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1.
Pain Manag Nurs ; 23(3): 318-323, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-34688552

RESUMEN

BACKGROUND: This study explores live and recorded music listening in the outpatient pain clinic. There is evidence demonstrating the effectiveness of live and recorded music in a hospital setting but a comparison study of this kind has yet to be conducted. METHODS: A multimethod survey study design was used. A questionnaire utilizing rating scales was self-administered across two outpatient pain clinic waiting rooms. Patients were included through convenience sampling. In one clinic, a playlist of recorded music curated by two of the authors was provided. In the second clinic, a music therapy student played live music using guitar, flute, and voice. The questionnaire gathered data on music's impact on pain and emotional states, as well as attitudes toward music in the waiting room. Quantitative data was analyzed using descriptive statistics and qualitative data, gathered in the questionnaires open ended question, was analyzed using thematic analysis. RESULTS: The questionnaire was completed by 200 adult patients. Patients reported lowered levels of anxiety, stress, and pain in both clinics, as well as a shorter waiting time and more caring experience. Patients in the live music clinic reported that music lowered levels of stress, nervousness, agitation, and pain more than in the recorded music clinic. CONCLUSIONS: Participants in this study identified that music is a useful tool in the pain clinic waiting room. This study contributes to evidence that music should be considered as a complimentary treatment for people living with pain and in the wider hospital setting. Additional research is warranted with a control group, pre- and posttesting, and studies of music in hospitals in a range of cultural contexts.


Asunto(s)
Musicoterapia , Música , Adulto , Ansiedad , Humanos , Música/psicología , Musicoterapia/métodos , Pacientes Ambulatorios , Dolor , Clínicas de Dolor , Proyectos Piloto , Salas de Espera
2.
Artículo en Inglés | MEDLINE | ID: mdl-30917977

RESUMEN

An urgent need exists for new antifungal compounds to treat fungal infections in immunocompromised patients. The aim of the current study was to investigate the potency of a novel antifungal compound, MYC-053, against the emerging yeast and yeast-like pathogens Candida glabrata, Candida auris, Cryptococcus neoformans, and Pneumocystis species. MYC-053 was equally effective against the susceptible control strains, clinical isolates, and resistant strains, with MICs of 0.125 to 4.0 µg/ml. Notably, unlike other antifungals such as azoles, polyenes, and echinocandins, MYC-053 was effective against Pneumocystis isolates, therefore being the only synthetic antifungal that may potentially be used against Pneumocystis spp., Candida spp., and Cryptococcus spp. MYC-053 was highly effective against preformed 48-h-old C. glabrata and C. neoformans biofilms, with minimal biofilm eradication concentrations equal to 1 to 4 times the MIC. Together, these data indicated that MYC-053 may be developed into a promising antifungal agent for the treatment and prevention of invasive fungal infections caused by yeasts and yeast-like fungi.


Asunto(s)
Antifúngicos/farmacología , Pirimidinas/farmacología , Biopelículas/efectos de los fármacos , Candida/efectos de los fármacos , Candida glabrata/efectos de los fármacos , Cryptococcus neoformans/efectos de los fármacos , Evaluación Preclínica de Medicamentos , Farmacorresistencia Fúngica/efectos de los fármacos , Pruebas de Sensibilidad Microbiana , Pneumocystis/efectos de los fármacos
3.
BMC Microbiol ; 18(1): 172, 2018 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-30382823

RESUMEN

BACKGROUND: Mycobacterium avium subsp. paratuberculosis (MAP) is the causative agent of paratuberculosis, a contagious infectious disease that affects domestic and wild ruminants causing chronic inflammation of the intestine. MAP has proven to be very resistant to both physical and chemical processes, making it difficult to control this pathogen. Based on the recognized antimicrobial properties of copper, the objective of this study was to evaluate the effectiveness of copper ions to reduce MAP numbers and/or MAP viability in a fluid matrix. Besides, methicillin-resistant Staphylococcus aureus (MRSA), and Escherichia coli were used as controls of the effectiveness of copper ions. MAP-spiked PBS was subjected to copper ions treatment at 24 V for 5 min and the PBS suspensions were sampled before and after treatment. MAP viability and quantification were determined using three complementary techniques: a phage amplification assay, MGIT culture and qPCR. RESULTS: Moderate numbers (103 CFU ml-1) of the two control bacteria were completely eliminated by treatment with copper ions. For MAP, copper ions treatment reduced both the viability and numbers of this pathogen. Phage assay information quickly showed that copper ions (24 V for 5 min) resulted in a significant reduction in viable MAP. MGIT culture results over time showed statistically significant differences in time-to-detection (TTD) values between PRE and POST treatment. MAP genome equivalent estimates for PBS suspensions indicated that MAP numbers were lower in samples POST-treatment with copper ions than PRE-treatment. CONCLUSIONS: The use of copper ions resulted in a significant reduction of MAP in a liquid matrix, although some MAP survival on some occasions was observed.


Asunto(s)
Cobre/farmacología , Viabilidad Microbiana/efectos de los fármacos , Mycobacterium avium subsp. paratuberculosis/efectos de los fármacos , Bacteriófagos/efectos de los fármacos , Bacteriófagos/genética , Tampones (Química) , Recuento de Colonia Microbiana , Escherichia coli/efectos de los fármacos , Genoma Bacteriano/genética , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Mycobacterium avium subsp. paratuberculosis/genética , Reacción en Cadena en Tiempo Real de la Polimerasa
4.
Osteoporos Int ; 27(12): 3615-3626, 2016 12.
Artículo en Inglés | MEDLINE | ID: mdl-27497815

RESUMEN

Cutaneous skeletal hypophosphatemia syndrome (CSHS), caused by somatic RAS mutations, features excess fibroblast growth factor-23 (FGF23) and skeletal dysplasia. Records from 56 individuals were reviewed and demonstrated fractures, scoliosis, and non-congenital hypophosphatemia that in some cases were resolved. Phosphate and calcitriol, but not skin lesion removal, were effective at controlling hypophosphatemia. No skeletal malignancies were found. PURPOSE: CSHS is a disorder defined by the association of epidermal and/or melanocytic nevi, a mosaic skeletal dysplasia, and an FGF23-mediated hypophosphatemia. To date, somatic RAS mutations have been identified in all patients whose affected tissue has undergone DNA sequencing. However, the clinical spectrum and treatment are poorly defined in CSHS. The purpose of this study is to determine the spectrum of the phenotype, natural history of the disease, and response to treatment of hypophosphatemia. METHODS: Five CSHS subjects underwent prospective data collection at clinical research centers. A review of the literature identified 45 reports that included a total of 51 additional patients, in whom the findings were compatible with CSHS. Data on nevi subtypes, bone histology, mineral and skeletal disorders, abnormalities in other tissues, and response to treatment of hypophosphatemia were analyzed. RESULTS: Fractures, limb deformities, and scoliosis affected most CSHS subjects. Hypophosphatemia was not present at birth. Histology revealed severe osteomalacia but no other abnormalities. Skeletal dysplasia was reported in all anatomical compartments, though less frequently in the spine; there was no clear correlation between the location of nevi and the skeletal lesions. Phosphate and calcitriol supplementation was the most effective therapy for rickets. Convincing data that nevi removal improved blood phosphate levels was lacking. An age-dependent improvement in mineral abnormalities was observed. A spectrum of extra-osseous/extra-cutaneous manifestations that included both benign and malignant neoplasms was present in many subjects, though osteosarcoma remains unreported. CONCLUSION: An understanding of the spectrum, natural history, and efficacy of treatment of hypophosphatemia in CSHS may improve the care of these patients.


Asunto(s)
Hipofosfatemia/diagnóstico , Hipofosfatemia/patología , Huesos/patología , Niño , Preescolar , Femenino , Factor-23 de Crecimiento de Fibroblastos , Factores de Crecimiento de Fibroblastos , Humanos , Hipofosfatemia/terapia , Lactante , Masculino , Nevo Pigmentado/etiología , Osteomalacia/etiología , Fosfatos , Estudios Prospectivos , Neoplasias Cutáneas/etiología
5.
Eur J Clin Nutr ; 66(12): 1295-302, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-23073259

RESUMEN

BACKGROUND/OBJECTIVES: This study explored interactions between dietary fat intake and the tumor necrosis factor-α gene (TNFA) -238G>A polymorphism (rs361525) on adiposity and serum lipid concentrations in apparently healthy premenopausal black and white South African (SA) women. SUBJECTS/METHODS: Normal-weight (N=107) and obese (N=120) black, and normal-weight (N=89) and obese (N=62) white SA women underwent measurements of body composition, fasting lipids and dietary intake, and were genotyped for the -238G>A polymorphism. RESULTS: Black women had a higher -238GA genotype frequency than white women (P<0.001), but there were no differences between body mass index groups. Black women with the -238A allele had a greater body fat % than those with the GG genotype (P<0.001). Further, in black women, with increasing polyunsaturated:saturated fat ratio and omega-6 (n-6):omega-3 (n-3) ratio, high-density lipoprotein-cholesterol (HDL-C) concentrations decreased, and total cholesterol (T-C):HDL-C ratio increased in those with the GA genotype but not the GG genotype. In addition, with increasing n-3 polyunsaturated fatty acid intake (percentage of total energy intake, %E), T-C:HDL-C ratio decreased in those with the GA genotype, but not in those with the GG genotype. In white SA women, with increasing eicosapentaenoic acid (%E) intake, low-density lipoprotein-cholesterol concentrations decreased in those with the GG genotype but not the GA genotype. CONCLUSIONS: The -238G>A polymorphism was associated with body fatness in black women. Interactions between -238G>A genotypes and dietary fat intake on serum lipids and adiposity differed depending on dietary fat intake, but those for serum lipids were not the same in black and white SA women.


Asunto(s)
Tejido Adiposo/efectos de los fármacos , Colesterol/sangre , Grasas de la Dieta/farmacología , Obesidad/genética , Polimorfismo Genético , Grupos Raciales/genética , Factor de Necrosis Tumoral alfa/genética , Adiposidad/efectos de los fármacos , Adiposidad/genética , Adolescente , Adulto , Alelos , Población Negra/genética , Índice de Masa Corporal , Colesterol/genética , Dieta , Grasas de la Dieta/sangre , Ácidos Grasos Omega-3/sangre , Ácidos Grasos Omega-3/farmacología , Femenino , Genotipo , Humanos , Obesidad/sangre , Valores de Referencia , Factores de Riesgo , Sudáfrica , Población Blanca/genética
6.
Aliment Pharmacol Ther ; 35(11): 1317-25, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22506503

RESUMEN

BACKGROUND: Adefovir and tenofovir are nucleotide analogues used as long-term therapy of chronic hepatitis B. Side effects are few, but prolonged and high-dose therapy has been associated with proximal renal tubular dysfunction (RTD). AIM: To assess the incidence of RTD during long-term nucleotide therapy of chronic hepatitis B. METHODS: A total of 51 patients being treated at the Clinical Center, National Institutes of Health were studied. Diagnosis of RTD required de novo appearance of at least three of five features: hypophosphataemia, hypouricaemia, serum creatinine elevation, proteinuria or glucosuria. RESULTS: Among 51 patients treated for 1-10 (mean 7.4) years with adefovir (n = 42), tenofovir (n = 4) or adefovir followed by tenofovir (n = 5), 7 (14%) developed RTD. Time to onset ranged from 22 to 94 (mean 49) months with an estimated 10-year cumulative rate of 15%. All seven had low urinary percent maximal tubular reabsorption of phosphate (<82%). Patients with RTD were older (58 vs. 44 years; P = 0.01) and had lower baseline glomerular filtration rates (82 vs. 97 cc/min; P = 0.08) compared to those without; but did not differ in other features. Six patients with RTD were switched to entecavir, all subsequently had improvements in serum phosphate (2.0-3.0 mg/dL), creatinine (1.6-1.1 mg/dL), uric acid (2.7-3.8 mg/dL) and proteinuria. CONCLUSIONS: Renal tubular dysfunction develops in 15% of patients treated with adefovir or tenofovir for 2-9 years and is partially reversible with change to other antivirals. Monitoring for serum phosphate, creatinine and urinalysis is prudent during long-term adefovir and tenofovir therapy.


Asunto(s)
Adenina/análogos & derivados , Antivirales/efectos adversos , Tasa de Filtración Glomerular/efectos de los fármacos , Hepatitis B Crónica/tratamiento farmacológico , Organofosfonatos/efectos adversos , Insuficiencia Renal/inducido químicamente , Adenina/efectos adversos , Adulto , Anciano , Biomarcadores/metabolismo , Creatinina/metabolismo , Femenino , Humanos , Túbulos Renales/efectos de los fármacos , Masculino , Persona de Mediana Edad , Fosfatos/metabolismo , Tenofovir , Factores de Tiempo , Ácido Úrico/metabolismo
7.
Eur J Vasc Endovasc Surg ; 38(3): 262-6, 2009 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-19540138

RESUMEN

INTRODUCTION: Previous studies indicate that local (LA) rather than general anaesthesia (GA) for carotid endarterectomy (CEA) is associated with reflex hypertension and preservation of cerebral cytochrome oxidase after carotid clamping. The hypothesis that LA offers protection against ischaemic cerebral injury has been investigated by measuring ipsilateral jugular venous neurone specific enolase (NSE: neuronal glycolytic enzyme) and S-100B (glial cell protein) during and after CEA. METHODS: 27 patients with symptomatic carotid artery disease (70-99% stenosis) underwent CEA, 14 under LA and 13 under GA. Jugular venous blood samples were assayed for NSE and S-100B before carotid clamping and at 5min before and 5min, 2, 4, 6, 8, 12 and 24h after clamp release. RESULTS: No neurological complications occurred. S-100B levels were low and did not increase from baseline in either group. Pre-clamp NSE levels were similar in both groups (LA: 17.6 (15.2-20.7)microg/l, GA: 21.5 (11.3-26.2)microg/l; p=0.37) but increased significantly 2h after clamp release in GA patients (LA: 25.5 (16.6-27.8)microg/l, GA: 48.2 (31.4-61.3)microg/l, p=0.05) with a significant rise from baseline in GA patients (p=0.04). CONCLUSIONS: CEA performed under GA is associated with greater rises in jugular venous NSE, and hence cerebral injury, than CEA performed under LA.


Asunto(s)
Anestesia General , Anestesia Local , Estenosis Carotídea/cirugía , Endarterectomía Carotidea , Venas Yugulares/enzimología , Fosfopiruvato Hidratasa/sangre , Anciano , Anestesia General/efectos adversos , Anestesia Local/efectos adversos , Biomarcadores/sangre , Isquemia Encefálica/enzimología , Isquemia Encefálica/etiología , Estenosis Carotídea/diagnóstico por imagen , Estenosis Carotídea/enzimología , Constricción , Endarterectomía Carotidea/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Crecimiento Nervioso/sangre , Subunidad beta de la Proteína de Unión al Calcio S100 , Proteínas S100/sangre , Índice de Severidad de la Enfermedad , Factores de Tiempo , Resultado del Tratamiento , Ultrasonografía , Regulación hacia Arriba
8.
Ann Rheum Dis ; 67(11): 1505-15, 2008 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-18055474

RESUMEN

Animal models of rheumatoid arthritis (RA) are widely used for testing potential new therapies for RA. However, the question of which animal model is most predictive of therapeutic efficacy in human RA commonly arises in data evaluation. A retrospective review of the animal models used to evaluate approved, pending RA therapies, and compounds that were discontinued during phase II or III clinical trials found that the three most commonly used models were adjuvant-induced arthritis (AIA) in rats and collagen-induced arthritis (CIA) in rats and mice. Limited data were found for more recently developed genetically modified animal models. Examination of the efficacy of various compounds in these animal models revealed that a compound's therapeutic efficacy, rather than prophylactic efficacy, in AIA and CIA models was more predictive of clinical efficacy in human RA than data from either model alone.


Asunto(s)
Antirreumáticos/uso terapéutico , Artritis Experimental/tratamiento farmacológico , Artritis Reumatoide/tratamiento farmacológico , Modelos Animales de Enfermedad , Evaluación Preclínica de Medicamentos/métodos , Animales , Artritis Experimental/patología , Artritis Reumatoide/patología , Ensayos Clínicos como Asunto , Humanos , Ratones , Ratas , Especificidad de la Especie , Resultado del Tratamiento
9.
J Clin Endocrinol Metab ; 89(9): 4489-92, 2004 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-15356053

RESUMEN

The Identification and characterization of FGF-23 has provided an opportunity to gain new insight into phosphorus metabolism. Circulating FGF-23 promotes renal excretion of phosphorus, and FGF-23 is measurable in the serum of normal subjects. Serum levels of FGF-23 are elevated in patients with renal phosphate wasting disorders such as tumor induced osteomalacia, X-linked hypophosphatemia and fibrous dysplasia. However, the factors that alter its serum concentration are not known. The study of serum FGF-23 is confounded by the fact that high serum calcium, PTH, and any other putative phosphotonins, have similar effects on serum and urine phosphorus. To circumvent the confounding effect of serum PTH and calcium, we studied serum FGF-23 and phosphate levels in patients with chronic hypoparathyroidism and hyperphosphatemia. Serum was collected in the morning after an overnight fast from three groups: 1) 9 patients with chronic hypoparathyroidism on stable treatment with calcium and calcitriol, 2) 9 patients with primary hyperparathyroidism, and 3) 77 normal controls. Patients with hypoparathyroidism had predictably higher levels of serum phosphorus than patients with hyperparathyroidism or normal controls (5.6 +/- 1.1, 3.1 +/- 0.6, and 3.1 +/- 0.5 mg/dL, mean +/- 1 SD, respectively (p < 0.01 for hypoparathyroid vs. either group)). They also had higher levels of FGF-23 (150 +/- 120 vs. 70 +/- 60, or 55 +/- 20 RIU/ml, respectively (p < 0.05 vs. either group)). In conclusion, serum FGF-23 levels are elevated in patients with hyperphosphatemia and chronic hypoparathyroidism, suggesting a feedback system in which serum FGF-23 responds to serum phosphorus and regulates it. However, in the setting of chronic hypoparathyroidism, the degree of elevation of FGF-23 is insufficient to normalize serum phosphorus.


Asunto(s)
Factores de Crecimiento de Fibroblastos/sangre , Fósforo/sangre , Adulto , Anciano , Anciano de 80 o más Años , Enfermedad Crónica , Femenino , Factor-23 de Crecimiento de Fibroblastos , Humanos , Hipoparatiroidismo/sangre , Masculino , Persona de Mediana Edad
10.
J Clin Endocrinol Metab ; 89(8): 4158-61, 2004 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-15292364

RESUMEN

Matrix extracellular phosphoglycoprotein (MEPE), a member of the Small Integrin Binding Ligand N-linked Glycoprotein (SIBLING) family, is primarily expressed in normal bone and has been proposed as a phosphaturic factor because of high expression and secretion in oncogenic hypophosphatemic osteomalacia tumors. In order to begin to address the role of MEPE in normal human physiology, we developed a competitive ELISA to measure serum levels of MEPE. The ELISA was used to characterize the distribution pattern in a population consisting of 114 normal adult subjects. The mean value of MEPE was 476 +/- 247 ng/ml and levels decreased significantly with increasing age. MEPE levels were also significantly correlated with serum phosphorus and parathyroid hormone (PTH). In addition, MEPE levels correlated significantly with measures of bone mineral density in the femoral neck and total hip in a subset of 50 elderly subjects. The results are consistent with MEPE being involved in phosphate and bone metabolism in a normal population.


Asunto(s)
Densidad Ósea , Proteínas de la Matriz Extracelular/sangre , Glicoproteínas/sangre , Hormona Paratiroidea/sangre , Fosfoproteínas/sangre , Fósforo/sangre , Adulto , Anciano , Envejecimiento/sangre , Ensayo de Inmunoadsorción Enzimática , Cuello Femoral/metabolismo , Articulación de la Cadera/metabolismo , Humanos , Valores de Referencia
12.
J Cataract Refract Surg ; 27(11): 1872-5, 2001 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-11709263

RESUMEN

We describe a second cluster of cases of iatrogenic strabismus that occurred in clinical practices following cataract surgeries that occurred in 2000 when hyaluronidase was once again unavailable for use in periocular anesthetic regimens. Twelve cases of transient or permanent strabismus were referred by 4 anterior segment surgeons who had no previous cases of postcataract strabismus when performing periocular injections with hyaluronidase. The charts of the patients were reviewed retrospectively. Recurrence of an increase in postoperative strabismus when hyaluronidase became unavailable for a second time supports the concept that this enzyme may be more important than previously suspected in preventing damage to the extraocular muscles after periocular anesthetic injections.


Asunto(s)
Anestesia Local/efectos adversos , Anestésicos Combinados/efectos adversos , Anestésicos Locales/efectos adversos , Hialuronoglucosaminidasa , Estrabismo/inducido químicamente , Anciano , Anciano de 80 o más Años , Bupivacaína/efectos adversos , Extracción de Catarata , Análisis por Conglomerados , Femenino , Humanos , Enfermedad Iatrogénica , Lidocaína/efectos adversos , Masculino , Órbita , Estudios Retrospectivos
13.
Antimicrob Agents Chemother ; 45(11): 3234-7, 2001 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-11600389

RESUMEN

Quinupristin-dalfopristin (Q-D), which is active against bacteria and Toxoplasma gondii, was examined for its activity against Pneumocystis carinii. After 72 h of incubation with rat P. carinii in an ATP cytotoxicity assay, the 50% inhibitory concentration of Q-D was 10.6 microg/ml, a level that can be achieved in serum with high-dose administration. Q-D administered intraperitoneally at doses of 50 to 200 mg per kg of body weight per day in the treatment and 100 mg/kg/day three times per week in the prophylaxis of pneumocystosis in immunosuppressed mice reduced the organism burden up to 15- and 302-fold, respectively. We conclude that Q-D has activity against P. carinii in vitro and in vivo.


Asunto(s)
Antibacterianos/uso terapéutico , Infecciones por Pneumocystis/tratamiento farmacológico , Pneumocystis/efectos de los fármacos , Virginiamicina/análogos & derivados , Virginiamicina/uso terapéutico , Adenosina Trifosfato/metabolismo , Animales , Antibacterianos/administración & dosificación , Inyecciones Intraperitoneales , Ratones , Ratones Endogámicos C3H , Pruebas de Sensibilidad Microbiana , Infecciones por Pneumocystis/microbiología , Virginiamicina/administración & dosificación
14.
Artículo en Inglés | MEDLINE | ID: mdl-11563068

RESUMEN

An antisense oligodeoxynucleotide against the human immunodeficiency virus type 1 (HIV-1) Rev response element, a ribozyme complementary to the HIV-1 5'-LTR, and the reverse transcriptase inhibitors 9-(2-phosphonylmethoxyethyl) adenine (PMEA) and (R)-9-(2-phosphonylmethoxypropyl)-adenine (PMPA) inhibited virus replication in monocyte-derived macrophages more effectively when delivered in pH-sensitive liposomes compared to the free drugs.


Asunto(s)
Adenina/análogos & derivados , Adenina/administración & dosificación , Fármacos Anti-VIH/administración & dosificación , VIH-1/efectos de los fármacos , Macrófagos/virología , Oligonucleótidos Antisentido/administración & dosificación , Organofosfonatos , Compuestos Organofosforados/administración & dosificación , ARN Catalítico/administración & dosificación , Replicación Viral/efectos de los fármacos , Adenina/farmacocinética , Fármacos Anti-VIH/farmacocinética , Genes env/genética , VIH-1/fisiología , Humanos , Concentración de Iones de Hidrógeno , Liposomas , Macrófagos/metabolismo , Oligonucleótidos Antisentido/genética , Compuestos Organofosforados/farmacocinética , Tenofovir , Tionucleótidos/administración & dosificación
15.
Ann Intern Med ; 133(5): 367-81, 2000 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-10979882

RESUMEN

PURPOSE: The optimal management of chronic abacterial prostatitis is not known. A systematic review of the literature was done to answer the following questions: Are there accurate, reliable tests to diagnose chronic abacterial prostatitis? Are there effective therapies for it? DATA SOURCES: Studies were identified by searching MEDLINE (1966 to 1999), the Cochrane Library, and bibliographies of identified articles and reviews and by contacting an expert STUDY SELECTION: Diagnostic test articles were included if they reported on controlled studies; treatment articles were included if they reported on randomized or controlled trials. No language restrictions were applied. DATA EXTRACTION: For each selected article, two investigators independently extracted key data on study design, patient characteristics, diagnostic test or treatment characteristics, and outcomes. DATA SYNTHESIS: 19 diagnostic test articles and 14 treatment trials met the inclusion criteria The disparity among studies in design, interventions, and other factors precluded quantitative analysis or pooling of the findings. Diagnostic test articles included 1384 men (mean age, 33 to 67 years) and evaluated infection; inflammation, immunology, and biochemistry; psychological factors; and ultrasonography. Treatment trials included 570 men (mean age, 38 to 45 years) and evaluated medications used to treat benign prostatic hyperplasia, anti-inflammatory drugs, antibiotics, thermotherapy, and miscellaneous medications. No trial was done in the United States. CONCLUSIONS: There is no gold-standard diagnostic test for chronic abacterial prostatitis, and the methodologic quality of available studies of diagnostic tests is low. The few treatment trials are methodologically weak and involved small samples. The routine use of antibiotics and alpha-blockers to treat chronic abacterial prostatitis is not supported by the existing evidence.


Asunto(s)
Prostatitis/diagnóstico , Prostatitis/terapia , Adulto , Anciano , Enfermedad Crónica , Ensayos Clínicos Controlados como Asunto , Humanos , Masculino , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Prostatitis/tratamiento farmacológico , Ensayos Clínicos Controlados Aleatorios como Asunto
16.
Health Phys ; 79(2): 136-46, 2000 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-10910383

RESUMEN

PURPOSE: The use of 192Ir brachytherapy for the treatment of in-stent restenosis of the coronary arteries has shown promising clinical results. This paper investigates the radiation exposure of catheterization laboratory staff associated with the performance of this procedure. METHODS AND MATERIALS: Cath lab staff were monitored using personal monitors (shielded against fluoroscopic x-rays) during the performance of eleven cases using nominal 10 GBq 192Ir sources. Staff positions in the lab were simultaneously tracked by video cameras. Direct measurements were also made using a survey meter. Treatments were administered in a conventional cardiac-catheterization-laboratory. RESULTS: The dosimeter readings were analyzed in combination with the radiation survey and time motion survey. Brachytherapy procedural times for the cardiologist, oncologist, physicist, and angiographic assistants were, respectively, 26 +/- 24, 401 +/- 132, 486 +/- 148, and 7 +/- 13 s per case (mean +/- standard deviation). Readings of the personnel monitors were low. Credible upper limits of the respective doses are estimated to be less than 10, 10, 7, and 5 microSv per procedure. Auxiliary shields reduced the dose to individuals located outside of the catheterization laboratory to less than 0.5 microSv per procedure. CONCLUSIONS: The average radiation dose received by laboratory personnel during a representative 192Ir endocoronary brachytherapy procedure is estimated to be less than 0.1% of the NCRP recommended annual radiation worker's Maximum Permissible Dose (1% of the general public's MPD). This level is justifiable as long as the use of 192Ir benefits patients by producing an improved clinical outcome relative to the use of a less penetrating radionuclide or the application of alternative therapies. Further optimization of the delivery procedure is expected to reduce staff dose.


Asunto(s)
Braquiterapia/normas , Monitoreo del Ambiente/métodos , Dosimetría por Película , Rayos gamma , Oclusión de Injerto Vascular/radioterapia , Personal de Salud , Exposición Profesional/análisis , Braquiterapia/efectos adversos , Braquiterapia/métodos , Enfermedad Coronaria/radioterapia , Humanos , Radioisótopos de Iridio/análisis , Exposición Profesional/prevención & control , Exposición Profesional/normas , Dosis de Radiación , Valores de Referencia , Grabación en Video
17.
Phys Med Biol ; 45(1): 185-96, 2000 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-10661591

RESUMEN

A calibration system has been developed to provide increased accuracy in the measurement of the irradiance responsivity appropriate for UV meters used with broadband, extended sources of the type employed in phototherapy. The single wavelength responsivity of the test meter is obtained in the wavelength range 250-400 nm by intercomparison with a transfer standard meter in a narrow, monochromatic beam. Traceability to primary standard irradiance scales is provided via the National Measurement System with a best uncertainty of 7% (at 95% confidence). The effective responsivity of the test meter, when used with broadband extended sources, is calculated using the measured spectral and angular response of the meter and tabulated data on the spectral and spatial characteristics of the source radiance. The uncertainty in the effective responsivity, independent of the source variability, is estimated to be 10% (at 95% confidence). The advantages of this calibration system over existing approaches are discussed.


Asunto(s)
Fototerapia/métodos , Calibración , Terapia PUVA/instrumentación , Fototerapia/instrumentación , Radiometría/instrumentación , Rayos Ultravioleta
18.
Brain Behav Evol ; 56(5): 269-75, 2000 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-11251319

RESUMEN

Glutamate decarboxylase (GAD), is a key enzyme in the central nervous system (CNS) that synthesizes the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) from glutamate. Our previous phylogenetic studies on the evolution of this enzyme indicates that there are at least two distinct forms: GAD65 and GAD67. They are the products of separate genes and probably derive from a common ancestral GAD gene following gene duplication prior to the emergence of the teleosts more than 200 Myr ago. Furthermore, a third GAD-like molecule, GAD3, discovered in the armed grenadier, Coryphaenoides (Nematonurus) armatus, is equally divergent from both GAD65 and GAD67. Specimens of C. (N.) armatus were collected by trawl at a depth of 4,000 m in the Porcupine Seabight (Northeastern Atlantic), and brains dissected and frozen for RNA extraction. All three GAD forms are found in the cerebellum, telencephalon and hypothalamus. Semiquantitative PCR analysis showed that males and females have similar levels of expression of GAD67 and GAD3 in the tissues studied. Independent of the sex examined, the levels of expression of GAD65 and GAD67 in the cerebellum were approximately half that in the telencephalon. GAD3 levels were approximately 30% higher in the cerebellum than in either the telencephalon or hypothalamus. In contrast to GAD67 and GAD3, hypothalamic expression of GAD65 mRNA is 1.8 times higher (p < 0.05) in males than in females. These data indicate that the expression of GAD65, a key enzyme for the synthesis of GABA is sexually dimorphic in females and males of C. (N.) armatus.


Asunto(s)
Peces/genética , Glutamato Descarboxilasa/genética , Hipotálamo/metabolismo , ARN Mensajero/genética , Caracteres Sexuales , Animales , Evolución Biológica , Femenino , Regulación Enzimológica de la Expresión Génica/fisiología , Isoenzimas/genética , Masculino , Filogenia , Reacción en Cadena de la Polimerasa
19.
Annu Rev Pharmacol Toxicol ; 39: 399-430, 1999.
Artículo en Inglés | MEDLINE | ID: mdl-10331090

RESUMEN

Either an excess or a deficiency of vitamin A and related compounds (retinoids) causes abnormal morphological development (teratogenesis). Potential retinoid sources come from dietary intake, nutritional supplements, and some therapeutic drugs. Therefore, understanding the mechanisms of retinoid teratogenesis is important. This review first gives an overview of the principles of teratology as they apply to retinoid-induced malformations. It then describes relevant aspects of the biochemical pathway and signal transduction of retinoids. The teratogenic activity of various retinoid compounds, the role of the retinoid receptors, and important toxicokinetic parameters in teratogenesis are reviewed.


Asunto(s)
Retinoides/toxicidad , Teratógenos/toxicidad , Anomalías Inducidas por Medicamentos/etiología , Anomalías Inducidas por Medicamentos/genética , Anomalías Inducidas por Medicamentos/patología , Animales , Desarrollo Embrionario y Fetal/genética , Femenino , Humanos , Embarazo , Receptores de Ácido Retinoico/efectos de los fármacos , Receptores de Ácido Retinoico/genética , Retinoides/metabolismo , Retinoides/farmacocinética , Teratógenos/metabolismo , Teratógenos/farmacocinética
20.
Am J Clin Nutr ; 69(5): 1052S-1057S, 1999 05.
Artículo en Inglés | MEDLINE | ID: mdl-10232648

RESUMEN

The microbiota of the human large intestine influences health and well-being. Whereas it has long been accepted that gut bacteria play a role in host pathogenesis, current opinion is that certain microflora components can have beneficial effects on gastroenteritis resistance, blood lipids, antitumor properties, lactose tolerance, and gastrointestinal immunity. It is postulated that in the infant gut an elevated bifidobacterial count may be associated with health advantages that breast-fed infants may have over formula-fed infants. Whereas beneficial aspects of the human gut flora still need definitive confirmation and mechanistic explanations, there is now interest in modulating the composition of gut flora such that a potentially more remedial community exists. This may be achieved through the targeted use of dietary supplementation. This article provides an overview of how probiotics, prebiotics, and synbiotics may contribute toward nutritional modulation of the gut microecology, with emphasis on the neonatal intestine where appropriate. The use of modern molecular methods, as an essential step forward for assessing the validity and accuracy of the modulatory approach, is also discussed.


Asunto(s)
Recién Nacido/inmunología , Intestinos/microbiología , Probióticos , Suplementos Dietéticos , Humanos , Intestinos/inmunología , Estado Nutricional
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