RESUMO
The present study aims to evaluate the efficacy of selenium (Se) alone or combined with carbamazepine (CBZ) against the adverse effects induced by the chemoconvulsant pentylenetetrazole (PTZ) in the cortex of adult male rats. Electrocorticogram (ECoG) and oxidative stress markers were implemented to evaluate the differences between treated and untreated animals. Animals were divided into five groups: control group that received i.p. saline injection, PTZ-treated group that received a single i.p. injection of PTZ (60 mg/kg) for induction of seizures followed by a daily i.p. injection of saline, Se-treated group that received an i.p. injection of sodium selenite (0.3 mg/kg/day) after PTZ administration, CBZ-treated group that received orally CBZ (80 mg/kg/day) after PTZ administration, and combination (Se plus CBZ)-treated group that received an oral administration of CBZ (80 mg/kg/day) followed by an i.p. injection of sodium selenite (0.3 mg/kg/day) after PTZ administration. Quantitative analyses of the ECoG indices and the neurochemical parameters revealed that Se and CBZ have mitigated the adverse effects induced by PTZ. The main results were decrease in the number of epileptic spikes, restoring the normal distribution of slow and fast ECoG frequencies and attenuation of most of the oxidative stress markers. However, there was an increase in lipid perioxidation marker in combined treatment of CBZ and Se. The electrophysiological and neurochemical data proved the potential of these techniques in evaluating the treatment's efficiency and suggest that supplementation of Se with antiepileptic drugs (AEDs) may be beneficial in ameliorating most of the alterations induced in the brain as a result of seizure insults and could be recommended as an adjunct therapy with AEDs.
Assuntos
Anticonvulsivantes/uso terapêutico , Carbamazepina/uso terapêutico , Modelos Animais de Doenças , Epilepsia/tratamento farmacológico , Selênio/uso terapêutico , Animais , Anticonvulsivantes/administração & dosagem , Carbamazepina/administração & dosagem , Eletrodos , Eletroencefalografia , Epilepsia/induzido quimicamente , Epilepsia/cirurgia , Injeções Intraperitoneais , Masculino , Pentilenotetrazol , Ratos , Ratos Wistar , Selênio/administração & dosagemRESUMO
There is an increasing evidence linking protective effect of selenium (Se) against Pb toxicology; however, Pb exposure risk assessments usually consider only the environmental Pb contamination and dietary intake. Based on the current understanding of mechanisms of SePb interactions, the physiological function/toxicology of Se and the toxicology of Pb, a new criterion for Se and Pb exposure assessment is developed. Additionally, seven existing criteria were also used to assess the resident health risks around a smelter in China. The Pb concentrations in locally-produced foods exceeded the national tolerance limits of China and the Se in the foods were similar to those in areas with adequate Se levels. In accordance with the illustrated assessments of the new criterion and seven existing criteria, we found a large knowledge gap between the new and traditional assessments of exposure to Pb and/or Se. The new assessment criteria suggested that almost all the residents were facing the Se deficiency and 58% of the residents not only had the adverse health of Se deficiency, but also had the health risks of Pb toxicity. The Pb and Se in the hair and urine may partly support the new criterion. This study suggested that the process of Se counteracting the Pb toxicity may result in Se deficiency. Pb exposure combined Se intake should be considered in future assessments of Pb exposure (or Se intake).
Assuntos
Exposição Ambiental/normas , Chumbo/toxicidade , Medição de Risco/normas , Selênio/deficiência , Selênio/uso terapêutico , China , HumanosRESUMO
AIMS: To investigate the production responses and cost-benefit of administering a controlled-release anthelmintic capsule (CRC) to pregnant yearling ewes prior to lambing. METHODS: Yearling ewes from two commercial sheep flocks (A, n=489; B, n=248) in the North Island of New Zealand were enrolled in the study. Prior to lambing, CRC containing albendazole and abamectin were administered to half the ewes while the other half remained untreated. Ewe liveweights and body condition scores were measured prior to lambing, at weaning and, for Flock B, prior to subsequent mating. Lambs were matched to dams shortly after birth and the weight and number of lamb weaned per ewe were determined. A cost-benefit analysis was undertaken for Flock B considering the increased weight of lamb weaned per ewe, and the weight of ewes at the next mating and the benefit in terms of lambs born. RESULTS: The mean weight at weaning of treated ewes was greater for treated than untreated ewes by 2.76 (95% CI 0.64-4.88)â kg in Flock A (p<0.001) and 2.35 (95% CI -0.41-5.12)â kg in Flock B (p=0.003); the weight of lamb weaned per ewe was greater for treated than untreated ewes by 1.43 (95% CI -0.71 to -3.49)â kg in Flock A (p=0.041) and 3.97 (95% CI 1.59-6.37)â kg in Flock B (p<0.001), and ewe liveweight prior to subsequent mating was greater for treated than untreated ewes in Flock B by 4.60 (95% CI 3.6-5.6)â kg (p<0.001). There was no difference in the percentage of lambs reared to weaning between treated and untreated ewes in either flock (p>0.8). The overall cost-benefit of treatment for Flock B was NZ$9.44 per treated ewe. CONCLUSIONS AND CLINICAL RELEVANCE: Pre-lambing CRC administration to yearling ewes resulted in increased ewe weaning weights and weight of lamb weaned in both the flocks studied. There was an economic benefit in the one flock where this was assessed.
Assuntos
Albendazol/uso terapêutico , Cobalto/uso terapêutico , Helmintíase Animal/prevenção & controle , Ivermectina/análogos & derivados , Selênio/uso terapêutico , Doenças dos Ovinos/prevenção & controle , Albendazol/administração & dosagem , Albendazol/economia , Animais , Anti-Helmínticos/economia , Anti-Helmínticos/uso terapêutico , Cobalto/administração & dosagem , Cobalto/economia , Análise Custo-Benefício , Preparações de Ação Retardada , Feminino , Helmintíase Animal/economia , Ivermectina/administração & dosagem , Ivermectina/economia , Ivermectina/uso terapêutico , Nova Zelândia/epidemiologia , Gravidez , Selênio/administração & dosagem , Selênio/economia , Ovinos , Doenças dos Ovinos/economia , Doenças dos Ovinos/epidemiologiaRESUMO
INTRODUCCIÓN: En el Hospital Nacional Edgardo Rebagliati Martins ESSALUD nacen aproximadamente 7 mil niños anualmente, de los cuales el 10 % requiere de una atención especial en la unidad de cuidados intensivos neonatales y donde también el 2.5 % son bebes prematuros que nacen con pesos menores de 1500 gramos y que requieren cuidados extremos como el de recibir soporte nutricional vía parenteral. La nutrición parenteral (NP) es una técnica de soporte vital y nutricional artificial, en la que los nutrientes se administran por vía endovenosa para cubrir las necesidades energéticas y mantener un estado nutricional adecuado en aquellos pacientes donde la vía enteral es insuficiente, inadecuada o está contraindicada. Existen diversas circunstancias o condiciones clínicas que hacen que un niño no pueda alimentarse de manera normal (vía oral) y deba recibir, vía parenteral, el soporte nutricional que necesita. Los elementos claves de una óptima nutrición, según la Organización Mundial de la Salud (OMS), están conformados por los macro y micronutrientes, estos últimos representados por las vitaminas, minerales y oligoelementos. Los oligoelementos son componentes químicos conformados principalmente por zinc, cobre, iodo, selenio, manganeso, entre otros, y que cumplen diversas funciones dentro del organismo entre las que destacan su participación en diversos sistemas enzimáticos. Actualmente, en EsSalud no se cuenta con soluciones de administración endovenosa que aporten oligoelementos en la NP para pacientes pediátricos. De este modo, los especialistas manifiestan la necesidad de contar con un suplemento nutricional que brinde estos elementos de acuerdo a las necesidades de cada paciente, y que, además, éste sea específicamente de uso pediátrico. TECNOLOGÍA SANITARIA DE INTERÉS: Los oligoelementos son micronutrientes o elementos químicos que en cantidades muy pequeñas resultan indispensables para diversas funciones dentro del organismo. Estos compuestos participan principalmente como catalizadores en sistemas enzimáticos (WHO, 1996). Estos son principalmente zinc, selenio, cobre, iodo y manganeso (NCBI, 1989), importantes para el presente dictamen. METODOLOGÍA: Se llevó a cabo una búsqueda sistemática de la literatura con respecto a la eficacia y seguridad del uso de oligoelementos pediátricos endovenosos que aporten zinc, cobre, iodo, manganeso y selenio a recién nacidos o lactantes que reciben nutrición parenteral. La búsqueda se inició revisando la información sobre el uso del medicamento de acuerdo con entidades reguladoras como: Food and Drug Administration (FDA); European Medicines Agency (EMA); Dirección General de Medicamentos y Drogas (DIGEMID); Organización Mundial de la Salud (OMS). Se realizó tanto una búsqueda sistemática como una búsqueda manual en las páginas web de grupos dedicados a la investigación y educación en salud que elaboran guías de práctica clínica descritas a continuación: National Guideline Clearinghouse (NGC); National Institute for Health and Care Excellence (NICE); Canadian Agency for Drugs and Technologies in Health (CADTH); Scottish Medicines Consortium (SMC). RESULTADOS: De acuerdo con la pregunta PICO, se llevó a cabo una búsqueda de evidencia científica relacionada al uso de oligoelementos pediátricos endovenosos que aporten zinc, cobre, iodo, manganeso y selenio a recién nacidos o lactantes que reciben nutrición parenteral. En la presente sinopsis se describe la evidencia disponible según el tipo de publicación, siguiendo lo indicado en los criterios de elegibilidad (GPC, ETS, RS, MA y ECA fase III). CONCLUSIONES: El presente dictamen tuvo como objetivo evaluar la mejor evidencia científica disponible hasta setiembre del 2019 en relación a la eficacia y seguridad del uso de oligoelementos pediátricos que aporten zinc, cobre, iodo, manganeso y selenio a pacientes pediátricos que reciben nutrición parenteral. La evidencia proveniente de dos RS y dos ECA, la cual también ha sido utilizada como evidencia en las GPC identificadas, sugieren de manera conjunta que el aporte de oligoelementos en la NP en neonatos y lactantes es necesario a fin de dar el soporte nutricional adecuado, tomando en consideración las concentraciones específicas para cada etapa de la vida, así como la edad gestacional al nacimiento, el peso al nacer y las condiciones fisiológicas de fondo. El aporte de cada oligoelemento trae beneficios específicos en cuanto a la función biológica que desempeñan cada uno dentro del organismo, entre los que se encuentran, optimización de las funciones bioquímicas relacionadas al crecimiento y desarrollo, mejora del sistema inmunológico, mejora del desarrollo neurológico. No obstante, el exceso o la falta de cada uno de los oligoelementos trae consigo consecuencias biológicas asociadas a toxicidad tales como, principalmente, problemas neurológicos (exceso de manganeso), mortalidad y problemas tiroideos (deficiencia de iodo), incremento de infecciones (deficiencia de zinc), y mayor de dependencia de oxígeno (deficiencia de selenio). Es necesario brindar el aporte específico requerido de oligoelementos a los neonatos y lactantes utilizando la mejor opción disponible comercialmente, que se ajuste a las necesidades recomendadas. Por lo expuesto, el Instituto de Evaluaciones de Tecnologías en Salud e Investigación - IETSI, aprueba el uso de oligoelementos pediátricos que aporten zinc, cobre, iodo, manganeso y selenio en neonatos y lactantes que reciben nutrición parenteral, según lo establecido en el Anexo N° 1. La vigencia del presente dictamen preliminar es de dos años a partir de la fecha de publicación. Así, la continuación de dicha aprobación estará sujeta a los resultados obtenidos de los pacientes que reciban este tratamiento y de nueva evidencia que pueda surgir en el tiempo.
Assuntos
Humanos , Selênio/uso terapêutico , Oligoelementos/administração & dosagem , Zinco/uso terapêutico , Nutrição Parenteral/instrumentação , Cobre/uso terapêutico , Nutrição do Lactente , Iodo/uso terapêutico , Manganês/uso terapêutico , Avaliação da Tecnologia Biomédica , Avaliação em Saúde , Análise Custo-BenefícioRESUMO
IMPORTANCE: African American men have the highest rates of prostate cancer incidence and mortality in the United States. Understanding underlying reasons for this disparity could identify preventive interventions important to African American men. OBJECTIVE: To determine whether the association of obesity with prostate cancer risk differs between African American and non-Hispanic white men and whether obesity modifies the excess risk associated with African American race. DESIGN, SETTING, AND PARTICIPANTS: Prospective study of 3398 African American and 22,673 non-Hispanic white men who participated in the Selenium and Vitamin E Cancer Prevention Trial (2001-2011) with present analyses completed in 2014. MAIN OUTCOMES AND MEASURES: Total, low-grade (Gleason score <7), and high-grade (Gleason score ≥7) prostate cancer incidence. RESULTS: With a median (interquartile range) follow-up of 5.6 (1.8) years, there were 270, 148, and 88 cases of total, low-, and high-grade prostate cancers among African American men and a corresponding 1453, 898, and 441 cases in non-Hispanic white men, respectively. Although not associated with risk among non-Hispanic white men, BMI was positively associated with an increase in risk among African American men (BMI, <25 vs ≥35: hazard ratio [HR], 1.49 [95% CI, 0.95, 2.34]; P for trend = .03). Consequently, the risk associated with African American race increased from 28% (HR, 1.28 [95% CI, 0.91-1.80]) among men with BMI less than 25 to 103% (HR, 2.03 [95% CI, 1.38-2.98]) among African American men with BMI at least 35 (P for trend = .03). Body mass index was inversely associated with low-grade prostate cancer risk within non-Hispanic white men (BMI, <25 vs ≥35: HR, 0.80 [95% CI, 0.58-1.09]; P for trend = .02) but positively associated with risk within African American men (BMI, <25 vs ≥35: HR, 2.22 [95% CI, 1.17-4.21]; P for trend = .05). Body mass index was positively associated with risk of high-grade prostate cancer in both non-Hispanic white men (BMI, <25 vs ≥35: HR, 1.33 [95% CI, 0.90-1.97]; P for trend = .01) and African American men, although the increase may be larger within African American men, albeit the racial interaction was not statistically significant (BMI, <25 vs ≥35: HR, 1.81 [95% CI, 0.79-4.11]; P for trend = .02). CONCLUSIONS AND RELEVANCE: Obesity is more strongly associated with increased prostate cancer risk among African American than non-Hispanic white men and reducing obesity among African American men could reduce the racial disparity in cancer incidence. Additional research is needed to elucidate the mechanisms underlying the differential effects of obesity in African American and non-Hispanic white men.
Assuntos
Anticarcinógenos/uso terapêutico , Negro ou Afro-Americano , Disparidades nos Níveis de Saúde , Obesidade/etnologia , Neoplasias da Próstata/etnologia , Neoplasias da Próstata/prevenção & controle , Vitamina E/uso terapêutico , População Branca , Idoso , Índice de Massa Corporal , Canadá/epidemiologia , Distribuição de Qui-Quadrado , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico , Modelos de Riscos Proporcionais , Estudos Prospectivos , Neoplasias da Próstata/diagnóstico , Porto Rico/epidemiologia , Medição de Risco , Fatores de Risco , Selênio/uso terapêutico , Fatores de Tempo , Resultado do Tratamento , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Until recently, there was limited documented data on both dietary and serum selenium deficiency in bariatric surgery. We performed an evaluation of selenium intake and both serum selenium and glutathione peroxidase (GTP; as a functional measurement of selenium) before and after roux-en-Y (RNY) gastric bypass and gastric banding surgery. METHODS: The endpoints obtained from the subjects included dietary intake of selenium and vitamins E and C, as well as serum levels of selenium, GTP and vitamins E. These were analyzed at pre-surgery (baseline) and 3 and 12 months post surgery. RESULTS: Dietary deficiencies in selenium intake (38.2 % recommended daily allowance) were noted at 3 months, but not baseline or 12 months, in the gastric bypass group. No dietary deficiencies were noted in the lap band group. For both surgeries, there was a significant reduction from baseline to 3 months in both serum selenium and GTP levels (p = 0.033 and 0.0033 respectively). The serum selenium levels and GTP levels both trended back toward baseline values by 12 months without concomitant selenium supplementation. Mean GTP levels were below normal at all three time points while mean serum selenium levels were all at or above normal. CONCLUSIONS: This study shows that RNY gastric bypass and laparoscopic adjustable gastric banding procedures, and accompanying dietary restrictions, increases the risk for disturbances of selenium and GTP homeostasis. Consideration for selenium supplementation at higher levels than the current RDA of 55 mcg daily during the first 3 months and perhaps longer should be studied further.
Assuntos
Derivação Gástrica , Gastroplastia , Glutationa Peroxidase/sangue , Obesidade Mórbida/sangue , Selênio/sangue , Dieta Redutora , Suplementos Nutricionais , Feminino , Derivação Gástrica/efeitos adversos , Gastroplastia/efeitos adversos , Humanos , Laparoscopia , Masculino , Obesidade Mórbida/dietoterapia , Obesidade Mórbida/cirurgia , Projetos Piloto , Período Pós-Operatório , Período Pré-Operatório , Estudos Prospectivos , Selênio/deficiência , Selênio/uso terapêutico , Redução de PesoRESUMO
BACKGROUND: The effect of antioxidant vitamin and mineral supplementation on health is one of the most controversial issues in human nutrition. Our objective was to investigate the effect of nutritional doses of a combination of antioxidant vitamins and minerals on health-related quality of life (HRQoL) in a sample of healthy French adults. METHODS: SU.VI.MAX is a randomized, double-blind, placebo-controlled, primary prevention trial in which a total of 8112 participants received a single capsule daily containing either placebo or vitamin C 120 mg, vitamin E 30 mg, beta-carotene 6 mg, selenium 100 µg and zinc 20 mg. Participants completed HRQoL questionnaires (SF36 and GHQ12) at baseline and after a mean of 76.0 ± 4.2 months. RESULTS: Scores for physical dimensions tended to decrease over time, whereas those for mental dimensions tended to improve. No differences in changes over time were observed between the supplement and placebo groups. Participants who believed that they received placebo had lower HRQoL scores than did those who thought they had received supplements [SF36 Bodily pain (-3.3), General health (-2.2), Vitality (-1.6) dimensions and physical component summary score (-1.1) in men, and in SF36 Social functioning (-2.3), General health (-1.4) dimensions and physical component summary score (-0.7) in women]. CONCLUSIONS: Long-term supplementation with antioxidant vitamins and minerals had no beneficial effect on HRQoL in this trial. This is contrary to conventional beliefs and claims that such an effect exists. Trial Registration "Primary Prevention Trial of the Health Effects of Antioxidant Vitamins and Minerals." NTC n 00272428 http://www.clinicaltrials.gov.
Assuntos
Antioxidantes/uso terapêutico , Suplementos Nutricionais/estatística & dados numéricos , Minerais/administração & dosagem , Qualidade de Vida , Adulto , Fatores Etários , Antioxidantes/administração & dosagem , Ácido Ascórbico/administração & dosagem , Ácido Ascórbico/uso terapêutico , Método Duplo-Cego , Feminino , França , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Minerais/uso terapêutico , Efeito Placebo , Prevenção Primária/métodos , Selênio/administração & dosagem , Selênio/uso terapêutico , Fatores Sexuais , Fatores Socioeconômicos , Vitamina E/administração & dosagem , Vitamina E/uso terapêutico , Zinco/administração & dosagem , Zinco/uso terapêutico , beta Caroteno/administração & dosagem , beta Caroteno/uso terapêuticoRESUMO
BACKGROUND: Colorectal cancer (CRC) is the third most common cancer in the UK: incidence increases with age, median age at diagnosis being over 70 years. Approximately 25% of cases occur in individuals with a family history of CRC, including 5% caused by familial adenomatous polyposis (FAP) or hereditary non-polyposis CRC (HNPCC). Most develop from adenomatous polyps arising from the intestine lining. Individuals with these polyps undergo polypectomy and are invited for endoscopic surveillance. Screening via faecal occult blood testing has been rolled out across the UK. OBJECTIVES: To evaluate the clinical effectiveness and cost-effectiveness of drug and micronutrient interventions for the prevention of CRC and/or adenomatous polyps. Interventions considered include: non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin and cyclo-oxygenase-2 (COX-2) inhibitors; folic acid; calcium; vitamin D and antioxidants (including vitamin A, vitamin C, vitamin E, selenium and beta-carotene). Chemoprevention was assessed in the general population, in individuals at increased risk of CRC, and in individuals with FAP or HNPCC. DATA SOURCES: A systematic review identified randomised controlled trials (RCTs) assessing drug and nutritional agents for the prevention of CRC or adenomatous polyps. A separate search identified qualitative studies relating to individuals' views, attitudes and beliefs about chemoprevention. MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, CINAHL, the Cochrane Database of Systematic Reviews, Cochrane CENTRAL Register of Controlled Trials, DARE, NHS-EED (NHS Economic Evaluation Database), HTA database, Science Citation Index, BIOSIS previews and the Current Controlled Trials research register were searched in June 2008. Data were extracted by one reviewer and checked by a second. REVIEW METHODS: The synthesis methods used were systematic review and meta-analysis for RCTs and qualitative framework synthesis for qualitative studies. A health economic model was developed to assess the cost-effectiveness of chemoprevention for two populations with different levels of risk of developing CRC: the general population and an intermediate-risk population. RESULTS: The search identified 44 relevant RCTs and six ongoing studies. A small study of aspirin in FAP patients produced no statistically significant reduction in polyp number but a possible reduction in polyp size. There was a statistically significant 21% reduction in risk of adenoma recurrence [relative risk (RR) 0.79, 95% confidence interval (CI) 0.68 to 0.92] in an analysis of aspirin versus no aspirin in individuals with a history of adenomas or CRC. In the general population, a significant 26% reduction in CRC incidence was demonstrated in studies with a 23-year follow-up (RR 0.74, 95% CI 0.57 to 0.97). Non-aspirin NSAID use in FAP individuals produced a non-statistically significant reduction in adenoma incidence after 4 years of treatment and follow-up and reductions in polyp number and size. In individuals with a history of adenomas there was a statistically significant 34% reduction in adenoma recurrence risk (RR 0.66, 95% CI 0.60 to 0.72) and a statistically significant 55% reduction in advanced adenoma incidence (RR 0.45, 95% CI 0.35 to 0.58). No studies assessed the effect of non-aspirin NSAIDs in the general population. There were no studies of folic acid in individuals with FAP or HNPCC. There was no significant effect of folic acid versus placebo on adenoma recurrence (RR 1.16, 95% CI 0.97 to 1.39) or advanced adenoma incidence in individuals with a history of adenomas. In the general population there was no significant effect of folic acid on risk of CRC (RR 1.13, 95% CI 0.77 to 1.64), although studies were of relatively short duration. Calcium use by FAP patients produced no significant reduction in polyp number or disease progression. In individuals with a history of adenomas there was a statistically significant 18% reduction in risk of adenoma recurrence (RR 0.82, 95% CI 0.69 to 0.98) and a non-significant reduction in risk of advanced adenomas (RR 0.77, 95% CI 0.50 to 1.17). In the general population there was no significant effect of calcium on risk of CRC (RR 1.08, 95% CI 0.87 to 1.34), although studies were of relatively short duration. There were no studies of antioxidant use in individuals with FAP or HNPCC, and in individuals with a history of adenomas no statistically significant differences in relative risk of adenoma recurrence were found. In the general population there was no difference in incidence of CRC (RR 1.00, 95% CI 0.88 to 1.13) with antioxidant use compared with no antioxidant use. Twenty studies reported qualitative findings concerning chemoprevention. People are more likely to use NSAIDs if there is a strong perceived need. Perceptions of risk and benefit also influence decision-making and use. People have fewer concerns about using antioxidants or other supplements, but their perception of the benefits of these agents is less well-defined. The model analysis suggested that the most cost-effective age-range policy in the general population would be to provide chemoprevention to all individuals within the general population from age 50 to 60 years. The use of aspirin in addition to screening within the general population is likely to result in a discounted cost per life-year gained of around 10,000 pounds and a discounted cost per quality-adjusted life-year (QALY) gained of around 23,000 pounds compared with screening alone. In the intermediate-risk group the most economically viable age-range policy would be to provide chemoprevention to individuals following polypectomy aged 61 to 70 years. Calcium is likely to have a discounted cost per QALY gained of around 8000 pounds compared with screening alone. Although aspirin in addition to screening should be more effective and less costly than screening alone, under the current assumptions of benefits to harms of aspirin and calcium, aspirin is expected to be extendedly dominated by calcium. LIMITATIONS: Whilst a number of studies were included in the review, the duration of follow-up was generally insufficient to detect an effect on cancer incidence. Given the uncertainties and ambiguities in the evidence base, the results of the health economic analysis should be interpreted with caution. CONCLUSIONS: Aspirin and celecoxib may reduce recurrence of adenomas and incidence of advanced adenomas in individuals with an increased risk of CRC and calcium may reduce recurrence of adenomas in this group. COX-2 inhibitors may decrease polyp number in patients with FAP. There is some evidence for aspirin reducing the incidence of CRC in the general population. Both aspirin and NSAIDs are associated with adverse effects so it will be important to consider the risk-benefit ratio before recommending these agents for chemoprevention. The economic analysis suggests that chemoprevention has the potential to represent a cost-effective intervention, particularly when targeted at intermediate-risk populations following polypectomy.
Assuntos
Neoplasias Colorretais/prevenção & controle , Polipose Adenomatosa do Colo/economia , Polipose Adenomatosa do Colo/epidemiologia , Polipose Adenomatosa do Colo/prevenção & controle , Anti-Inflamatórios/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Antioxidantes/uso terapêutico , Cálcio/uso terapêutico , Neoplasias Colorretais/economia , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais Hereditárias sem Polipose/economia , Neoplasias Colorretais Hereditárias sem Polipose/epidemiologia , Neoplasias Colorretais Hereditárias sem Polipose/prevenção & controle , Inibidores de Ciclo-Oxigenase 2/uso terapêutico , Ácido Fólico/uso terapêutico , Humanos , Incidência , Modelos Econômicos , Prognóstico , Medição de Risco , Selênio/uso terapêutico , Reino Unido/epidemiologia , beta Caroteno/uso terapêuticoRESUMO
BACKGROUND: African American accrual to prevention trials at rates representative of the disease burden experienced by this population requires additional resources and focused efforts. PURPOSE: To describe the rationale, context, and criteria for selection of sites that received Minority Recruitment Enhancement Grants (MREGs) to increase African American recruitment to the Selenium and Vitamin E Cancer Prevention Trial (SELECT). To determine if African American accrual was higher among the 15 MREG sites when compared with similar nonawarded sites. METHODS: Changes in African American accrual at sites that received MREGs are compared with changes in a group of 15, frequency-matched, nonawarded sites using a quasi-experimental, post hoc analysis. Successful and unsuccessful recruitment strategies reported by the MREG sites are described. RESULTS: The increased number of African American participants accrued per month at MREG sites post-funding was higher than the change at comparison sites by a factor of 3.38 (p = 0.004, 95% CI: 1.51-7.57). An estimated 602 additional African American participants were recruited at MREG sites due to MREG funding, contributing to the overall 14.9% African American recruitment. Successful recruitment strategies most reported by MREG sites included increasing staff, transportation resources, recruiting through the media, mailings, and prostate cancer screening clinics during off-hours. LIMITATIONS: Comparison sites were chosen retrospectively, not by randomization. Although comparison sites were selected to be similar to MREG sites with regard to potential confounding factors, it is possible that unknown factors could have biased results. Cost-effective analyses were not conducted. CONCLUSIONS: MREG sites increased African American accrual in the post-funding period more than comparison sites, indicating MREG funding enhanced the sites' abilities to accrue African American participants. Targeted grants early in the accrual period may be a useful multi-site intervention to increase African American accrual for a prevention study where adequate African American representation is essential.
Assuntos
Antioxidantes/uso terapêutico , Negro ou Afro-Americano , Neoplasias/prevenção & controle , Seleção de Pacientes , Neoplasias da Próstata/prevenção & controle , Apoio à Pesquisa como Assunto/economia , Selênio/uso terapêutico , Vitamina E/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , Neoplasias/etnologia , Neoplasias da Próstata/etnologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Estados UnidosRESUMO
Prostate cancer is among the most common causes of death from cancer in men, and accounts for 10% of all new male cancers worldwide. The diagnosis and treatment of prostate cancer place a substantial physical and emotional burden on patients and their families, and have considerable financial implications for healthcare providers and society. Given that the risk of prostate cancer continues to increase with age, the burden of the disease is likely to increase in line with population life-expectancy. Reducing the risk of prostate cancer has gained increasing coverage in recent years, with proof of principle shown in the Prostate Cancer Prevention Trial with the type 2 5alpha-reductase (5AR) inhibitor, finasteride. The long latency period, high disease prevalence, and significant associated morbidity and mortality make prostate cancer a suitable target for a risk-reduction approach. Several agents are under investigation for reducing the risk of prostate cancer, including selenium/vitamin E and selective oestrogen receptors modulators (e.g. toremifene). In addition, the Reduction by Dutasteride of Prostate Cancer Events trial, involving >8000 men, is evaluating the effect of the dual 5AR inhibitor, dutasteride, on the risk of developing prostate cancer. A successful risk-reduction strategy might decrease the incidence of the disease, as well as the anxiety, cost and morbidity associated with its diagnosis and treatment.
Assuntos
Azasteroides/uso terapêutico , Colestenona 5 alfa-Redutase/antagonistas & inibidores , Inibidores Enzimáticos/uso terapêutico , Finasterida/uso terapêutico , Neoplasias da Próstata/prevenção & controle , Idoso , Dutasterida , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/economia , Neoplasias da Próstata/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Selênio/uso terapêutico , Toremifeno/uso terapêutico , Vitamina E/uso terapêuticoRESUMO
The goal of this study was to investigate the effect of selenium deficit replenishment in patients with bronchial asthma (BA) on manifestations of oxidative stress and conditions of the antioxidant system (AOS). The need of correction of selenium deficit in BA-patient is determined by the increased needs in antioxidants due to chronic inflammatory process responcible for pathogenesis of BA. Latvia and also Eastern Finland, Byelorussia, some regions of Ukraine, some regions of the NorthWestern Russia, New Zealand belong to endemic areas with marked selen deficit in soils and foodstuff. Twenty patients (7 men and 13 women) with selen deficit and verified diagnosis of BA have been examined. In addition to basic therapy all patients received organic selenium SelenoPRECISE, ("PharmaNord") 200 microg daily for 16 weeks. This caused statistically significant increase of plasma selenium from 50.94+/-7.58 microg/l to 63.59+/-10.87 microg/l (p<0.001), the increase of selenium-dependent glutathione peroxidase (from 38.64+/-10.72 U/g Hb to 58.57+/-14.64 U/g Hb, p<0.001). Treatment of patients with selenium also normalized parameters charecterizing oxidative stress (chemiluminescence). The use of selenium in addition to basic therapy allows to abolish or alternate manifestations of oxidative stress by correcting the antioxidant system.
Assuntos
Asma/tratamento farmacológico , Estresse Oxidativo/efeitos dos fármacos , Selênio/uso terapêutico , Asma/metabolismo , Catalase/sangue , Feminino , Glutationa Peroxidase/sangue , Humanos , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Estudos Prospectivos , Selênio/deficiência , Selênio/farmacologiaRESUMO
The efficacy of two free radical scavengers, selenium and zinc, and a microsomal epoxide hydrolase-inducing agent, cis-stilbene oxide on the acute toxicity of T-2 toxin, a potent cytotoxic trichothecene, was investigated. Mice were pretreated daily for 3 consecutive days with either zinc sulfate (4.4 mg/kg, intraperitoneally [i.p.]), sodium selenite (1, 2, and 3 mg/kg i.p.) or cis-stilbene oxide (50 mg/kg i.p.). A full 24-hr after the final dosing with these agents, mice were given T-2 toxin (2, 2.5, or 3 mg/kg i.p.). The acute lethal toxicity of T-2 toxin (2.5 mg/kg) was reduced by administration of only sodium selenite (3 mg/kg) and cis-stilbene oxide (50 mg/kg). No significant effect on weight gain was observed.
Assuntos
Selênio/uso terapêutico , Estilbenos/uso terapêutico , Toxina T-2/toxicidade , Zinco/uso terapêutico , Animais , Relação Dose-Resposta a Droga , Epóxido Hidrolases/metabolismo , Sequestradores de Radicais Livres/uso terapêutico , Masculino , Camundongos , Camundongos Endogâmicos , Microssomos/enzimologia , Intoxicação/prevenção & controleAssuntos
Intoxicação por Cádmio/prevenção & controle , Cádmio/toxicidade , Carcinógenos/toxicidade , Cloretos/toxicidade , Mesocricetus , Reprodução/efeitos dos fármacos , Selênio/toxicidade , Análise de Variância , Animais , Cádmio/administração & dosagem , Cloreto de Cádmio , Intoxicação por Cádmio/tratamento farmacológico , Carcinógenos/administração & dosagem , Diferenciação Celular/efeitos dos fármacos , Cloretos/administração & dosagem , Cricetinae , Epididimo/efeitos dos fármacos , Epididimo/patologia , Injeções Subcutâneas , Masculino , Tamanho do Órgão/efeitos dos fármacos , Próstata/efeitos dos fármacos , Próstata/patologia , Distribuição Aleatória , Selênio/administração & dosagem , Selênio/uso terapêutico , Glândulas Seminais/efeitos dos fármacos , Glândulas Seminais/patologia , Contagem de Espermatozoides/efeitos dos fármacos , Espermatozoides/citologia , Espermatozoides/efeitos dos fármacos , Coloração e Rotulagem , Testículo/efeitos dos fármacos , Testículo/patologiaRESUMO
The occurrence and incidence of pneumonia in housed calves were not related to the selenium status of the herd as measured by blood glutathione peroxidase activity nor were they affected by selenium treatment of calves during the neonatal period. Pneumonia was related more closely to herd size and building design.