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1.
Pharmazie ; 78(8): 141-149, 2023 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-37592417

RESUMO

This study aimed to investigate adverse reactions to medications administered during palliative care and compare the responses of Board-Certified Pharmacists in Palliative Pharmacy (BCPPP) and non-BCPPP professionals. Methods: This multicentre prospective survey included hospital and community pharmacists who are members of the Japanese Society for Pharmaceutical Palliative Care and Sciences. Study participants included patients who experienced new drug reactions during the study period and responded to the requested survey items. The follow-up period for each eligible patient began on the day the pharmacists initiated the intervention and ended at discharge, death, or after one month of intervention. The primary endpoint was the impact of pharmacist intervention on adverse drug reactions. The pharmacists included in the study evaluated the severity of adverse drug reactions to assess the effect of their intervention using an integrated palliative care outcome scale before and after the intervention. Key findings: During the survey period, 79 adverse drug reaction intervention reports from 69 patients were obtained from 54 pharmacists (28 certified and 26 non-certified). The response rate was 1.62% (54/3,343). The management of palliative pharmacotherapy side effects by BCPPP and non-BCPPP significantly improved the patients' activities of daily living (P < 0.001). The BCPPP group intervened for significantly more patients with adverse drug reactions and overall adverse drug reactions than the non-BCPPP group (P < 0.023 and P < 0.013, respectively). Conclusion: BCPPP interventions can improve symptom management.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Cuidados Paliativos , Humanos , Farmacêuticos , Atividades Cotidianas , Projetos Piloto , Estudos Prospectivos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia
2.
Pharmazie ; 78(5): 42-46, 2023 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-37189266

RESUMO

Adverse drug events (ADEs) rates associated with anti-dementia acetylcholinesterase inhibitors are estimated to be 5%-20% and show a wide range of symptoms. No report has examined whether there is a difference in the anti-dementia drugs' ADEs profile. This study aimed to establish whether anti-dementia drugs' ADEs profile differed. Data was based on the Japanese Adverse Drug Event Report (JADER) database. The reporting odds ratios (RORs) was used to analyze data for ADEs from April 2004-October 2021. The target drugs were donepezil, rivastigmine, galantamine, and memantine. The top ten most frequently occurring adverse events were selected. The association between the RORs and antidementia drug ADEs was evaluated, and compared the distribution rate of expression age related to ADEs and each ADEs' timing of onset due to anti-dementia drugs. The primary outcome was RORs. Secondary outcome were expression age and time-to-onset of ADE associated with anti-dementia drugs. A total of 705,294 reports were analyzed. The adverse events incidence differed. Bradycardia, loss of consciousness, falls, and syncope incidence were significantly diverse. The Kaplan-Meier curve results for the cumulative ADEs incidence showed that donepezil had the slowest onset, while galantamine, rivastigmine, and memantine had approximately the same timing of onset.


Assuntos
Inibidores da Colinesterase , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Humanos , Inibidores da Colinesterase/efeitos adversos , Donepezila/efeitos adversos , Rivastigmina/efeitos adversos , Galantamina/efeitos adversos , Memantina/efeitos adversos , Acetilcolinesterase , Piperidinas , Indanos/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia
3.
Pharmazie ; 77(5): 165-170, 2022 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-35655381

RESUMO

So far, no studies investigated the association between pharmacist intervention and rehabilitation outcomes. The aim of study was to establish whether the pharmacist-led deprescribing intervention affects rehabilitation outcomes. This retrospective, observational, single-center, cohort study included consecutive geriatric patients (n = 448) with pharmacist-led intervention between 2017 and 2019. Participants were divided based on pharmacist-led deprescribing and non deprescribing interventions during hospitalization. Demographic data, laboratory data, the Functional Independence Measure were (FIM) analyzed between the groups. Multiple linear regression analysis was performed to analyze the relationship between pharmacist-led deprescribing and FIM total gain. The primary outcome was FIM total gain. The rate of pharmacist intervention during the study period was 92.4%. A multiple linear regression analysis of FMI-T gain, adjusting for confounding factors, revealed that the pharmacist-led deprescribing intervention was independently correlated with FMI-T gain. Particularly, the use of dyslipidemia drugs, antipsychotic drugs, hypnotics, and nonsteroidal anti-inflammatory drugs significantly decreased during hospitalization. The pharmacist-led deprescribing intervention was independently and significantly associated with FIM-T gain. The pharmacist-led deprescribing intervention improved functional recovery in a rehabilitation setting.


Assuntos
Desprescrições , Farmacêuticos , Idoso , Estudos de Coortes , Humanos , Recuperação de Função Fisiológica , Estudos Retrospectivos
4.
Folia Morphol (Warsz) ; 81(1): 183-189, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34018175

RESUMO

BACKGROUND: The aim of the study was to determine sex and age from hyoid bone morphology on cone-beam computed tomography (CBCT). MATERIALS AND METHODS: The study sample comprised 130 CBCT images. Eight different measurements were performed for each hyoid bone. Fusion conditions were assigned to each side of the hyoid bone separately as; unfused, partially fused, and totally fused. RESULTS: The hyoid length, width of the left proximal end and stature variables showed sexual dimorphism in all hyoid fusion types (p < 0.05). In young adult age group, a significant difference was found between sex and fusion types (p = 0.025). The body length (81.35%) and stature measurements (76.25%) contributed most significantly to sex estimation. CONCLUSIONS: Patient's CBCT scans which enable reproducible and reliable measurements for bone tissues can be used for forensic procedures. Hyoid bone measurements with CBCT are useful methodology for age and sex estimation in forensic sciences with high predictive accuracy.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Osso Hioide , Tomografia Computadorizada de Feixe Cônico/métodos , Humanos , Osso Hioide/anatomia & histologia , Osso Hioide/diagnóstico por imagem , Adulto Jovem
5.
Niger J Clin Pract ; 24(11): 1609-1615, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34782498

RESUMO

BACKGROUND: The aim of this study was to compare the anthropometric and cone beam computed tomography (CBCT) measurements taken from risk-free and risky groups by using the modified Mallampati score (MMS). PATIENTS AND METHODS: A total of 176 volunteers between the ages of 18 and 65 in four different MMS classes were included in the study. The patients in classes MMS I and MMS II were accepted as risk-free and the patients in classes MMS III and MMS IV were accepted as risky for intubation. The Mann-Whitney U test was performed on the data to compare the anthropometric and radiological measurements taken from the risk-free and risky groups. A receiver operating characteristic (ROC) analysis was applied to the parameters that had a statistically significant difference. RESULTS: According to the analysis results, statistically significant differences were found in the neck circumference (NC), maximum interincisal distance (MID), thyromental distance (TMD) and sternomental distance (SMD) of the anthropometric measurements of men and women between the risk-free and risky groups (P < 0.05). In terms of CBCT measurements, the thickness of the tongue (TT), distance between the uvula and posterior wall of pharynx (U-Ph), distance between posterior nasal spine and nasopharynx (Snp-Nph) and length of the epiglottis (LE) were found to have statistically significant differences between the risk-free and risky groups of men and women (P < 0.05). CONCLUSION: The NC, MID, TMD and SMD anthropometric measurements and TT, U-Ph, Snp-Nph and LE radiologic measurements were found to support MMS, which is one of the most widely used bedside intubation prediction tests. In addition to the inclusion of CBCT for intubation prediction, U-Ph and Snp-Nph radiologic measurements were added as difficult intubation markers.


Assuntos
Intubação Intratraqueal , Laringoscopia , Adolescente , Adulto , Idoso , Antropometria , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Adulto Jovem
6.
J Nutr Health Aging ; 24(1): 20-27, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31886804

RESUMO

OBJECTIVES: The association between anticholinergic load-based Anticholinergic Risk Scale scores and nutritional status is unclear in Japanese patients. The aim of this study was to establish whether anticholinergic load affects the nutritional status of geriatric patients in convalescent stages. DESIGN: Retrospective longitudinal cohort study. SETTING: Convalescent rehabilitation wards. PARTICIPANTS: Of the 1490 patients aged ≥65 years who were discharged from convalescent rehabilitation wards between July 2010 and October 2018, 908 patients met the eligibility criteria. They were categorized according to the presence or absence of increased anticholinergic load from admission to discharge. MEASUREMENTS: Demographic data, laboratory data, the Functional Independence Measure were analyzed between the groups. The primary outcome was Geriatric Nutritional Risk Index (GNRI) at discharge. Multiple linear regression analysis was performed to analyze the relationship between anticholinergic load and GNRI at discharge. RESULTS: Multiple linear regression analysis after adjusting for confounding factors revealed that anticholinergic load was independently and negatively correlated with GNRI at discharge. Particularly, the use of chlorpromazine, hydroxyzine, haloperidol, metoclopramide, risperidone, etc. increased significantly from admission to discharge. CONCLUSION: Increased anticholinergic load during hospitalization may be a predictor of nutritional status in geriatric patients.


Assuntos
Antagonistas Colinérgicos/sangue , Antagonistas Colinérgicos/farmacocinética , Desnutrição/epidemiologia , Estado Nutricional/fisiologia , Idoso , Idoso de 80 Anos ou mais , Clorpromazina/farmacocinética , Antagonistas Colinérgicos/uso terapêutico , Feminino , Avaliação Geriátrica , Haloperidol/farmacocinética , Hospitalização , Humanos , Hidroxizina/farmacocinética , Japão/epidemiologia , Modelos Lineares , Estudos Longitudinais , Masculino , Metoclopramida/farmacocinética , Análise Multivariada , Avaliação Nutricional , Alta do Paciente , Análise de Regressão , Estudos Retrospectivos , Risperidona/farmacocinética
7.
Pharmazie ; 73(6): 356-360, 2018 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-29880089

RESUMO

In chronic kidney disease (CKD) patients, the ratio of warfarin enantiomers is changed and becomes unstable due to a reduction of cytochrome P450 (CYP) 2C9 activity of, which contributes to the development of hemorrhagic complications. The aim of this study was to investigate the influence of interventions by clinical pharmacists in addition to guidance by physicians on time in therapeutic range (TTR) control of warfarin therapy for CKD patients with non-valvular atrial fibrillation (NVAF). This retrospective cohort study included NVAF patients with CKD admitted and discharged from a cardiovascular internal medicine ward between March 2011 and July 2013 in Yokosuka Kyousai Hospital. Participants were classified into two groups according to the instructions by clinical pharmacists and physicians (intervention group) and by physicians only (usual care group). The primary outcome was TTR. Secondary outcomes were major bleeding and minor bleeding. In total, 39 participants (28 males, 11 females; mean age: 72.1 years) were classified into the intervention (n = 16) and usual care (n = 23) groups. TTR in the intervention group was significantly higher than in the usual care group. Major bleeding and minor bleeding were not significantly different between the two groups. The intervention of clinical pharmacists with anticoagulation therapy can lead to a proper use of warfarin prescribed by physicians.


Assuntos
Anticoagulantes/administração & dosagem , Assistência Farmacêutica/organização & administração , Farmacêuticos/organização & administração , Varfarina/administração & dosagem , Administração Oral , Idoso , Anticoagulantes/efeitos adversos , Fibrilação Atrial/tratamento farmacológico , Estudos de Coortes , Citocromo P-450 CYP2C9/metabolismo , Feminino , Hemorragia/induzido quimicamente , Hemorragia/epidemiologia , Humanos , Masculino , Papel Profissional , Insuficiência Renal Crônica/complicações , Estudos Retrospectivos , Varfarina/efeitos adversos
8.
J Clin Pharm Ther ; 43(6): 799-806, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29770467

RESUMO

WHAT IS KNOWN AND OBJECTIVE: Anticholinergic drugs are associated with risks of falls, confusion and cognitive dysfunction. However, the effect of anticholinergic drug use on rehabilitation outcomes after a stroke is poorly documented. We therefore aimed to establish whether the anticholinergic load was associated with functional recovery among geriatric patients convalescing after stroke. METHOD: Consecutive geriatric stroke patients admitted and discharged from a convalescence rehabilitation ward between 2010 and 2016 were included in this retrospective cohort study. Anticholinergic load was assessed by the Anticholinergic Risk Scale (ARS), and functional recovery was assessed by the Functional Independence Measure (FIM). The primary outcome was cognitive FIM (FIM-C) gain, but we also assessed the interaction of other putative factors identified from univariate analysis. Multivariate analyses were performed, adjusting for confounding factors. RESULTS AND DISCUSSION: We included 418 participants (171 males, 247 females) with a median age of 78 years (interquartile range, 72-84 years). Multiple regression analysis revealed that ARS change, length of stay, and epilepsy were independently and negatively correlated with cognitive FIM gain. Multiple logistic regression analysis indicated that the "Comprehension" and "Memory" items of the cognitive FIM gain were independently and negatively associated with anticholinergic load. WHAT IS NEW AND CONCLUSION: A causal relationship cannot be established, but increased ARS scores during hospitalization may predict limited cognitive functional improvement in geriatric patients after stroke. Alternatively, cognitive impairment may lead to increased use of anticholinergic drugs.


Assuntos
Atividades Cotidianas/psicologia , Antagonistas Colinérgicos/administração & dosagem , Cognição/efeitos dos fármacos , Acidente Vascular Cerebral/terapia , Idoso , Idoso de 80 Anos ou mais , Antagonistas Colinérgicos/efeitos adversos , Cognição/fisiologia , Estudos de Coortes , Feminino , Hospitalização , Humanos , Tempo de Internação , Masculino , Análise Multivariada , Recuperação de Função Fisiológica/efeitos dos fármacos , Análise de Regressão , Estudos Retrospectivos , Acidente Vascular Cerebral/psicologia , Reabilitação do Acidente Vascular Cerebral/métodos , Resultado do Tratamento
9.
J Clin Pharm Ther ; 43(1): 124-128, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28741715

RESUMO

WHAT IS KNOWN AND OBJECTIVE: Carglumic acid is a structural analogue of human N-acetylglutamate, which has become an alternative therapeutic option for hyperammonaemia in organic acidaemias such as isovaleric acidaemia, methylmalonic acidaemia and propionic acidaemia, and it has been suggested in other urea cycle disorders such as ornithine transcarbamylase deficiency and carbamoyl phosphate synthetase 1 deficiency. CASE DESCRIPTION: A male newborn was diagnosed with citrullinemia after serum amino acid analyses revealed markedly elevated citrulline concentration together with homozygous p.Gly390Arg mutation in ASS1 gene. The ammonia concentration decreased and blood gas analysis normalized after peritoneal dialysis was performed for three days. Also, sodium benzoate, L-arginine and parenteral nutrition with glucose and lipid therapy were initiated. Until 1 year of age, low adherence to sodium benzoate therapy due to unpleasant taste caused hyperammonaemic episodes and obligated us to initiate carglumic acid (100 mg/kg/day) therapy. During treatment with carglumic acid, the median ammonia level was 45.6 µmol/L. The patient's treatment was switched from carglumic acid to sodium phenylbutyrate when he was 4.5 years old. Currently, the patient is 6.5 years old and remains under follow-up with sodium phenylbutyrate, L-arginine and protein-restricted diet. Plasma ornithine level was found to be significantly lower during the carglumic acid treatment compared to other treatments (P=.039). Also, glutamic acid was found to be higher during the sodium benzoate treatment period compared to other treatment periods (P=.024). WHAT IS NEW AND CONCLUSION: To the best of our knowledge, this is the first report describing the long-term use of carglumic acid in a patient with argininosuccinate synthetase deficiency.


Assuntos
Citrulinemia/tratamento farmacológico , Glutamatos/uso terapêutico , Citrulinemia/genética , Humanos , Recém-Nascido , Masculino , Mutação/genética
10.
Artigo em Inglês | MEDLINE | ID: mdl-27107533

RESUMO

Isophthalic acid (C6H4(CO2H)2) is a noteworthy organic compound widely used in coating and synthesis of resins and the production of commercially important polymers such as drink plastic bottles. The effects of isophthalic acid (IPA) on human health, toxicology, and biodegradability are the main focus of many researchers. Because structural and spectroscopic investigation of molecules provides a deep understanding of interactional behaviors of compounds, this study stands for exploring those features. Therefore, the spectroscopic, structural, electronic, and thermodynamical properties of IPA were thoroughly studied in this work experimentally using UV-Vis, (1)H and (13)C NMR, FT-IR, FT-Raman and theoretically via DFT and TD-DFT calculations. The UV-Vis absorption spectrum in water was taken in the region 200-400nm. The NMR chemical shifts ((1)H and (13)C) were recorded in DMSO solution. The infrared and Raman spectra of the solid IPA were recorded in the range of 4000-400cm(-1) and 3500-50cm(-1), respectively. DFT and TD-DFT calculations were performed at the level of B3LYP/6-311++G(d,p) in determination of geometrical structure, electronic structure analysis and normal mode. The (13)C and (1)H nuclear magnetic resonance (NMR) spectra were estimated by using the gauge-invariant atomic orbital (GIAO) method. The scaled quantum mechanics (SQM) method was used to determine the total energy distribution (TED) to assign the vibrational modes accurately. Weak interactions such as hydrogen bonding and Van der Walls were analyzed via reduced density gradient (RDG) analysis in monomeric and dimeric forms. Furthermore, the excitation energies, density of state (DOS) diagram, thermodynamical properties, molecular electro-static potential (MEP), and nonlinear optical (NLO) properties were obtained.

11.
Hernia ; 20(5): 659-65, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-26621137

RESUMO

PURPOSE: Corona mortis (CMOR) is the arterial and/or venous vascular communication(s) between the obturator and external iliac vessels. Totally extraperitoneal (TEP) inguinal hernioplasty can be associated with vascular complications especially during the fixation of the mesh. Theoretically, CMOR is an important nominee. But, the data in literature are insufficient about CMOR injury. Additionally, most of the studies about CMOR have been usually performed on cadavers. We aimed to reveal the preperitoneal vascular anatomy of inguinal area and provide in vivo knowledge about CMOR. The risk of arterial injury was also evaluated. MATERIALS: The data of preperitoneal vascular anatomy of 321 patients who underwent TEP procedure between January 2005 and July 2014 were retrospectively evaluated. RESULTS: Mean age was 46 ± 8.9 years, 53 females vs 268 males. 391 hemipelvises were evaluated. Two types of arterial structure were identified; (1) an aberrant obturator artery forming an anastomosis with branches of ordinary obturator artery; (2) a pubic branch of inferior epigastric artery. The incidence of arterial CMOR was 28.4 % and of any arterial structure was 45.0 %. An arterial CMOR was considered as thick (≥2 mm) or thin (<2 mm). Injury of arterial CMOR during tack stapling on Cooper's ligament was seen in six cases (1.5 %). All of them were thin (<2 mm) in structure. Venous CMOR was visible only under low pressure in work space. CONCLUSION: During TEP hernia repair, CMOR and/or pubic branch of inferior epigastric artery can be damaged. To prevent this complication, tacks should be stapled to Cooper's ligament close to symphysis pubis and dissection should be careful on the posterior surface of superior pubic ramus. Small caliber (<2 mm) arterial CMOR is more prone to be injured during TEP procedure. To explore venous structures properly, pressure in workspace should be kept as low as possible.


Assuntos
Hérnia Inguinal/cirurgia , Herniorrafia/efeitos adversos , Artéria Ilíaca/lesões , Veia Ilíaca/lesões , Pelve/irrigação sanguínea , Lesões do Sistema Vascular/etiologia , Adulto , Cadáver , Feminino , Herniorrafia/métodos , Humanos , Artéria Ilíaca/anormalidades , Veia Ilíaca/anormalidades , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
12.
Pharmazie ; 71(9): 510-513, 2016 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-29441846

RESUMO

In recent years, an association between chronic kidney disease (CKD) and arteriosclerosis has been identified. Pulse pressure (PP) is used as an index of arteriosclerosis. However, there have been few studies of the relationship between PP and renal dysfunction in patients with CKD. Therefore, we examined the association of increased PP on renal function in patients with CKD and dyslipidemia. This study included 104 patients with CKD who were diagnosed with dyslipidemia and commenced on drug treatment. In the present study, patients with PP ≥65 mmHg were included in the High PP group, and patients with PP <65 mmHg were included in the Low PP group. We compared the High PP group with the Low PP group about background patient characteristics, laboratory data and antihypertensive medications and type. Mutiple logistic regression analysis identified estimated glomerular filtration rate (eGFR) as a significant predictor of PP ≥65 mmHg. In addition, values of BUN, Ccr, and eGFR baseline and 12 months later were compared. In the High PP group, compared with baseline, BUN increased significantly and Ccr and eGFR decreased significantly after 12 months later. We consider that PP may be an auxiliary indicator of generalized arterial sclerosis and renal function.


Assuntos
Pressão Sanguínea , Dislipidemias/complicações , Dislipidemias/fisiopatologia , Hipertensão Renal/complicações , Hipertensão Renal/fisiopatologia , Rim/fisiopatologia , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/fisiopatologia , Idoso , Anti-Hipertensivos/uso terapêutico , Nitrogênio da Ureia Sanguínea , Feminino , Taxa de Filtração Glomerular , Humanos , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
15.
Pharmazie ; 70(7): 489-93, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26373211

RESUMO

It has been reported that the improvement of activities of daily living (ADL) by rehabilitation affects glycemic control. However, there are no reports about antidiabetes drugs as factors affecting the outcomes of rehabilitation. Therefore, we investigated the effects of antidiabetes drugs on functional independence measure (FIM) [total (T), motor (M), and cognition (C) items] in stroke patients with diabetes who were discharged from the subacute rehabilitation ward. We chose the frequently used antidiabetes drugs [sulfonylurea (SU), dipeptidyl peptidase-IV inhibitors (DPP-IVIs), and α-glycosidase inhibitors (α-GIs)] as the basis for categorizing the patients. We compared the patients' background features and laboratory data among the three groups. As a result, when SU was used in stroke patients with diabetes, it is difficult to obtain significant FIM-M gain, FIM-C gain, FIM-M efficiency, and FIM-C efficiency compared with of-GIs. As a reason for this, we hypothesize the possibility of the involvement of insulin resistance. Therefore, we consider that insulin resistance should be determined early and that it is important to reduce insulin resistance comprehensively by involving experts.


Assuntos
Hipoglicemiantes/uso terapêutico , Reabilitação do Acidente Vascular Cerebral , Atividades Cotidianas , Idoso , Cognição , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Quimioterapia Combinada , Feminino , Humanos , Vida Independente , Masculino , Pessoa de Meia-Idade , Atividade Motora/fisiologia , Alta do Paciente , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/psicologia
16.
Pharmazie ; 70(7): 494-8, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26373212

RESUMO

The protective efficacy of warfarin for cardiogenic cerebral embolism has been established. However, warfarin is generally administered to only approximately 35% of the atrial fibrillation patients who required warfarin therapy. It has been reported that international normalized ratio (INR) control was carried out appropriately in < 50% of such patients. Therefore, from the viewpoint of prevention of the onset and recurrence of embolism, the maintenance of a stable anticoagulant level is necessary. In warfarin therapy, in addition to INR control, time in therapeutic range (TTR) also markedly affects the efficacy of warfarin therapy. Therefore, we classified patients into two groups on the basis of the cutoff TTR ≥ 65% at which the inhibitory effect of warfarin on stroke has been observed. We aimed to examine the association between INR and TTR with the correction of the therapeutic efficacy of warfarin by analyzing the factors leading to poor TTR control. The most valuable finding of this study is that marked fluctuations of brain natriuretic peptide levels in patients with complication of heart failure was a risk factor for poor TTR control. Identification of the factors leading to the poor TTR control is useful for making the decision to switch to other anticoagulants, such as dabigatran or apixaban, or to continue warfarin by correcting risk factors in atrial fibrillation patients receiving long-term warfarin therapy.


Assuntos
Anticoagulantes/administração & dosagem , Anticoagulantes/uso terapêutico , Varfarina/administração & dosagem , Varfarina/uso terapêutico , Idoso , Fibrilação Atrial/tratamento farmacológico , Feminino , Humanos , Coeficiente Internacional Normatizado , Masculino , Pessoa de Meia-Idade , Fatores de Risco
17.
Spectrochim Acta A Mol Biomol Spectrosc ; 136 Pt B: 306-20, 2015 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-25448934

RESUMO

The spectroscopic (FT-IR, FT-Raman, (1)H and (13)C NMR, UV-Vis), structural, electronic and thermodynamical properties of 3-fluorophenylboronic acid (C6H4FB(OH)2), 3FPBA) were submitted by using both experimental techniques and theoretical methods (quantum chemical calculations) in this work. The experimental infrared and Raman spectra were obtained in the region 4000-400 cm(-1) and 3500-10 cm(-1), respectively. The equilibrium geometry and vibrational spectra were calculated by using DFT (B3LYP) with 6-311++G(d,p) basis set. The vibrational wavenumbers were also corrected with scale factor to take better results for the calculated data. The total energy distributions (TED) of the vibrational modes were performed for the assignments of the title molecule by using scaled quantum mechanics (SQM) method. The NMR chemical shifts ((1)H and (13)C) were recorded in DMSO solution. The (1)H and (13)C NMR spectra were computed by using the gauge-invariant atomic orbital (GIAO) method, showing a good agreement with the experimental ones. The last one UV-Vis absorption spectra were analyzed in two solvents (ethanol and water), saved in the range of 200-400 nm. In addition these, HOMO and LUMO energies, the excitation energies, density of states (DOS) diagrams, thermodynamical properties and molecular electrostatic potential surface (MEPs) were presented. Nonlinear optical (NLO) properties and thermodynamic features were performed. The experimental results are combined with the theoretical calculations using DFT calculations to fortification of the paper. At the end of this work, the results were proved our paper had been indispensable for the literature backing.


Assuntos
Ácidos Borônicos/química , Espectroscopia de Ressonância Magnética , Modelos Moleculares , Teoria Quântica , Análise Espectral Raman , Espectroscopia de Ressonância Magnética Nuclear de Carbono-13 , Dimerização , Elétrons , Conformação Molecular , Dinâmica não Linear , Fenômenos Ópticos , Espectroscopia de Prótons por Ressonância Magnética , Espectrofotometria Ultravioleta , Espectroscopia de Infravermelho com Transformada de Fourier , Eletricidade Estática , Termodinâmica , Vibração
18.
Pharmazie ; 70(11): 716-9, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26790187

RESUMO

In this study, we compared patients whose activated partial thromboplastin time (APTT) was prolonged excessively with those whose APTT was controlled within the normal range after dabigatran administration. We analyzed the factors for the APTT prolongation. We divided the patients into two groups: those whose APTTs prolonged to more than 65 s and those whose APTTs were less than 65 s after dabigatran administration. There were 130 patients from March 2011 to July 2013, and we analyzed the background features and laboratory data of these patients. Results showed that there were no significant differences in the patients' background and laboratory data except for the high-density lipoprotein cholesterol (HDL-C) level. However, details of the relationship between the APTT prolongation and the HDL-C level are currently unknown. We hypothesize that the reason for the APTT prolongation is the variability in such parameters as the time of blood drawing, internal time of dabigatran, individual variability, and blood concentration. Therefore, we consider that these parameters need to be carefully evaluated even if APTT does not show prolongation.


Assuntos
Antitrombinas/efeitos adversos , Dabigatrana/efeitos adversos , Tempo de Tromboplastina Parcial , Idoso , Antitrombinas/uso terapêutico , Contagem de Células Sanguíneas , Análise Química do Sangue , HDL-Colesterol/sangue , Dabigatrana/uso terapêutico , Feminino , Humanos , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade
19.
Cytotechnology ; 67(6): 1031-8, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25260542

RESUMO

Cyclophosphamide (CYC) and doxorubicin (DOX) are among the most effective and widely used anticancer chemotherapeutic drugs. Potential chemopreventive and chemotherapeutic functions have recently been attributed to flavonoids. We hypothesized that Quercetin (QR) would protect against the toxic effects of chemotherapeutic agents applied prior to pregnancy. Rats were treated with the chemotherapeutic drugs CYC (27 mg/kg) and DOX (1.8 mg/kg) applied in a single intraperitoneal dose once every 3 weeks for 10 weeks. QR was administered at a dose of 10 mg/kg/day by oral gavage. 48 h following the experimental chemotherapy exposure, female rats were transferred to cages containing male rat for mating. Fetal brain tissues were removed from fetuses extracted by cesarean section on the 20th day of gestation for evaluation of antioxidant parameters. A significant increase in superoxide dismutase and malondialdehyde activity was observed in CYC and DOX treatment groups relative to the control group (p < 0.05). Similarly, carnitine acylcarnitine translocase and Glutathione activity was significantly reduced in the CYC and DOX groups relative to the control group (p < 0.05). Our results indicate that the use of chemotherapeutic drugs before pregnancy can result in oxidative damage to fetal brain tissue. Therefore, women who have been exposed to chemotherapy and may become pregnant should be treated with antioxidant compounds such as QR to reduce the risk of damage to fetal brain tissues.

20.
Spectrochim Acta A Mol Biomol Spectrosc ; 137: 1315-33, 2015 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-25305625

RESUMO

In this study, the Fourier Transform Infrared (FT-IR) and Fourier Transform Raman (FT-Raman) spectra of 5-bromo-2-ethoxyphenylboronic acid (5Br2EPBA) are recorded in the solid phase in the region 4000-400 cm(-1) and 3500-10 cm(-1), respectively. The (1)H, (13)C and DEPT nuclear magnetic resonance (NMR) spectra are recorded in DMSO solution. The UV-Vis absorption spectrum of 5Br2EPBA is saved in the range of 200-400 nm in ethanol and water. The following theoretical calculations for monomeric and dimeric structures are supported by experimental results. The molecular geometry and vibrational frequencies in the ground state are calculated by using DFT methods with 6-31G(d,p) and 6-311G(d,p) basis sets. There are four conformers for the present molecule. The computational results diagnose the most stable conformer of 5Br2EPBA as Trans-Cis (TC) form. The complete assignments are performed on the basis of the total energy distribution (TED) of vibrational modes, calculated with scaled quantum mechanics (SQM) method in parallel quantum solutions (PQS) program. The (1)H and (13)C NMR chemical shifts of 5Br2EPBA molecule are calculated by using the Gauge Invariant Atomic Orbital (GIAO) method in DMSO and gas phase for monomer and dimer structures of the most stable conformer. Moreover, electronic properties, such as the HOMO and LUMO energies (by TD-DFT and CIS methods) and molecular electrostatic potential surface (MEPs) are investigated. Stability of the molecule arising from hyper-conjugative interactions, charge delocalization is analyzed using natural bond orbital (NBO) analysis. Nonlinear optical (NLO) properties and thermodynamic features are presented. All calculated results are compared with the experimental data of the title molecule. The correlation of theoretical and experimental results provides a detailed description of the structural and physicochemical properties of the title molecule.


Assuntos
Ácidos Borônicos/química , Reagentes de Ligações Cruzadas/química , Dimerização , Espectroscopia de Ressonância Magnética , Modelos Moleculares , Espectrofotometria Ultravioleta , Espectroscopia de Infravermelho com Transformada de Fourier , Análise Espectral Raman
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