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1.
Article in Chinese | WPRIM | ID: wpr-927339

ABSTRACT

Heat-sensitive moxibustion is the appropriate technique of the external treatment in traditional Chinese medicine and it is widely used in community because of its "easy learning, simple operation and clear curative effect". Pragmatic randomized controlled trial is a main intervention design in the real world study, which provides a high-level evidence for the effectiveness assessment of heat-sensitive moxibustion in community management. Focusing on the key links of randomization, e.g. block randomization, stratified randomization, cluster randomization, sample size allocation, allocation concealment and blinding, the paper elaborates the advantages, disadvantages and technical details of two-stage randomization with consideration of patient preference in pragmatic randomized controlled trials of heat-sensitive moxibustion in community. It facilitates improving the quality of evidence, reproducibility and methodological homogeneity among different trials.


Subject(s)
Hot Temperature , Humans , Moxibustion , Patient Preference , Random Allocation , Reproducibility of Results
2.
Rev. bras. oftalmol ; 81: e0035, 2022. tab
Article in English | LILACS | ID: biblio-1376791

ABSTRACT

ABSTRACT Objective: To evaluate the efficacy of mitomycin C in anatomical and functional success after modified transcanalicular diode laser dacryocystorhinostomy. Methods: A prospective, double-blinded, randomized placebo-controlled study compared the effect of topical mitomycin C on modified transcanalicular diode laser dacryocystorhinostomy. Group 1 had modified transcanalicular diode laser dacryocystorhinostomy with topical saline, while Group 2 had modified transcanalicular diode laser dacryocystorhinostomy with topical mitomycin C. Success was defined as anatomical patency and relief of symptoms at the end of 6 months. Results: Six months after surgery, Group 1 (30 patients) showed anatomical and functional success rates of 86.7% and 83.3%, respectively. Group 2 (32 patients) showed anatomical and functional success rates of 87.5% and 84.3%, respectively. There was no statistically significant difference between the groups 1 and 2 (p = 1.000). Conclusion: The use of mitomycin C did not improve the anatomical and functional success rates of modified transcanalicular diode laser dacryocystorhinostomy compared to placebo.


RESUMO Objetivo: Avaliar a eficácia da mitomicina C no sucesso anatômico e funcional após dacriocistorrinostomia transcanalicular com laser de diodo. Métodos: Estudo prospectivo, duplo-cego, randomizado e controlado por placebo. Comparou o efeito da mitomicina C tópica na dacriocistorrinostomia transcanalicular com laser de diodo. No Grupo 1, foi utilizada apenas solução salina tópica, enquanto no Grupo 2 foi utilizada mitomicina C tópica. O sucesso foi definido como permeabilidade da via lacrimal e alívio dos sintomas ao final de 6 meses. Resultados: Seis meses após a cirurgia, o Grupo 1 (30 pacientes) apresentou taxas de sucesso anatômico e funcional de 86,7% e 83,3%, respectivamente. O Grupo 2 (32 pacientes) apresentou taxas de sucesso anatômico e funcional de 87,5% e 84,3%, respectivamente. Não houve diferença estatística significante entre os Grupos 1 e 2 (p=1,000). Conclusão: O uso de mitomicina C não melhora as taxas de sucesso anatômico e funcional do dacriocistorrinostomia transcanalicular com laser de diodo em comparação ao placebo.


Subject(s)
Humans , Male , Female , Middle Aged , Dacryocystorhinostomy/methods , Mitomycin/administration & dosage , Mitomycin/therapeutic use , Mitomycin/pharmacology , Lasers, Semiconductor/therapeutic use , Nasolacrimal Duct/drug effects , Placebos , Random Allocation , Double-Blind Method , Prospective Studies , Follow-Up Studies , Treatment Outcome , Chemotherapy, Adjuvant , Dacryocystitis/surgery , Laser Therapy/methods , Lacrimal Duct Obstruction/therapy , Nasolacrimal Duct/surgery
3.
Acta Paul. Enferm. (Online) ; 35: eAPE0010345, 2022. tab, graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1374001

ABSTRACT

Resumo Objetivo Avaliar parâmetros hematológicos de crianças desnutridas após intervenção nutricional com farinha da castanha de caju. Métodos Ensaio clínico randomizado, controlado, cego. O estudo foi realizado no período de abril a dezembro de 2017, em duas Unidades Básicas de Saúde. A amostra foi composta de crianças menores de 5 anos que preencheram os critérios de inclusão, sendo 15 no Grupo Intervenção (farinha da castanha de caju) e 15 crianças no Grupo Controle (farinha de carboximetilcelulose), alocadas nos grupos de forma randômica aleatória simples. Foram analisados os parâmetros de eritrócitos, hemoglobina e hematócrito (série vermelha) e de leucócitos, neutrófilos, segmentados, eosinófilos, monócitos e linfócitos (série branca). A coleta de sangue foi realizada em dois momentos: o primeiro antes da implementação da intervenção e o segundo após 32 semanas de utilização da farinha da castanha de caju. Para avaliação da normalidade e homogeneidade da amostra, utilizaram-se os testes de Shapiro-Wilk e de variância de Bartlett, respectivamente. Utilizou-se o teste T pareado dentro de cada grupo e, para avaliar possíveis associações entre os Grupos Intervenção e Controle e o nível de leucócitos (abaixo, normal e acima), utilizaram-se o teste exato de Fisher e/ou o teste Fisher-Freeman-Halton. Resultados Houve incremento na média das células individuais da série vermelha do hemograma, sobretudo nos padrões de hemoglobina de crianças desnutridas do Grupo Intervenção (p<0,05). A investigação também apontou diferença intragrupo no parâmetro da hemoglobina, tanto no Grupo Controle (p=0,007) como no Intervenção (p<0,001), bem como no parâmetro hematócrito para ambos os grupos (p=0,001). Especificamente na série branca, após a intervenção, evidenciou-se diminuição significativa nos leucócitos (p=0,04) e linfócitos (p<0,01) Conclusão Após intervenção, a utilização da farinha da castanha de caju melhorou os parâmetros hematológicos das crianças desnutridas. Registro Brasileiro de Ensaios Clínicos (REBEC): U1111.1213.9219


Resumen Objetivo Evaluar parámetros hematológicos de niños desnutridos después de la intervención nutricional con harina da castaña de cajú. Métodos Ensayo clínico aleatorizado, controlado, ciego. El estudio se realizó en el período de abril a diciembre de 2017, en dos Unidades Básicas de Salud. La muestra se compuso por niños menores de 5 años que cumplieron con los criterios de inclusión, 15 en el Grupo Intervención (harina de castaña de cajú) y 15 niños en el Grupo Control (harina de carboximetilcelulosa), repartidas en los grupos de forma muestreo aleatorio simple. Se analizaron los parámetros de eritrocitos, hemoglobina e hematocrito (serie roja) y de leucocitos, neutrófilos, segmentados, eosinófilos, monocitos e linfocitos (serie blanca). La muestra de sangre se realizó en dos momentos: el primero antes de la implementación de la intervención y el segundo después de 32 semanas de utilización de la harina da castaña de cajú. Para la evaluación de la normalidad y la homogeneidad de la amuestra, se utilizaron los tests de Shapiro-Wilk y de varianza de Bartlett, respectivamente. Se utilizó la prueba T pareada dentro de cada grupo y, para evaluar posibles asociaciones entre los Grupos Intervención y Control y el nivel de leucocitos (debajo, normal y superior), se utilizó la prueba exacta de Fisher o prueba de Fisher-Freeman-Halton. Resultados Hubo un aumento en el promedio de las células individuales de la serie roja del hemograma, sobre todo en los estándares de hemoglobina de niños desnutridos del Grupo Intervención (p<0,05). La investigación también apuntó una diferencia intragrupo en el parámetro de la hemoglobina, tanto en el Grupo Control (p=0,007) como en la Intervención (p<0,001), así como en el parámetro hematocrito para ambos grupos (p=0,001). Específicamente en la serie blanca, después de la intervención, se evidenció una disminución significativa en los leucocitos (p=0,04) y linfocitos (p<0,01) Conclusión Después de la intervención, la utilización de la harina de la castaña de cajú mejoró los parámetros hematológicos de los niños desnutridos.


Abstract Objective To assess hematological parameters of malnourished children after nutritional intervention with cashew nut flour. Methods This is a randomized, controlled, blind trial. The study was conducted from April to December 2017, in two Basic Health Units. The sample consisted of children under 5 years of age who met the inclusion criteria, 15 in the Intervention Group (cashew nut flour) and 15 children in the Control Group (carboxymethylcellulose flour), randomly allocated to the groups. The parameters of erythrocytes, hemoglobin and hematocrit (red blood cells) and leukocytes, neutrophils, segmented, eosinophils, monocytes and lymphocytes (white blood cells) parameters were analyzed. Blood collection was performed in two moments: the first before intervention implementation and the second after 32 weeks of use of cashew nut flour. To assess the sample normality and homogeneity, Shapiro-Wilk and Bartlett variance tests were used, respectively. The paired t-test was used within each group and, to assess possible associations between the Intervention and Control Groups and the level of leukocytes (below, normal and above), Fisher's Exact test and/or Fisher-Freeman-Halton test were used. Results There was an increase in the mean of the individual red blood cell count, especially in the hemoglobin patterns of malnourished children in the Intervention Group (p<0.05). The investigation also showed an intragroup difference in the hemoglobin parameter, both in the Control Group (p=0.007) and in the Intervention (p<0.001) as well as in the hematocrit parameter for both groups (p=0.001). Specifically in the white blood cells, after intervention, there was a significant decrease in leukocytes (p=0.04) and lymphocytes (p<0.01) Conclusion After intervention, the use of cashew nut flour improved the hematological parameters of malnourished children. Brazilian Clinical Trial Registry (REBEC): U1111.1213.9219


Subject(s)
Humans , Male , Female , Child, Preschool , Blood Cell Count , Child Nutrition Disorders , Random Allocation , Dietary Supplements , Hematologic Tests
4.
Rev. bras. oftalmol ; 81: e0054, 2022. tab
Article in English | LILACS | ID: biblio-1387978

ABSTRACT

ABSTRACT Purpose Evaluate blue-violet light filter and additional power of +0.40 D in the near zone ophthalmic lenses, on convergence, accommodative functions, and symptoms of digital asthenopia (DA). Methods Randomized study in cross-over design conducted on 49 volunteers (age, 29 ± 5.5 years; male: female, 18:31). Each subject wore test (+0.40 D in the near zone) and control lenses (regular single vision) for 4 weeks in randomized order. Both lenses had a selective blue-violet light filter. A baseline measurement was taken with the subjects' current updated glasses. Accommodation amplitude (AA) and near point of convergence (NPC) were measured binocularly with the RAF ruler. DA was evaluated by a questionnaire. Results No significant difference (p=.52) was found for AA comparing baseline (11.50±1.88 D), test (11.61± 1.62 D), and control SV lenses (11.88±1.50 D). No significant difference was found for NPC (p=.94), between baseline (6.50 ± 2.89cm), test (6.71± 3.49) and control SV lenses (6.82± 3.50 cm). No significant difference was found comparing test and control SV lenses in symptoms of DA (p=0.20). Conclusions The +0.40 D lenses have no negative impact on convergence or loss of accommodation power. The +0.40 D and control SV lenses had a similar impact on attenuating symptoms of DA.


RESUMO Objetivo Avaliar os efeitos do uso de lentes oftálmicas com filtro seletivo de luz azul-violeta, sem e com poder adicional de + 0,4D na zona de perto nas funções de acomodação e convergência e para sintomas de astenopia digital (AD). Métodos Ensaio clínico controlado, randomizado e mascarado, com 49 voluntários (idade, 29 ± 5,5 anos; masculino: feminino, 18: 31). Cada participante usou lentes de teste (+0,40 D na zona de perto) e controle (visão simples), por 4 semanas de forma randomizada. Ambas as lentes tinham filtro seletivo de luz azul-violeta. A medição inicial (baseline) foi feita com os óculos atualizados de cada participante. A amplitude de acomodação (AA) e o ponto de convergência próximo (PPC) foram medidos binocularmente com a régua RAF. A AD foi avaliada por um questionário. Resultados Não houve diferença estatisticamente significante (p=0,52) para as medidas de AA comparando as lentes baseline (11,50±1,88 D), teste (11,61±1,62 D) e controle VS (11,88±1,50 D). Nenhuma diferença significativa foi encontrada para a medida do PPC (p=0,94), entre as lentes baseline (6,50 ± 2,89cm), teste (6,71±3,49) e controle VS (6,82±3,50 cm). Nenhuma diferença significativa foi encontrada comparando lentes teste de VS e controle nos sintomas de AD (p=0,20). Conclusões As lentes com +0,40 D não têm impacto negativo na convergência ou na perda de acomodação. As lentes +0,40 D e controle VS, tiveram impacto semelhante na redução dos sintomas de AD.


Subject(s)
Humans , Male , Female , Adult , Lighting/adverse effects , Computers , Asthenopia/prevention & control , Eyeglasses , Filtration/instrumentation , Light/adverse effects , User-Computer Interface , Dry Eye Syndromes/etiology , Dry Eye Syndromes/prevention & control , Random Allocation , Asthenopia/etiology , Surveys and Questionnaires , Computers, Handheld , Smartphone , Accommodation, Ocular/physiology
5.
West Indian med. j ; 69(1): 56-59, 2021. tab
Article in English | LILACS | ID: biblio-1341862

ABSTRACT

ABSTRACT Background: Gestational diabetes mellitus is an increasingly frequent metabolic disorder that is important for both baby and mother. New studies on the development and treatment of the disease are required. Objective: To investigate the effects on offspring's survival and the biochemical values of diabetes mellitus, induced by different doses of two chemical agents among 35 rats with advanced pregnancy. Methods: The rats were randomly divided into five groups, with the rats in Group 1 as the control group. Alloxan was administered intraperitoneally at doses of 40 and 60 mg/kg in Groups 2 and 3, respectively. Streptozotocin was injected intraperitoneally at doses of 40 and 60 mg/kg in Groups 4 and 5, respectively. Deliveries were monitored, and offspring numbers, survival rates and congenital anomalies were recorded. At the end of the study, blood was drawn from one female offspring in each group; glucose, total protein, albumin, triglyceride, cholesterol, calcium and phosphorus levels were measured, and inter-group comparisons were made. Diabetic agents administered at various doses prolonged the duration of pregnancy. Results: Offspring's deaths were most frequent in the alloxan groups. The number of offspring mortalities in the streptozotocin group was higher than that of the control group, but lower than that of the alloxan group. No differences in glucose, total protein, albumin, triglyceride, cholesterol, calcium and phosphorus levels were observed between the groups. These results indicate that the female offspring, born from rats with gestational diabetes mellitus induced by different chemicals, were only clinically affected. No effect of the type of chemicals on the results was found. Conclusion: The use of streptozotocin in the studies on female offspring born from rats with gestational diabetes mellitus is recommended.


Subject(s)
Animals , Female , Pregnancy , Rats , Pregnancy Complications , Diabetes Mellitus, Experimental , Animals, Newborn , Random Allocation , Rats, Wistar
6.
Article in English | WPRIM | ID: wpr-880327

ABSTRACT

BACKGROUND@#Prenatal stress can cause neurobiological and behavioral defects in offspring; environmental factors play a crucial role in regulating the development of brain and behavioral; this study was designed to test and verify whether an enriched environment can repair learning and memory impairment in offspring rats induced by prenatal stress and to explore its mechanism involving the expression of insulin-like growth factor-2 (IGF-2) and activity-regulated cytoskeletal-associated protein (Arc) in the hippocampus of the offspring.@*METHODS@#Rats were selected to establish a chronic unpredictable mild stress (CUMS) model during pregnancy. Offspring were weaned on 21st day and housed under either standard or an enriched environment. The learning and memory ability were tested using Morris water maze and Y-maze. The expression of IGF-2 and Arc mRNA and protein were respectively measured by using RT-PCR and Western blotting.@*RESULTS@#There was an elevation in the plasma corticosterone level of rat model of maternal chronic stress during pregnancy. Maternal stress's offspring exposed to an enriched environment could decrease their plasma corticosterone level and improve their weight. The offspring of maternal stress during pregnancy exhibited abnormalities in Morris water maze and Y-maze, which were improved in an enriched environment. The expression of IGF-2, Arc mRNA, and protein in offspring of maternal stress during pregnancy was boosted and some relationships existed between these parameters after being exposed enriched environment.@*CONCLUSIONS@#The learning and memory impairment in offspring of prenatal stress can be rectified by the enriched environment, the mechanism of which is related to the decreasing plasma corticosterone and increasing hippocampal IGF-2 and Arc of offspring rats following maternal chronic stress during pregnancy.


Subject(s)
Animals , Cytoskeletal Proteins/metabolism , Female , Gene Expression Regulation , Hippocampus/metabolism , Insulin-Like Growth Factor II/metabolism , Learning , Learning Disabilities/psychology , Male , Memory Disorders/psychology , Nerve Tissue Proteins/metabolism , Pregnancy , Prenatal Exposure Delayed Effects/psychology , Random Allocation , Rats , Rats, Wistar , Social Environment , Stress, Psychological/genetics
7.
Article in English | WPRIM | ID: wpr-878371

ABSTRACT

Objective@#This study aimed to investigate the effects of @*Methods@#In this study, 0.1% DMG was supplemented in 20% casein diets that were either folate-sufficient (20C) or folate-deficient (20CFD). Blood and liver of rats were subjected to assays of Hcy and its metabolites. Hcy and its related metabolite concentrations were determined using a liquid chromatographic system.@*Results@#Folate deprivation significantly increased pHcy concentration in rats fed 20C diet (from 14.19 ± 0.39 μmol/L to 28.49 ± 0.50 μmol/L; @*Conclusion@#DMG supplementation exhibited hypohomocysteinemic effects under folate-sufficient conditions. By contrast, the combination of folate deficiency and DMG supplementation has deleterious effect on pHcy concentration.


Subject(s)
Animals , Biomarkers/metabolism , Chromatography, Liquid , Diet , Dietary Supplements , Folic Acid Deficiency/metabolism , Homocysteine/metabolism , Liver/metabolism , Male , Random Allocation , Rats , Rats, Wistar , Sarcosine/metabolism
8.
Braz. dent. sci ; 24(1): 1-13, 2021. ilus, tab
Article in English | LILACS, BBO | ID: biblio-1141394

ABSTRACT

Objective: to compare the clinical performance of newly introduced resin modified glass ionomer varnish (Clinpro™ XT) versus resin infiltration in treatment of post-orthodontic white spot lesions. Material and Methods: Six participants (70 teeth) were enrolled with post-orthodontic white spot lesions. Randomization was performed according to patient selection for the sealed envelope containing which half will receive the control (resin infiltration (ICON, DMG) and the other will receive the intervention (resin modified glass-ionomer cement varnish (Clinpro™ XT, 3M)). Follow up was done after 1 day, 1 week, 1 month, and 3 months, 6 months and 12 months. The color was assessed by spectrophotometer while the degree of demineralization was measured by Diagnodent pen 2910. Patient satisfaction was assessed using (VAS) Visual analogue scale Results:Regarding color change, significant improvement in lightness for ICON group, while Clinpro™ XT group, the change was insignificant. The demineralization data revealed significant decrease in demineralization with resin infiltration after immediate application. Clinpro™ XT showed also significant decrease after immediate assessment and significant increase in demineralization in 6 and 12 months. Conclusion: Resin infiltration can be considered more as an alternative treatment rather than fluoride varnish. Clinpro™ XTis considered as a preventive protocol, provided that renewal application is needed after 3 months (AU)


Objetivo: comparar o desempenho clínico do recém-introduzido verniz de ionômero de vidro modificado por resina (Clinpro ™ XT) com a infiltração de resina no tratamento de lesões de manchas brancas pós-ortodônticas. Material e Métodos: Seis participantes (70 dentes) foram inscritos com lesões pós-ortodônticas de manchas brancas. A randomização foi realizada de acordo com a seleção do paciente para o envelope lacrado contendo qual metade receberá o controle (infiltração de resina (ICON, DMG) e a outra metade receberá a intervenção (verniz de cimento de ionômero de vidro modificado por resina (Clinpro ™ XT, 3M)). O acompanhamento foi feito após 1 dia, 1 semana, 1 mês e 3 meses, 6 meses e 12 meses. A cor foi avaliada por espectrofotômetro, enquanto o grau de desmineralização foi medido pela caneta Diagnodent 2910. A satisfação do paciente foi avaliada usando (VAS) Escala visual analógica. Resultados: Em relação à mudança de cor, houve uma melhora significativa na luminosidade para o grupo ICON, enquanto o grupo Clinpro ™ XT, a mudança foi insignificante. Os dados de desmineralização revelaram diminuição significativa da desmineralização com infiltração de resina após a aplicação imediata. O grupo Clinpro ™ XT também mostrou diminuição significativa após avaliação imediata e aumento significativo na desmineralização em 6 e 12 meses. Conclusão: A infiltração de resina pode ser considerada mais como uma alternativa de tratamento do que o verniz fluoretado. O Clinpro ™ XT é considerado um protocolo preventivo, uma vez que a renovação é necessária após 3 meses. (AU)


Subject(s)
Humans , Random Allocation , Patient Satisfaction , Resin Cements , Fluorides , Glass Ionomer Cements
9.
Rev. bras. anestesiol ; 70(6): 627-634, Nov.-Dec. 2020. graf
Article in English | LILACS | ID: biblio-1155766

ABSTRACT

Abstract Background and objectives The mechanisms by which local anesthetics cause neurotoxicity are very complicated. Apoptosis and autophagy are highly coordinated mechanisms that maintain cellular homeostasis against stress. Studies have shown that autophagy activation serves as a protective mechanism in vitro. However, whether it also plays the same role in vivo is unclear. The aim of this study was to explore the role of autophagy in local anesthetic-induced neurotoxicity and to elucidate the mechanism of neurotoxicity in an intrathecally injected rat model. Methods Eighteen healthy adult male Sprague-Dawley rats were randomly divided into three groups. Before receiving an intrathecal injection of 1% bupivacaine, each rat received an intraperitoneal injection of vehicle or rapamycin (1 mg.kg-1) once a day for 3 days. The pathological changes were examined by Haematoxylin and Eosin (HE) staining. Apoptosis was analysed by TdT-mediated dUTP Nick-End Labelling (TUNEL) staining. Caspase-3, Beclin1 and LC3 expression was examined by Immunohistochemical (IHC) staining. Beclin1 and LC3 expression and the LC3-II/LC3-I ratio were detected by western blot analysis. Results After bupivacaine was injected intrathecally, pathological damage occurred in spinal cord neurons, and the levels of apoptosis and caspase-3 increased. Enhancement of autophagy with rapamycin markedly alleviated the pathological changes and decreased the levels of apoptosis and caspase-3 while increasing the expression of LC3 and Beclin1 and the ratio of LC3-II to LC3-I. Conclusions Enhancement of autophagy decreases caspase-3-dependent apoptosis and improves neuronal survivalin vivo. Activation of autophagy may be a potential therapeutic strategy for local anaesthetic-induced neurotoxicity.


Resumo Introdução e objetivos Os mecanismos de neurotoxicidade dos anestésicos locais são complexos. A apoptose e a autofagia são mecanismos altamente organizados que mantêm a homeostase celular durante o estresse. Estudos revelam que a ativação da autofagia atua como mecanismo de proteção in vitro. Não está claro se a autofagia também desempenha essa função in vivo. O objetivo deste estudo foi analisar o papel da autofagia na neurotoxicidade induzida por anestésico local e esclarecer o mecanismo dessa neurotoxicidade utilizando um modelo de injeção intratecal em ratos. Métodos Dezoito ratos Sprague‐Dawley machos adultos saudáveis foram divididos aleatoriamente em três grupos. Antes de receber a injeção intratecal de bupivacaína a 1%, cada rato recebeu injeção intraperitoneal de veículo ou rapamicina (1 mg.kg‐1) uma vez ao dia durante 3 dias. As alterações patológicas foram examinadas por coloração com Hematoxilina e Eosina (HE). A apoptose foi analisada por coloração com o método dUTP Nick‐End Labeling (TUNEL) mediado por TdT. A expressão de caspase‐3, Beclin1 e LC3 foram examinadas por coloração Imunohistoquímica (IHQ). A expressão de Beclin1 e LC3 e a razão LC3‐II/LC3‐I foram detectadas por análise de western blot. Resultados Após a injeção intratecal de bupivacaína, ocorreu lesão patológica nos neurônios da medula espinhal e os níveis de apoptose e caspase‐3 aumentaram. A ativação da autofagia causada pela rapamicina mitigou de forma expressiva as alterações patológicas e diminuiu os níveis de apoptose e caspase‐3, aumentando a expressão de LC3 e Beclin1 e a razão LC3‐II/LC3‐I. Conclusões O aumento da autofagia diminui a apoptose dependente da caspase‐3 e melhora a sobrevivência neuronal in vivo. A ativação da autofagia pode ser uma estratégia terapêutica potencial para a neurotoxicidade induzida por anestésicos locais.


Subject(s)
Animals , Male , Rats , Autophagy/drug effects , Bupivacaine/toxicity , Neurotoxicity Syndromes/prevention & control , Caspase 3/metabolism , Anesthetics, Local/toxicity , Neurons/drug effects , Spinal Cord/drug effects , Autophagy/physiology , Bupivacaine/administration & dosage , Random Allocation , Rats, Sprague-Dawley , Apoptosis/drug effects , Sirolimus/administration & dosage , In Situ Nick-End Labeling , Beclin-1/metabolism , Microtubule-Associated Proteins/metabolism , Neurons/pathology
10.
Rev. bras. anestesiol ; 70(6): 635-641, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1155763

ABSTRACT

Abstract Background and objectives: Sugammadex is an alternative pharmacological drug capable of reversing neuromuscular blockades without the limitations that are presented by anticholinesterase drugs. Coagulation disorders that are related to treatment with sugammadex were reported. The exact mechanism of the effects on coagulation are not fully understood. The objective of this research is to evaluate the effects of rocuronium, sugammadex and the rocuronium-sugammadex complex on coagulation in an experimental model in rats. Methods: This is an experimental randomized animal study. Wistar rats were randomly assigned into the following groups: the Control Group; the Ssal Group - 0.5 mL of intravenous saline; the Sugammadex Group - intravenous sugammadex (100 mg kg−1); and the Rocuronium-Sugammadex Group - intravenous solution with rocuronium (3.75 mg kg−1) and sugammadex (100 mg kg−1). Anesthesia was performed by using isoflurane with controlled ventilation. Coagulation factors were measured 10 minutes after the end of the preoperative preparation and 30 minutes after the administration of the drugs in accordance with the chosen groups. Results: Platelet counts, prothrombin times, and activated partial thromboplastin times were similar between the groups and between the moments within each group. There were reductions in the plasma fibrinogen levels between sample times 1 and 2 in the Rocuronium-Sugammadex group (p = 0.035). Conclusions: The rocuronium-sugammadex complex promoted reductions in plasma fibrinogen counts, although the levels were still within normal limits.


Resumo Introdução e objetivos: O sugamadex é uma substância farmacológica alternativa capaz de reverter o bloqueio neuromuscular sem as limitações apresentadas pelos anticolinesterásicos. Entretanto, há relatos de transtornos de coagulação relacionados ao tratamento com sugamadex sem que mecanismos exatos de seus efeitos sobre a coagulação sejam totalmente compreendidos. O objetivo da presente pesquisa foi avaliar os efeitos do rocurônio, sugamadex e do complexo rocurônio-sugamadex sobre a coagulação em um modelo experimental com ratos. Métodos: Este é um estudo randomizado experimental animal. Ratos Wistar foram aleatoriamente designados aos seguintes grupos: grupo controle; Grupo Ssal - 0,5 mL de solução salina intravenosa; Grupo sugamadex - sugamadex intravenoso (100 mg.kg-1); e Grupo rocurônio-sugamadex - solução intravenosa com rocurônio (3,75 mg.kg-1) e sugamadex (100 mg.kg-1). A anestesia foi realizada utilizando-se isoflurano com ventilação controlada. Os fatores de coagulação foram medidos 10 minutos após o final do preparo pré-operatório e 30 minutos após a administração de drogas de acordo com os grupos escolhidos. Resultados: Contagem de plaquetas, tempo de protrombina e tempo de tromboplastina parcial ativada foram semelhantes entre os grupos e entre os momentos dentro de cada grupo. Houve redução nos níveis de fibrinogênio plasmático entre os tempos 1 e 2 no grupo rocurônio-sugamadex (p = 0,035). Conclusões: O complexo rocurônio-sugamadex promoveu reduções na contagem de fibrinogênio plasmático, apesar de os níveis continuarem dentro dos limites normais.


Subject(s)
Animals , Rats , Blood Coagulation/drug effects , Neuromuscular Nondepolarizing Agents/pharmacology , Neuromuscular Blockade , Sugammadex/pharmacology , Rocuronium/pharmacology , Partial Thromboplastin Time , Platelet Count , Prothrombin Time , Fibrinogen/analysis , Random Allocation , Rats, Wistar , Neuromuscular Nondepolarizing Agents/administration & dosage , Anesthetics, Inhalation , Drug Combinations , Sugammadex/administration & dosage , Rocuronium/administration & dosage , Isoflurane , Anesthesia/methods
11.
Rev. bras. ativ. fís. saúde ; 25: 1-7, set. 2020. tab
Article in Portuguese | LILACS | ID: biblio-1128491

ABSTRACT

Distúrbios do equilíbrio consistem em um grande problema na doença de Parkinson (DP). A terapia por vibração do corpo inteiro mostra-se benéfica em pessoas saudáveis, mas apresenta eficácia incerta na DP. O objetivo desse estudo foi verificar os efeitos agudos da terapia por vibração do corpo inteiro sobre o equilíbrio de pacientes com DP e analisar o tamanho do efeito da intervenção para predizer o número ideal de participantes. Doze participantes com DP foram randomicamente divididos entre grupos intervenção e placebo. O grupo intervenção foi submetidos à terapia vibratória, tendo o equilíbrio avaliado em período anterior, imediatamente após e transcorrido cinco minutos da sessão. O grupo placebo fez uma intervenção simulada, tendo o equilíbrio avaliado nos mesmos períodos. Ambos os grupos tiveram seus olhos vendados para manter cegamento dos participantes sobre a intervenção. As variáveis analisadas foram deslocamento, área e velocidade de deslocamento. O tamanho do efeito foi verificado em análises univariadas e multivariadas, admitindo significância em 5%. Sobre os resultados, a terapia por vibração do corpo inteiro não apresentou eficácia sobre o equilíbrio na DP em momento imediato e transcorrido cinco minutos da aplicação da terapia. A análise que apresentou maior tamanho do efeito se deu quando o equilíbrio foi mensurado de forma multivariada, predizendo a necessidade de 46 pacientes. Em conclusão, os resultados desse estudo foram imprecisos quanto à eficácia da terapia por vibração do corpo inteiro no equilíbrio de pacientes com DP. Novas pesquisas com uma amostra superior a 46 participantes devem ser realizadas


Balance disorders are a major problem in Parkinson's disease (PD). The whole body vibration has benefits on the balance in healthy people, but it has imprecise effectiveness in PD. The aim of this study was to verify the effects of whole body vibration on balance in patients with PD and to predict the ideal number of participants from the effects size. Twelve participants with PD were randomly divided into intervention and placebo groups. Participants in the intervention group underwent whole body vibration and the subjects had their balance assessed prior therapy, immediately and five minutes after the session. The control group underwent a placebo intervention and the subjects had their balance assessed on the same periods. Both groups had their eyes closed during the intervention protocol. The variables assessed were body displacement, area and velocity of body displacement. The effect size of the intervention was analysed under univariate and multivariate analyses. Significance was set at 5%. With respect to the results, the whole body vibration was inefficient in improving balance immediately and five minutes after the session. The analysis that presented the strongest effect size occurred when balance was assessed under a multivariate basis, predicting the need of 46 participants. In conclusion, the results were imprecise as to the effects of whole body vibration on the balance in patients with PD. Studies with a sample size higher than 46 participants should be carried out to further address this topic


Subject(s)
Parkinson Disease , Random Allocation , Pilot Projects , Sample Size , Postural Balance
12.
Rev. Pesqui. Fisioter ; 10(3): 512-519, ago.2020. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-1224118

ABSTRACT

Ensaios clínicos randomizados (ECR) são o padrão ouro para desenho experimental de estudo ou ensaio clínico. Apenas por meio de uma investigação do tipo ECR é possível avaliar e demonstrar a relação de causa-e-efeito entre um conjunto de variáveis independentes e dependentes. O ECR adicionou vantagens em relação aos outros modelos experimentais, principalmente devido à presença de um grupo controle. Existem várias críticas à validade interna das pesquisas em saúde, incluindo preconceitos e desvantagens que são apontadas para seu descrédito. OBJETIVO: O objetivo do presente estudo é informar características, vantagens, desvantagens e desvios deste método científico. MATERIAL E MÉTODOS: Análise crítica de método científico com base em revisão narrativa da literatura. Foi consultada a base de dados Medline por meio dos portais PubMed e Scopus, sem data de início e até julho de 2020, para extração das informações relativas aos ECR. Apenas artigos de língua inglesa foram incluídos, usando as palavras-chave "estudo randomizado controlado", "ensaio clínico randomizado", "projeto experimental" e "estudo experimental", intercaladas pelos operadores booleanos "AND ," "OR" e "NOT". Anais de conferências e resumos não foram considerados para a análise dos dados. RESULTADOS: Dos ECR selecionados, foram extraídas características, vantagens, desvantagens, importância e vantagens dos controles em pesquisa, o princípio de equilíbrio, ensaios clínicos randomizados na população pediátrica, ECR na população geriátrica, ameaças à validade interna e medidas para minimização de viéses e preconceitos em ECR. CONCLUSÃO: Tópicos relevantes dos ECR foram explicados nesta revisão que devem guiar pesquisadores clínicos.


Randomized controlled trial (RCT) is the gold standard of experimental design or clinical trial design. Only by RCT in research, the cause-and-effect relationship between a set of independent and dependent variables could be demonstrated. RCT has added advantages over other experimental designs due to the presence of the control group. The importance of control in health research trials and its advantages to be elaborated. Though various threats to internal validity in health research trials could be minimized by RCT, various biases in RCT and disadvantages add to its discredit. OBJECTIVE: The aim of the present narrative review is to brief the characteristics, advantages, disadvantages, and various biases in RCT. METHODS: This review does not follow the PRISMA statement, as it was a narrative review. Two databases, namely, Medline through PubMed and Scopus, were searched from inception to July 2020 for the information pertaining to RCTs and included in this narrative review. Only English language articles were searched with the keywords, "Randomized controlled trial," "Randomized clinical trial," "experimental design," and "experimental study." These keywords are linked together by the Boolean words, "AND," "OR" and "NOT." Conference proceedings and only abstracts were not considered for the review. RESULTS: RCTs were explained under characteristics, advantages, disadvantages, importance, and advantages of controls in research, the principle of equipoise, RCTs in the pediatric population, RCTs in the geriatric population, threats to internal validity and steps to minimize them and various biases in RCTs. CONCLUSION: The narrative presentation of RCTs under various important topics have been explained in this review.


Subject(s)
Randomized Controlled Trial , Research Design , Random Allocation
13.
Int. braz. j. urol ; 46(3): 436-443, May-June 2020. tab, graf
Article in English | LILACS | ID: biblio-1090601

ABSTRACT

ABSTRACT Purpose: Spongioplasty (mobilization and midline approximation of the two branches of the bifid dysplastic distal corpus spongiosum) can form a covering layer for the neourethra to prevent urethrocutaneous fistula in hypospadias repair surgery. However, it remains unclear whether spongioplasty affects neourethral function. The objective of this study was to compare neourethral function after hypospadias repair with and without spongioplasty. Materials and Methods: Fourteen congenital hypospadiac New Zealand male rabbits were randomly allocated into two groups, seven animals underwent Duplay hypospadias repair and spongioplasty (experimental group), while seven underwent Duplay surgery alone (control group). Functional differences between groups were assessed by comparing neourethral compliance and flow rate. Two months after surgery, in vivo neourethral compliance was assessed by measuring intraluminal pressure with a digital pressure meter of an isolated neourethral segment, following progressive distension with 1, 2, and 3mL of air. Penises were harvested for uroflowmetry test using a simple device. Results: Postoperatively, fistula developed in one and zero rabbits in the control and experimental groups, respectively. Mean pressures tended to be higher in the experimental group than in the control group (82.14 vs. 69.57, 188.43 vs. 143.26, and 244.71 vs. 186.29mmHg for 1, 2, and 3mL of air, respectively), but the difference was not statistically significant. Mean flow rates also did not significantly differ between the experimental and control groups (2.93mL/s vs. 3.31mL/s). Conclusion: In this congenital rabbit model, no obvious functional differences were found between reconstructed urethras after hypospadias repair with and without spongioplasty.


Subject(s)
Humans , Animals , Male , Infant , Hypospadias , Penis , Rabbits , Urologic Surgical Procedures, Male , Surgical Flaps , Urethra , Random Allocation
14.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(3): 295-308, May-June 2020. graf
Article in English | LILACS | ID: biblio-1132066

ABSTRACT

Objective: Several studies have shown that the time of day regulates the reinforcing effects of cocaine. Additionally, melatonin and its MT1 and MT2 receptors have been found to participate in modulation of the reinforcing effects of such addictive drugs as cocaine. Loss of the diurnal variation in cocaine-induced locomotor sensitization and cocaine-induced place preference has been identified in pinealectomized mice. In addition, several studies in rodents have shown that administration of melatonin decreased the reinforcing effects of cocaine. The objective of this study was to evaluate the effect of melatonin on cocaine-induced locomotor activity in pinealectomized rats at different times of day (zeitgeber time [ZT]4, ZT10, ZT16, and ZT22). Methods: Naïve, pinealectomized Wistar rats received cocaine at different times of day. Melatonin was administered 30 min before cocaine; luzindole was administered 15 min prior to melatonin and 45 min before cocaine. After administration of each treatment, locomotor activity for each animal was recorded for a total of 30 min. Pinealectomy was confirmed at the end of the experiment through melatonin quantitation by ELISA. Results: Cocaine-induced locomotor activity varied according to the time of day. Continuous lighting and pinealectomy increased cocaine-induced locomotor activity. Melatonin administration decreased cocaine-induced locomotor activity in naïve and pinealectomized rats at different times of day. Luzindole blocked the melatonin-induced reduction in cocaine-induced locomotor activity in pinealectomized rats. Conclusion: Given its ability to mitigate various reinforcing effects of cocaine, melatonin could be a useful therapy for cocaine abuse.


Subject(s)
Humans , Animals , Male , Central Nervous System Depressants/pharmacology , Cocaine-Related Disorders/drug therapy , Pinealectomy , Locomotion/drug effects , Melatonin/pharmacology , Time Factors , Enzyme-Linked Immunosorbent Assay , Random Allocation , Tryptamines/pharmacology , Reproducibility of Results , Circadian Rhythm , Treatment Outcome , Rats, Wistar
15.
Arch. endocrinol. metab. (Online) ; 64(3): 201-204, May-June 2020. graf
Article in English | LILACS | ID: biblio-1131082

ABSTRACT

ABSTRACT Objective Autonomic nervous system, especially the sympathetic nervous system, may stimulate the expression of peroxisome proliferator-activated receptor γ coactivator-1α, which regulates irisin. This study aimed to explore whether there was any association between autonomic function as assessed by heart rate related indices and irisin release following acute exercise. Subjects and methods Seventeen healthy adults were asked to perform an incremental exhaustive cycling as well as an incremental exhaustive running separately on different days. Heart rate was monitored, and blood samples were collected before, immediately, 10-, and 60-minutes post-exercise. Serum irisin was measured using ELISA kit. Results Markers for autonomic function, such as heart rate at rest, peak, or recovery, heart rate reserve, heart rate recovery, and chronotropic index, were comparable between cycling and running (all P > 0.10). Irisin was increased immediately following both exercise. No significant association was observed between heart rate at rest, peak, or recovery and irisin level at the corresponding time-point, as well as between heart rate reserve, heart rate recovery, or chronotropic index and exercise induced irisin release, with or without controlling for age, body mass index, and glucose (all P > 0.10). Conclusions Autonomic function might not be associated with irisin release in healthy adults. Arch Endocrinol Metab. 2020;64(3):201-4


Subject(s)
Humans , Male , Female , Adult , Young Adult , Running/physiology , Autonomic Nervous System/physiology , Autonomic Nervous System/blood supply , Fibronectins/blood , Heart Rate/physiology , Enzyme-Linked Immunosorbent Assay , Random Allocation , Cross-Over Studies
16.
Arch. endocrinol. metab. (Online) ; 64(3): 251-256, May-June 2020. tab, graf
Article in English | LILACS | ID: biblio-1131079

ABSTRACT

ABSTRACT Objective We aimed to evaluate the impact of minimal extrathyroidal extension (mETE) alone on the risk of recurrence of papillary thyroid carcinoma (PTC). The impact of other factors, including multifocality, age, tumor size, and stimulated thyroglobulin (sTg) values was also assessed. Subjects and methods We retrospectively analyzed 1,108 PTC patients from a medical institution, who presented tumors ≤ 4 cm without any adverse characteristics other than mETE. Patients were classified according to their response to initial treatment 12 to 24 months after surgery as proposed by the 2015 American Thyroid Association (ATA) guideline. Statistical analysis was performed using multivariate logistic regression and receiver operating characteristic (ROC) curve. Results In the multivariate logistic regression analysis, mETE did not have an impact on the response to initial treatment (p = 0.44), similar to multifocality, age, and tumor size. Initial Tg value was the only variable associated with a poor response (p < 0.01, odds ratio = 1.303, 95% confidence interval 1.25-1.36). The ROC analysis revealed that Tg was significant (area under curve = 0.8750); the cutoff value of sTg as a predictor of poor response was 10 ng/mL (sensitivity = 72.2%, specificity = 98.5%). Conclusion For low-risk PTC presenting mETE as the only aggressive feature, the initial sTg value is essential to identify patients who may have a poor response after initial treatment and benefit from further treatment. Arch Endocrinol Metab. 2020;64(3):251-6


Subject(s)
Humans , Male , Female , Adult , Young Adult , Thyroid Neoplasms/pathology , Thyroid Cancer, Papillary/pathology , Thyroidectomy , Thyroid Neoplasms/surgery , Random Allocation , Retrospective Studies , Tumor Burden , Thyroid Cancer, Papillary/surgery , Middle Aged , Neoplasm Invasiveness , Neoplasm Recurrence, Local , Neoplasm Staging
17.
Prensa méd. argent ; 106(2): 119-127, 20200000. fig, tab
Article in English | LILACS, BINACIS | ID: biblio-1369492

ABSTRACT

Sexual relation is a very important part of the marital relationship. Any problem in the marital relationship affects the family and society cohesion. This study aim to determine the effect of Group sexual assertiveness training on Sexual assertiveness of Female Students. This quasi-experimental pre and posttest study was conducted on 80 married female students of Sistan and Baluchestan University (southeast of Iran), from 1 July 2018 to 30 March 2019.Students were selected and randomly allocated in the two intervention and control groups. The intervention group received group sexual assertiveness training in the 4 two-hourly sessions over a period of two weeks. The control group did not receive any training. The data were collected before and 12 weeks after the intervention by Hurlbert's sexual assertiveness questionnaire, and then were analyzed. After the implementation of group sexual assertiveness training, the mean score of sexual assertiveness significantly increased in the intervention group compared to the control group (p=0.01). It is recommended to add sexual assertive training to the pre-marriage education, especially in cultures in which women have a low level of sexual assertiveness


Subject(s)
Humans , Female , Assertiveness , Sex Education , Random Allocation , Surveys and Questionnaires , Coitus , Spouses/education , Non-Randomized Controlled Trials as Topic
18.
Demetra (Rio J.) ; 15(1): 49720, jan.- mar.2020. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-1361831

ABSTRACT

Objetivo: Descrever o processo de construção e desenvolvimento de ações educativas via mHealth para redução de sódio e realizar avaliação do ponto de vista do receptor. Método: Estudo de intervenção com 155 adultos (20-59 anos) de uma instituição de ensino em Vitória-ES. Os participantes foram contatados por exposição a banner, convite face to face e mídia eletrônica. Após primeira coleta de dados, os participantes foram randomizados em dois grupos: Intervenção (GI) e Controle (GC). Dados socioeconômicos, de saúde e práticas alimentares foram obtidos antes e após a intervenção. Foram elaboradas 21 mensagens e três vídeos focados na redução de sódio, enviadas por aplicativo WhatsApp® ou e-mail, durante três meses. Testes adequados, segundo o delineamento da amostra, foram aplicados utilizando o software SPSS 23, adotando-se nível de significância de 5%. Resultados: Na linha de base, não foram observadas diferenças significativas entre grupos de alocação. Cerca de 70% dos participantes do GI relataram que as mensagens foram úteis, claras e objetivas; 50% relataram que as mensagens ajudaram a realizar escolhas alimentares mais saudáveis e 47% disseram que seguiram as sugestões propostas. Mais de 60% do GI relataram que adotaram hábitos alimentares mais saudáveis, enquanto no GC as respostas foram associadas à prática de "dietas da moda". Esses resultados mostram a importância da utilização de ações educativas baseadas em conhecimento científico e na adoção de práticas alimentares saudáveis. Conclusão: A maioria dos participantes identificou a estratégia mHealth como de fácil compreensão e útil, bem como foram mais expostos à informação sobre alimentação saudável. (AU)


Objective: Describe the process of construction and development of educational actions through mHealth aiming sodium reduction and accomplishment of evaluation from the receptor's point of view. Methods: Interventional study accomplished within 155 adults from 20 to 59 years old from a public institution in Vitória-ES. The participants were approached through banners, face to face invitations and electronic medias. After the first data collection the participants were randomized into two groups: Intervention (GI) and control (GC). Socioeconomic data about health and eating habits were obtained before and after the intervention. 21 messages and 3 videos focusing on the sodium reduction were prepared and sent via Whatsapp or email for 3 months. Appropriate tests, according to the sample's design, were applied using the software SPSS 23 with a significance level of 5%. Results: On the baseline were not observed significant differences between the allocation groups. Nearly 70% of the GI participants reported that the information was useful, clear and objective; 50% reported that the messages helped them to do healthier eating choices and 47% claimed that they followed the suggestions that were proposed to them. More than 60% of GI reported that they have adopted healthier eating habits while in GC the reports were related to the execution of ''trending diets''. These results show the importance of the use of educational actions based on scientific knowledge and adoption of healthy eating habits. Conclusion: Most of the participants classified the mHealth strategy as a useful and easy understanding one, as well as they were exposed to health eating information. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Food and Nutrition Education , Sodium, Dietary , Feeding Behavior , Diet, Healthy , Random Allocation , Data Collection , Instructional Film and Video , Computers, Handheld
19.
Rev. bras. ter. intensiva ; 32(1): 58-65, jan.-mar. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1138472

ABSTRACT

RESUMO Objetivo: Determinar se a administração de adalimumabe previamente à ventilação mecânica reduz a lesão pulmonar induzida por ventilação mecânica. Métodos: Randomizaram-se 18 ratos em três grupos submetidos à ventilação mecânica por 3 horas com uma fração inspirada de oxigênio de 0,40%. Os três grupos foram assim caracterizados: um grupo com baixo volume corrente (n = 6), no qual se utilizaram volume corrente de 8mL/kg e pressão expiratória final positiva de 5cmH2O; um grupo com alto volume corrente (n = 6), no qual se utilizaram volume corrente de 35mL/kg e pressão expiratória final positiva de zero; e um grupo pré-tratado com alto volume corrente (n = 6), no qual se administraram adalimumabe (100µg/kg) por via intraperitoneal 24 horas antes do início da ventilação mecânica, volume corrente de 35mL/kg e pressão expiratória final positiva de zero. Realizou-se ANOVA para comparação de dano histológico (com utilização de escores segundo o ATS 2010 Lung Injury Scoring System), edema pulmonar, complacência pulmonar, pressão parcial de oxigênio arterial e pressão arterial média entre os grupos. Resultados: Após 3 horas de ventilação, o escore médio de lesão histológica pulmonar foi mais elevado no grupo com alto volume corrente do que no grupo com baixo volume corrente (0,030 versus 0,0051; p = 0,003). O grupo com alto volume corrente demonstrou complacência pulmonar diminuída após 3 horas (p = 0,04) e hipoxemia (p = 0,018 versus controle). O grupo alto volume corrente tratado previamente teve melhora do escore histológico, principalmente devido à redução significante da infiltração leucocitária (p = 0,003). Conclusão: O exame histológico após 3 horas de ventilação lesiva revelou lesão pulmonar induzida por ventilação mecânica na ausência de modificações mensuráveis na mecânica pulmonar e na oxigenação; a administração de adalimumabe antes da ventilação mecânica diminuiu o edema pulmonar e o dano histológico.


ABSTRACT Objective: To determine whether adalimumab administration before mechanical ventilation reduces ventilator-induced lung injury (VILI). Methods: Eighteen rats randomized into 3 groups underwent mechanical ventilation for 3 hours with a fraction of inspired oxygen = 0.40% including a low tidal volume group (n = 6), where tidal volume = 8mL/kg and positive end-expiratory pressure = 5cmH2O; a high tidal volume group (n = 6), where tidal volume = 35mL/kg and positive end-expiratory pressure = 0; and a pretreated + high tidal volume group (n = 6) where adalimumab (100ug/kg) was administered intraperitoneally 24 hours before mechanical ventilation + tidal volume = 35mL/kg and positive end-expiratory pressure = 0. ANOVA was used to compare histological damage (ATS 2010 Lung Injury Scoring System), pulmonary edema, lung compliance, arterial partial pressure of oxygen, and mean arterial pressure among the groups. Results: After 3 hours of ventilation, the mean histological lung injury score was higher in the high tidal volume group than in the low tidal volume group (0.030 versus 0.0051, respectively, p = 0.003). The high tidal volume group showed diminished lung compliance at 3 hours (p = 0.04) and hypoxemia (p = 0,018 versus control). Pretreated HVt group had an improved histological score, mainly due to a significant reduction in leukocyte infiltration (p = 0.003). Conclusion: Histological examination after 3 hours of injurious ventilation revealed ventilator-induced lung injury in the absence of measurable changes in lung mechanics or oxygenation; administering adalimumab before mechanical ventilation reduced lung edema and histological damage.


Subject(s)
Humans , Animals , Rats , Young Adult , Respiration, Artificial/methods , Ventilator-Induced Lung Injury/prevention & control , Adalimumab/therapeutic use , Random Allocation , Rats, Wistar , Disease Models, Animal
20.
Rev. Assoc. Med. Bras. (1992) ; 66(2): 174-179, Feb. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1136174

ABSTRACT

SUMMARY INTRODUCTION Although estrogen therapy is widely used against post-menopausal symptoms, it can present adverse effects, including endometrial cancer. Soy isoflavones are considered a possible alternative to estrogen therapy. However, there are still concerns whether isoflavones exert trophic effects on the uterine cervix. OBJECTIVES To evaluate the histomorphometric and immunohistochemical alterations in the uterine cervix of ovariectomized rats treated with soy isoflavones (Iso). METHODS Fifteen adult Wistar rats were ovariectomized (Ovx) and divided into three groups: Group I (Ovx), administered with vehicle solution; Group II (OVX-Iso), administered with concentrated extract of Iso (150 mg/kg) by gavage; and Group III (OVX-E2), treated with 17β-estradiol (10 µg/kg), subcutaneously. After 30 days of treatments, the uterine cervix was fixed in 10% formaldehyde and processed for paraffin-embedding. Sections were stained with Hematoxylin and eosin for morphological and morphometric studies or subjected to immunohistochemistry for detections of Ki-67 and vascular endothelial growth factor-A (Vegf-A). The data obtained were subjected to statistical analysis (p ≤ 0.05). RESULTS We noted an atrophic uterine cervix in GI, whereas it was more voluminous in GII and even more voluminous in GIII. The thickness of the cervical mucosa was significantly higher in GIII, as compared to GI and GII. The cell proliferation (Ki-67) was significantly elevated in the estradiol and isoflavones treated groups, whereas Vegf-A immunoexpression was significantly higher in GIII, as compared to groups GII and GI. CONCLUSIONS Soy isoflavones cause less trophic and proliferative effects in the uterine cervix of rats as compared to estrogen.


RESUMO INTRODUÇÃO Embora a terapia estrogênica seja amplamente utilizada contra sintomas pós-menopausais, ela pode apresentar efeitos adversos, incluindo câncer de mama e endometrial. Assim, as isoflavonas da soja são consideradas uma alternativa possível à terapia estrogênica. No entanto, ainda há controvérsias se estes compostos exercem efeitos tróficos significativos no colo do útero. OBJETIVOS Avaliar as alterações histomorfométricas e imuno-histoquímicas no colo do útero de ratas ovariectomizadas tratadas com isoflavonas da soja (iso). MÉTODOS Quinze ratas Wistar adultas foram ovariectomizadas bilateralmente (Ovx) e separadas em três grupos: Grupo I (Ovx) - veículo (propilenoglicol); Grupo II (Ovx-Iso) - receberam extrato concentrado de Iso (150 mg/kg) e Grupo III (Ovx-E2) - tratado com 17β-estradiol (10 µg/kg); as soluções foram administradas via gavagem por 30 dias consecutivos. Posteriormente, os colos uterinos foram retirados, fixados em formaldeído a 10% tamponado e processados para inclusão em parafina. Cortes (4 µm) foram coradas com hematoxilina e eosina para estudo morfológico e morfométricos, enquanto outros foram submetidos à imuno-histoquímica para detecção de Ki-67 e do fator de crescimento endotelial vascular-A (Vegf-A). Os dados obtidos foram submetidos à análise estatística (p≤0,05). RESULTADOS Observamos a presença de colo uterino atrófico no GI (Ovx), sendo este mais volumoso no GII (Ovx+Iso) e ainda mais volumoso no GIII (Ovx+E2). A espessura da mucosa cervical foi significativamente maior no GIII (Ovx-E2), em comparação ao GI (Ovx) e ao GII (Ovx-Iso). A proliferação celular (Ki-67) foi significativamente mais elevada nos grupos tratados com estradiol e isoflavonas, enquanto a imunoexpressão de Vegf-A foi significativamente maior no GIII (Ovx-E2), em comparação ao GII (Ovx-Iso) e ao GI (Ovx-E2). CONCLUSÕES As isoflavonas da soja causam menos efeitos tróficos e proliferativos no colo do útero de ratas em comparação ao estrogênio.


Subject(s)
Humans , Animals , Cervix Uteri/drug effects , Phytoestrogens/pharmacology , Estrogens/pharmacology , Isoflavones/pharmacology , Time Factors , Immunohistochemistry , Ovariectomy , Random Allocation , Cervix Uteri/pathology , Reproducibility of Results , Rats, Wistar , Ki-67 Antigen/analysis , Vascular Endothelial Growth Factor A/analysis , Cell Proliferation/drug effects , Epithelium/drug effects , Mucous Membrane/drug effects
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