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1.
Epilepsia ; 65(4): 1128-1140, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38299621

RESUMO

OBJECTIVE: Children with self-limited epilepsy characterized by centrotemporal spikes (SeLECTS) exhibit cognitive deficits in memory during the active phase, but there is currently a lack of studies and techniques to assess their memory development after well-controlled seizures. In this study, we employed eye-tracking techniques to investigate visual memory and its association with clinical factors and global intellectual ability, aiming to identify potential risk factors by examining encoding and recognition processes. METHODS: A total of 26 recruited patients diagnosed with SeLECTS who had been seizure-free for at least 2 years, along with 24 control subjects, underwent Wechsler cognitive assessment and an eye-movement-based memory task while video-electroencephalographic (EEG) data were recorded. Fixation and pupil data related to eye movements were utilized to detect distinct memory processes and subsequently to compare the cognitive performance of patients exhibiting different regression patterns on EEG. RESULTS: The findings revealed persistent impairments in visual memory among children with SeLECTS after being well controlled, primarily observed in the recognition stage rather than the encoding phase. Furthermore, the age at onset, frequency of seizures, and interictal epileptiform discharges exhibited significant correlations with eye movement data. SIGNIFICANCE: Children with SeLECTS exhibit persistent recognition memory impairment after being well controlled for the disease. Controlling the frequency of seizures and reducing prolonged epileptiform activity may improve memory cognitive development. The application of the eye-tracking technique may provide novel insights into exploring memory cognition as well as underlying mechanisms associated with pediatric epilepsy.


Assuntos
Epilepsia Rolândica , Tecnologia de Rastreamento Ocular , Humanos , Criança , Convulsões/diagnóstico , Cognição , Eletroencefalografia/métodos , Transtornos da Memória/etiologia , Transtornos da Memória/complicações , Epilepsia Rolândica/complicações , Epilepsia Rolândica/psicologia
2.
Psychol Health Med ; 26(10): 1258-1265, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32816533

RESUMO

Executive function (EF) skills involve higher-level cognitive functions, such as planning, goal formation, goal-directed behavior, and effective performance. Previous research has shown that these aspects of EF are essential for successful functioning in everyday life. This study aimed to examine differences in the behavioral aspects of EF between young adults with epilepsy and healthy controls. The study involved 62 young adults, aged 18 to 30 years, divided into two groups: a study group of young adults with well-controlled epilepsy and a control group of healthy young adults. The groups were matched according to basic sociodemographic characteristics. The Behavior Rating Inventory of Executive Function - Adult version was used to assess the behavioral aspects of executive functions. A significant difference between groups was only observed on the Organization of Materials scale, where the group with epilepsy achieved better performance. Our findings suggest that self-assessed behavioral control of EF is almost the same in healthy young adults and young adults with epilepsy who have no comorbidities and have good control of the disease as well as preserved intellectual ability and functionality in everyday activities.


Assuntos
Epilepsia , Função Executiva , Cognição , Humanos , Motivação , Testes Neuropsicológicos , Adulto Jovem
3.
J Foot Ankle Surg ; 59(6): 1229-1233, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32921562

RESUMO

The objective of this study is to compare risk adjusted matched cohorts of Charcot neuroarthropathy patients who underwent osseous reconstruction with and without diabetes. The 2 groups were matched based on age, body mass index, hypertension, history of end-stage renal disease, and peripheral arterial disease. Bivariate analysis was performed for preoperative infection, location of Charcot breakdown, and post reconstruction outcomes, in patients with a minimum of 1 year follow-up period. Through bivariate analysis, presence of preoperative ulceration (p = .0499) was found to be statistically more likely in the patients with diabetes; whereas, delayed osseous union (p = .0050) and return to ambulation (p ≤ .0001) was statistically more likely in patients without diabetes. The nondiabetic Charcot patients were 17.6 folds more likely to return to ambulation (odds ratio [OR] 17.6 [95% confidence interval {CI} {3.5-87.6}]), and 16.4 folds more likely to have delayed union (OR 16.4 [95% CI {1.9-139.6)]). Subanalysis compared well-controlled diabetic and nondiabetic Charcot neuroarthropathy patients for same factors. Multivariate analysis, in the subanalysis, found return to ambulation was 15.1 times likely to occur in the nondiabetic CN cohort (OR 15.1 [95% CI 1.3-175.8]) compared to the well-controlled diabetic CN cohort.


Assuntos
Artropatia Neurogênica , Diabetes Mellitus , Pé Diabético , Doença Arterial Periférica , Artropatia Neurogênica/cirurgia , Estudos de Coortes , Diabetes Mellitus/epidemiologia , Humanos
4.
J Allergy Clin Immunol ; 137(2): 474-81, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26483177

RESUMO

BACKGROUND: Few data are available that describe response patterns in patients with chronic idiopathic urticaria (CIU)/chronic spontaneous urticaria (CSU) treated with omalizumab. OBJECTIVE: We sought to describe response patterns by using data from the 3 pivotal omalizumab CIU/CSU trials. METHODS: Every 4 weeks, randomized patients received dosing with placebo or 75, 150, or 300 mg of omalizumab (ASTERIA I: n = 318, 24 weeks; ASTERIA II: n = 322, 12 weeks) or placebo or 300 mg of omalizumab (GLACIAL: n = 335, 24 weeks). Response was defined as well-controlled urticaria (weekly Urticaria Activity Score [UAS7] ≤ 6) or complete response (UAS7 = 0). RESULTS: Response rates were dose dependent and highest with 300 mg of omalizumab. Some patients responded early (before week 4). At week 12, a higher proportion of patients treated with 300 mg of omalizumab reported a UAS7 ≤ 6 (26.0% [75 mg of omalizumab], 40.0% [150 mg of omalizumab], 51.9% [300 mg of omalizumab], and 11.3% [placebo] for ASTERIA I; 26.8% [75 mg of omalizumab], 42.7% [150 mg of omalizumab], 65.8% [300 mg of omalizumab], and 19.0% [placebo] for ASTERIA II; and 52.4% [300 mg of omalizumab] and 12.0% [placebo] for GLACIAL) or a UAS7 = 0 (11.7% [75 mg of omalizumab], 15.0% [150 mg of omalizumab], 35.8% [300 mg of omalizumab], and 8.8% [placebo] for ASTERIA I; 15.9% [75 mg of omalizumab], 22.0% [150 mg of omalizumab], 44.3% [300 mg of omalizumab], and 5.1% [placebo] for ASTERIA II; and 33.7% [300 mg of omalizumab] and 4.8% [placebo] for GLACIAL). In patients receiving 300 mg of omalizumab with 24 weeks of treatment, median time to achieve a UAS7 ≤ 6 was 6 weeks (ASTERIA I and GLACIAL) and median time to achieve a UAS7 = 0 was 12 or 13 weeks (ASTERIA I and GLACIAL, respectively). Some patients who achieved well-controlled urticaria or complete response sustained response throughout the treatment period. CONCLUSION: Benefits of omalizumab treatment were evident early (before week 4) in some patients and persisted to week 24. Use of 300 mg of omalizumab demonstrated best results in controlling CIU/CSU symptoms.


Assuntos
Antialérgicos/uso terapêutico , Omalizumab/uso terapêutico , Urticária/tratamento farmacológico , Adulto , Antialérgicos/administração & dosagem , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Omalizumab/administração & dosagem , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Urticária/diagnóstico
5.
Mod Rheumatol ; 27(1): 130-136, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27168463

RESUMO

OBJECTIVES: S-flurbiprofen plaster (SFPP) is a novel non-steroidal anti-inflammatory drug (NSAID) patch, intended for topical treatment for musculoskeletal diseases. This trial was conducted to examine the effectiveness of SFPP using active comparator, flurbiprofen (FP) patch, on knee osteoarthritis (OA) symptoms. METHODS: This was a phase III, multi-center, randomized, adequate, and well-controlled trial, both investigators and patients were blinded to the assigned treatment. Enrolled 633 knee OA patients were treated with either SFPP or FP patch for two weeks. The primary endpoint was improvement in knee pain on rising from the chair as assessed by visual analogue scale (rVAS). Safety was evaluated through adverse events (AEs). RESULTS: The change in rVAS was 40.9 mm in SFPP group and 30.6 mm in FP patch group (p < 0.001). The incidence of drug-related AEs at the application site was 9.5% (32 AEs, 29 mild and 3 moderate) in SFPP and 1.6% in FP patch (p < 0.001). Withdrawals due to AE were five in SFPP and one in FP patch. CONCLUSIONS: The superiority of SFPP in efficacy was demonstrated. Most of AEs were mild and few AEs led to treatment discontinuation. Therefore, SFPP provides an additional option for knee OA therapy.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Flurbiprofeno/uso terapêutico , Osteoartrite do Joelho/tratamento farmacológico , Dor/tratamento farmacológico , Administração Tópica , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios não Esteroides/administração & dosagem , Feminino , Flurbiprofeno/administração & dosagem , Humanos , Articulação do Joelho , Masculino , Pessoa de Meia-Idade , Medição da Dor , Resultado do Tratamento
6.
J Asthma ; 53(6): 644-9, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27058241

RESUMO

OBJECTIVE: Despite the use of optimal therapy and guidelines, the rate of asthma control is suboptimal in adult populations. Purpose of this study is to describe factors associated with ability to achieve well-controlled asthma over time for adult patients treated in a tertiary medical center-based asthma outpatient specialty clinic. METHODS: Existing clinical data collected for 320 adult patients enrolled in a hospital-based outpatient asthma specialty clinic from July 1, 2003 through June 30, 2011 evaluated time to achieve well-controlled asthma and factors associated with well-controlled asthma such as adherence and lack of previous exacerbations. RESULTS: Adherence to prescribed therapy (p = 0.004) and no previous asthma related ED visits (p = 0.004) were associated with well-controlled asthma for moderate persistent baseline. BMI on a continuous spectrum (p = 0.120) and the diagnosis of allergic rhinitis (p = 0.769) were not independently significant. Body-mass-index (BMI) in combination with adherence did influence ability to achieve well-controlled asthma (p < 0.05). Adherence (p = 0.615), allergic rhinitis (p = 0.172), BMI continuous scale (p = 0.074) and visit interval <90 days (p = 0.653) were not independently associated with likelihood of achieving well-controlled asthma in severe persistent asthmatics. Significance of particular factors in combination (adherence, allergic rhinitis, sex, BMI) showed dependency on other variables in achieving well-controlled asthma. CONCLUSIONS: Different factors are associated with asthma control for different patient subpopulations. Adherence to standard therapy did not improve obese (BMI > 30) patients' ability to achieve asthma control. Female patients were less likely to obtain well-controlled asthma per unit increase of BMI. Multiple factors must be addressed to optimize attaining asthma control.


Assuntos
Antiasmáticos/uso terapêutico , Asma/tratamento farmacológico , Adulto , Fatores Etários , Antiasmáticos/administração & dosagem , Asma/epidemiologia , Índice de Massa Corporal , Feminino , Humanos , Masculino , Adesão à Medicação , Ambulatório Hospitalar , Grupos Raciais , Rinite Alérgica/epidemiologia , Estações do Ano , Índice de Gravidade de Doença , Fatores Sexuais , Centros de Atenção Terciária , Fatores de Tempo
7.
J Biopharm Stat ; 26(1): 55-70, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26397979

RESUMO

Statistical principles and ongoing proliferation of novel statistical methodologies have dramatically improved the clinical drug development process. This journey over the last seven decades reshaped the pharmaceutical industry and regulatory agencies, highlighted the importance of statistical thinking in drug development and decision-making, and, most importantly, improved the lives of countless patients around the world. Some significant highlights in the history of this journey are recounted here as well as some exciting opportunities of what the future may hold for the science and profession of statistics.


Assuntos
Ensaios Clínicos como Assunto/estatística & dados numéricos , Interpretação Estatística de Dados , Indústria Farmacêutica , Humanos , Projetos de Pesquisa
8.
Sci Bull (Beijing) ; 69(12): 1920-1935, 2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38423871

RESUMO

Diabetic retinopathy (DR) is the leading cause of blindness among the working-age population. Although controlling blood glucose levels effectively reduces the incidence and development of DR to less than 50%, there are currently no diagnostic biomarkers or effective treatments for DR development in glucose-well-controlled diabetic patients (GW-DR). In this study, we established a prospective GW-DR cohort by strictly adhering to glycemic control guidelines and maintaining regular retinal examinations over a median 2-year follow-up period. The discovery cohort encompassed 71 individuals selected from a pool of 292 recruited diabetic patients at baseline, all of whom consistently maintained hemoglobin A1c (HbA1c) levels below 7% without experiencing hypoglycemia. Within this cohort of 71 individuals, 21 subsequently experienced new-onset GW-DR, resulting in an incidence rate of 29.6%. In the validation cohort, we also observed a significant GW-DR incidence rate of 17.9%. Employing targeted metabolomics, we investigated the metabolic characteristics of serum in GW-DR, revealing a significant association between lower levels of ethanolamine and GW-DR risk. This association was corroborated in the validation cohort, exhibiting superior diagnostic performance in distinguishing GW-DR from diabetes compared to the conventional risk factor HbA1c, with AUCs of 0.954 versus 0.506 and 0.906 versus 0.521 in the discovery and validation cohorts, respectively. Furthermore, in a streptozotocin (STZ)-induced diabetic rat model, ethanolamine attenuated diabetic retinal inflammation, accompanied by suppression of microglial diacylglycerol (DAG)-dependent protein kinase C (PKC) pathway activation. In conclusion, we propose that ethanolamine is a potential biomarker and represents a viable biomarker-based therapeutic option for GW-DR.


Assuntos
Biomarcadores , Retinopatia Diabética , Etanolamina , Humanos , Retinopatia Diabética/sangue , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/epidemiologia , Biomarcadores/sangue , Animais , Masculino , Feminino , Pessoa de Meia-Idade , Hemoglobinas Glicadas/análise , Hemoglobinas Glicadas/metabolismo , Ratos , Glicemia/metabolismo , Glicemia/análise , Estudos Prospectivos , Diabetes Mellitus Experimental/sangue , Idoso , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/complicações , Controle Glicêmico/métodos
9.
ACS Nano ; 18(32): 20957-20979, 2024 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-39086355

RESUMO

Multifunctional micro-/nanomaterials featuring functional superiority and high value-added physicochemical nature have received immense attention in electrochemical energy storage. Microfluidic synthesis has become an emergent technology for massively producing multifunctional micro-/nanomaterials with tunable microstructure and morphology due to its rapid mass/heat transfer and precise fluid controllability. In this review, the latest progresses and achievements in microfluidic-synthesized multifunctional micro-/nanomaterials are summarized via reaction process intensification, multifunctional micro-/nanostructural engineering and electrochemical energy storage applications. The reaction process intensification mechanisms of various micro-/nanomaterials, including quantum dots (QDs), metal materials, conducting polymers, metallic oxides, polyanionic compounds, metal-organic frameworks (MOFs) and two-dimensional (2D) materials, are discussed. Especially, the multifunctional structural engineering principles of as-fabricated micro-/nanomaterials, such as vertically aligned structure, heterostructure, core-shell structure, and tunable microsphere, are introduced. Subsequently, the electrochemical energy storage application of as-prepared multifunctional micro-/nanomaterials is clarified in supercapacitors, lithium-ion batteries, sodium-ion batteries, all-vanadium redox flow batteries, and dielectric capacitors. Finally, the current problems and future forecasts are illustrated.

10.
Kaohsiung J Med Sci ; 39(12): 1233-1242, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37843189

RESUMO

Lenvatinib has been approved as one of the first-line treatments for advanced hepatocellular carcinoma (HCC) due to its high treatment efficacy being non-inferior to sorafenib. Previous studies have shown well-controlled viremia contributes to the prognosis of HCC patients receiving first-line sorafenib; hence, we postulated this association might also exist in HCC patients with lenvatinib treatment. From April 2018 to December 2021, 201 unresectable HCC patients with first-line lenvatinib treatment in our institute were assessed. High-effect nucleoside analogues were administered for hepatitis B virus (HBV) control, while direct-acting antivirals were used for hepatitis C virus (HCV) elimination. Based on our previous study, well-controlled viremia was defined as patients who had undetectable viremia, or who had been receiving antivirals at least 6 months before lenvatinib. This study enrolled 129 patients, including 85 patients with HBV-related HCC (HBV-HCC) and 44 patients with HCV-related HCC (HCV-HCC), respectively. Progression-free survival (PFS) and overall survival (OS) rates between the two groups were not different. Before administration of lenvatinib, 57.1% of the HBV-HCC patients and 88.4% of the HCV-HCC patients had well-controlled viremia, and their PFS (8.8 vs. 3.1 months, p < 0.001) and OS (30.2 vs. 12.8 months, p = 0.041) were better than those who had uncontrolled viremia; moreover, well-controlled viremia reduced tumor progression in multivariate analysis (Hazard ratio: 0.41, 95% confidence interval: 0.25-0.68, p = 0.001) after adjusting for albumin-bilirubin grade and concurrent treatment. HBV or HCV infection was not associated with tumor progression of HCC patients receiving lenvatinib, but viremia, controlled or not, was.


Assuntos
Carcinoma Hepatocelular , Hepatite B , Hepatite C Crônica , Hepatite C , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/complicações , Carcinoma Hepatocelular/tratamento farmacológico , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/tratamento farmacológico , Sorafenibe , Hepatite B/complicações , Viremia/complicações , Viremia/tratamento farmacológico , Antivirais/uso terapêutico , Hepatite C Crônica/complicações , Hepatite C Crônica/tratamento farmacológico , Vírus da Hepatite B , Hepacivirus
11.
Bioengineering (Basel) ; 10(10)2023 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-37892869

RESUMO

(1) Background: Persistent hyperglycemia in diabetes mellitus (DM) increases the risk of death and causes cardiovascular disease (CVD), resulting in significant social and economic costs. This study used a machine learning (ML) technique to build prediction models with the factors of lifestyle, medication compliance, and self-control in eating habits and then implemented a predictive system based on the best model to forecast whether blood glucose can be well-controlled within 1 year in diabetic patients attending a DM nutritional clinic. (2) Methods: Data were collected from outpatients aged 20 years or older with type 2 DM who received nutrition education in Chi Mei Medical Center. Multiple ML algorithms were used to build the predictive models. (3) Results: The predictive models achieved accuracies ranging from 0.611 to 0.690. The XGBoost model with the highest area under the curve (AUC) of 0.738 was regarded as the best and used for the predictive system implementation. SHAP analysis was performed to interpret the feature importance in the best model. The predictive system, evaluated by dietitians, received positive feedback as a beneficial tool for diabetes nutrition consultations. (4) Conclusions: The ML prediction model provides a promising approach for diabetes nutrition consultations to maintain good long-term blood glucose control, reduce diabetes-related complications, and enhance the quality of medical care.

12.
Neurol India ; 70(5): 1846-1851, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36352577

RESUMO

Background: Trace elements have been implicated in pathogenesis of epilepsy. Studies till date have shown altered levels of serum trace elements in children with epilepsy. Objective: The objective of the current was to estimate serum levels of trace elements in children with well-controlled and drug refractory epilepsy and compare it with controls. Methodology: In a tertiary care teaching hospital of North India, serum selenium, copper, zinc, and iron were estimated in well-controlled and drug refractory epileptic children aged 2-12 years and compared with age and gender matched controls. Results: A total of 106 children with epilepsy (55 drug refractory and 51 well controlled) and 52 age and gender matched controls were included in the study. Serum selenium and copper were significantly decreased in cases compared to controls. After classifying epilepsy into well-controlled and drug refractory cases, only in the latter the significant difference for serum selenium and copper levels remained compared to controls. Additionally, in the drug refractory cases, serum iron levels were significantly reduced compared to controls. Conclusions: Serum trace elements are altered in children with epilepsy (more so in the drug refractory group) compared to controls. Monitoring of serum trace elements in children with epilepsy should be considered. Up to one-third of epilepsy is drug refractory of which only another third are amenable to surgery. It is worth investigating the therapeutic potential of altered micronutrient status in these patients.


Assuntos
Epilepsia Resistente a Medicamentos , Epilepsia , Selênio , Oligoelementos , Criança , Humanos , Cobre , Ferro , Epilepsia/tratamento farmacológico
13.
Cancers (Basel) ; 14(16)2022 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-36010961

RESUMO

Without analyzing the status of viremia, hepatitis C virus-related hepatocellular carcinoma (HCV-HCC) patients are proposed to have better prognosis than hepatitis B virus-related HCC (HBV-HCC) patients using sorafenib. We aimed to elucidate the efficacy of concurrent sorafenib and anti-viral treatment for HCC patients with HBV or HCV infection in real world. Between January 2018 and January 2021, 256 unresectable HCC patients receiving first-line sorafenib were evaluated. High-potency nucleoside analogs were used for HBV control, whereas direct-acting antivirals were administered for HCV eradication. Well-controlled viremia was defined as patients who had undetectable viremia, or who had been receiving antivirals at least 6 months before sorafenib. We recruited 116 (65.2%) HBV-HCC patients and 62 (34.8%) HCV-HCC patients. Using sorafenib, progression-free survival and overall survival (OS) rates between these two groups were not different. Before sorafenib, 56% of HBV-HCC patients and 54.8% of HCV-HCC patients had well-controlled viremia and their OS was superior to those who had uncontrolled viremia (15.5 vs. 11.1 months, p = 0.001). Dividing our patients into four subgroups as well-controlled HCV viremia, well-controlled HBV viremia, uncontrolled HCV viremia, and uncontrolled HBV viremia, their OS rates were distributed with a significantly decreasing trend as 21.9 months, 15.0 months, 14.2 months, and 5.7 months (p = 0.009). Furthermore, well-controlled viremia was associated with mortality in multivariate analysis (Hazard ratio: 0.63, 95% confidence interval: 0.42-0.93, p = 0.022). In real-life, HBV or HCV infection did not contribute to the prognosis of HCC patients receiving sorafenib; however, whether viremia was controlled or not did contribute.

14.
ACS Nano ; 15(4): 7386-7391, 2021 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-33729762

RESUMO

Lead halide perovskites have been promising materials for lasing applications. Despite that a series of perovskite microlasers have been reported, their lasing modes are confined by either the as-grown morphology or the etched boundary. The first one is quite random and incompatible with integration, whereas the latter one strongly spoils the laser performances. Herein, we propose and experimentally demonstrate a robust and generic mechanism to realize well-controlled perovskite microlasers without the etching process. By patterning a one-dimensional polymer grating onto a perovskite film, we show that the symmetry-protected bound states in the continuum (BICs) can be formed in it. The intriguing properties of BICs including a widely spread mode profile and high Q factor, associated with the exceptional gain of perovskite, produce single-mode microlasers with high repeatability, controllability, directionality, and a polarization vortex. This mechanism can also be extended to two-dimensional nanostructures, enabling BIC lasers with different topological charges.

15.
Pharmaceutics ; 12(2)2020 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-32085488

RESUMO

To decrease critical micelle concentration (CMC), improve stability, and keep high drug-loading capacity, three pH-sensitive mixed micelles applied for anticancer drug controlled delivery were prepared by the mixture of polymers poly (N,N-diethylaminoethyl methacrylate)-b-poly(poly(ethylene glycol) methyl ether methacrylate) (PDEAEMA-PPEGMA) and polycaprolactone-b-poly (poly(ethylene glycol) methyl ether methacrylate) (PCL-PPEGMA), which were synthesized and confirmed by 1H NMR and gel permeation chromatographic (GPC). The critical micelle concentration (CMC) values of the prepared mixed micelles were low, and the micellar sizes and zeta potentials of the blank mixed micelles demonstrated good pH-responsive behavior. Combined experimental techniques with dissipative particle dynamics (DPD) simulation, the particle sizes, zeta potentials, drug loading content (LC), encapsulation efficiency (EE), aggregation morphologies, and doxorubicin (DOX) distribution of the mixed micelles were investigated, and the high DOX-loading capacity of the mixed micelles was found. Both in vitro DOX release profiles and DPD simulations of the DOX dynamics release process exhibited less leakage and good stability in neutral conditions and accelerated drug release behavior with a little initial burst in slightly acidic conditions. Cytotoxicity tests showed that the polymer PDEAEMA-PPEGMA and the blank mixed micelles had good biocompatibility, and DOX-loaded mixed micelles revealed certain cytotoxicity. These results suggest that the drug-loaded mixed micelles that consisted of the two polymers PDEAEMA-PPEGMA and PCL-PPEGMA can be new types of pH-responsive well-controlled release anticancer drug delivery mixed micelles.

16.
Psychol Health ; 33(7): 872-887, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29350063

RESUMO

OBJECTIVE: While many people with Type 1 diabetes find it difficult to achieve recommended blood glucose levels, a minority do achieve good control. Our study was conceived by patient and public (PP) partners and sought to learn about experiences of people living with well-controlled diabetes. DESIGN: A collaboration between academic health psychologists and five PP partners with experience of diabetes, who were trained to conduct and analyse semi-structured interviews. Fifteen adults with well-controlled Type 1 diabetes were interviewed about the history of their diabetes and their current self-management practices. Interviews were subjected to inductive thematic analysis. RESULTS: Eight sub-themes were arranged into two overarching themes, 'facing up to diabetes' and 'balance leads to freedom'. Participants described a process of acceptance and mastery of diabetes, and talked about how they gained a deeper understanding of bodily processes through trial and error. CONCLUSION: Based on the experiences of people with well-controlled Type 1 diabetes, interventions for people with this condition should encourage acceptance of the diagnosis and increasing confidence to experiment with behaviours (trial and error) to encourage 'mastery' of self-management. The research collaboration described here is an example of best practice for future researchers wanting to actively engage PP partners.


Assuntos
Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 1/terapia , Autocuidado/psicologia , Adaptação Psicológica , Adulto , Glicemia/metabolismo , Diabetes Mellitus Tipo 1/sangue , Feminino , Humanos , Masculino , Pesquisa Qualitativa
17.
Respir Med ; 120: 78-86, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27817819

RESUMO

BACKGROUND: For patients with well-controlled asthma, 'step down' of therapy is recommended. We evaluated Japanese patients switching from inhaled corticosteroid (ICS)/long-acting beta2-agonists (LABA; equivalent to fluticasone propionate [FP]/salmeterol [SAL] 250/50 µg twice daily [BD]) to fluticasone furoate (FF)/vilanterol (VI) 100/25 µg, then stepping down to ICS alone. METHODS: This phase III trial had two treatment periods (P): P1, patients with well-controlled asthma on FP/SAL 250/50 µg BD equivalent stepped across to once daily (OD) FF/VI 100/25 µg (open-label, eight weeks); P2, patients remaining 'well controlled' after P1 stepped down to FF 100 µg OD/FP 100 µg BD/FP 250 µg BD (randomized 1:1:1, double-blind, 12 weeks). Co-primary P2 endpoints: percentage of patients with well-controlled asthma; time to withdrawal due to poorly controlled asthma requiring step-up therapy. Adverse events (AEs) were monitored. RESULTS: At the end of P1 (n = 430), 373 (90.5%; 95% confidence interval 87.29-93.18) patients' asthma remained well controlled with FF/VI; in P2 (n = 371), control was maintained in 89.5% (FF 100 µg)/79.5% (FP 100 µg)/83.8% (FP 250 µg) of patients. In P2, 4.9-7.3% of patients were withdrawn due to worsening asthma (time-to-withdrawal cumulative incidence curves were comparable). AEs were reported by 37% of patients during P1; and by 36% (FF 100 µg)/48% (FP 100 µg)/49% (FP 250 µg) of patients in P2. CONCLUSIONS: For patients with well-controlled asthma on mid dose ICS/LABA (equivalent to FP/SAL 250/50 µg BD), control can be maintained when they are stepped across to FF/VI 100/25 µg OD. FF 100 µg OD is an effective step-down therapy from FF/VI 100/25 µg OD with similar efficacy to FP 100 µg BD and FP 250 µg BD.


Assuntos
Corticosteroides/administração & dosagem , Agonistas de Receptores Adrenérgicos beta 2/administração & dosagem , Androstadienos/administração & dosagem , Asma/tratamento farmacológico , Álcoois Benzílicos/administração & dosagem , Clorobenzenos/administração & dosagem , Combinação Fluticasona-Salmeterol/administração & dosagem , Fluticasona/administração & dosagem , Administração por Inalação , Corticosteroides/farmacologia , Agonistas de Receptores Adrenérgicos beta 2/farmacologia , Adulto , Androstadienos/farmacologia , Androstadienos/uso terapêutico , Álcoois Benzílicos/uso terapêutico , Clorobenzenos/uso terapêutico , Combinação de Medicamentos , Feminino , Fluticasona/farmacologia , Combinação Fluticasona-Salmeterol/uso terapêutico , Volume Expiratório Forçado/efeitos dos fármacos , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Pico do Fluxo Expiratório/efeitos dos fármacos , Prevalência , Fumar/epidemiologia , Resultado do Tratamento
18.
Acta Med Iran ; 53(11): 690-6, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26786990

RESUMO

Lipoprotein-associated phospholipase A2 (Lp-PLA2) is produced by inflammatory cells, bound to LDL and other lipoproteins, and hydrolyzes oxidized phospholipids in LDL. Type 2 diabetes is the most common form of diabetes some investigations show the association of lipoprotein-associated phospholipase A2 mass and activity with the incidence of cardiovascular disease (CVD) in populations with high prevalences of insulin resistance and diabetes. This study is a cross-sectional descriptive and analytic study on 80 individuals with diabetes referring to the Tehran Diabetes Association. Patients divided into two groups (well-controlled and poorly controlled) based on their HbA1C. Personal information, anthropometric assessments (including height, weight, waist circumference and hip circumference) and semi-quantitative 147 items FFQ was used and vein blood samples were taken. After plasma separation, blood sample used for FBS, HbA1c and LP-PLA2 measurement. The independent sample T test was used for comparing means. Data analyses showed a significant difference between weight and WHR (waist to hip ratio) means in two studied groups, also there was a statistically significant difference in food intake (Energy, carbohydrate, protein, micronutrients percent and some of the micronutrients). FBS, HbA1C and LP-PLA2 means showed statistically significant difference (P<0/001) between two groups. This study showed LP-PLA2 is elevated in poorly-controlled patients compared to well-controlled diabetic patients, which may suggest some nutritional factors contributing to the regulation of this enzyme.


Assuntos
1-Alquil-2-acetilglicerofosfocolina Esterase/sangue , Doenças Cardiovasculares/etiologia , Diabetes Mellitus Tipo 2/fisiopatologia , Adulto , Idoso , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Circunferência da Cintura
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