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Medicinas Complementárias
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1.
J Ocul Pharmacol Ther ; 33(6): 487-492, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28375789

RESUMEN

PURPOSE: To evaluate the effect of tear supplementation with preservative free 0.15% zinc-hyaluronate on ocular surface sensations and corneal sensitivity in dry eye patients. METHODS: Ocular surface sensations were assessed using the ocular surface disease index (OSDI) questionnaire and by recording ocular sensations during forced blinking in parallel with noninvasive tear film breakup time measurement in 20 eyes of 20 dry eye patients. Corneal sensitivity thresholds to selective stimulation of corneal mechano-, thermal- and chemical receptors were measured using the Belmonte gas esthesiometer. All baseline measurements were repeated after 1 month of treatment with 0.15% zinc-hyaluronate. RESULTS: After 1 month, a significant decrease in mean OSDI score (from 35.66 ± 12.36 to 15.03 ± 11.22; P < 0.001) and a significant improvement in tear film breakup time (from 3.83 ± 0.80 to 8.67 ± 4.50 s; P < 0.001) was observed compared to baseline. Sensory responses during the interblink period also significantly decreased after 1 month (P < 0.004). Corneal sensitivity thresholds to mechanical stimulation (90.61 ± 20.35 vs. 103.92 ± 17.97 mL/min; P < 0.025) and chemical stimulation (33.21 ± 0.51 vs. 33.58% ± 0.44% CO2; P < 0.025) significantly increased after 1 month, however sensitivity thresholds to thermal stimulation remained unchanged compared to baseline (P > 0.05). CONCLUSION: Prolonged use of 0.15% zinc-hyaluronate results in an improvement of tear film stability and a decrease of dry eye complaints. The decrease in corneal mechano-and polymodal receptor excitability suggests that zinc-hyaluronate helps to recover normal corneal sensitivity, and thus might have a beneficial additional effect on reducing ocular surface complaints in dry eye patients.


Asunto(s)
Enfermedades de la Córnea/tratamiento farmacológico , Síndromes de Ojo Seco/tratamiento farmacológico , Ácido Hialurónico/uso terapéutico , Soluciones Oftálmicas/uso terapéutico , Conservadores Farmacéuticos/uso terapéutico , Lágrimas/química , Enfermedades de la Córnea/diagnóstico , Síndromes de Ojo Seco/diagnóstico , Femenino , Humanos , Ácido Hialurónico/administración & dosificación , Masculino , Persona de Mediana Edad , Soluciones Oftálmicas/administración & dosificación , Conservadores Farmacéuticos/administración & dosificación , Propiedades de Superficie
2.
Orv Hetil ; 155(37): 1454-60, 2014 Sep 14.
Artículo en Húngaro | MEDLINE | ID: mdl-25194867

RESUMEN

Accumulating clinical evidence supports co-morbidity of irritable bowel, irritable eye and irritable mind symptoms. Furthermore, perturbation of the microbiota-host symbiosis (dysbiosis) is considered a common pathogenic mechanism connecting gastrointestinal, ocular and neuropsychiatric symptoms. Consequently, maintaining or restoring microbiota-host symbiosis represents a new approach to treat these symptoms or to prevent their relapses. Current treatment approach assigned a primary role to live probiotics alone or in combination with prebiotics to enhance colonization of beneficial bacteria and to strengthen the symbiosis. However, several papers showed major benefits of heat-killed probiotics as compared to their live counterparts on both intestinal and systemic symptoms. Recently, in addition to killing probiotics, in a proof of concept study lysates (fragments) of probiotics in combination with vitamins A, B, D and omega 3 fatty acids were successfully tested. These findings suggested a conceptual change in the approach addressed to both the microbiota and host as targets for intervention.


Asunto(s)
Oftalmopatías/fisiopatología , Oftalmopatías/terapia , Mucosa Intestinal/fisiopatología , Síndrome del Colon Irritable/fisiopatología , Síndrome del Colon Irritable/terapia , Genio Irritable , Microbiota , Trastornos del Humor/fisiopatología , Trastornos del Humor/terapia , Probióticos/uso terapéutico , Síntomas Afectivos/fisiopatología , Síntomas Afectivos/terapia , Medicina Basada en la Evidencia , Oftalmopatías/inmunología , Humanos , Mucosa Intestinal/inmunología , Síndrome del Colon Irritable/inmunología , Trastornos del Humor/inmunología , Prebióticos , Simbiosis
3.
Ocul Surf ; 12(2): 134-45, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24725325

RESUMEN

Previous studies showed comorbidity of some ocular, enteral, and affective symptoms comprising irritable eye syndrome. Aims of the present study were to learn more about the pathogenic mechanisms of this syndrome and to evaluate benefits of food supplements on these disorders. In in vitro assay, Lactobacillus acidophilus lysate inhibited interleukin (IL)-1ß and tumor necrosis factor (TNF)-α generation of lipopolysaccharide (LPS)-stimulated macrophages in dose- and size-dependent manner. For a prospective, open-label phase I/II controlled clinical trial, 40 subjects affected by ocular dysesthesia and hyperesthesia and comorbid enteral and anxiety-depression symptoms were randomly assigned either into the treated group, which received a composition containing probiotic lysate, vitamins A, B, and D and omega 3 fatty acids, or into the control group, which received vitamins and omega 3 fatty acids. For reference, 20 age- and sex-matched healthy subjects were also selected. White blood count (WBC) and lymphocyte and monocyte counts, as well as IL-6 and TNF-α levels, were significantly above the reference levels in both treated and control groups. After 8 weeks, WBC and lymphocyte and monocyte counts, and cytokine levels significantly decreased, and ocular, enteral, and anxiety-depression symptoms significantly improved in the treated group as compared to the control group. This proof-of-concept study suggested that subclinical inflammation may be a common mechanism connecting ocular, enteral, and anxiety/depression symptoms, and supplements affecting dysbiosis may be a new approach to treating this syndrome.


Asunto(s)
Ácidos Grasos Omega-3/administración & dosificación , Queratitis/inmunología , Queratitis/terapia , Probióticos/uso terapéutico , Vitaminas/administración & dosificación , Adulto , Animales , Aceite de Hígado de Bacalao/administración & dosificación , Estreñimiento/complicaciones , Depresión/complicaciones , Diarrea/complicaciones , Femenino , Humanos , Interleucina-1beta/inmunología , Interleucina-6/inmunología , Queratitis/complicaciones , Lactobacillus acidophilus , Macrófagos/inmunología , Masculino , Ratones Endogámicos , Persona de Mediana Edad , Neuroinmunomodulación/inmunología , Parestesia/inmunología , Parestesia/terapia , Estudios Prospectivos , Factor de Necrosis Tumoral alfa/inmunología
4.
Orv Hetil ; 152(37): 1477-85, 2011 Sep 11.
Artículo en Húngaro | MEDLINE | ID: mdl-21893478

RESUMEN

Recent studies have revealed that inflammation, among other factors, may be involved in the pathogenesis of depression. One line of studies has shown that depression is frequently associated with manifest gastrointestinal inflammations and autoimmune diseases as well as with cardiovascular diseases, neurodegenerative diseases, type 2-diabetes and also cancer, in which chronic low-grade inflammation is a significant contributing factor. Thus depression may be a neuropsychiatric manifestation of a chronic inflammatory syndrome. Another line of studies has shown that the primary cause of inflammation may be the dysfunction of the "gut-brain axis". Although, this is a bidirectional mechanism, life style factors may primarily affect the symbiosis between host mucous membrane and the microbiota. Local inflammation through the release of cytokines, neuropeptides and eicosanoids may also influence the function of the brain and of other organs. Role of metabolic burst due to inflammation represents a new aspect in both pathophysiology and treatment of the depression. Finally, an increasing number of clinical studies have shown that treating gastrointestinal inflammations with probiotics, vitamin B, D and omega 3 fatty acids, through attenuating proinflammatory stimuli to brain, may also improve depression symptoms and quality of life. All these findings justify an assumption that treating gastrointestinal inflammations may improve the efficacy of the currently used treatment modalities of depression and related diseases. However, further studies are certainly needed to confirm these findings.


Asunto(s)
Depresión/etiología , Depresión/terapia , Gastritis/metabolismo , Gastritis/psicología , Enfermedades Inflamatorias del Intestino/metabolismo , Enfermedades Inflamatorias del Intestino/psicología , Enfermedad Crónica , Citocinas/biosíntesis , Depresión/tratamiento farmacológico , Depresión/metabolismo , Eicosanoides/biosíntesis , Ácidos Grasos Omega-3/uso terapéutico , Mucosa Gástrica/metabolismo , Mucosa Gástrica/microbiología , Gastritis/microbiología , Humanos , Enfermedades Inflamatorias del Intestino/microbiología , Mucosa Intestinal/metabolismo , Mucosa Intestinal/microbiología , Neuropéptidos/biosíntesis , Probióticos/uso terapéutico , Complejo Vitamínico B/uso terapéutico , Vitamina D/uso terapéutico
5.
Orv Hetil ; 152(9): 323-30, 2011 Feb 27.
Artículo en Húngaro | MEDLINE | ID: mdl-21324803

RESUMEN

Vitamin D deficiency is pandemic in industrialized countries due to life-style changes. Recent studies suggest that besides bone-metabolism, vitamin D plays a central role in basic cell function like multiplication, differentiation and metabolism. This may explain that low vitamin D levels represent a risk factor for several apparently different diseases such as infective, autoimmune, neurodegenerative and cardiovascular diseases, as well as diabetes, osteoporosis and cancer. Accumulating evidences suggest that an adequate intake of vitamin D may significantly decrease prevalence and clinical outcome of these diseases. Estimated reduction of the economic burden might reach about 10 percent through normalizing vitamin D levels for these diseases. However, high doses of vitamin D monotherapy needs precaution for potential adverse effects and it should be substituted with the recommended doses of vitamin D in combination with synergistic vitamin A and omega 3 fatty acids, such as cod liver oil.


Asunto(s)
Aceite de Hígado de Bacalao/uso terapéutico , Suplementos Dietéticos , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/tratamiento farmacológico , Vitamina D/uso terapéutico , Enfermedades Autoinmunes/etiología , Enfermedades Cardiovasculares/etiología , Aceite de Hígado de Bacalao/administración & dosificación , Aceite de Hígado de Bacalao/metabolismo , Diabetes Mellitus/etiología , Humanos , Neoplasias/etiología , Enfermedades Neurodegenerativas/etiología , Osteoporosis/etiología , Infecciones del Sistema Respiratorio/etiología , Factores de Riesgo , Vitamina D/administración & dosificación , Vitamina D/metabolismo , Deficiencia de Vitamina D/epidemiología , Deficiencia de Vitamina D/prevención & control , Vitaminas/uso terapéutico
6.
Orv Hetil ; 148(48): 2259-68, 2007 Dec 02.
Artículo en Húngaro | MEDLINE | ID: mdl-18039616

RESUMEN

Currently, age-related macular degeneration is one of the most common eye diseases causing severe and permanent loss of vision. This disease is estimated to affect approximately 300-500 thousand Hungarians. While earlier no treatment was available, in the recent decade an antioxidant therapy became very popular using combinations of high dosage antioxidant vitamins C, E, beta carotene and zinc. Based on theoretical concepts and mostly in vitro experiences, this combination was thought to be effective through neutralizing reactive oxygen species. According to a large clinical trial (AREDS) it reduced progression of intermediate state disease to advanced state, but did not influence early disease. This original combination, due to potential severe side effects, is not on the market anymore. However, the efficacy of modified formulas has not been proved yet. Recently, the metabolic therapy, a combination of omega-3 fatty acids, coenzyme Q10 and acetyl-L-carnitine has been introduced for treating early age-related macular degeneration through improving mitochondrial dysfunction, specifically improving lipid metabolism and ATP production in the retinal pigment epithelium, improving photoreceptor turnover and reducing generation of reactive oxygen species. According to a pilot study and a randomized, placebo-controlled, double blind clinical trial, both central visual field and visual acuity slightly improved after 3-6 months of treatment and they remained unchanged by the end of the study. The difference was statistically significant as compared to the base line or to controls. These functional changes were accompanied by an improvement in fundus alterations: drusen covered area decreased significantly as compared to the base line or to control. Characteristically, all these changes were more marked in less affected eyes. A prospective case study on long-term treatment confirmed these observations. With an exception that after slight improvement, visual functions remained stable, drusen regression continued for years. Sometimes significant regression of drusen was found even in intermediate and advanced cases. All these findings strongly suggested that the metabolic therapy may be the first choice for treating age-related macular degeneration. Currently, this is the only combination of ingredients corresponding to the recommended daily allowance, and at the same time, which showed clinically proved efficacy.


Asunto(s)
Acetilcarnitina/uso terapéutico , Antioxidantes/uso terapéutico , Ácidos Grasos Omega-3/uso terapéutico , Degeneración Macular/metabolismo , Degeneración Macular/terapia , Especies Reactivas de Oxígeno/metabolismo , Ubiquinona/análogos & derivados , Vitaminas/uso terapéutico , Adenosina Trifosfato/biosíntesis , Ácido Ascórbico/uso terapéutico , Coenzimas/uso terapéutico , Progresión de la Enfermedad , Quimioterapia Combinada , Humanos , Hungría/epidemiología , Peroxidación de Lípido/efectos de los fármacos , Degeneración Macular/epidemiología , Degeneración Macular/fisiopatología , Mitocondrias/metabolismo , Células Fotorreceptoras/efectos de los fármacos , Células Fotorreceptoras/metabolismo , Epitelio Pigmentado Ocular/efectos de los fármacos , Epitelio Pigmentado Ocular/metabolismo , Ensayos Clínicos Controlados Aleatorios como Asunto , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Ubiquinona/uso terapéutico , Agudeza Visual , Campos Visuales , Vitamina E/uso terapéutico , Compuestos de Zinc/uso terapéutico , beta Caroteno/uso terapéutico
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