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1.
Clin Ter ; 175(2): 144-152, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38571473

RESUMO

Background: Adolescence is a critical phase of development characterized by numerous physical, psychological and social changes. During this stage, individuals may engage in experimentation and risky behavior, leading to increased vulnerability to addiction. This article aims to present the results of a survey based on the HBSC (Health Behavior in School-aged Children) surveillance model in a province of Southern Italy for primary and secondary school students. Methods: We conducted a prospective study from March 2020 to April 2023 through the administration of a questionnaire to students of the healthcare faculties of the University of Messina and primary and secondary school students, composed of 19 items and based on HBSC surveillance. Results: We collected a total of 664 questionnaires. We found that smoking habits increase with age: approximately 31% of secondary school students declare they are real smokers compared to 40% of HCP students. At least once, in the three study groups, students experienced alcohol consumption at different rates, with younger students having a greater propensity to drink than older students. Fortunately, in our sample, no middle school students had tried cannabis. At the same time there is a surprising decrease in gambling in all categories compared to national data. Conclusions: The presence of addictive behaviors in our sample was found to be widespread despite being in line with the national trend. Furthermore, we have observed a reduction in recent years which needs to be investigated to assess the reasons. Primary prevention is probably the main weapon in the hands of politicians and must be applied early in school and community settings to reduce prevalence.


Assuntos
Comportamento Aditivo , Fumar , Adolescente , Criança , Humanos , Estudos Prospectivos , Fumar/epidemiologia , Inquéritos e Questionários , Assunção de Riscos , Comportamento Aditivo/epidemiologia
2.
Pulmonology ; 2024 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-38184410

RESUMO

Sarcoidosis is a rare granulomatous disease of unknown aetiology belonging to the wide group of interstitial lung diseases.). Although the limitlessness of BAL fluid is debated, it remains one of the best matrices for studying the pathogenesis of sarcoidosis. Natural killer (NK) cells have been described in BAL fluid from sarcoidosis patients. Elevated NK cells in BAL fluid from sarcoidosis patients have been found to be associated with poor outcomes. In this study, NK cells were evaluated in BAL samples from sarcoidosis patients at the time of diagnosis and associated with clinical characteristics in order to evaluate their prognostic role. Of the 276 patients suspected to have sarcoidosis on the basis of clinical and radiological findings, 248 had a final diagnosis of sarcoidosis. Clinical parameters, Scadding stage, and extrapulmonary localization were collected in a database. It resulted in fibrotic sarcoidosis patients being associated with an increase in lymphocyte percentages in BAL samples, particularly NK cells when compared with other groups. From ROC analysis, NK cell percentages in BAL samples resulted as being the best predictive markers in discriminating stage 4 of sarcoidosis from other RX stages (AUC=0.85, p<0.0001). Furthermore, after the stratification of patients on the basis of the number of extrapulmonary localizations, patients with an higher number of extrapulmonary localizations also showed higher percentages of NK cells in BAL fluid. In conclusion, NK cell percentages in BAL fluid can be considered a good prognostic marker of fibrotic phenotypes of sarcoidosis and involvement of other organs, although their diagnostic utility was poor.

3.
Animal ; 17(6): 100815, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37167820

RESUMO

The use of alternative feed ingredients from the Agro-industry could be an efficient tool to improve the sustainability of dairy cow production. Since the richness in polyphenols, olive oil pomace (OOP), produced during olive oil milling, seems a promising by-product to ameliorate milk's nutritional value. The aim of this study was to test the use of OOP produced by means of a new technology (biphasic with stone deprivation) in dairy cow feeding strategy to evaluate the effect on animal performances, rumen microbiota, biohydrogenation processes and milk quality by a multidisciplinary approach. Forty multiparous Italian-Friesian dairy cows, at middle lactation, were randomly allotted into two homogenous groups and fed respectively a commercial diet (CON) and the experimental diet (OOPD) obtained by adding OOP to CON as partial replacement of maize silage. The two diets were formulated to be isoproteic and isoenergetic. The same diets were tested also in an in vitro trial aimed to evaluate their rumen degradability (% DEG). The dietary supplementation with OOP did not affect DM intake, rumen % DEG and milk production. The milk's nutritional quality was improved by increasing several important functional fatty acids (FAs; i.e., linoleic acid, conjugated linoleic acid, oleic acid, vaccenic acid). This finding was related to a decrease in rumen liquor biohydrogenation rate of unsaturated FAs. The stochiometric relation between volatile FA production in the rumen and methanogenesis suggested that OOP lowers the methane potential production (CON = 0.050 mol/L vs OOPD = 0.024 mol/L, SEM = 0.005, P = 0.0011). Rumen microbiota and fungi community did not be strongly altered by OOP dietary inclusion because few bacteria were affected at the genus level only. Particularly, Acetobacter, Prevotellaceae_UCG-004, Prevotellaceae_UCG-001, Eubacterium coprostanoligenes, Lachnospira, Acetitomaulatum, Lachnospiraceae_NK3A20 group were more abundant with OOPD condition (P < 0.05). Data reported in this study confirm that the use of OOP in dairy cow feeding can be an interesting strategy to improve milk nutritional quality increasing functional FA content without compromising the rumen degradability of the diet or causing strong perturbation of rumen ecosystem and maintaining animal performances.


Assuntos
Microbiota , Leite , Animais , Bovinos , Feminino , Ração Animal/análise , Dieta/veterinária , Ácidos Graxos/metabolismo , Fermentação , Lactação , Azeite de Oliva/metabolismo , Rúmen/metabolismo , Silagem/análise
4.
Eur J Paediatr Dent ; 22(1): 47-54, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33719483

RESUMO

AIM: The aim of this study was to review the craniofacial growth impairment and different malfunctions associated with short lingual frenum and to assess the validity of lingual frenum surgery based on minimally invasive laser release with a myofunctional approach. MATERIALS AND METHODS: Thirty patients, children and adolescents whose ages ranged from 8 years to 18 years, diagnosed with a short lingual frenum and concomitant orthodontic problems and/or presence of associated muscular or postural problems, were treated in this study. Pre-operative tongue assessment was performed following morphological and functional criteria, consisting of measurement of the free tongue, and of visual assessment of tongue protrusion out of the mouth and elevation to the incisive palatal papilla. Postural evaluation was assessed in frontal and lateral view. Laser surgery was completed with local anaesthesia, using Erbium YAG laser (2940 nm, LightWalker, AT-Fotona, Ljubljana, Slovenia) equipped with sapphire conical tip (600 micron), with energy ranging from 120 to 160 mJ, at 15 Hz frequency, and varying the adjustable pulse duration from 300 µs to 600 µs. RESULTS: Significant improvement was noted in 29 of 30 patients comparing preoperative scores to both three-week and two-month post-op scores. Postural improvement was found in 18 of 30 patients, indicating the multifactorial involvement of different causes for correct body posture. CONCLUSION: This study confirmed the validity of Erbium:YAG laser surgery as an effective technique in children and adolescents to release a short lingual frenum. The functional approach of the procedure performed with the Erbium:YAG laser, and the concomitant myofunctional therapy demonstrated to be simple and safe in children, and adolescents. Because of the multifactorial causes involved in correct body posture, an adequate osteopathic therapy is important to successfully complete the full body rehabilitation.


Assuntos
Terapia a Laser , Lasers de Estado Sólido , Doenças da Língua , Adolescente , Criança , Humanos , Lactente , Freio Lingual/cirurgia , Língua , Doenças da Língua/cirurgia
5.
Scand J Rheumatol ; 49(5): 361-370, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32468892

RESUMO

Objective: SB4, SB2, and SB5 are biosimilars of etanercept (ETN), infliximab (INF), and adalimumab (ADA), respectively. This pooled analysis evaluated the immunogenicity of these treatments across three phase III randomized controlled trials of patients with rheumatoid arthritis (RA). Methods: Patients had to have at least one anti-drug antibody (ADAb) assessment up to the time of the primary endpoint from each study (week 24 in SB4 and SB5 studies; week 30 in SB2 study). The effect of ADAbs on American College of Rheumatology 20% (ACR20) response and the incidences of injection-site reactions (ISRs)/infusion-related reactions (IRRs) were evaluated. Results: The study included 1709 patients. The cumulative incidences of ADAbs were 30.3% in the all-treatments-combined group, 29.1% in the biosimilars combined group, and 31.5% in the reference products combined group. ACR20 response rates were significantly lower in ADAb-positive patients in the all-treatments-combined [odds ratio (95% confidence interval) 1.77 (1.37, 2.27), p < 0.0001], biosimilars combined [2.24 (1.53, 3.30), p < 0.0001], and reference products combined [1.49 (1.06, 2.09), p = 0.0225] groups. ADAb-positive patients also had a higher likelihood of developing ISRs/IRRs in the all-treatments-combined group [0.56 (0.31, 1.01), p = 0.0550], predominantly due to the results observed with SB2 + INF combined rather than with SB4 + ETN or SB5 + ADA combined. Conclusion: In this pooled analysis, ADAbs were associated with reduced efficacy in patients with RA treated with biosimilars (SB4, SB2, and SB5) or their reference products (ETN, INF, and ADA). ADAbs were associated with an increased incidence of ISRs/IRRs in those treated with SB2 + INF. Clinical trial registration numbers: NCT01936181 (SB2 study), NCT01895309 (SB4 study), and NCT02167139 (SB5 study).


Assuntos
Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Medicamentos Biossimilares/uso terapêutico , Etanercepte/uso terapêutico , Inibidores do Fator de Necrose Tumoral/uso terapêutico , Adalimumab/efeitos adversos , Adalimumab/uso terapêutico , Adulto , Anticorpos , Antirreumáticos/efeitos adversos , Medicamentos Biossimilares/efeitos adversos , Etanercepte/efeitos adversos , Feminino , Humanos , Infliximab/efeitos adversos , Infliximab/uso terapêutico , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Inibidores do Fator de Necrose Tumoral/efeitos adversos
6.
Eur J Paediatr Dent ; 19(1): 56-60, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29569455

RESUMO

AIM: Anomalous maxillary median labial frenum may be associated with undesired effects such as persistence of diastema between anterior teeth or traction of marginal gingiva. The aim of this study was to propose a surgical frenum repositioning technique that is minimally invasive, safe, easy, reproducible, and predictable. Another objective of the study was to identify clinical scenarios that could have indication for labial frenectomy associated with early orthodontic therapy, so as to justify early frenum repositioning in children. A retrospective assessment of clinical outcomes of this technique is described. MATERIALS AND METHODS: A total of 20 frenectomies were performed on children aged 8 to 10 years. Frenectomies were performed with Er:YAG laser set at 150mJ 2.25-3.0W and 15-20 pulse per second, with water spray. Recall visits were done at 7, 21 and 90 days and 1, 2, 3 and 4 years. RESULTS: At post-operative visits, all patients reported no post-operative pain or minimal discomfort. None experienced post-operative bleeding at a distance of few hours. All patients reported that the procedure was well tolerated and "acceptable". No recurrences occurred 4 years after frenectomy. CONCLUSION: The Er:YAG laser used in this study allowed considerable reduction of the operating time, reducing the amount of local anaesthetic used as well as avoiding surgical sutures. The surgical design and technique also minimised post-operative discomfort and complications resulting in stable healing overtime, making the procedure fully accepted by children.


Assuntos
Freio Labial/cirurgia , Terapia a Laser/métodos , Criança , Estética Dentária , Feminino , Humanos , Lasers de Estado Sólido , Masculino , Estudos Retrospectivos , Cicatrização
8.
Eur J Paediatr Dent ; 18(2): 163-166, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28598190

RESUMO

AIM: Erbium lasers can provide effective and minimally invasive caries removal in children. The bonding phase remains a critic step as well as the choice of material. Glass ionomers exhibits lower bonding properties in laser irradiated teeth compared to the conventional method or to composite and resin modified glass ionomer. Laser can also provide effective decontamination and coagulation effects in vital and non vital pulp therapy of primary teeth, improving and simplifying the cleaning and disinfecting steps.


Assuntos
Descontaminação/métodos , Colagem Dentária/métodos , Assistência Odontológica para Crianças/métodos , Cárie Dentária/radioterapia , Terapia a Laser/métodos , Coagulação Sanguínea/efeitos da radiação , Criança , Resinas Compostas/química , Cimentos de Ionômeros de Vidro/química , Humanos , Lasers de Estado Sólido , Dente Decíduo
9.
Eur J Paediatr Dent ; 18(1): 80-82, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28494610

RESUMO

AIM: Knowledge of the physical characteristics of different laser lights and optical and thermal properties of oral tissues is very important to understand the interaction of dental lasers with biological tissues. Choosing the correct dental laser is crucial to match specific wavelengths with target chromophores of different tissues; this affinity makes laser irradiation selective and therefore minimally invasive. Various types of lasers are used in dentistry, offering a viable alternative to low and high-speed handpieces and surgical blades, and also minimising fear and discomfort of the patient. Lasers can provide innovative and minimally invasive therapies in different branches of dentistry including preventive and restorative dentistry, traumatic injury treatments and surgical procedures. Laser has also biostimulating and anti-inflammatory effects, as well as analgesic effect.


Assuntos
Terapia a Laser/métodos , Odontopediatria/métodos , Humanos
10.
Eur J Paediatr Dent ; 18(4): 332-334, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29380621

RESUMO

AIM: Lasers can provide effective soft tissues applications in children. All the wavelengths produce incision and vaporisation of oral tissues, together with a high bactericidal effect. The haemosthatic effect varys according to the wavelength used, and the choice of a visibile, near, medium or far infrared laser allows a better interaction with specific targets, gingiva, mucosa, frenum, or oral pathology.


Assuntos
Assistência Odontológica para Crianças , Terapia a Laser/métodos , Doenças da Boca/cirurgia , Mucosa Bucal/cirurgia , Criança , Humanos
11.
Mar Pollut Bull ; 106(1-2): 119-26, 2016 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-26992747

RESUMO

One of the main challenges of bioremediation is to define efficient protocols having a low environmental impact. We have investigated the effect of three treatments in oily-seawater after a real oil-spill occurred in the Gulf of Taranto (Italy). Biostimulation with inorganic nutrients allowed the biodegradation of the 73±2.4% of hydrocarbons, bioaugmentation with a selected hydrocarbonoclastic consortium consisting of Alcanivorax borkumensis, Alcanivorax dieselolei, Marinobacter hydrocarbonoclasticus, Cycloclasticus sp. 78-ME and Thalassolituus oleivorans degraded 79±3.2%, while the addition of nutrients and a washing agent has allowed the degradation of the 69±2.6%. On the other hand, microbial community was severely affected by the addition of the washing agent and the same product seemed to inhibit the growth of the majority of strains composing the selected consortium at the tested concentration. The use of dispersant should be accurately evaluated also considering its effect on the principal actors of biodegradation.


Assuntos
Recuperação e Remediação Ambiental/métodos , Poluição por Petróleo , Petróleo/metabolismo , Água do Mar/química , Poluentes Químicos da Água/metabolismo , Bactérias/metabolismo , Biodegradação Ambiental , Hidrocarbonetos/metabolismo , Itália , Óleos , Petróleo/análise , Poluentes Químicos da Água/análise
12.
Mar Genomics ; 17: 43-52, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25088485

RESUMO

Obligate marine hydrocarbonoclastic bacteria possess genetic and physiological features to use hydrocarbons as sole source of carbon and to compete for the uptake of nutrients in usually nutrient-depleted marine habitats. In the present work we have studied the siderophore-based iron uptake systems in Alcanivorax borkumensis SK2 and their functioning during biodegradation of an aliphatic hydrocarbon, tetradecane, under iron limitation conditions. The antiSMASH analysis of SK2 genome revealed the presence of two different putative operons of siderophore synthetases. Search for the predicted core structures indicated that one siderophore is clearly affiliated to the family of complex oligopeptidic siderophores possessing an Orn-Ser-Orn carboxyl motif whereas the second one is likely to belong to the family of SA (salicylic acid)-based siderophores. Analyzing the supernatant of SK2 culture, an extracellular siderophore was identified and its structure was resolved. Thus, along with the recently described membrane-associated amphiphilic tetrapeptidic siderophore amphibactin, strain SK2 additionally produces an extracellular type of iron-chelating molecule with structural similarity to pseudomonins. Comparative Q-PCR analysis of siderophore synthetases demonstrated their significant up-regulation in iron-depleted medium. Different expression patterns were recorded for two operons during the early and late exponential phases of growth, suggesting a different function of these two siderophores under iron-depleted conditions.


Assuntos
Alcanivoraceae/metabolismo , Matriz Extracelular/metabolismo , Genoma Bacteriano/genética , Hidrocarbonetos/metabolismo , Sideróforos/biossíntese , Alcanivoraceae/genética , Alcanos/metabolismo , Biodegradação Ambiental , Primers do DNA/genética , Hidroxibenzoatos , Indóis , Ferro/farmacocinética , Deficiências de Ferro , Espectroscopia de Ressonância Magnética , Espectrometria de Massas , Reação em Cadeia da Polimerase em Tempo Real
13.
Arthritis Rheum ; 65(4): 880-9, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23359344

RESUMO

OBJECTIVE: Tabalumab, a fully human IgG4 monoclonal antibody, neutralizes soluble and membrane-bound BAFF. The aim of this study was to examine the tolerability and efficacy of tabalumab in patients with active rheumatoid arthritis receiving methotrexate. METHODS: In this randomized, double-blind, placebo-controlled, parallel, multiple-dose study, patients who were naive to biologic therapy received infusions of tabalumab (30, 60, or 160 mg) or placebo at weeks 0, 3, and 6 in combination with methotrexate and were evaluated for 24 weeks. The primary efficacy end point was the percentage of patients meeting American College of Rheumatology 20% improvement criteria (achieving an ACR20 response) at week 16. RESULTS: At week 16, the percentages of patients achieving an ACR20 response in the 30-mg (57.6%), 60-mg (67.6%), and 160-mg (51.5%) groups were significantly greater than the percentage of patients achieving an ACR20 response in the placebo group (29.4%; P<0.05). There were initial transient increases from baseline in the frequency of CD20+ and IgD+/CD27- B cells, followed by reductions, although B cells were not completely depleted. Also, the frequency of IgD-/CD27+ B cells increased in all tabalumab groups compared with the placebo group and returned toward baseline levels by the end of the study. The incidence of adverse events was similar across all treatment groups; no deaths occurred. Serum IgM levels decreased significantly in all tabalumab groups combined compared with the placebo group. There were no significant decreases in serum IgG or IgA levels in the tabalumab groups compared with the placebo group. CONCLUSION: Tabalumab treatment significantly reduces the signs and symptoms of rheumatoid arthritis and has a safety profile similar to that seen with placebo treatment.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Fator Ativador de Células B/antagonistas & inibidores , Metotrexato/uso terapêutico , Adolescente , Adulto , Idoso , Anticorpos Monoclonais Humanizados , Relação Dose-Resposta a Droga , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
14.
Eur J Paediatr Dent ; 13(2): 101-6, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22762170

RESUMO

AIM: When ankyloglossia is relatively severe and generates mechanical limitations and functional challenges, surgical reduction of the frenum is indicated. MATERIALS AND METHODS: Laser technique is an innovative, safe and effective therapy for frenectomy in both children and adolescents. Erbium:YAG laser (2940nm) can be useful for paediatric dentist: 1.5W at 20pps is a commonly used average power to easily, safely and quickly cut the frenum. RESULTS: Usually after laser frenectomy, the postoperative symptoms and relapse are absent. CONCLUSION: Early intervention is advisable to reduce the onset of alterations correlated to the ankyloglossia. A multidisciplinary approach to the problem is advisable, in collaboration with orthodontist, physiotherapist and speech therapist, to better resolve the problem.


Assuntos
Terapia a Laser/métodos , Freio Lingual/cirurgia , Adolescente , Criança , Transtornos de Deglutição/etiologia , Humanos , Lasers Semicondutores/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Freio Lingual/anormalidades , Lordose/etiologia , Má Oclusão/etiologia , Equipe de Assistência ao Paciente , Postura , Distúrbios da Fala/etiologia , Doenças da Língua/etiologia
15.
Arthritis Rheum ; 64(2): 360-70, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22389919

RESUMO

OBJECTIVE: To evaluate the safety and efficacy of ocrelizumab plus methotrexate (MTX) or leflunomide (LEF) in patients with active rheumatoid arthritis (RA) and an inadequate response to tumor necrosis factor α inhibitors. METHODS: This was a multicenter randomized, double-blind, placebo-controlled, parallel-group study that continued over 48 weeks. Patients receiving stable doses of MTX or LEF were randomized to receive 2 infusions of placebo (n = 277), ocrelizumab 200 mg (n = 278), or ocrelizumab 500 mg (n = 285) on days 1 and 15 as well as at weeks 24 and 26. Coprimary end points were the proportion of patients with response according to the American College of Rheumatology 20% improvement criteria (ACR20) at weeks 24 and 48. Secondary end points included the change from baseline in the modified Sharp/van der Heijde score (SHS) and the ACR50/70 responses. RESULTS: ACR20 responses were 22.0% in the placebo group, 42.2% in the ocrelizumab 200 mg group, and 47.9% in the ocrelizumab 500 mg group at 24 weeks and 19.5%, 48.7%, and 50.7%, respectively, at 48 weeks (P < 0.0001 versus placebo for each comparison at each time point). At 48 weeks, patients receiving both doses of ocrelizumab showed significantly improved ACR50 and ACR70 responses of ~3-fold versus placebo. Only those in the ocrelizumab 500 mg group showed statistically significant (P = 0.0017) inhibition of joint damage progression (mean change in the SHS) relative to placebo (61% inhibition) at 48 weeks. Overall adverse events and infections during the 48 weeks of study were comparable in all treatment groups. Serious infections were observed more frequently in patients taking ocrelizumab (5.1% and 4.3%) than in those taking placebo (2.5%). CONCLUSION: Patients in both of the ocrelizumab groups met the clinical primary efficacy end points. Inhibition of change in the SHS was statistically significant at 48 weeks for those in the ocrelizumab 500 mg group. The rate of serious infections in this trial was higher for both ocrelizumab doses as compared with placebo.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Adulto , Idoso , Anticorpos Monoclonais Humanizados/efeitos adversos , Antirreumáticos/efeitos adversos , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
16.
Arthritis Rheum ; 63(10): 2854-64, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21618201

RESUMO

OBJECTIVE: To compare the efficacy and safety of subcutaneous (SC) and intravenous (IV) abatacept. METHODS: In this phase IIIb double-blind, double-dummy, 6-month study, patients with rheumatoid arthritis (RA) and inadequate responses to methotrexate were randomized to receive 125 mg SC abatacept on days 1 and 8 and weekly thereafter (plus an IV loading dose [∼10 mg/kg] on day 1) or IV abatacept (∼10 mg/kg) on days 1, 15, and 29 and every 4 weeks thereafter. The primary end point for determining the noninferiority of SC abatacept to IV abatacept was the proportion of patients in each group meeting the American College of Rheumatology 20% improvement criteria (achieving an ACR20 response) at month 6. Other efficacy end points, immunogenicity, and safety were also assessed. RESULTS: Of 1,457 patients, 693 of 736 (94.2%) treated with SC abatacept and 676 of 721 (93.8%) treated with IV abatacept completed 6 months. At month 6, 76.0% (95% confidence interval 72.9, 79.2) of SC abatacept-treated patients versus 75.8% (95% confidence interval 72.6, 79.0) of IV abatacept-treated patients achieved an ACR20 response (estimated difference between groups 0.3% [95% confidence interval -4.2, 4.8]), confirming noninferiority of SC abatacept to IV abatacept. Onset and magnitude of ACR responses and disease activity and physical function improvements were comparable between the SC and IV abatacept-treated groups. The proportions of adverse events (AEs) and serious AEs over 6 months were 67.0% and 4.2%, respectively, in the SC abatacept-treated group and 65.2% and 4.9%, respectively, in the IV abatacept-treated group, with comparable frequencies of serious infections, malignancies, and autoimmune events between groups. SC injection site reactions (mostly mild) occurred in 19 SC abatacept (IV placebo)-treated patients (2.6%) and 18 IV abatacept (SC placebo)-treated patients (2.5%). Abatacept-induced antibodies occurred in 1.1% of SC abatacept-treated patients and 2.3% of IV abatacept-treated patients. CONCLUSION: SC abatacept provides efficacy and safety comparable with that of IV abatacept, with low immunogenicity and high retention rates, consistent with the established IV abatacept profile. Rates of injection site reactions were low. SC abatacept will provide additional treatment options, such as an alternative route of administration, for patients with RA.


Assuntos
Antirreumáticos/administração & dosagem , Artrite Reumatoide/tratamento farmacológico , Imunoconjugados/administração & dosagem , Abatacepte , Adulto , Idoso , Antirreumáticos/uso terapêutico , Método Duplo-Cego , Feminino , Humanos , Imunoconjugados/uso terapêutico , Injeções Intravenosas , Injeções Subcutâneas , Masculino , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Resultado do Tratamento
17.
Eur Arch Paediatr Dent ; 12(2): 68-78, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21473836

RESUMO

BACKGROUND: The idea of substituting a drill with a laser light, has led to its introduction in dentistry. Besides being more accepted to patients, in paediatric dentistry the laser has demonstrated safety compared with rotating instruments. REVIEW: A review of the past 20 years of the dental literature concerning laser use in dentistry, including paediatric dentistry was completed. The findings of that review are presented. TECHNIQUES: The various types of lasers and their uses for caries detection, tooth sealing and caries removal are described. RESULTS: Laser caries detection demonstrated a good reproducibility, reliability and predictability to monitor the caries process over time. Erbium lasers have been found to be efficient for caries removal, tooth cleaning and decontamination. CONCLUSION: The laser erbium technology represents a safe device to effectively and selectively remove carious tissues from decayed teeth. For children, all the recognized advantages of this technique play a decisive role in the successful day-to-day treatment of dental caries.


Assuntos
Restauração Dentária Permanente/métodos , Terapia a Laser , Adolescente , Criança , Assistência Odontológica para Crianças , Cárie Dentária/diagnóstico , Cárie Dentária/terapia , Humanos , Terapia a Laser/métodos , Lasers , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade
18.
Eur Arch Paediatr Dent ; 12(2): 79-84, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21473837

RESUMO

BACKGROUND: Dental trauma in children is a frequent and often complex clinical event in which laser-assisted therapy, particularly using erbium lasers, can offer new treatment possibilities, improving the outcomes and reducing the associated complications. REVIEW: In particular, it is worth considering that the use of laser-assisted therapies is associated with a marked reduction in the use of analgesics and anti-inflammatory medications compared with conventional procedures. Laser anaesthesia is another interesting and challenging area. CONCLUSION: Given the paucity of data on laser-assisted dental trauma therapy in the international literature and the absence of well-structured guidelines, this is an area ripe for scientific research.


Assuntos
Terapia a Laser/métodos , Terapia com Luz de Baixa Intensidade/métodos , Traumatismos Dentários/terapia , Analgésicos/uso terapêutico , Anestesia Dentária/métodos , Anti-Inflamatórios/uso terapêutico , Criança , Humanos , Lasers de Estado Sólido/uso terapêutico , Periodonto/lesões , Fraturas dos Dentes/terapia
19.
Arthritis Rheum ; 63(7): 1793-803, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21452293

RESUMO

OBJECTIVE: To assess the efficacy, safety, and biologic activity of atacicept in patients with rheumatoid arthritis (RA) in whom the response to treatment with tumor necrosis factor antagonists was inadequate. METHODS: The Atacicept for Reduction of Signs and Symptoms in Rheumatoid Arthritis Trial (AUGUST I) was a multicenter, phase II, double-blind, placebo-controlled dose-finding study involving 256 patients randomized 1:1:1:1 to receive atacicept (25 mg, 75 mg, or 150 mg) or placebo twice weekly for 4 weeks, then weekly for 21 weeks, with a 13-week treatment-free followup period (week 38). The primary end point was a response at week 26 according to the American College of Rheumatology criteria for 20% improvement in disease severity, using the C-reactive protein level. RESULTS: No statistically significant differences were observed in the efficacy end points at week 26 (P = 0.410 for overall treatment effect). However, atacicept significantly reduced immunoglobulin and rheumatoid factor (RF) levels, but not anti-citrullinated protein antibody levels, in a dose-dependent manner, with levels returning toward baseline values during followup. The effects of treatment on IgG-RF and IgA-RF were more pronounced than the effects on total IgG and IgA. Adverse events (AEs), including serious AEs, leading to withdrawal were more common among patients treated with atacicept compared with placebo. AEs were variable in nature, and no dose-dependent trends were observed. The frequency of infection-related AEs was similar across treatments. No notable effect of treatment on immunization status (protective versus nonprotective titer) was observed after initiation of treatment. CONCLUSION: This study did not meet the primary efficacy end point. However, clear biologic activity consistent with the proposed mechanism of action was observed. The results suggest that decreasing the expression of RF may not be sufficient to induce clinical improvement in RA. The safety of atacicept was considered acceptable in this patient population.


Assuntos
Antirreumáticos/administração & dosagem , Artrite Reumatoide/tratamento farmacológico , Proteínas Recombinantes de Fusão/administração & dosagem , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Adulto , Idoso , Antirreumáticos/uso terapêutico , Artrite Reumatoide/sangue , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Imunoglobulinas/sangue , Análise de Intenção de Tratamento , Masculino , Pessoa de Meia-Idade , Proteínas Recombinantes de Fusão/uso terapêutico , Fator Reumatoide/sangue , Resultado do Tratamento
20.
Eur J Paediatr Dent ; 11(1): 44-8, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20359282

RESUMO

AIM: Modern technology has perfected a new instrument that has become almost indispensable in modern dentistry, in accordance with the philosophy of minimally invasive therapy: the laser. The aim of this work is to evaluate the effectiveness and efficacy of laser technology to solve mucogingival problems associated with orthodontic treatment. Some laser wavelengths work both on hard and soft tissues (2780 nm, 2940 nm), other lasers, such as the 810 nm diode, have a very good surgical and haemostatic action on soft tissues and an important analgesic and biostimulating effect that can help the healing of both TMJ painful symptoms as well as the pain following active orthodontic treatment. Several cases connected to orthodontic therapy are presented. MATERIALS AND METHODS: Different laser systems (diode laser at 810 nm; Er,Cr:YSGG laser at 2780 nm; Erbium:YAG laser at 2940 nm) were used, both for soft tissue surgery and enamel etching, and for biostimulating effect. These wavelengths were used with different parameters for each case, according to international current studies in view of minimally invasive therapy. RESULTS: The cases reported showed very quick and good healing of the laser treated tissues. These treatments, necessary for the orthodontic therapy or for its completion, become extremely simple, safe and rapid and the orthodontic specialist can perform them himself. CONCLUSION: The laser technique is very effective in many operative and surgical procedures during orthodontic therapy. Further studies are however necessary to set the treatment protocols in orthodontic biostimulation.


Assuntos
Terapia a Laser , Ortodontia Corretiva , Adolescente , Criança , Dente Canino/cirurgia , Feminino , Seguimentos , Humanos , Freio Labial/cirurgia , Lasers Semicondutores/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Freio Lingual/anormalidades , Freio Lingual/cirurgia , Terapia com Luz de Baixa Intensidade , Masculino , Mandíbula/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos , Técnicas de Movimentação Dentária/instrumentação , Dente Impactado/cirurgia
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