm for the drug and 330 nm for the internal standared (tinidazole). The total time for a chromatographic separation was ~6.5 min. Linearity was demonstrated over the concentration range 0.01-4 µg/mL. The observed within- and between-day assay precision ranged from 0.346 to 13.6%; accuracy varied between 100.4 and 111.2%. This method was successfully applied for therapeutic drug monitoring in patients treated with clinical doses of fexofenadine and for pharmacokinetic studies. Copyright © 2015 John Wiley & Sons, Ltd.
Assuntos
Cromatografia Líquida de Alta Pressão/métodos , Monitoramento de Medicamentos/métodos , Antagonistas não Sedativos dos Receptores H1 da Histamina/sangue , Terfenadina/análogos & derivados , Adulto , Calibragem , Antagonistas não Sedativos dos Receptores H1 da Histamina/farmacocinética , Humanos , Controle de Qualidade , Terfenadina/sangue , Terfenadina/farmacocinética , Adulto JovemRESUMO
BACKGROUND: A subset of women with a tubal ectopic pregnancy can be safely managed expectantly. Expectant management involves a degree of disruption with hospital visits to determine serum ß-hCG (ß-human chorionic gonadotrophin) concentration until the pregnancy test becomes negative and expectant management is considered complete. The length of time required for the pregnancy test to become negative and the parameters that influence this interval have not been described. Information on the likely length of follow up would be useful for women considering expectant management of their tubal ectopic pregnancy. METHODS: This was a retrospective study at a tertiary referral center in an inner city London Hospital. We included women who were diagnosed with a tubal ectopic pregnancy by transvaginal ultrasound between March 2009 and March 2014. During the study period 474 women were diagnosed with a tubal ectopic pregnancy and 256 (54 %) of them fulfilled our management criteria for expectant management. A total of 158 (33 %) women had successful expectant management and in those cases we recorded the diameter of the ectopic pregnancy (mm), the maximum serum ß-hCG (IU/L) and levels during follow up until resolution as well as the interval to resolution (days). RESULTS: The median interval from maximum serum ß-hCG concentration to resolution was 18.0 days (IQR 11.0-28.0). The maximum serum ß-hCG concentration and the rate of decline of ß-hCG were independently associated with the length of follow up. Women's age and size of ectopic pregnancy did not have significant effects on the length of follow up. CONCLUSION: Women undergoing expectant management of ectopic pregnancy can be informed that the likely length of follow up is under 3 weeks and that it positively correlates with initial ß-hCG level at the time of diagnosis.
Assuntos
Gonadotropina Coriônica Humana Subunidade beta/sangue , Gravidez Tubária , Adulto , Fatores Etários , Gerenciamento Clínico , Feminino , Seguimentos , Humanos , Londres , Monitorização Fisiológica/métodos , Gravidez , Testes de Gravidez/métodos , Gravidez Tubária/sangue , Gravidez Tubária/diagnóstico por imagem , Estudos Retrospectivos , Fatores de Tempo , UltrassonografiaRESUMO
The effect of the UV-C treatment on the physico-chemical characteristics, pectin methylesterase activity (PME) as well as microbial quality of orange juice, compared to fresh juice, was studied. The juice samples were UV-C (254â nm) irradiated for different exposure times (15, 30, 45 and 60â min) and stored at 4 ± 1 °C for 30 days. UV-C treatment didn't significantly (p ≤ 0.05) affect pH values, titratable acidity, TSS (%), ascorbic acid content and PME activity in both fresh and stored samples. Increasing the exposure time from 5 to 60â min. showed no significant effect (p ≤ 0.05) on L* and a* values for both the fresh and the stored samples. On the contrary, negative relationship was observed between UV-C exposure time and b* values. Total bacterial counts were significantly (p ≤ 0.05) reduced from 2.69 to 0.93 log10 CFU/mL when the exposure time was increased from 0 to 60â min. The UV-C treatment showed similar trend on yeast and mold counts but to a lesser extend due to their resistance to UV. The sensory characteristics, i.e. odour, colour, taste, consistency and overall acceptability didn't change (p ≤ 0.05) as a result of UV-C treatment at any tested exposure times.
Assuntos
Citrus sinensis , Sucos de Frutas e Vegetais , Ácido Ascórbico/análise , Leveduras , FungosRESUMO
The molecular forms of two lysosomal enzymes, cathepsin C and cathepsin D, have been examined in lysosomes and coated vesicles (CVs) of rat liver. In addition, the relative proportion of these lysosomal enzymes residing in functionally distinct CV subpopulations was quantitated. CVs contained newly synthesized precursor forms of the enzymes in contrast to lysosomes where only the mature forms were detected. Exocytic and endocytic CV subpopulations were prepared by two completely different protocols. One procedure, a density shift method, uses cholinesterase to alter the density of CVs derived from exocytic or endocytic pathways. The other relies on electrophoretic heterogeneity to accomplish the CV subfractionation. Subpopulations of CVs prepared by either procedure showed similar results, when examined for their relative proportion of cathepsin C and cathepsin D precursors. Within the starting CV preparation, exocytic CVs contained approximately 80-90% of the total steady-state levels of these enzymes while the level in the endocytic population was approximately 10-13%. The implications of these findings are discussed with regard to lysosome trafficking.
Assuntos
Catepsina D/análise , Dipeptidil Peptidases e Tripeptidil Peptidases/análise , Endossomos/enzimologia , Precursores Enzimáticos/análise , Lisossomos/enzimologia , Animais , Catepsina C , Fracionamento Celular , Eletroforese em Gel de Ágar , Endocitose , Exocitose , Fígado , RatosRESUMO
OBJECTIVE: To assess the efficacy of a progesterone-based algorithm for the management of women with pregnancies of unknown location (PULs) and explore the feasibility of developing a single-visit strategy in those with a low risk of requiring medical intervention. METHODS: All clinically stable women in whom pregnancy could not be identified on ultrasound scan were managed by a pre-defined protocol based on measurement of serum progesterone and beta-human chorionic gonadotropin (beta-hCG). Intervention in the form of surgery or medical treatment with methotrexate was offered to all women with persistent or worsening symptoms and non-declining serum beta-hCG. Decision-tree analysis was used to develop a protocol for the management of women with resolving pregnancies who are at low risk of requiring medical intervention. RESULTS: 1110 women were included in the data analysis: normal intrauterine pregnancy was diagnosed in 248 (22.3%; 95% CI, 19.9-24.8) women. 761 (68.6%; 95% CI, 65.8-71.3) abnormal pregnancies resolved spontaneously on expectant management, while the remaining 101 (9.1%; 95% CI, 7.4-10.8) women with abnormal pregnancies required some form of medical intervention. Intervention rates in patients presenting with initial serum progesterone levels of Assuntos
Gonadotropina Coriônica Humana Subunidade beta/sangue
, Gravidez Ectópica/diagnóstico
, Progesterona/sangue
, Abortivos não Esteroides
, Adulto
, Algoritmos
, Biomarcadores/sangue
, Estudos de Viabilidade
, Feminino
, Seguimentos
, Humanos
, Metotrexato
, Valor Preditivo dos Testes
, Gravidez
, Gravidez Ectópica/sangue
, Gravidez de Alto Risco
, Medição de Risco
, Ultrassonografia Pré-Natal
RESUMO
To assess the relation of quantitative measures of coronary stenoses to the development of exercise-induced regional wall motion abnormalities, 34 patients with isolated, single vessel coronary artery lesions and normal wall motion at rest underwent exercise echocardiography and quantitative angiography on the same day. Although all 11 patients with a visually estimated stenosis greater than or equal to 75% had an ischemic response and 10 (91%) of 11 patients with a less than or equal to 25% visually estimated stenosis had a normal response by exercise echocardiography, among 12 patients with a visually estimated stenosis of 50%, 6 (50%) had an ischemic response and 6 (50%) had a normal exercise echocardiogram. Quantitative measurements of stenosis severity distinguished patients with ischemic (group 1) from normal (group 2) exercise echocardiographic responses as follows: minimal luminal diameter (mm), group 1 1.0 +/- 0.4 versus group 2 1.7 +/- 0.4, p less than 0.0001; minimal cross-sectional area (mm2), group 1 0.9 +/- 0.6 versus group 2 2.5 +/- 1.1, p less than 0.0001; percent diameter stenosis, group 1 68.3 +/- 14.2 versus group 2 42.2 +/- 12.1, p less than 0.0001; and percent area stenosis, group 1 87.5 +/- 7.8 versus group 2 64.8 +/- 15.9, p less than 0.0001. These data validate the utility of exercise echocardiography by demonstrating that 1) coronary stenosis severity measured by quantitative angiography is closely related to wall motion abnormalities detected by exercise echocardiography, and 2) exercise echocardiography can be used as a noninvasive means to assess the physiologic significance of coronary artery lesions.
Assuntos
Doença das Coronárias/diagnóstico , Ecocardiografia/métodos , Teste de Esforço/métodos , Adulto , Idoso , Angiografia Digital , Angiografia Coronária , Doença das Coronárias/fisiopatologia , Eletrocardiografia , Feminino , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos TestesRESUMO
OBJECTIVE: To investigate a possible correlation between the volume of the tubal ectopic pregnancy (EP) measured by vaginal-ultrasound (VUS) and methotrexate (MTX) therapy outcome. STUDY DESIGN: Data of EP volume measured by one expert-sonographer, viability, clinical symptoms, previous IVF/insemination, follow-up of ß-hCG and progesterone levels, and treatment of EP was collected of 100 patients with sonographically diagnosed EP, who attended the Department of Obstetrics and Gynecology of the Medical University Vienna between March 2008 and September 2011. RESULTS: The mean volume of EP (mVol.) in the group with successful MTX therapy (n = 38) was 5.11 ml, 95%CI [2.4; 7.8] with a median 3.2 ml, IQR [5.0], in the group with unsuccessful MTX treatment (n = 11) it was 15.24 ml, 95%CI [-2.6; 33.1], with a median 4.4 ml, IQR [11.4]. We could observe a trend towards a lower mVol. in the successful MTX group (5.11 ml vs. 15.24 ml). We could not show a significant correlation (u-test p = 0.208). CONCLUSION: A clear tendency was observed towards a lower mVol. in the successful MTX therapy group, but we could not verify a statistically significant correlation of volume of EP and MTX therapy outcome most likely due to the small sample size. This was the first study investigating the correlation of volume of EP and MTX therapy outcome as principal question.
Assuntos
Abortivos não Esteroides/uso terapêutico , Metotrexato/uso terapêutico , Gravidez Ectópica/diagnóstico por imagem , Gravidez Ectópica/tratamento farmacológico , Abortivos não Esteroides/administração & dosagem , Adulto , Gonadotropina Coriônica Humana Subunidade beta/sangue , Estudos de Coortes , Feminino , Humanos , Metotrexato/administração & dosagem , Gravidez , Progesterona/sangue , Estudos Retrospectivos , UltrassonografiaRESUMO
AIMS: The high objective response rate to cetuximab along with chemotherapy in patients with colorectal liver metastases makes it an effective downsizing protocol to facilitate surgery in those with initially unresectable disease. Adoption of this strategy has been variable in the UK. A retrospective observational study was conducted in 7 UK specialist liver surgical centres to describe the liver resection rate following a downsizing protocol of cetuximab and chemotherapy and to evaluate the quality and efficiency of processes by which the treatment was provided. METHODS: Data were collected in 2012 by reviewing medical records of patients with colorectal metastases confined to the liver, defined as unresectable without downsizing therapy at first review by a specialist Multi Disciplinary Team (MDT). RESULTS: Sixty patients were included; 29 (48%) underwent liver resection following cetuximab and chemotherapy. Of the 29, 17 (59% or 28% of all patients) achieved R0 resection and 7 (24% or 12% of all patients) R1 resection. All treated patients were KRAS wild-type. CONCLUSION: In specialist liver surgical centres, where patients are evaluated for liver resection, optimal management by MDT using KRAS testing, cetuximab and chemotherapy results in a 28% R0 resection rate in patients with initially unresectable colorectal cancer liver metastases.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Colorretais/patologia , Hepatectomia , Neoplasias Hepáticas/terapia , Idoso , Anticorpos Monoclonais Humanizados/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Camptotecina/administração & dosagem , Camptotecina/análogos & derivados , Cetuximab , Quimioterapia Adjuvante , Feminino , Fluoruracila/administração & dosagem , Humanos , Leucovorina/administração & dosagem , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Neoplasia Residual , Compostos Organoplatínicos/administração & dosagem , Avaliação de Processos e Resultados em Cuidados de Saúde , Proteínas Proto-Oncogênicas/genética , Proteínas Proto-Oncogênicas p21(ras) , Estudos Retrospectivos , Taxa de Sobrevida , Carga Tumoral , Reino Unido , Proteínas ras/genéticaRESUMO
This report from the Egyptian National Hypertension Project presents national estimates of the prevalence of hypertension and the extent to which high blood pressure is being detected, treated with medications, and controlled in the Egyptian population. The results are based on findings from a national probability survey of adults > or = 25 years of age conducted in six Egyptian governorates. With the use of a stratified multistage probability design, 6733 people (85% response rate) were examined. Hypertension was defined as systolic pressure > or = 140 mm Hg, and/or diastolic pressure > or = 90 mm Hg, and/or reported treatment with one or more antihypertensive medications. Overall, the estimated prevalence of hypertension in Egypt was 26.3%. Hypertension prevalence increased progressively with age, from 7.8% in 25- to 34-year-olds to 56.6% in those 75 years or older. Hypertension was slightly more common in women than in men (26.9% versus 25.7%, respectively). Overall, 37.5% of hypertensive individuals were aware that they had high blood pressure, 23.9% were being treated with antihypertensive medications, and 8.0% were under control (systolic pressure < 140 mm Hg and diastolic pressure < 90 mm Hg). Hypertension prevalence as well as awareness, treatment, and control rates varied by region, with Cairo having the highest prevalence (31.0%) and the Coastal Region having the highest control rate (15.9%). Rates of awareness, treatment, and control tended to be lowest in areas of lower socioeconomic status. Our results indicate that hypertension is highly prevalent in Egypt and that the rates of hypertension is awareness, treatment, and control are relatively low.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Hipertensão/epidemiologia , Adulto , Idoso , Atitude Frente a Saúde , Pressão Sanguínea , Coleta de Dados , Egito/epidemiologia , Feminino , Serviços de Saúde , Inquéritos Epidemiológicos , Humanos , Hipertensão/prevenção & controle , Hipertensão/terapia , Masculino , Pessoa de Meia-Idade , Prevalência , Pesquisa , Fatores SocioeconômicosRESUMO
OBJECTIVES: To define the prevalence of cardiovascular risk factors and their relation to the level of blood pressure, in Egyptians. METHODS: Data were collected during the Egyptian National Hypertension project, a national hypertension survey in Egypt. During phase I of the survey, hypertensive (HT) patients were identified. In phase II, clinical and laboratory evaluations were made on HT and gender-matched normotensives (NT). A total of 2313 individuals were examined, 311 NT males, 443 NT females, 670 HT males and 889 HT females. RESULTS: The prevalence of obesity was 33 and 47% in hypertensive men and women, respectively. After adjusting for age, HT men had significantly higher heart rate, total cholesterol (TC), triglycerides (TG), fasting blood sugar (FBS), post-prandial blood sugar (PBS), body mass index and waist/hip (W/H) ratio than their NT counterparts. In addition, HT women had higher low-density lipoprotein cholesterol (LDL-C). The prevalence of elevated LDL-C and FBS increased with age. The prevalence of hypertriglyceridemia, elevated FBS and obesity rose with increasing level of blood pressure (BP). From the 25-34 to the 55-64 age group, the percentage of hypertensives with > or = 2 risk factors rose from 42.9 to 60.6% in men, and from 9.4 to 46.2% in women. All risk factors were more prevalent in urban populations. CONCLUSION: This is one of the few reports on the prevalence of cardiovascular risk factors in a developing country. Risk factors cluster with rising level of BP and with ageing. Obesity is very prevalent, particularly in hypertensive Egyptian women. Health efforts directed at the prevention and treatment of obesity should be a high priority.
Assuntos
Doenças Cardiovasculares/etiologia , Hipertensão/complicações , Adulto , Distribuição por Idade , Idoso , Doenças Cardiovasculares/epidemiologia , Análise por Conglomerados , Egito , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Valores de Referência , Fatores de Risco , População Rural , População UrbanaRESUMO
BACKGROUND: Excimer laser photorefractive keratectomy (PRK) can be effective in correcting myopia up to -6.00 diopters (D). Between -6.00 D and -10.00 D, the procedure is considered less effective and safe because it has been associated with dense scar formation and a high rate of regression. We compared photorefractive keratectomy (PRK) in this group of myopes with excimer laser keratomileusis in situ (LASIK). METHODS: Forty consecutive eyes with a manifest refraction between -6.00 and -10.00 D were treated with PRK using an ablation-zone diameter of 6 mm. Subsequently, 40 consecutive eyes were treated with LASIK under a hinged flap using an ablation-zone diameter of 5 mm. All procedures used a Summit OmniMed laser and were done by the same surgeon. RESULTS: Preoperatively, 24 eyes (60%) undergoing PRK had 20/20 spectacle-corrected visual acuity; 1 year postoperatively, 20 (50%) had 20/20 vision uncorrected. Preoperatively, 13 eyes (33%) undergoing LASIK had 20/20 spectacle-corrected visual acuity; 1 year postoperatively, 24 (60%) could see 20/20 uncorrected. Sixteen (39%) PRK eyes had a spherical equivalent refraction within +/-1.00 D at 1 year; 20 (60%) eyes undergoing LASIK had a refraction within +/-1.00 D at that point. None of the eyes treated with LASIK developed corneal haze, while after PRK, 36 eyes (90%) developed haze (23 eyes [57%] +2 to +3). CONCLUSION: LASIK under a hinged flap proved superior to PRK in treating myopia between -6.00 D and -10.00 D.
Assuntos
Córnea/cirurgia , Miopia/cirurgia , Ceratectomia Fotorrefrativa , Adulto , Astigmatismo/etiologia , Córnea/patologia , Feminino , Humanos , Hiperopia/etiologia , Lasers de Excimer , Masculino , Métodos , Complicações Pós-Operatórias , Período Pós-Operatório , Refração Ocular , Acuidade VisualRESUMO
Nitric oxide (NO), a labile free radical synthesised from L-arginine by the action of nitric oxide synthase (NOS), is said to be implicated in uraemic complications, such as infection and a tendency to bleed. In this study of NO production by peripheral blood cells, an increased level is seen in platelets from uraemic patients (both non-dialysed and haemodialysed) and a decreased level in leucocytes (neutrophils and monocytes). A negative correlation was noted between blood urea level and inducible NO in neutrophils and monocytes in uraemic patients not on dialysis. In contrast, haemodialysis appears to lead to an increase in inducible NO production in neutrophils and monocytes. Plasma NO levels were significantly increased in uraemic patients, compared with normal controls, and hemodialysis led to further increases. Superoxide dismutase (SOD) activity was significantly reduced in platelets, neutrophils and monocytes in the uraemic group. It is concluded that increased NO production by platelets may contribute to the bleeding tendency observed in uraemia, and high urea concentrations may contribute to the regulation of inducible NO production in leucocytes.
Assuntos
Falência Renal Crônica/sangue , Óxido Nítrico/biossíntese , Idoso , Plaquetas/metabolismo , Humanos , Falência Renal Crônica/terapia , Pessoa de Meia-Idade , Monócitos/metabolismo , Neutrófilos/metabolismo , Diálise Renal , Superóxido Dismutase/sangue , Uremia/sangueRESUMO
We report three sibs, one boy and two girls, with a similar MCA/MR syndrome, where parents were first cousins. They had macrodolichocephaly, an elongated face, apparently low-set simple ears, hypertelorism, bilateral "key-hole' colobomata of the iris, retina and choroid, a beaked nose, micrognathia and dental anomalies. Brain CT scan showed dilated ventricles and an absent corpus callosum. Skeletal anomalies included brachydactyly of the hands and feet, genua vara and flat feet. Two sibs had left ventricular enlargement, and aortic dilatation and regurgitation. Review of the literature from the London Dysmorphology Data Base (LDDB) and OMIM suggests that this family represents a new syndrome.
Assuntos
Anormalidades Múltiplas/genética , Agenesia do Corpo Caloso , Coloboma/genética , Tecido Conjuntivo/anormalidades , Anormalidades Craniofaciais/genética , Deficiência Intelectual/genética , Iris/anormalidades , Adulto , Criança , Família , Feminino , Genes Recessivos , Humanos , Masculino , LinhagemRESUMO
62 Hepatocellular carcinoma (HCC) were studied to define some possible high risk group. The males to females ratio was 3:1, and the age ranged from 24-77 years. A high percentage of history of schistosomal infection, Jaundice, blood transfusion, cirrhosis and also contraceptive pill users among the females were found. The duration of the presenting symptoms and the survival since diagnoses were analyzed.
Assuntos
Carcinoma Hepatocelular/epidemiologia , Neoplasias Hepáticas/epidemiologia , Adulto , Idoso , Carcinoma Hepatocelular/etiologia , Carcinoma Hepatocelular/patologia , Egito/epidemiologia , Feminino , Seguimentos , Hospitais Universitários , Humanos , Neoplasias Hepáticas/etiologia , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Fatores de Risco , Taxa de SobrevidaRESUMO
A hospital based case-control study was conducted to define the role of some of the factors predisposing to hepatocellular carcinoma (HCC). It included 62 HCC cases and 62 age, sex and occupation matching control. Selected past history like schistosomal infection, jaundice, blood transfusion, contraceptive pills use, alcohol consumption and family history of cancer were examined. The history of schistosomiasis and that of jaundice show statistical significant differences.
Assuntos
Carcinoma Hepatocelular/epidemiologia , Neoplasias Hepáticas/epidemiologia , Adulto , Idoso , Carcinoma Hepatocelular/etiologia , Estudos de Casos e Controles , Causalidade , Egito/epidemiologia , Feminino , Hospitais Universitários , Humanos , Neoplasias Hepáticas/etiologia , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
BACKGROUND: A combination of methocarbamol (MET) and paracetamol (PAR) is a widely used treatment approach. It provides complementary modes of action for treatment of pain associated with muscle spasm. The aim of this work was to develop and validate a new sensitive and reproducible isocratic reversed phase HPLC-UV detection method for simultaneous determination of MET and PAR in human plasma for the routine use in a therapeutic drug monitoring and pharmacokinetic laboratories. METHODS: A simple HPLC assay was developed and validated for the simultaneous determination of the above-mentioned drugs in small samples of human plasma (0.25 mL). After protein precipitation with methanol, satisfactory separation was achieved on a Hypersil® BDS C18 column (250 mm × 4.6 mm, 5 µm) using a mobile phase comprising 20 mM sodium dihydrogen phosphate buffer (pH=3) and methanol at a ratio of 80:20, v/v; the elution was isocratic at ambient temperature with a flow rate of 1.2 ml/min. The UV detector was programmed at 254 nm for 7.0 min to measure PAR and IS and at 272 nm for the subsequent 3 min to measure MET. RESULTS: Linearity was demonstrated over the concentration range from 0.02 to 20 µg/ml (mean R(2) = 0.9998, n = 10). The observed within- and between-day assay precision ranged from 1.11 to 9.4 and 2.46 to 10.0% for PAR and MET, respectively; whereas, accuracy varied between 95.2-101% and 93.9-102.2% for PAR and MET, respectively. Mean drug recovery was 99.8 for PAR and 99.0% for MET. PAR and MET were stable in frozen plasma over a period of 3 months at -80 °C. CONCLUSIONS: The validated method was applied successfully to a bioequivalence study of PAR/MET (500/400 mg) fixed dose combination tablet in healthy volunteers (n=24).
Assuntos
Acetaminofen/química , Acetaminofen/farmacocinética , Metocarbamol/química , Metocarbamol/farmacocinética , Adolescente , Adulto , Cromatografia Líquida de Alta Pressão/métodos , Humanos , Limite de Detecção , Masculino , Comprimidos/química , Comprimidos/farmacocinética , Raios Ultravioleta , Adulto JovemRESUMO
OBJECTIVE: To determine the optimal serum ß-hCG cut-off level to predict MTX treatment success in tubal ectopic pregnancy (EP). STUDY DESIGN: Data of 240 women, who presented between 2003 and 2011 at the Department of Gynecology and Obstetrics, Medical University of Vienna, with tubal EP and who received MTX as primary treatment, were retrieved from the hospital information system (KIS). 198 patients could be included for final evaluation. Statistical analysis included area under the ROC curve, maximal Euclidean and Youden index, chi-squared and a five-fold cross validation. RESULTS: The serum ß-hCG level cut-off value was calculated at 2121mlU/ml with a specificity of 76.54% and sensitivity of 80.56% (AUC 0.789; p<0.001). Patients with an initial serum ß-hCG level below 2121mlU/ml (n=131) experienced MTX treatment failure in 5.3% (n=7), compared to 43.3% (n=29) of patients with an initial serum ß-hCG level equal to or above 2121mlU/ml (n=67). There was no statistically significant correlation between clinical symptoms and the MTX therapy outcome (p=0.580; likelihood quotient p=0.716). CONCLUSION: The correct decision of therapy in patients with tubal ectopic pregnancy still represents a challenge. In this study we can conclude that, according to our results there is no endpoint of initial serum ß-hCG levels, which can be clearly used as cut-off value for the optimal management of tubal EP. However, an initial serum ß-hCG level of less than 2121mlU/ml seems to be a good value to expect a successful MTX treatment. Limitations are the retrospective study design and the inability of classifying clinical symptoms like pain as an objective parameter. Wider implications of the findings may include more detailed patient information and more accurate selection of suitable patients for MTX therapy.
Assuntos
Abortivos não Esteroides/uso terapêutico , Gonadotropina Coriônica Humana Subunidade beta/sangue , Metotrexato/uso terapêutico , Gravidez Ectópica/sangue , Gravidez Ectópica/tratamento farmacológico , Adulto , Estudos de Coortes , Feminino , Humanos , Gravidez , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
The oral liquid formulations poses an alternative way in providing medications to pediatric patients, geriatric patients, patients with feeding tubes, and patients who cannot swallow solid dosage forms. This study was conducted to evaluate the pharmacokinetics (PKs) and relative bioavailability of suspension (reference) and tablet (test) formulations of Linezolid (LZD). In vivo study was established according to a single-center, randomized, single-dose, laboratory-blinded, 2 Way, Cross-Over Study with a washout period of 1-week. Under fasting conditions, 28 healthy Egyptian male volunteers were randomly allocated to receive a single oral dose of either 30 ml LZD or 1 tablet (600 mg LZD) of marketed suspension and tablet formulations. Plasma samples were obtained over a 48-h interval and analyzed for LZD by reversed phase liquid chromatography with ultraviolet detection. The 90% confidence intervals for the ratio of log transformed values of Cmax, AUC0-t, and AUCt-∞ of the two treatments were within the acceptable range (0.8-1.25) for bioequivalence. From PK perspectives, in this small study in healthy Egyptian adult male volunteers, a single 600 mg dose of the tablet formulation demonstrated comparable rate and extent of absorption to a single 600 mg dose of the suspension formulation based on the US FDA's regulatory definition. No adverse events occurred or were reported after a single 600 mg LZD and both formulations were well tolerated.