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1.
Pharmazie ; 75(5): 172-176, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32393422

RESUMO

This is a report on the chemical stability and physical compatibility of intravenous tedizolid phosphate 0.8 mg/mL-sodium rifampicin 2.4 mg/mL and tedizolid phosphate 0.8 mg/mL-meropenem 4 mg/mL combinations in polypropylene 0.9% sodium chloride infusion bags stored at different storage conditions. Triplicate solutions of both admixtures were prepared in 0.9% sodium chloride polypropylene infusion bags and stored under light protection at room temperature (25±2 °C), refrigeration (2-8 °C) or freezing (-15 - -25 °C) conditions. The study was performed using a validated and stability-indicating liquid chromatography (LC) method. For both admixtures and for all storage conditions, at least 90% of the initial drug concentration of tedizolid phosphate remained unchanged throughout the entire study period. Stability of sodium rifampicin at 25±2 °C was determined to be seven hours and six days when it was stored at 2-8 °C. Under the same storage conditions, meropenem was stable for 12 h or 6 days, respectively. Under freezing conditions, sodium rifampicin was stable throughout all 28 days, while stability of meropenem was only 8 days. Solutions of 0.8 mg/mL tedizolid phosphate admixtured with 2.4 mg/mL rifampicin or 4 mg/mL meropenem, in polypropylene 0.9% sodium chloride infusion bags, are stable for at least 7 or 12 hours, respectively, when stored at 25±2 °C. When stored at 2-8 °C, stability was increased to 6 days for both admixtures.


Assuntos
Antibacterianos/química , Meropeném/química , Organofosfatos/química , Oxazóis/química , Rifampina/química , Antibacterianos/administração & dosagem , Cromatografia Líquida , Estabilidade de Medicamentos , Armazenamento de Medicamentos , Congelamento , Infusões Intravenosas , Meropeném/administração & dosagem , Organofosfatos/administração & dosagem , Oxazóis/administração & dosagem , Polipropilenos/química , Refrigeração , Rifampina/administração & dosagem , Cloreto de Sódio/química , Temperatura , Fatores de Tempo
2.
Mol Psychiatry ; 20(4): 424-32, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25048004

RESUMO

The postsynaptic density (PSD) contains a complex set of proteins of known relevance to neuropsychiatric disorders, and schizophrenia specifically. We enriched for this anatomical structure, in the anterior cingulate cortex, of 20 schizophrenia samples and 20 controls from the Stanley Medical Research Institute, and used unbiased shotgun proteomics incorporating label-free quantitation to identify differentially expressed proteins. Quantitative investigation of the PSD revealed more than 700 protein identifications and 143 differentially expressed proteins. Prominent among these were altered expression of proteins involved in clathrin-mediated endocytosis (CME) (Dynamin-1, adaptor protein 2) and N-methyl-D-aspartate (NMDA)-interacting proteins such as CYFIP2, SYNPO, SHANK3, ESYT and MAPK3 (all P<0.0015). Pathway analysis of the differentially expressed proteins implicated the cellular processes of endocytosis, long-term potentiation and calcium signaling. Both single-gene and gene-set enrichment analyses in genome-wide association data from the largest schizophrenia sample to date of 13,689 cases and 18,226 controls show significant association of HIST1H1E and MAPK3, and enrichment of our PSD proteome. Taken together, our data provide robust evidence implicating PSD-associated proteins and genes in schizophrenia, and suggest that within the PSD, NMDA-interacting and endocytosis-related proteins contribute to disease pathophysiology.


Assuntos
Regulação da Expressão Gênica/genética , Genômica , Giro do Cíngulo/patologia , Densidade Pós-Sináptica , Proteômica , Esquizofrenia , Animais , Antipsicóticos/farmacologia , Endocitose/efeitos dos fármacos , Endocitose/fisiologia , Feminino , Estudos de Associação Genética , Giro do Cíngulo/efeitos dos fármacos , Giro do Cíngulo/metabolismo , Haloperidol/farmacologia , Humanos , Masculino , N-Metilaspartato/genética , N-Metilaspartato/metabolismo , Proteínas do Tecido Nervoso/genética , Proteínas do Tecido Nervoso/metabolismo , Densidade Pós-Sináptica/genética , Densidade Pós-Sináptica/metabolismo , Densidade Pós-Sináptica/patologia , Ratos , Reprodutibilidade dos Testes , Esquizofrenia/genética , Esquizofrenia/metabolismo , Esquizofrenia/patologia , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/fisiologia , Sinaptotagminas/metabolismo , Espectrometria de Massas em Tandem
3.
Mol Psychiatry ; 19(1): 76-87, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23207651

RESUMO

Cognitive decline is a feared aspect of growing old. It is a major contributor to lower quality of life and loss of independence in old age. We investigated the genetic contribution to individual differences in nonpathological cognitive ageing in five cohorts of older adults. We undertook a genome-wide association analysis using 549 692 single-nucleotide polymorphisms (SNPs) in 3511 unrelated adults in the Cognitive Ageing Genetics in England and Scotland (CAGES) project. These individuals have detailed longitudinal cognitive data from which phenotypes measuring each individual's cognitive changes were constructed. One SNP--rs2075650, located in TOMM40 (translocase of the outer mitochondrial membrane 40 homolog)--had a genome-wide significant association with cognitive ageing (P=2.5 × 10(-8)). This result was replicated in a meta-analysis of three independent Swedish cohorts (P=2.41 × 10(-6)). An Apolipoprotein E (APOE) haplotype (adjacent to TOMM40), previously associated with cognitive ageing, had a significant effect on cognitive ageing in the CAGES sample (P=2.18 × 10(-8); females, P=1.66 × 10(-11); males, P=0.01). Fine SNP mapping of the TOMM40/APOE region identified both APOE (rs429358; P=3.66 × 10(-11)) and TOMM40 (rs11556505; P=2.45 × 10(-8)) as loci that were associated with cognitive ageing. Imputation and conditional analyses in the discovery and replication cohorts strongly suggest that this effect is due to APOE (rs429358). Functional genomic analysis indicated that SNPs in the TOMM40/APOE region have a functional, regulatory non-protein-coding effect. The APOE region is significantly associated with nonpathological cognitive ageing. The identity and mechanism of one or multiple causal variants remain unclear.


Assuntos
Envelhecimento/genética , Apolipoproteínas E/genética , Cognição/fisiologia , Polimorfismo de Nucleotídeo Único/genética , Estudos de Coortes , Inglaterra , Feminino , Frequência do Gene , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Humanos , Desequilíbrio de Ligação , Masculino , Proteínas de Membrana Transportadoras/genética , Proteínas do Complexo de Importação de Proteína Precursora Mitocondrial , Escócia
4.
Mol Psychiatry ; 17(3): 337-49, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21173776

RESUMO

Personality can be thought of as a set of characteristics that influence people's thoughts, feelings and behavior across a variety of settings. Variation in personality is predictive of many outcomes in life, including mental health. Here we report on a meta-analysis of genome-wide association (GWA) data for personality in 10 discovery samples (17,375 adults) and five in silico replication samples (3294 adults). All participants were of European ancestry. Personality scores for Neuroticism, Extraversion, Openness to Experience, Agreeableness and Conscientiousness were based on the NEO Five-Factor Inventory. Genotype data of ≈ 2.4M single-nucleotide polymorphisms (SNPs; directly typed and imputed using HapMap data) were available. In the discovery samples, classical association analyses were performed under an additive model followed by meta-analysis using the weighted inverse variance method. Results showed genome-wide significance for Openness to Experience near the RASA1 gene on 5q14.3 (rs1477268 and rs2032794, P=2.8 × 10(-8) and 3.1 × 10(-8)) and for Conscientiousness in the brain-expressed KATNAL2 gene on 18q21.1 (rs2576037, P=4.9 × 10(-8)). We further conducted a gene-based test that confirmed the association of KATNAL2 to Conscientiousness. In silico replication did not, however, show significant associations of the top SNPs with Openness and Conscientiousness, although the direction of effect of the KATNAL2 SNP on Conscientiousness was consistent in all replication samples. Larger scale GWA studies and alternative approaches are required for confirmation of KATNAL2 as a novel gene affecting Conscientiousness.


Assuntos
Estudo de Associação Genômica Ampla , Personalidade/genética , Adenosina Trifosfatases/genética , Adenosina Trifosfatases/fisiologia , Adulto , Idoso , Austrália , Cromossomos Humanos/genética , Simulação por Computador , Europa (Continente)/etnologia , Comportamento Exploratório , Feminino , Genótipo , Humanos , Katanina , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Inventário de Personalidade , Fenótipo , Polimorfismo de Nucleotídeo Único , Estudos de Amostragem , Estados Unidos , População Branca/genética
5.
Minerva Stomatol ; 61(1-2): 37-43, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22274309

RESUMO

Polymorphous low-grade adenocarcinoma (PLGA) is a rare, malignant salivary gland tumor, which is found almost exclusively in minor salivary glands, primarily those in the palate. We report a case of PLGA arising from minor salivary gland of the palate in a 63-year-old female patient. The tumor was resected through the oral cavity performing a bilateral maxillectomy and surgical defect was reconstructed using a free radial forearm flap combined with iliac crest bone graft. The patient was free of disease at 48 months follow-up. The histopathological features of PLGA, the importance of differential diagnosis from pleomorphic adenoma and adenoid cystic carcinoma and the type of reconstruction are discussed in this article.


Assuntos
Adenocarcinoma/patologia , Neoplasias Maxilares/patologia , Adenocarcinoma/cirurgia , Feminino , Humanos , Neoplasias Maxilares/cirurgia , Pessoa de Meia-Idade , Gradação de Tumores
7.
Clin Infect Dis ; 52(2): 163-70, 2011 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-21288838

RESUMO

BACKGROUND: Nongonococcal urethritis (NGU) is a common chlamydia-associated syndrome in men; however, Trichomonas vaginalis and Mycoplasma genitalium are associated with its etiology and should be considered in approaches to therapy. We sought to determine whether the addition of tinidazole, an anti-trichomonal agent, to the treatment regimen would result in higher cure rates than those achieved with treatment with doxycycline or azithromycin alone. A secondary aim was to compare the efficacy of doxycycline therapy and with that of azithromycin therapy. METHODS: Randomized, controlled, double-blinded phase IIB trial of men with NGU. Participants were randomized to receive doxycycline plus or minus tinidazole or azithromycin plus or minus tinidazole and were observed for up to 45 days. RESULTS: The prevalences of Chlamydia trachomatis, M. genitalium, and T. vaginalis were 43%, 31%, and 13%, respectively. No pathogens were identified in 29% of participants. Clinical cure rates at the first follow-up visit were 74.5% (111 of 149 patients) for doxycycline-containing regimens and 68.6% (107 of 156 patients) for azithromycin-containing regimens. By the final visit, cure rates were 49% (73 of 149 patients) for doxycycline-containing regimens and 43.6% (68 of 156 patients) for azithromycin-containing regimens. There were no significant differences in clinical response rates among the treatment arms. However, the chlamydia clearance rate was 94.8% (55 of 58 patients) for the doxycycline arm and 77.4% (41 of 53 patients) for the azithromycin arm (P = .011), and the M. genitalium clearance rate was 30.8% (12 of 39 patients) for the doxycycline arm and 66.7% (30 of 45 patients) for the azithromycin arm (P = .002). CONCLUSIONS: Addition of tinidazole to the treatment regimen did not result in higher cure rates but effectively eradicated trichomonas. Clinical cure rates were not significantly different between patients treated with doxycycline and those treated with azithromycin; however, doxycycline had significantly better efficacy against Chlamydia, whereas azithromycin was superior to doxycycline for the treatment of M. genitalium.


Assuntos
Antibacterianos/administração & dosagem , Antiprotozoários/administração & dosagem , Azitromicina/administração & dosagem , Doxiciclina/administração & dosagem , Tinidazol/administração & dosagem , Uretrite/tratamento farmacológico , Adolescente , Adulto , Infecções por Chlamydia/tratamento farmacológico , Chlamydia trachomatis/isolamento & purificação , Método Duplo-Cego , Quimioterapia Combinada/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycoplasma/tratamento farmacológico , Mycoplasma genitalium/isolamento & purificação , Resultado do Tratamento , Tricomoníase/tratamento farmacológico , Trichomonas vaginalis/isolamento & purificação , Uretrite/microbiologia , Uretrite/parasitologia , Adulto Jovem
8.
Radiologia ; 53(6): 544-51, 2011.
Artigo em Espanhol | MEDLINE | ID: mdl-21565373

RESUMO

OBJECTIVE: To analyze the role of core needle biopsy of axillary lymph nodes with suspected metastases from breast cancer and to correlate the imaging and histologic findings. MATERIAL AND METHODS: We retrospectively studied 74 patients diagnosed with breast cancer who underwent ultrasound-guided core needle biopsy of axillary lymph nodes with characteristics suggestive of metastases on ultrasonography. The following ultrasonographic findings were considered suspicious for metastases: cortical thickening and changes in the hilar fat and/or non-hilar cortical vascular flow. Patients with negative findings after axillary biopsy underwent sentinel node biopsy. RESULTS: Core needle biopsy confirmed lymph node metastases in 47 (63.5%) patients. The 27 patients (36.5%) with negative findings after lymph node biopsy underwent sentinel node biopsy; 3 (11%) of these had a positive sentinel lymph node and underwent axillary lymph node resection. Of the 50 lymph nodes with metastases, 44 (88%) had cortical thickening, 20 (40%) had changes in the hilar fat, and 29 (58%) had non-hilar cortical vascular flow. All biopsies of lymph nodes with both cortical thickening and non-hilar cortical vascular flow were positive, yielding a 100% positive predictive value in this series. CONCLUSIONS: Ultrasound-guided core needle biopsy of axillary lymph nodes that are suspicious for metastases from breast cancer at ultrasonography is a highly effective procedure that has low morbidity. Findings of cortical thickening and non-hilar cortical vascular flow in the same lymph node yield a positive predictive value of 100% in this series.


Assuntos
Biópsia por Agulha/métodos , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Carcinoma/diagnóstico por imagem , Carcinoma/patologia , Linfonodos/patologia , Cuidados Pré-Operatórios/métodos , Biópsia de Linfonodo Sentinela/métodos , Ultrassonografia de Intervenção , Adulto , Idoso , Idoso de 80 Anos ou mais , Axila , Neoplasias da Mama/cirurgia , Carcinoma/cirurgia , Feminino , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos
9.
Ultrasonics ; 102: 105680, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29361330

RESUMO

Lactic acid, psychrophilic, and mesophilic bacteria, Escherichia coli, Salmonella spp. and Staphylococcus aureus were enumerated on chicken breasts after treatment with different high intensity ultrasound (frequency 40 kHz, intensity 9.6 W/cm-2) application times (0, 30, and 50 min) and packaging atmospheres (aerobic and vacuum) after a 7-day storage. The experiment was performed in commercial 7-week-old chicken breasts. Counts were performed prior to and immediately after ultrasonication, and on the 7th day of chill-storage. After sonication and storage, mesophiles, psychrophiles, LAB and S. aureus increased statistically. Psychrophiles decreased significantly under anaerobic packaging. There were no differences among ultrasonication times in terms of mesophiles, psychrophiles, LAB, E. coli and Salmonella spp. S. aureus numbers had a significant reduction after 50 min sonication. Under these experimental conditions, high-intensity ultrasound for 50 min is a control method of S. aureus and the anaerobic packaging reduces numbers of psychrophiles in chicken breast. The effect of ultrasound is only significant after the storage time.


Assuntos
Contaminação de Alimentos/prevenção & controle , Microbiologia de Alimentos , Carne/microbiologia , Sonicação , Animais , Temperatura Baixa , Contagem de Colônia Microbiana , Escherichia coli , Embalagem de Alimentos , Aves Domésticas , Salmonella , Staphylococcus aureus
10.
Food Sci Nutr ; 8(2): 786-795, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32148788

RESUMO

This research aimed to evaluate the physicochemical characteristics and their relationship with sensory properties of cured porcine m. longissimus lumborum assisted by high-intensity ultrasound (HIU, 37 kHz, 22 Wcm-2). An experiment was designed with three factors at two levels each: type of curing (immersion or ultrasound-assisted -UA-), immersion time (30 or 90 min), and steak thickness (1.27 or 2.54 cm). After treatment and 7 days of storage at 4°C, the percentage of salt, pH, CIE L* a* b* color, water holding capacity (WHC), and shear force were determined in the samples. A quantitative descriptive analysis was performed using eight trained panelists. The HIU significantly increased the percentage of NaCl (p < .0005) and decreased the color saturation of the meat (p < .05), but did not affect the luminosity, redness (a*), yellowness (b*), pH, WHC, or shear force (all p > .05). The thickness of the steak had significant effects on almost all of the evaluated variables. Samples with 1.27 cm thickness had lower shear force, higher WHC and salt percentage (p < .0001). In agreement with this, the sensory profiles showed that the 1.27 cm samples treated with HIU for 30 min were perceived as less tough (more tender) and juicier.

12.
Aust Vet J ; 97(9): 301-307, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31328260

RESUMO

Chronic enteropathy (CE) in dogs is common worldwide, but little data is available from Australia. The aim of this study was to describe treatment response and long-term outcome in a cohort of dogs with CE. Dogs were prospectively enrolled at Murdoch University and the University of Melbourne. After diagnostic investigation to rule out diseases other than CE, dogs underwent sequential therapeutic trials until achieving a clinical response (diet then antibiotics, and finally immunosuppressants). Success was defined as 75% reduction of clinical severity for a minimum of five weeks. A total of 21 dogs were enrolled, and 19 completed the study. One dog was euthanised for lack of response to treatment and one excluded for lack of owner compliance. Most dogs responded to diet (n = 10), followed by antibiotics (n = 7) and immunosuppressants (n = 2). Long-term remission (median 21.1 months, [3.0-44.7]) was achieved in eight out of ten dietary responders without additional treatment. In contrast, only two dogs with antibiotic response remained in long-term remission, of which one needed on-going antibiotic treatment. Longer term remission was achieved in the two dogs treated with immunosuppressants with on-going low dose therapy. This study concludes that most dogs referred for CE in Australia respond to dietary treatment (even after previous dietary interventions), and remission is long-term compared to dogs treated with an antibiotic. Furthermore, the need for long-term antibiotics in some dogs to maintain response may lead to antibiotic resistance. This study supports adequate dietary trials for CE in dogs, and a need for alternative second-line treatments.


Assuntos
Doenças do Cão/dietoterapia , Gastroenteropatias/veterinária , Animais , Antibacterianos/uso terapêutico , Austrália , Doença Crônica , Estudos de Coortes , Doenças do Cão/diagnóstico , Doenças do Cão/tratamento farmacológico , Cães , Feminino , Gastroenteropatias/diagnóstico , Gastroenteropatias/dietoterapia , Gastroenteropatias/tratamento farmacológico , Doenças Inflamatórias Intestinais/veterinária , Masculino , Estudos Prospectivos , Resultado do Tratamento , Vitória
13.
Cochrane Database Syst Rev ; (1): CD006586, 2008 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-18254106

RESUMO

BACKGROUND: Premenstrual syndrome (PMS) is a common problem. Premenstrual dysphoric disorder (PMDD) is a severe form of PMS. Combined oral contraceptives (COCs), which have both progestin and estrogen, have been examined for their ability to relieve premenstrual symptoms. A COC containing drospirenone and low estrogen has been approved for treating PMDD in women who choose COCs for contraception. OBJECTIVES: To review all randomized controlled trials comparing combined oral contraceptives containing drospirenone versus a placebo or another COC for effect on premenstrual symptoms. SEARCH STRATEGY: We searched the computerized databases MEDLINE, POPLINE, CENTRAL, EMBASE, LILACS, PsycINFO, and CINAHL for studies of drospirenone and premenstrual syndrome. We also examined references lists of relevant articles, and wrote to known investigators to find other trials. SELECTION CRITERIA: We included randomized controlled trials in any language that compared a COC containing drospirenone versus a placebo or another COC for effect on premenstrual symptoms. Primary outcome was the prospective recording of premenstrual symptoms (affective and physical). Adverse events related to COC use were examined. DATA COLLECTION AND ANALYSIS: Two review authors independently abstracted data and assessed study quality. MAIN RESULTS: We included five trials with a total of 1600 women. Two placebo-controlled trials of women with PMDD showed less severe premenstrual symptoms after three months with drospirenone (plus ethinyl estradiol (EE) 20g) than with the placebo (WMD -7.83; 95% CI -10.91 to -4.75). The drospirenone group had greater decreases in impairment of productivity (WMD -0.42; 95% CI -0.64 to -0.20), social activities (WMD -0.39; 95% CI -0.62 to -0.15), and relationships (WMD -0.38; 95% CI -0.61 to -0.51). Side effects more common with COC use were nausea, intermenstrual bleeding, and breast pain. Little effect was found on less severe symptoms when comparing drospirenone plus more estrogen to another COC. A six-month study showed fewer symptoms with drospirenone, while a two-year trial found the groups to be similar. AUTHORS' CONCLUSIONS: Drospirenone plus EE 20 mug may help treat premenstrual symptoms in women with PMDD. The placebo also had a large effect. We do not know whether the COC works after three cycles, for women with less severe symptoms, or better than other COCs. Larger and longer trials of higher quality are needed to address these issues. Trials should follow CONSORT reporting guidelines.


Assuntos
Androstenos/uso terapêutico , Anticoncepcionais Orais Combinados/uso terapêutico , Síndrome Pré-Menstrual/tratamento farmacológico , Androstenos/efeitos adversos , Anticoncepcionais Orais Combinados/efeitos adversos , Feminino , Humanos , Síndrome Pré-Menstrual/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto
14.
Cochrane Database Syst Rev ; (1): CD003552, 2008 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-18254023

RESUMO

BACKGROUND: The delivery of combination contraceptive steroids from a skin patch or vaginal ring offers potential advantages over the traditional oral route. The skin patch and vaginal ring could require a lower dose due to increased bioavailability and improved user compliance. OBJECTIVES: To compare the contraceptive effectiveness, cycle control, compliance, and safety of the skin patch or the vaginal ring versus combination oral contraceptives (COCs). SEARCH STRATEGY: We searched MEDLINE, POPLINE, CENTRAL, EMBASE, and LILACS for trials of the contraceptive patch or the vaginal ring. We contacted manufacturers and researchers to identify other trials. SELECTION CRITERIA: All randomized controlled trials comparing the skin patch or vaginal ring with a COC. DATA COLLECTION AND ANALYSIS: Data were abstracted by two authors and entered into RevMan. For dichotomous variables, the Peto odds ratio (OR) with 95% confidence intervals (CI) was calculated. For continuous variables, the weighted mean difference was computed. MAIN RESULTS: We found three trials of the skin patch and eight of the vaginal ring. Contraceptive effectiveness was similar for the patch or ring and the comparison COC. Patch users reported more compliant cycles than COC users; ORs were 2.05 (95% CI 1.83 to 2.29) and 2.76 (95% CI 2.35 to 3.24) in two trials. One crossover ring trial had more noncompliance for the ring users. Satisfaction with method was higher for ring users than COC users in two studies. More patch users discontinued early than COC users: OR 1.58 (95% CI 1.25 to 1.99) and 1.45 (95% CI 1.11 to 1.90) in two trials. Patch users also had more discontinuation due to adverse events (AEs). The ring trials generally showed similar discontinuation for ring and COC users. Compared to COC users, patch users were more likely to report breast discomfort, dysmenorrhea, nausea, and vomiting. Ring users reported less nausea, irritability, and depression than COC users in single trials. However, ring users had more vaginitis and leukorrhea. Bleeding problems were generally similar or less common for the ring versus COC. AUTHORS' CONCLUSIONS: Effectiveness rates were similar for the methods compared. The patch group had better compliance than the COC group. Compared to COC users, patch users had more side effects. Ring users generally had fewer adverse events than COC users but more vaginal irritation and discharge. The patch could lead to more discontinuation while the vaginal ring showed little difference. High losses to follow up can affect the validity of the results.


Assuntos
Anticoncepcionais Femininos/administração & dosagem , Dispositivos Anticoncepcionais Femininos , Implantes de Medicamento , Comportamento do Consumidor , Anticoncepcionais Femininos/efeitos adversos , Dispositivos Anticoncepcionais Femininos/efeitos adversos , Anticoncepcionais Orais Combinados/administração & dosagem , Anticoncepcionais Orais Combinados/efeitos adversos , Implantes de Medicamento/efeitos adversos , Feminino , Humanos , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto
15.
Cochrane Database Syst Rev ; (2): CD006964, 2008 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-18425974

RESUMO

BACKGROUND: Knowledge of contraceptive effectiveness is crucial to making an informed choice. The consumer has to comprehend the pros and cons of the contraceptive methods being considered. Choice may be influenced by understanding the likelihood of pregnancy with each method and factors that influence effectiveness. OBJECTIVES: To review all randomized controlled trials comparing strategies for communicating to consumers the effectiveness of contraceptives in preventing pregnancy. SEARCH STRATEGY: We searched the computerized databases MEDLINE, POPLINE, CENTRAL, PsycINFO, and EMBASE for studies of communicating contraceptive effectiveness. We also examined references lists of relevant articles, and wrote to known investigators for information about other published or unpublished trials. SELECTION CRITERIA: We included randomized controlled trials that compared methods for communicating contraceptive effectiveness to consumers. The comparison could be usual practice or an alternative to the experimental intervention. DATA COLLECTION AND ANALYSIS: Data were abstracted by two authors and entered into RevMan. For dichotomous variables, the Peto odds ratio (OR) with 95% confidence intervals (CI) was calculated. For continuous variables, the weighted mean difference (WMD) was computed. MAIN RESULTS: Five trials met the inclusion criteria. In one study, knowledge gain favored a slide-and-sound presentation versus a physician's oral presentation (WMD -19.00; 95% CI -27.52 to -10.48). Another trial showed a table with effectiveness categories led to more correct answers than one based on numbers [ORs were 2.42 (95% CI 1.43 to 4.12) and 2.19 (95% CI 1.21 to 3.97)] or a table with categories and numbers [ORs were 2.58 (95% CI 1.5 to 4.42) and 2.03 (95% CI 1.13 to 3.64)]. One trial examined contraceptive choice: women in the expanded program were more likely to choose sterilization (OR 4.26; 95% CI 2.46 to 7.37) or use a modern contraceptive method (OR 2.35; 95% CI 1.82 to 3.03). No trial had an explicit theoretical base, but each used concepts from common theories or models. AUTHORS' CONCLUSIONS: We have limited evidence about what works to help consumers choose an appropriate contraceptive method. For presenting pregnancy risk data, one trial showed that categories were better than numbers. In another trial, audiovisual aids worked better than the usual oral presentation. Strategies for communicating information should be examined in clinical settings and assessed for effect on contraceptive choice and retention of knowledge. To expand the knowledge base of what works in contraceptive counseling, randomized trials could intentionally use and test theories or models.


Assuntos
Comunicação , Anticoncepção/métodos , Anticoncepcionais , Atitude , Anticoncepção/psicologia , Feminino , Humanos , Avaliação de Programas e Projetos de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
16.
Cochrane Database Syst Rev ; (2): CD006260, 2008 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-18425943

RESUMO

BACKGROUND: Health care providers often tell women to wait until the next menses to begin hormonal contraception. The main intent is to avoid contraceptive use during an undetected pregnancy. An alternative is to start hormonal contraception immediately with back-up birth control for the first seven days. Immediate initiation was first introduced with combined oral contraceptives (COCs), and has expanded to other hormonal contraceptives. How immediate start compares to conventional menses-dependent start is unclear regarding effectiveness, continuation, and acceptability. The immediate-start approach may improve women's access to, and continuation of, hormonal contraception. OBJECTIVES: This review examined randomized controlled trials of immediate-start hormonal contraception for differences in effectiveness, continuation, and acceptability. SEARCH STRATEGY: We searched MEDLINE, CENTRAL, POPLINE, EMBASE, and LILACS for trials of immediate-start hormonal contraceptives. We contacted researchers to find other studies. SELECTION CRITERIA: We included randomized controlled trials that compared immediate start to conventional start of hormonal contraception. Also included were trials that compared immediate start of different hormonal contraceptive methods with each other. DATA COLLECTION AND ANALYSIS: Data were abstracted by two authors and entered into RevMan. The Peto odds ratio (OR) with 95% confidence interval (CI) was calculated. MAIN RESULTS: Five studies were included. Method discontinuation was similar between groups in all trials. Bleeding patterns and side effects were similar in trials that compared immediate with conventional start. In a study of depot medroxyprogesterone acetate (DMPA), immediate start of DMPA showed fewer pregnancies than a 'bridge' method before DMPA (OR 0.36; 95% CI 0.16 to 0.84). Further, more women in the immediate-DMPA group were very satisfied versus those with a 'bridge' method (OR 1.99; 95% CI 1.05 to 3.77).A trial of two immediate-start methods showed the vaginal ring group had less prolonged bleeding (OR 0.42; 95% CI 0.20 to 0.89) and less frequent bleeding (OR 0.23; 95% CI 0.05 to 1.03) than COC users. The ring group also reported fewer side effects. For satisfaction, more immediate ring users were very satisfied than immediate COC users (OR 2.88; 95% CI 1.59 to 5.22). AUTHORS' CONCLUSIONS: We found limited evidence that immediate start of hormonal contraception reduces unintended pregnancies or increases method continuation. However, the pregnancy rate was lower with immediate start of DMPA versus another method. Some differences were associated with contraceptive type rather than initiation method, that is, immediate ring versus immediate COC. More studies are needed of immediate versus conventional start of the same hormonal contraceptive.


Assuntos
Anticoncepção/métodos , Anticoncepcionais Orais Hormonais/administração & dosagem , Menstruação , Gravidez não Planejada , Feminino , Humanos , Fatores de Tempo
17.
J Cardiovasc Surg (Torino) ; 49(4): 483-7, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18665111

RESUMO

AIM: The aim of this study was to show the initial experience of a therapeutic alternative in the surgical treatment of thoracic aorta coarctation in adult patients by means of a Talent endoprosthesis implant and angioplasty, maintaining the advantages of minimally invasive surgery, avoiding recurrence, offering safety and protection against dissections, tearing, or even aortic ruptures and, hence, minimizing risks and complications from a thoracic aorta surgery through thoracotomy. METHODS: The authors present a series of 12 cases of thoracic aorta coarctation in adult patients, treated with endovascular surgery by means of a Talent endoprosthesis implant using a transfemoral or iliac access. Age, gender, gradient release, perioperative mortality and morbidity, presence of palpable pulses in the limbs, claudication, and follow-up time. RESULTS: Eight men and four women, average age of 23.6 years (18 to 38). The average diameter of the normal aorta was 21.65 mm (13.5-24.5 mm) and the smallest diameter at the coarctation site was 3.4 mm (0 to 8 mm). No complications occurred and no patient required blood transfusion. The time spent in the intensive care unit for postoperative monitoring averaged 15 h (12 to 18 h) and hospital stay averaged 2.33 days (1 to 4 days). All patients presented palpable pulses of normal characteristics during the postoperative period. No residual pressure gradient was present requiring treatment. In this series, neither trans nor postoperative complications occurred, and the follow-up time averaged 52 months (6 to 93 months). CONCLUSION: Endovascular treatment of thoracic aorta coarctation with protected dilatation is a safe and effective procedure.


Assuntos
Angioplastia com Balão/instrumentação , Angioplastia , Aorta Torácica , Coartação Aórtica/terapia , Prótese Vascular , Stents , Adolescente , Adulto , Angioplastia com Balão/efeitos adversos , Aorta Torácica/diagnóstico por imagem , Coartação Aórtica/diagnóstico por imagem , Aortografia/métodos , Feminino , Humanos , Masculino , Desenho de Prótese , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento
18.
J Hazard Mater ; 155(3): 580-9, 2008 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-18207635

RESUMO

The ignition of firedamp by permissible explosives is assessed by means of gallery testing conducted by the Bruceton up-and-down method. Six test series were made in order to analyze the influence of several blasting practices in long-holes coal blasting, namely: use of slotted PVC pipes, detonating cord, salt cartridges and double (top and bottom) initiation. The parameters of the distributions of the probability of ignition are determined by the maximum likelihood method; normal, logistic, lognormal and Weibull distributions have been used. Confidence bands for the probability points are obtained both from the asymptotic standard errors of the parameters and by a bootstrap-like technique. The four distributions used give similar results in a rather ample probability range; discrepancies in the probability points are within 2% and in the confidence limits within 10% in a range of probability [0.1, 0.9] in most of the cases. The use of detonating cord is found to affect significantly the probability of ignition; the double initiation does also have an influence though not statistically significant at a 95% level; the use of salt cartridges, in the amount tested, has little effect in the ignition probability; the use of PVC pipe shows no effect.


Assuntos
Substâncias Explosivas , Funções Verossimilhança , Probabilidade
20.
Oncogene ; 37(2): 271-276, 2018 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-28925392

RESUMO

Atypical E2F transcription factors (E2F7 and E2F8) function as key regulators of cell cycle progression and their inactivation leads to spontaneous cancer formation in mice. However, the mechanism of the tumor suppressor functions of E2F7/8 remain obscure. In this study we discovered that atypical E2Fs control tumor angiogenesis, one of the hallmarks of cancer. We genetically inactivated atypical E2Fs in epithelial and mesenchymal neoplasm and analyzed blood vessel formation in three different animal models of cancer. Tumor formation was either induced by application of 7,12-Dimethylbenz(a)anthracene/12-O-Tetradecanoylphorbol-13-acetate or by Myc/Ras overexpression. To our surprise, atypical E2Fs suppressed tumor angiogenesis in all three cancer models, which is in a sharp contrast to previous findings showing that atypical E2Fs promote angiogenesis during fetal development in mice and zebrafish. Real-time imaging in zebrafish displayed that fluorescent-labeled blood vessels showed enhanced intratumoral branching in xenografted E2f7/8-deficient neoplasms compared with E2f7/8-proficient neoplasms. DLL4 expression, a key negative inhibitor of vascular branching, was decreased in E2f7/8-deficient neoplastic cells, indicating that E2F7/8 might inhibit intratumoral vessel branching via induction of DLL4.


Assuntos
Fator de Transcrição E2F7/metabolismo , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Proteínas de Membrana/metabolismo , Neoplasias/patologia , Neovascularização Patológica/patologia , Proteínas Repressoras/metabolismo , Proteínas Adaptadoras de Transdução de Sinal , Animais , Proteínas de Ligação ao Cálcio , Carcinógenos/toxicidade , Linhagem Celular Tumoral , Fator de Transcrição E2F7/genética , Fibroblastos , Regulação Neoplásica da Expressão Gênica , Humanos , Queratinócitos , Camundongos , Camundongos Knockout , Camundongos Nus , Neoplasias/irrigação sanguínea , Neoplasias/induzido quimicamente , Neoplasias/genética , Neoplasias Experimentais/irrigação sanguínea , Neoplasias Experimentais/induzido quimicamente , Neoplasias Experimentais/genética , Neoplasias Experimentais/patologia , Neovascularização Patológica/genética , Cultura Primária de Células , Proteínas Repressoras/genética , Ensaios Antitumorais Modelo de Xenoenxerto , Peixe-Zebra
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