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1.
J Endocrinol Invest ; 46(7): 1385-1395, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36515869

RESUMO

BACKGROUND: Selenium has been shown to influence the pathological processes and physiological functions of thyroid. Although growing evidence has shown that selenium can improve the treatment of Hashimoto's thyroiditis (HT), there is a need to evaluate the association between dietary selenium intake and HT in a large cross-sectional study. This study explored the association between dietary selenium intake and HT based on the National Health reand Nutrition Examination Survey (NHANES) database (2007-2012). METHODS: A total of 8756 of 30,442 participants were included in the study. Dietary selenium intake was the independent variable, while HT was the dependent variable. In addition, the relative importance of the selected variables was determined using the XGBoost model. A smooth curve was constructed based on the fully adjusted model to investigate the potential linear relationship between dietary selenium intake and HT. Smooth curves were also constructed to explore the linear/non-linear relationship between dietary selenium intake and thyroid peroxidase antibody (TPOAb)/ thyroglobulin antibody (TgAb). RESULTS: The mean age of the enrolled participants was 44.35 years (± 20.92). The risk of HT was significantly reduced by a 35% per-unit increase in dietary selenium intake after fully adjusting for covariates according to the model (log2-transformed data; OR 0.65; 95% CI 0.51, 0.83). The XGBoost model revealed that dietary selenium intake was the most important variable associated with Hashimoto's thyroiditis. Dietary selenium intake (Log2-transformed) was negatively correlated with TPOAb levels [- 16.42 (- 22.18, - 10.65), P < 0.0001], while a non-linear relationship was observed between dietary selenium intake and TgAb with an inflection point of 6.58 (95.67 µg, Log2-transformed). CONCLUSION: Dietary selenium intake is independently and inversely associated with HT risk. Moreover, dietary selenium intake is negatively correlated with TPOAb levels and non-linearly correlated with TGAb levels. Therefore, dietary selenium intake may be a safe and low-cost alternative for the prevention and treatment of HT.


Assuntos
Doença de Hashimoto , Selênio , Adulto , Humanos , Inquéritos Nutricionais , Estudos Transversais , Doença de Hashimoto/diagnóstico , Autoanticorpos
2.
Public Health ; 210: 149-159, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35970017

RESUMO

OBJECTIVES: Previous studies have evaluated the effects of probiotic/prebiotic/synbiotic supplementation on blood glucose profiles among diabetic patients. However, the results were inconsistent. STUDY DESIGN: Systematic review and meta-analysis. METHODS: A systematic searching from PubMed, ISI Web of Science, Embase, and Cochrane Central was conducted to identify high-quality clinical trials investigating the effect of probiotic/prebiotic/synbiotic supplementation on blood glucose profiles [including fasting blood glucose (FBG), hemoglobin A1c (HbA1c), and homeostasis model assessment of insulin resistance (HOMA-IR)] up to December 2020. Subgroup analyses by types or durations of probiotic/prebiotic/synbiotic supplementation were conducted to investigate the different effects among different populations. RESULTS: A total of 39 trials with 3517 participants were included in the final analyses. Among patients with type II diabetes (T2DM), the summarized standardized mean differences (SMDs) and 95% confidential intervals (95% CIs) of FBG, HbA1c, and HOMA-IR were -0.30 (95% CI: -0.65 to 0.05), -0.59 (95% CI: -0.88 to -0.30), and -0.68 (95% CI: -1.13 to -0.23), respectively. Among patients with gestational diabetes (GDM), the summary SMDs of FBG, HbA1c and HOMA-IR were -0.67 (95% CI: -1.23 to -0.11), -0.24 (95% CI: -0.57 to 0.08), and -1.06 (95% CI: -1.72 to -0.40), respectively. Similar improvements in blood glucose profiles were also found among persons with prediabetes or gestational woman with normal glucose, but not among patients with type I diabetes. Subgroup analyses showed similar results of probiotic supplementation for patients with T2DM and probiotic/synbiotic supplementation for patients with GDM. CONCLUSION: Probiotic/prebiotic/synbiotic supplementation might improve the blood glucose profiles among patients with T2DM/GDM, persons with prediabetes, or gestational woman with normal glucose. Trials with more sophisticated design are needed to validate the results in the future. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020161975.


Assuntos
Diabetes Mellitus Tipo 2 , Diabetes Gestacional , Estado Pré-Diabético , Probióticos , Simbióticos , Glicemia , Suplementos Nutricionais , Feminino , Hemoglobinas Glicadas , Humanos , Prebióticos , Gravidez , Probióticos/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Zhonghua Gan Zang Bing Za Zhi ; 28(11): 954-958, 2020 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-33256282

RESUMO

Objective: To investigate the clinical characteristics, incidence trend, underlying diseases, causative drug and prognosis of drug-induced liver injury (DILI), so as to provide basis for its prevention and treatment. Methods: A retrospective study was conducted on 2 820 DILI cases who were admitted to our hospital from January 2002 to December 2015, and their clinical characteristics, incidence trends, underlying related diseases, causative drug, treatment and outcome were analyzed. Results: Among 2 820 DILI cases, the ratio of male to female was 1:1.44, and the age was (44.00±16.32) years old. According to the clinical classification of DILI, there were 2 353 cases (83.43%) of hepatocyte injury, 353 cases (12.51%) of cholestatic type and 114 cases (4.04%) of mixed type. In the three clinical classification of DILI, there was no statistically significant difference in the ratio of male to female (χ(2) = 3.032, P > 0.05). However, the difference in the ratio of male to female between different age groups was statistically significant (χ(2) = 48.367, P < 0.001). Among the patients with liver disease and acute liver disease admitted to our hospital from January 2002 to December 2015, the proportion of DILI and acute DILI showed an overall upward trend. The main underlying related diseases of 2 820 DILI cases were fever (15.14%), skin diseases (11.84%), cardiovascular and cerebrovascular diseases (11.17%). Chinese herbal patent medicines (37.49%), antibiotics (15.85%), antipyretic-analgesics (14.37%), and so on were the main causative drugs involved, and the prognostic differences among the three clinical classifications of DILI in terms of cure, improvement, ineffectiveness, and death were statistically significant (H = 61.300, P < 0.001). Conclusion: In recent years, among the patients with liver disease in our hospital, the proportion of DILI has shown an obvious upward trend, involving a variety of underlying diseases and causative drugs, and thus it needs clinical attention.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas , Colestase , Adulto , Antibacterianos , Doença Hepática Induzida por Substâncias e Drogas/epidemiologia , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Feminino , Hepatócitos , Humanos , Fígado , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
4.
J Ethnopharmacol ; 147(2): 497-502, 2013 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-23542144

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: The use of African chewing sticks in maintaining oral health is widely practiced in African countries. It has been reported that chewing stick users have a lower rate of dental caries and a better general oral health than non-users. It is generally thought that the beneficial effect of chewing stick is attributed to the mechanical cleansing effect and antimicrobial substances present in the stick. However, the active antimicrobial substances remain uncharacterized. AIM OF THE STUDY: To provide a scientific basis for the anti-caries effect of African chewing sticks, the authors purify an active antibacterial compound from Garcinia kola Heckel, a Nigerian chewing stick and examined the antibacterial activity of this compound against the cariogenic bacterium Streptococcus mutans. MATERIALS AND METHODS: Methanol extract was prepared from Garcinia kola and was further fractionated by solvent extractions. Silica gel chromatography was used to purify the antibacterial compound from the active fraction. The identity of the purified compound was determined by NMR analysis. The antibacterial activity of the purified compound was examined by standard microbiological assays. RESULTS: The antibacterial activity was found in the ether fraction and the active compound was isolated and determined to be a biflavonoid named GB1. GB1 was active against Streptococcus mutans and other oral bacteria with minimum inhibitory concentration (MIC) values of 32-64µg/ml. The basis for the antibacterial effect of GB1 was investigated using Streptococcus mutans as the target. At 256µg/ml, GB1 exhibited some bacteriocidal activity against Streptococcus mutans and induced the aggregation of Streptococcus mutans. GB1 has no apparent effects on protein synthesis and DNA synthesis but inhibited glucose uptake and utilization by Streptococcus mutans suggesting that GB1 exerts its antibacterial effect by inhibiting metabolism. GB1 also inhibited the formation of water-insoluble glucan by the extracellular glucosyltransferases from Streptococcus mutans in a dose-dependent manner. Streptococcus mutans did not develop resistance to GB1 upon subculturing in the presence of sub-MIC level of the biflavonoid. CONCLUSION: The antibacterial effect and glucan synthesis-inhibition property of this biflavonoid may account for some of the beneficial effects reported in the chewing stick users.


Assuntos
Antibacterianos/farmacologia , Biflavonoides/farmacologia , Garcinia kola , Extratos Vegetais/farmacologia , Antibacterianos/isolamento & purificação , Bactérias/efeitos dos fármacos , Bactérias/crescimento & desenvolvimento , Bactérias/metabolismo , Biflavonoides/isolamento & purificação , Glucanos/metabolismo , Testes de Sensibilidade Microbiana , Raízes de Plantas
5.
AJNR Am J Neuroradiol ; 34(7): 1341-7, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23391838

RESUMO

BACKGROUND AND PURPOSE: Secondary degeneration of the pyramidal tract after focal motor pathway stroke has been observed by diffusion tensor imaging. However, the relationships between outcomes in hand function and secondary degeneration in widespread regions are not well understood. For the first time, we investigated the differences of secondary degeneration across the whole brain between subgroups of patients with stroke. MATERIALS AND METHODS: We selected 23 patients who had a subcortical stroke in the left motor pathway and displayed only motor deficits. The patients were divided into 2 subgroups: CPH (11 patients) and PPH (12 patients). Twelve healthy controls matched for age and handedness were also recruited. We used both optimized VBM and TBSS to explore differences of FA across the whole brain between CPH and PPH. Furthermore, ROI analysis was carried out in the identified regions detected by VBM analysis to further quantify the degree of secondary degeneration in the CPH and PPH and compare these with healthy controls. RESULTS: Compared with PPH, FA was significantly decreased in the CPH in widespread regions of the motor system remote from the primary lesion, including the ipsilesional brain stem, medial frontal gyrus, precentral gyrus, superior temporal gyrus, supplementary motor area, and contralesional postcentral gyrus. In addition, FA within these identified regions correlated with Fugl-Meyer Assessment scores (hand+wrist). CONCLUSIONS: This study suggests a potential biomarker for outcome differences in hand function after subcortical stroke.


Assuntos
Imagem de Tensor de Difusão/métodos , Mãos/fisiopatologia , Degeneração Neural/diagnóstico , Paralisia/fisiopatologia , Tratos Piramidais/patologia , Doenças da Medula Espinal/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Anisotropia , Gânglios da Base/patologia , Mapeamento Encefálico , Tronco Encefálico/patologia , Estudos de Casos e Controles , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Cápsula Interna/patologia , Masculino , Pessoa de Meia-Idade , Córtex Motor/patologia , Vias Neurais/patologia , Paralisia/etiologia , Estudos Prospectivos , Acidente Vascular Cerebral/complicações , Tálamo/patologia
6.
Plant Mol Biol ; 78(1-2): 171-83, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22086333

RESUMO

The Arabidopsis AtMYB80 transcription factor (formerly AtMYB103) regulate genes essential for tapetal and pollen development. One of these genes, coding for an aspartic protease (UNDEAD), may control the timing of tapetal programmed cell death (PCD). In crop plants such as rice and wheat, abiotic stresses lead to abnormal tapetal development resulting in delayed PCD. Manipulation of AtMYB80 function has been used to develop a reversible male sterility system applicable to hybrid crop production. MYB80 homologs were cloned from wheat, rice, canola and cotton. The promoters of the homologs drove temporal and spatial expression patterns of the GUS reporter gene in the tapetum and microspores of Arabidopsis anthers identical to the AtMYB80 promoter. A short region is conserved in all five MYB80 promoters. The MYB80 homolog genes, driven by the AtMYB80 or their respective promoters, rescued the atmyb80 mutant, completely restoring male fertility. The canola MYB80 was fused to the EAR (ERF-associated amphiphilic repression) repressor and canola plants transgenic for the construct exhibited premature tapetal degradation and subsequent pollen abortion. The five MYB80 homologs all shared a 44 amino acid sequence immediately adjacent to the R2R3 domain which appears to be necessary for MYB80 function.


Assuntos
Produtos Agrícolas/genética , Regulação da Expressão Gênica no Desenvolvimento , Regulação da Expressão Gênica de Plantas , Proteínas de Plantas/genética , Pólen/genética , Sequência de Aminoácidos , Proteínas de Arabidopsis/genética , Sequência de Bases , Brassica napus/genética , Produtos Agrícolas/crescimento & desenvolvimento , Teste de Complementação Genética , Glucuronidase/genética , Glucuronidase/metabolismo , Gossypium/genética , Dados de Sequência Molecular , Mutação , Oryza/genética , Filogenia , Infertilidade das Plantas/genética , Proteínas de Plantas/classificação , Plantas Geneticamente Modificadas , Pólen/crescimento & desenvolvimento , Regiões Promotoras Genéticas/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Homologia de Sequência de Aminoácidos , Homologia de Sequência do Ácido Nucleico , Triticum/genética
7.
Plant Cell ; 23(6): 2209-24, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21673079

RESUMO

Arabidopsis thaliana MYB80 (formerly MYB103) is expressed in the tapetum and microspores between anther developmental stages 6 and 10. MYB80 encodes a MYB transcription factor that is essential for tapetal and pollen development. Using microarray analysis of anther mRNA, we identified 404 genes differentially expressed in the myb80 mutant. Employing the glucocorticoid receptor system, the expression of 79 genes was changed when MYB80 function was restored in the myb80 mutant following induction by dexamethasone. Thirty-two genes were analyzed using chromatin immunoprecipitation, and three were identified as direct targets of MYB80. The genes encode a glyoxal oxidase (GLOX1), a pectin methylesterase (VANGUARD1), and an A1 aspartic protease (UNDEAD). All three genes are expressed in the tapetum and microspores. Electrophoretic mobility shift assays confirmed that MYB80 binds to all three target promoters, with the preferential binding site containing the CCAACC motif. TUNEL assays showed that when UNDEAD expression was silenced using small interfering RNA, premature tapetal and pollen programmed cell death occurred, resembling the myb80 mutant phenotype. UNDEAD possesses a mitochondrial targeting signal and may hydrolyze an apoptosis-inducing protein(s) in mitochondria. The timing of tapetal programmed cell death is critical for pollen development, and the MYB80/UNDEAD system may regulate that timing.


Assuntos
Proteínas de Arabidopsis/metabolismo , Arabidopsis/anatomia & histologia , Arabidopsis/crescimento & desenvolvimento , Flores/citologia , Flores/fisiologia , Pólen/crescimento & desenvolvimento , Fatores de Transcrição/metabolismo , Arabidopsis/genética , Arabidopsis/metabolismo , Proteínas de Arabidopsis/genética , Sequência de Bases , Hidrolases de Éster Carboxílico/genética , Hidrolases de Éster Carboxílico/metabolismo , Morte Celular/fisiologia , Imunoprecipitação da Cromatina , Perfilação da Expressão Gênica , Regulação da Expressão Gênica de Plantas , Análise em Microsséries , Dados de Sequência Molecular , Plantas Geneticamente Modificadas , Pólen/citologia , Regiões Promotoras Genéticas , RNA Interferente Pequeno/metabolismo , Proteínas Recombinantes de Fusão/genética , Proteínas Recombinantes de Fusão/metabolismo , Fatores de Transcrição/genética
8.
Water Sci Technol ; 63(6): 1230-5, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21436561

RESUMO

Fortified soil was made up of a mixture at a mass ratio 4/1000-6/1000 of sponge and natural soil according to the results of column experiment. The fortified soil had bigger porosity and higher hydraulic conductivity than the natural soil. The columns packed with 900 mm of the fortified soil endured a flow rate equivalent to 100 L/m(2)/d of septic tank effluent and the average chemical oxygen demand, nitrogen, and phosphorus removal rates were around 92%, 75% and 96%, respectively. After 100 weeks of operation, the saturated hydraulic conductivity of the fortified soil kept higher than 0.2 m/d. The bigger porosity of sponge improved the effective porosity, and the bigger specific surface area of sponge acted as an ideal support for biomat growth and ensured the sewage treatment performance of the fortified soil. The comparable performance was due to a similar and sufficient degree of soil clogging genesis coupled with bioprocesses that effectively purified the septic tank effluent given the adequate retention times.


Assuntos
Poliuretanos , Esgotos , Solo , Eliminação de Resíduos Líquidos/métodos , Purificação da Água
9.
Health Technol Assess ; 14(8): iii, ix-xi, 1-193, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20181324

RESUMO

OBJECTIVES: To identify and appraise empirical studies on publication and related biases published since 1998; to assess methods to deal with publication and related biases; and to examine, in a random sample of published systematic reviews, measures taken to prevent, reduce and detect dissemination bias. DATA SOURCES: The main literature search, in August 2008, covered the Cochrane Methodology Register Database, MEDLINE, EMBASE, AMED and CINAHL. In May 2009, PubMed, PsycINFO and OpenSIGLE were also searched. Reference lists of retrieved studies were also examined. REVIEW METHODS: In Part I, studies were classified as evidence or method studies and data were extracted according to types of dissemination bias or methods for dealing with it. Evidence from empirical studies was summarised narratively. In Part II, 300 systematic reviews were randomly selected from MEDLINE and the methods used to deal with publication and related biases were assessed. RESULTS: Studies with significant or positive results were more likely to be published than those with non-significant or negative results, thereby confirming findings from a previous HTA report. There was convincing evidence that outcome reporting bias exists and has an impact on the pooled summary in systematic reviews. Studies with significant results tended to be published earlier than studies with non-significant results, and empirical evidence suggests that published studies tended to report a greater treatment effect than those from the grey literature. Exclusion of non-English-language studies appeared to result in a high risk of bias in some areas of research such as complementary and alternative medicine. In a few cases, publication and related biases had a potentially detrimental impact on patients or resource use. Publication bias can be prevented before a literature review (e.g. by prospective registration of trials), or detected during a literature review (e.g. by locating unpublished studies, funnel plot and related tests, sensitivity analysis modelling), or its impact can be minimised after a literature review (e.g. by confirmatory large-scale trials, updating the systematic review). The interpretation of funnel plot and related statistical tests, often used to assess publication bias, was often too simplistic and likely misleading. More sophisticated modelling methods have not been widely used. Compared with systematic reviews published in 1996, recent reviews of health-care interventions were more likely to locate and include non-English-language studies and grey literature or unpublished studies, and to test for publication bias. CONCLUSIONS: Dissemination of research findings is likely to be a biased process, although the actual impact of such bias depends on specific circumstances. The prospective registration of clinical trials and the endorsement of reporting guidelines may reduce research dissemination bias in clinical research. In systematic reviews, measures can be taken to minimise the impact of dissemination bias by systematically searching for and including relevant studies that are difficult to access. Statistical methods can be useful for sensitivity analyses. Further research is needed to develop methods for qualitatively assessing the risk of publication bias in systematic reviews, and to evaluate the effect of prospective registration of studies, open access policy and improved publication guidelines.


Assuntos
Disseminação de Informação , Viés de Publicação , Viés , Pesquisa Biomédica/normas , Medicina Baseada em Evidências/normas , Humanos , Viés de Publicação/estatística & dados numéricos , Literatura de Revisão como Assunto
10.
Phytomedicine ; 17(1): 75-80, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19682877

RESUMO

Semen Ziziphi spinosae (Suanzaoren in China) and Radix et Rhizoma Salviae miltiorrhizae (Danshen in China) are conventional herbal drugs in traditional Chinese medicine and have been used widely for the treatment of insomnia. In the present study, the sedative-hypnotic activity of the active fractions extracted from Suanzaoren and Danshen were studied using the method of pentobarbital-induced sleep in the mouse model. Qualitative analysis of the standardized extracts was carried out by HPLC-DAD. The results showed that the water extract of Suanzaoren (SWE) (400 and 800 mg/kg body wt.) and the ether extract of Danshen (DTT) (300 and 600 mg/kg body wt.) can shorten sleep latency significantly, increase sleeping time and prolong movement convalescence time induced by sodium pentobarbital (55 mg/kg body wt.) administration in mice. Furthermore, the combination of SWE and DTT showed significant synergistic effect (p<0.05) in decreasing sleep latency and increasing sleeping time, but not in prolonging the movement convalescence time, which might be helpful for energy recovery in the treatment of insomnia. The results suggest that SWE, DTT, and the combination of SWE and DTT possess significant sedative-hypnotic activity, which supports the popular use of Suanzaoren and Danshen for treatment of insomnia and provide the basis for new drug discovery. Furthermore, the results demonstrate that the combination of SWE and DTT may be preferable for the treatment of insomnia.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Hipnóticos e Sedativos/uso terapêutico , Movimento/efeitos dos fármacos , Fenantrolinas/uso terapêutico , Salvia miltiorrhiza/química , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Ziziphus/química , Animais , Sinergismo Farmacológico , Medicamentos de Ervas Chinesas/farmacologia , Hipnóticos e Sedativos/farmacologia , Masculino , Camundongos , Pentobarbital , Fenantrolinas/farmacologia , Raízes de Plantas , Sementes
11.
Eur J Clin Nutr ; 62(12): 1412-8, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17684522

RESUMO

OBJECTIVE: To clearly clarify the protective effect of vitamin A supplementation on immune function of well-nourished children suffering from vitamin A deficiency. METHODS: Three hundred sixty-two children in two kindergartens in Wuhan China were enrolled. Detailed dietary assessment and anthropometry were undertaken to facilitate the exclusion of malnourished children. Seventy vitamin A-deficient children with informed consent were randomly divided into the vitamin A-deficient-supplemented group and vitamin A-deficient placebo group, 35 vitamin A-sufficient children (age- and sex-matched with the vitamin A-deficient-supplemented group children) were selected as vitamin A-sufficient placebo group. The baseline and follow-up level of selected immune parameters of the 105 children in three intervention groups were compared. RESULTS: The total proportion of severe and marginal vitamin A-deficient children was 10.9 and 21.96%, respectively. At baseline, the serum complement C3 and sIgA level of vitamin A-sufficient children was significantly higher than that of vitamin A-deficient children (P < 0.05). However, the serum lysozyme level of vitamin A-sufficient children was inversely lower. After intervention, vitamin A-deficient-supplemented children increased serum vitamin A, complement C3 and sIgA level, but their serum lysozyme level inversely decreased. CONCLUSIONS: Vitamin A deficiency was still a serious health problem in children in China cities. Vitamin A supplementation was efficacious in ameliorating serum vitamin A status and partially impaired immune function of well-nourished children suffering from vitamin A deficiency.


Assuntos
Complemento C3/metabolismo , Imunoglobulina A/sangue , Muramidase/sangue , Deficiência de Vitamina A/imunologia , Vitamina A/sangue , Vitamina A/farmacologia , Criança , Pré-Escolar , China/epidemiologia , Suplementos Nutricionais , Feminino , Humanos , Imunidade/efeitos dos fármacos , Masculino , Estado Nutricional , Deficiência de Vitamina A/sangue , Deficiência de Vitamina A/tratamento farmacológico , Deficiência de Vitamina A/epidemiologia
12.
Health Technol Assess ; 11(38): iii-iv, ix-66, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17903392

RESUMO

OBJECTIVES: To examine the clinical effectiveness and cost-effectiveness of self-testing and self-management of oral anticoagulation treatment compared with clinic-based monitoring. DATA SOURCES: Major electronic databases were searched up to September 2005. REVIEW METHODS: A systematic review was undertaken of relevant data from selected studies. Results about complication events and deaths were pooled in meta-analyses using risk difference (RD) as the outcome statistic. Heterogeneity across trials and possible publication bias were statistically measured. Subgroup analyses (post hoc) were conducted to compare results of self-testing versus self-management, low versus high trial quality, trials conducted in the UK versus trials in other countries and industry versus other sponsors. A Markov-type, state-transition model was developed. Stochastic simulations using the model were conducted to investigate uncertainty in estimated model parameters. RESULTS: In the 16 randomised and eight non-randomised trials selected, patient self-monitoring of oral anticoagulation therapy was found to be more effective than poor-quality usual care provided by family doctors and as effective as good-quality specialised anticoagulation clinics in maintaining the quality of anticoagulation therapy. There was no significant RD of major bleeding events between patient self-monitoring and usual care controls and pooled analyses found that compared with primary care or anticoagulation control (AC) clinics, self-monitoring was statistically significantly associated with fewer thromboembolic events. However, the reduction in complication events and deaths was not consistently associated with the improvement of AC; in some trials this may be due to alternative explanations, including patient education and patient empowerment. Also, the improved AC and the reduction of major complications and deaths by patient self-monitoring were mainly observed in trials conducted outside the UK. According to UK-specific data, for every 100 eligible patients, 24% would agree to conduct self-monitoring, 17 of the 24 patients (70%) could be successfully trained and able to carry out self-monitoring and only 14 of these (80%) would conduct long-term self-monitoring. Seven cost-effectiveness studies were identified and the study that provided the most relevant UK data found that patient self-management was more expensive than current routine care (417 pounds versus 122 pounds per patient-year) and concluded that using a cost-effectiveness threshold of 30,000 pounds per quality-adjusted life-year (QALY) gained, patient self-management does not appear to be cost-effective. De novo modelling for this report found that the incremental cost per QALY gained by patient self-monitoring is 122,365 pounds over 5 years and 63,655 pounds over 10 years. The estimated probability that patient self-monitoring is cost-effective (up to 30,000 pounds/QALY) is 44% over a 10-year period. Wide adoption of patient self-monitoring of anticoagulation therapy would cost the NHS an estimated additional 8-14 million pounds per year. CONCLUSIONS: For selected and successfully trained patients, self-monitoring is effective and safe for long-term oral anticoagulation therapy. In general, patient self-management (PSM) is unlikely to be more cost-effective than the current specialised anticoagulation clinics in the UK; self-monitoring may enhance the quality of life for some patients who are frequently away from home, who are in employment or education, or those who find it difficult to travel to clinics. Further research is needed into alternative dosing regimes, the clinical effectiveness and cost-effectiveness of patient education and training in long-term oral anticoagulation therapy, UK-relevant cost-effectiveness, the effectiveness of PSM in children, and the potential future developments of near-patient testing devices.


Assuntos
Anticoagulantes , Autocuidado/normas , Trombose/tratamento farmacológico , Resultado do Tratamento , Administração Oral , Anticoagulantes/administração & dosagem , Anticoagulantes/efeitos adversos , Anticoagulantes/economia , Anticoagulantes/uso terapêutico , Ensaios Clínicos Controlados como Assunto , Análise Custo-Benefício , Bases de Dados Bibliográficas , Hemorragia/induzido quimicamente , Hemorragia/mortalidade , Humanos , Cadeias de Markov , Modelos Econômicos , Cooperação do Paciente , Educação de Pacientes como Assunto , Satisfação do Paciente , Seleção de Pacientes , Tempo de Protrombina , Anos de Vida Ajustados por Qualidade de Vida , Autocuidado/economia , Trombose/mortalidade , Trombose/prevenção & controle , Reino Unido , Varfarina/administração & dosagem , Varfarina/efeitos adversos , Varfarina/economia , Varfarina/uso terapêutico
13.
Antiviral Res ; 75(3): 242-9, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17475343

RESUMO

The chemical nature, the mode of action, and the in vitro and in vivo anti-HSV activities of the polysaccharide from Prunella vulgaris were characterized. The polysaccharide was isolated by ethanol precipitation, dialysis, CTAB precipitation, and gel exclusion chromatography. The isolated compound (PPS-2b) was a lignin-carbohydrate complex with a molecular weight of 8500. The carbohydrate moiety was composed of glucose, galactose, mannose, galacturonic acid, rhamnose, xylose, and arabinose with glucose as the major sugar. In plaque reduction assay, PPS-2b showed activities against HSV-1 and HSV-2. The anti-HSV activity could be abolished by periodate oxidation. Mechanism studies showed that PPS-2b inactivated HSV-1 directly, blocked HSV-1 binding to Vero cells, and inhibited HSV-1 penetration into Vero cells. A similar inhibition was observed with a gC-deficient strain of HSV-1. The in vivo activities of a Prunella cream formulated with a semi-purified fraction was assessed in a HSV-1 skin lesion model in guinea pigs and a HSV-2 genital infection model in BALB/c mice. Guinea pigs that received the Prunella cream treatment showed a significant reduction (P<0.01) in skin lesions. Mice that received the Prunella cream treatment showed a significant reduction (P<0.01) in mortality. In conclusion, the anti-HSV compound from P. vulgaris is a lignin-polysaccharide complex with potent activity against HSV-1 and HSV-2. Its mode of action appears to be inhibiting viral binding and penetration into host cells.


Assuntos
Antivirais/uso terapêutico , Herpes Simples/tratamento farmacológico , Herpesvirus Humano 1/efeitos dos fármacos , Herpesvirus Humano 2/efeitos dos fármacos , Polissacarídeos/uso terapêutico , Prunella , Animais , Antivirais/farmacologia , Antivirais/toxicidade , Chlorocebus aethiops , Feminino , Cobaias , Herpes Genital/tratamento farmacológico , Lignina/farmacologia , Lignina/uso terapêutico , Camundongos , Camundongos Endogâmicos BALB C , Fitoterapia , Extratos Vegetais/uso terapêutico , Polissacarídeos/química , Polissacarídeos/isolamento & purificação , Polissacarídeos/farmacologia , Células Vero
14.
Phytother Res ; 18(8): 647-51, 2004 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15476302

RESUMO

Using a bioassay-directed purification scheme, the active antibacterial principle from Caesalpina sappan was isolated and identified to be brasilin. This compound showed potent activity against antibiotic-resistant bacteria, notably methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), multi-drug resistant Burkholderia cepacia as well as a number of other bacteria. The minimal inhibitory concentrations ranged from 4 to 32 microg/mL. The results from time-kill studies showed that brasilin is bactericidal against MRSA. The addition of brasilin to growing MRSA cells resulted in a rapid inhibition of incorporation of [(3)H] thymidine or [(3)H] serine into DNA and proteins, respectively. Exposure of MRSA to a sub-MIC level of brasilin for ten consecutive subcultures did not induce resistance to the compound. The Trypan blue dye exclusion test showed that brasilin lacked cytotoxicity against Vero cells. In conclusion, brasilin is an antibacterial principle from C. sappan and it has the potential to be developed into an antibiotic.


Assuntos
Antibacterianos/farmacologia , Benzopiranos/farmacologia , Fabaceae , Fitoterapia , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Proteínas de Bactérias/efeitos dos fármacos , Benzopiranos/administração & dosagem , Benzopiranos/uso terapêutico , Burkholderia cepacia/efeitos dos fármacos , Enterococcus/efeitos dos fármacos , Humanos , Resistência a Meticilina , Testes de Sensibilidade Microbiana , Extratos Vegetais/administração & dosagem , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Staphylococcus aureus/efeitos dos fármacos , Resistência a Vancomicina , Madeira
15.
J Tradit Chin Med ; 21(3): 187-8, 2001 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11789322

RESUMO

Thirty-six cases with hyperglycemia were treated with the method of promoting blood circulation and removing stasis in a course of 4 weeks. The treatment was significantly effective in correcting the abnormal viscosity of the blood by reducing the contents of total plasmic cholesterol (TC), triglyceride (TG) and apoprotein B (apoB), while the level of the apoprotein A (apoA) was elevated.


Assuntos
Viscosidade Sanguínea , Medicamentos de Ervas Chinesas/uso terapêutico , Hiperglicemia/tratamento farmacológico , Adulto , Apolipoproteínas A/sangue , Circulação Sanguínea , Colesterol/sangue , Feminino , Humanos , Hiperglicemia/sangue , Hiperglicemia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Triglicerídeos/sangue
16.
Rapid Commun Mass Spectrom ; 14(14): 1280-6, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-10918381

RESUMO

Electrospray ionization multi-stage tandem mass spectrometry (ESI-MS(n)) and liquid chromatography coupled with on-line mass spectrometry (LC/MS/MS) were applied to characterize saponins in crude extracts from Panax ginseng. The MS(n) data of the [M - H](-) ions of saponins can provide structural information on the sugar sequences of the saccharide chains and on the sapogins of saponins. By ESI-MS(n), non-isomeric saponins and isomeric saponins with different aglycones can be determined rapidly in plant extracts. LC/MS/MS is a good complementary analytical tool for determination of isomeric saponins. These approaches constitute powerful analytical tools for rapid screening and structural assignment of saponins in plant extracts.


Assuntos
Plantas/química , Saponinas/análise , Saponinas/química , Cromatografia Líquida/métodos , Espectrometria de Massas/métodos
17.
Planta Med ; 65(1): 68-73, 1999 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17260238

RESUMO

Using electrospray ionization mass spectrometry combined with sequential tandem mass spectrometry (ESI-MS (n)), the steroidal saponin mixture extracted from TRIBULUS TERRESTRIS was studied. The structures of five known steroidal saponins and two unknown steroidal saponins in the saponin mixture were investigated by sequential tandem mass spectrometry experiments. All of the steroidal saponins displayed similar fragmentation behavior in ESI-MS (n), and the characteristic cross ring cleavage pattern could be used as a fingerprint for the identification of steroidal saponins. The methodology has been established as a powerful tool for the profiling of mixtures, especially of crude plant extracts, and the structural elucidation of compounds.

18.
Planta Med ; 65(5): 432-6, 1999 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17260270

RESUMO

Electrospray ionization mass spectrometry (ESI-MS) combined with multiple tandem mass spectrometry (MS (n)) has been applied for simultaneously determining lipo-alkaloids from the aconite tubers. ESI-MS can give a very good mass separation for lipo-alkaloid mixture and MS (n) can provide structural information. Accordingly, structures were assigned to 12 known lipo-alkaloids including lipoaconitines, lipomesaconitines, lipodeoxyaconitines, and lipohypaconitines on the base of the information obtained using MS ( n). Also, four new lipo-alkaloids were found and their structures were interpreted using the MS (n) data.

19.
Zhongguo Zhong Yao Za Zhi ; 23(9): 551-2, inside back cover, 1998 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-11599389

RESUMO

OBJECTIVE: To have further comprehension of American Ginseng on the basis of its water-soluble components. METHOD: The water suspension of 80% methanol extract of American Ginseng was sequentially extracted with ethyl ether and n-butyl alcohol. The saccharides in the water-soluble portion were removed by macro-reticular resin column, and three compounds were obtained by silica-gel column chromatography. Their structures were confirmed on the basis of spectral analysis(IR, NMR, MALDI-MS) melting points and optical degrees. RESULT: Three compounds were identified as malonyl ginsenosides Rb1, ginsenoside Rb1 and Re respectively. Among them Rb1 and Re are known, while malonyl ginsenoside Rb1 was isolated from American Ginseng for the first time. Its structure was elucidated as (3 beta, 12 beta)-20-[(-6-O-beta-D- glucopyranosyl-beta-D-glucopyranosyl)oxy]-12-hydroxylammar-24-en-3-yl-O- [6-O-(carboxyacetyl)-beta-D-glucopyranosyl)]-beta-D-glucopyranoside. CONCLUSION: Water-soluble ginsenosides were isolated from the water-soluble extract of American Ginseng suggesting that malonyl ginsenosides exist both in American Ginseng and Ginseng.


Assuntos
Panax/química , Saponinas/isolamento & purificação , Ginsenosídeos , Saponinas/química
20.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 19(6): 451-5, 1997 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-10453538

RESUMO

OBJECTIVE AND METHODS: In order to study the inhibitory effects of antioxidant vitamins on serum (low oxidative density lipoproteins, oxLDL) and experimental atherosclerosis in rabbits, 20 rabbits were fed on cholesterol rich diet and antioxidant vitamins (vitamin E, vitamin C and beta carotene) for 12 weeks. oxLDL were tested by ELISA at the beginning of experiment and after 4 weeks 8 weeks. RESULTS: The results showed that supplement of antioxidant vitamins can decrease the oxLDL level significantly and inhibited development of atherosclerosis lesion around aorta in rabbits.


Assuntos
Antioxidantes/farmacologia , Arteriosclerose/sangue , Lipoproteínas LDL/sangue , beta Caroteno/farmacologia , Animais , Aorta/patologia , Arteriosclerose/prevenção & controle , Ácido Ascórbico/farmacologia , Masculino , Coelhos , Vitamina E/farmacologia
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