RESUMO
The use of d-cycloserine (DCS) to augment exposure based therapy for anxiety disorders has shown mixed, although overall positive effects. Aim of the present study was to examine post-exposure administration of DCS in patients with agoraphobia with or without panic disorder. 73 patients with agoraphobia (with or without panic disorder) were treated with 12 sessions of cognitive behavioral therapy (CBT) including 3 exposures. Following successful exposure patients were given double blind either placebo or 50â¯mg of DCS. Primary outcome criterion was change in the Panic and Agoraphobia Scale (PAS) between CBT session t1, t4 (+â¼2 months), t10 (+â¼3 months) und t11 (+â¼4 months). During the course of CBT the patients' symptomatology decreased significantly as measured by primary and secondary outcome criteria, however, without an additional benefit for DCS treated patients. Exploratory sub-group analyses for severely ill patients and patients with high anxiety and strong habituation during exposure showed that DCS administration was associated with increased improvement during the 1-month follow-up period (t10 - t11) with medium to large effect sizes (range in effect size η2p from .06 to .25). Our study results are consistent with recent research on DCS, indicating a beneficial augmentative effect for sub-groups of anxiety patients. The lack of an overall DCS effect for the whole patient sample might be explained by a dual mechanism in fear conditioning and extinction with different cognitive processes being involved during exposure depending on the degree of anxiety experienced by the patient.
Assuntos
Agorafobia/terapia , Terapia Cognitivo-Comportamental/métodos , Ciclosserina/farmacologia , Agonistas de Aminoácidos Excitatórios/farmacologia , Extinção Psicológica/efeitos dos fármacos , Terapia Implosiva/métodos , Avaliação de Resultados em Cuidados de Saúde , Adulto , Terapia Combinada , Ciclosserina/administração & dosagem , Agonistas de Aminoácidos Excitatórios/administração & dosagem , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno de Pânico/terapia , Receptores de N-Metil-D-Aspartato/agonistasRESUMO
Premenstrual changes (PMCs) in mood and behavior are very prevalent. Nonetheless, their pathophysiology is still obscure and no proven treatment is yet available. Evaluation of the plethora of available data leads to the suggestion that PMCs may result from a temporary impairment of homeostasis among a multitude of systems. This impairment is triggered by a differential pace and magnitude of change-over-time in levels of several hormones and other substances during the luteal phase.
Assuntos
Hormônios/fisiologia , Ciclo Menstrual , Síndrome Pré-Menstrual/fisiopatologia , Carboidratos da Dieta/metabolismo , Endorfinas/fisiologia , Feminino , Homeostase , Humanos , Sistema Hipotálamo-Hipofisário/fisiopatologia , Mineralocorticoides/fisiologia , Prolactina/fisiologia , Prostaglandinas/fisiologia , Glândula Tireoide/fisiopatologia , Vasopressinas/fisiologiaRESUMO
Premenstrual changes (PMCs) in mood and behavior are very prevalent. Nonetheless, their pathophysiology is still obscure and no proven treatment is yet available. Evaluation of the plethora of available data leads to the suggestion that PMCs may result from a temporary impairment of homeostasis among a multitude of systems. This impairment is triggered by a differential pace and magnitude of change-over-time in levels of several hormones and other substances during the luteal phase.
Assuntos
Hormônios/sangue , Sistemas Neurossecretores/metabolismo , Síndrome Pré-Menstrual/sangue , Endorfinas/sangue , Feminino , Homeostase , Humanos , Ciclo Menstrual , Sistemas Neurossecretores/fisiopatologia , Síndrome Pré-Menstrual/fisiopatologia , Prolactina/sangue , Prostaglandinas/sangue , Fatores de Tempo , Vasopressinas/sangueRESUMO
Following elevation of a full thickness flap a transient burst of regional remodeling occurs. This phenomenon is termed in orthopedic surgery as regional accelerated phenomenon (RAP), beginning with accelerated resorption activity followed by a slow process of bone regeneration. Recently we have demonstrated that a mucoperiosteal surgical flap of rat mandible is producing a typical RAP process. Bisphosphonates are synthetic compounds that are taken up preferentially by the skeleton and suppress osteoclast-mediated bone resorption by a mechanism that is not yet fully understood. Amino bisphosphonate has been shown to inhibit active bone resorption without interfering with bone formation. In this study we evaluated the effect of amino bisphosphonate on bone resorption associated with a mucoperiosteal flap used as a resorptive model. We compared the effect of amino bisphosphonate in rats using IV administration with topical application at 3 dose levels. The results show that topical application of all 3 doses (0.15, 0.75, and 1.5 mg/ml) had no inhibiting effect on bone resorption after surgery, while IV administration at 0.5 mg/kg body weight significantly reduced the bone resorption. Interestingly, in the non-operated side, amino bisphosphonate increased mineral density.
Assuntos
Perda do Osso Alveolar/prevenção & controle , Remodelação Óssea/efeitos dos fármacos , Difosfonatos/uso terapêutico , Retalhos Cirúrgicos/efeitos adversos , Administração Tópica , Animais , Densidade Óssea/efeitos dos fármacos , Difosfonatos/administração & dosagem , Difosfonatos/farmacologia , Injeções Intravenosas , Masculino , Ratos , Ratos WistarRESUMO
Mucoperiosteal flaps are used to access the bone and root surface in a wide range of periodontal procedures and in implant surgery. We have demonstrated that the mucoperiosteal surgical flap of the rat mandible produces a transient burst of alveolar bone resorption similar to the clinical observations in humans. This resorptive activity, when coupled with local irritation factors, may cause confined alveolar bone loss. Recently, we have demonstrated that an amino bisphosphonate, which is used in preventing systemic bone resorption in osteoporosis and other bone diseases, reduces alveolar bone resorption in the rat model when administered systemically. In this study we evaluated the effect of local delivery of the amino bisphosphonate on bone resorption associated with mucoperiosteal flaps. Following mucoperiosteal flap elevation in the premolar and molar region of the rat mandible, a surgical pellet soaked with amino bisphosphonate was locally applied on the exposed bone surface and covered by flap. The results show that local delivery of amino bisphosphonate reduces significantly alveolar bone resorption activated by mucoperiosteal flap surgery. This study suggests that local application of amino bisphosphonate can be used as an adjunct in therapy for reducing bone resorption following surgery.
Assuntos
Alendronato/uso terapêutico , Processo Alveolar/efeitos dos fármacos , Reabsorção Óssea/prevenção & controle , Doenças Mandibulares/prevenção & controle , Retalhos Cirúrgicos/efeitos adversos , Administração Tópica , Alendronato/administração & dosagem , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/etiologia , Perda do Osso Alveolar/patologia , Perda do Osso Alveolar/prevenção & controle , Processo Alveolar/diagnóstico por imagem , Processo Alveolar/patologia , Animais , Doenças Ósseas/prevenção & controle , Reabsorção Óssea/diagnóstico por imagem , Reabsorção Óssea/etiologia , Reabsorção Óssea/patologia , Implantação Dentária/efeitos adversos , Processamento de Imagem Assistida por Computador , Doenças Mandibulares/diagnóstico por imagem , Doenças Mandibulares/etiologia , Doenças Mandibulares/patologia , Microrradiografia , Osteogênese , Osteoporose/prevenção & controle , Doenças Periodontais/cirurgia , Complicações Pós-Operatórias , Ratos , Ratos Wistar , Raiz Dentária/cirurgiaRESUMO
A specific cementum attachment protein (CAP) was identified in human cementum and found to bind with high affinity to non-demineralized root surfaces, hydroxyapatite and fibronectin. Attempting to elucidate the biological function of this protein and its possible role in cementogenesis the capacity of CAP to promote selective cell migration towards and attachment of various periodontal derived cell populations to root surfaces in vitro was assessed. Human gingival fibroblasts (HGF), periodontal ligament cells (HPC), and alveolar bone cells (HABC) were labeled with [3H]Thymidine during their exponential growth phase. Root slices, 300 microns thick, were incubated with increasing concentrations of CAP. Untreated and fibronectin (FN) treated root slices served as negative and positive controls, respectively. Migration was assessed by placing root slices on confluent layers of labeled cells maintained in serum free medium and determining the number of cells migrated onto the root surface 3 days thereafter. Attachment was assessed by incubating root slices with labeled cell suspensions for 2 h and determining the number of attached cells. CAP promoted both cell migration and attachment dose dependently. HABC responded better than HPC and HGF to CAP treated root slices, and HPC response was higher than that of HGF. Cell attachment was dose dependently inhibited by synthetic RGD peptides. FN did not affect the migration of HGF, barely enhanced that of HABC, and was less potent than CAP at enhancing the migration of HPC. FN was more effective than CAP in promoting the attachment of HGF to root slices, but it was as potent as CAP in supporting the attachment of HPC and HABC.(ABSTRACT TRUNCATED AT 250 WORDS)