Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 23.348
Filtrar
1.
Life Sci ; 253: 117696, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32334013

RESUMO

AIMS: We have previously demonstrated that p-tyramine (TYR), an endogenous trace amine-associated receptor 1 agonist, passage across neuronal membranes involves a transporter exhibiting the pharmacological profile of Organic Cation Transporter 2 (OCT2). Since TYR is also a constituent of foodstuffs and produced by the intestinal microbiota, here we have investigated whether similar processes are involved in the passage of 100 nM TYR across apical and basolateral membranes of the Caco-2 human intestinal epithelial cell line. MATERIALS AND METHODS: [3H]TYR transport across apical and basolateral membranes of Caco-2 cell monolayers was measured in the presence of inhibitors of TYR metabolizing enzymes. Cellular, apical, and basolateral compartments were collected at various timepoints, TYR concentrations calculated, and transport properties pharmacologically characterized. KEY FINDINGS: Apical transport resulted in equimolar accumulation of TYR within cells. Pentamidine (OCT1/OCT2 inhibitor) decreased apical transport (P = 0.001) while atropine (OCT1 inhibitor) had no effect, suggesting apical transport involved OCT2. In contrast, basolateral transport resulted in 500-1000 nM cellular concentrations (P < 0.0001) indicating the presence of an active transporter. Replacement of Na+ on an equimolar basis with choline resulted in loss of TYR transport (P = 0.017). Unexpectedly, this active transport was also atropine-sensitive (P = 0.020). Kinetic analysis of the active transporter revealed Vmax = 43.0 nM/s with a Kt = 33.1 nM. SIGNIFICANCE: We have demonstrated for the first time that TYR is transported across Caco-2 apical membranes via facilitated diffusion by OCT2, whereas transport across basolateral membranes is by a Na+-dependent, atropine-sensitive, active transporter.


Assuntos
Mucosa Intestinal/metabolismo , Transportador 2 de Cátion Orgânico/metabolismo , Sódio/metabolismo , Tiramina/metabolismo , Atropina/metabolismo , Transporte Biológico/fisiologia , Transporte Biológico Ativo/fisiologia , Células CACO-2 , Humanos
2.
Medicine (Baltimore) ; 99(5): e18956, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32000420

RESUMO

Intussusception is common emergency condition in children. Pneumatic or hydrostatic reduction (HR) is considered the first-choice management strategy in cases lacking indications for surgical intervention. Generally, sedatives are not used in children undergoing interventional radiology procedures. Surgical management is associated with long hospitalization durations and high costs, unlike nonsurgical reduction. To avoid surgery, reduction procedures are repeated despite initial treatment failure. However, in cases involving repeated failures, children should be referred for surgery.To ensure good response to reduction, we planned HR under sedation during the third reduction attempt. Sedative reduction (SR) was performed with the administration of ketamine, midazolam, and atropine. All patients with contraindications against HR underwent laparoscopic reduction (LR) without HR.During 3 years, SR was performed in 43 patients, and in 28 (65.1%), the treatment was successful. Among the 15 patients in whom the procedure failed, 14 underwent LR without intestinal resection. There was no significant risk factor contributing to failed reduction under sedation.During the second or third HR attempt, successful reduction may be ensured with the SR procedure with intravenous ketamine, midazolam, and atropine; this procedure may further reduce surgery rates in pediatric intussusception.


Assuntos
Hipnóticos e Sedativos/uso terapêutico , Intussuscepção/terapia , Administração Intravenosa , Atropina/uso terapêutico , Pré-Escolar , Feminino , Humanos , Lactente , Ketamina/uso terapêutico , Laparoscopia , Masculino , Midazolam/uso terapêutico , Retratamento , Estudos Retrospectivos , Resultado do Tratamento
3.
Life Sci ; 243: 117257, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-31917992

RESUMO

Electrical field stimulation (EFS) has been used for decades in classical pharmacological preparations in order to characterize the mediators released by neural endings involved in smooth muscle contraction or relaxation. Since most of the human umbilical cord has no innervation, EFS has never been used in this preparation. This study aimed to investigate the effect of EFS on vascular responsiveness from human umbilical cord. Segments of the human umbilical cord were obtained from normotensive parturients and the human umbilical artery (HUA) and the human umbilical vein (HUV) were isolated and mounted in organ bath chambers. Electrical field stimulation-induced contractions in both HUA (2.35 ±â€¯1.31 mN and 3.77 ±â€¯2.31 mN for 8 Hz and 16 Hz respectively, n = 24) and HUV (3.81 ±â€¯2.54 mN and 6.26 ±â€¯4.51 mN for 8 Hz and 16 Hz respectively, n = 25). The addition of tetrodotoxin (1 µM) did not alter the EFS-induced contractions in both tissues (n = 5). Pre-incubation with atropine (10 and 100 µM), glibenclamide (10 µM) and indomethacin (10 µM) did not affect the EFS-induced contractions in both tissues. The contractions of both vessels were significantly reduced by pre-incubation of the tissues with phentolamine (10 and 100 µM). The endothelium removal almost abolished the EFS- induced contractions in both vessels (n = 5). In sandwich preparation, donor tissue (with endothelium) released a factor (s) that promoted contraction of the recipient tissue (endothelium removal) in both HUA and HUV (n = 5, respectively). Our findings indicate a potential role of endothelium-derived catecholamines in modulating HUA and HUV reactivities.


Assuntos
Vasos Sanguíneos/fisiologia , Estimulação Elétrica , Cordão Umbilical/irrigação sanguínea , Adulto , Atropina/farmacologia , Vasos Sanguíneos/efeitos dos fármacos , Glibureto/farmacologia , Humanos , Indometacina/farmacologia , Contração Muscular/efeitos dos fármacos , Tetrodotoxina/farmacologia , Adulto Jovem
4.
Cochrane Database Syst Rev ; 1: CD004916, 2020 01 13.
Artigo em Inglês | MEDLINE | ID: mdl-31930781

RESUMO

BACKGROUND: Nearsightedness (myopia) causes blurry vision when one is looking at distant objects. Interventions to slow the progression of myopia in children include multifocal spectacles, contact lenses, and pharmaceutical agents. OBJECTIVES: To assess the effects of interventions, including spectacles, contact lenses, and pharmaceutical agents in slowing myopia progression in children. SEARCH METHODS: We searched CENTRAL; Ovid MEDLINE; Embase.com; PubMed; the LILACS Database; and two trial registrations up to February 2018. A top up search was done in February 2019. SELECTION CRITERIA: We included randomized controlled trials (RCTs). We excluded studies when most participants were older than 18 years at baseline. We also excluded studies when participants had less than -0.25 diopters (D) spherical equivalent myopia. DATA COLLECTION AND ANALYSIS: We followed standard Cochrane methods. MAIN RESULTS: We included 41 studies (6772 participants). Twenty-one studies contributed data to at least one meta-analysis. Interventions included spectacles, contact lenses, pharmaceutical agents, and combination treatments. Most studies were conducted in Asia or in the United States. Except one, all studies included children 18 years or younger. Many studies were at high risk of performance and attrition bias. Spectacle lenses: undercorrection of myopia increased myopia progression slightly in two studies; children whose vision was undercorrected progressed on average -0.15 D (95% confidence interval [CI] -0.29 to 0.00; n = 142; low-certainty evidence) more than those wearing fully corrected single vision lenses (SVLs). In one study, axial length increased 0.05 mm (95% CI -0.01 to 0.11) more in the undercorrected group than in the fully corrected group (n = 94; low-certainty evidence). Multifocal lenses (bifocal spectacles or progressive addition lenses) yielded small effect in slowing myopia progression; children wearing multifocal lenses progressed on average 0.14 D (95% CI 0.08 to 0.21; n = 1463; moderate-certainty evidence) less than children wearing SVLs. In four studies, axial elongation was less for multifocal lens wearers than for SVL wearers (-0.06 mm, 95% CI -0.09 to -0.04; n = 896; moderate-certainty evidence). Three studies evaluating different peripheral plus spectacle lenses versus SVLs reported inconsistent results for refractive error and axial length outcomes (n = 597; low-certainty evidence). Contact lenses: there may be little or no difference between vision of children wearing bifocal soft contact lenses (SCLs) and children wearing single vision SCLs (mean difference (MD) 0.20D, 95% CI -0.06 to 0.47; n = 300; low-certainty evidence). Axial elongation was less for bifocal SCL wearers than for single vision SCL wearers (MD -0.11 mm, 95% CI -0.14 to -0.08; n = 300; low-certainty evidence). Two studies investigating rigid gas permeable contact lenses (RGPCLs) showed inconsistent results in myopia progression; these two studies also found no evidence of difference in axial elongation (MD 0.02mm, 95% CI -0.05 to 0.10; n = 415; very low-certainty evidence). Orthokeratology contact lenses were more effective than SVLs in slowing axial elongation (MD -0.28 mm, 95% CI -0.38 to -0.19; n = 106; moderate-certainty evidence). Two studies comparing spherical aberration SCLs with single vision SCLs reported no difference in myopia progression nor in axial length (n = 209; low-certainty evidence). Pharmaceutical agents: at one year, children receiving atropine eye drops (3 studies; n = 629), pirenzepine gel (2 studies; n = 326), or cyclopentolate eye drops (1 study; n = 64) showed significantly less myopic progression compared with children receiving placebo: MD 1.00 D (95% CI 0.93 to 1.07), 0.31 D (95% CI 0.17 to 0.44), and 0.34 (95% CI 0.08 to 0.60), respectively (moderate-certainty evidence). Axial elongation was less for children treated with atropine (MD -0.35 mm, 95% CI -0.38 to -0.31; n = 502) and pirenzepine (MD -0.13 mm, 95% CI -0.14 to -0.12; n = 326) than for those treated with placebo (moderate-certainty evidence) in two studies. Another study showed favorable results for three different doses of atropine eye drops compared with tropicamide eye drops (MD 0.78 D, 95% CI 0.49 to 1.07 for 0.1% atropine; MD 0.81 D, 95% CI 0.57 to 1.05 for 0.25% atropine; and MD 1.01 D, 95% CI 0.74 to 1.28 for 0.5% atropine; n = 196; low-certainty evidence) but did not report axial length. Systemic 7-methylxanthine had little to no effect on myopic progression (MD 0.07 D, 95% CI -0.09 to 0.24) nor on axial elongation (MD -0.03 mm, 95% CI -0.10 to 0.03) compared with placebo in one study (n = 77; moderate-certainty evidence). One study did not find slowed myopia progression when comparing timolol eye drops with no drops (MD -0.05 D, 95% CI -0.21 to 0.11; n = 95; low-certainty evidence). Combinations of interventions: two studies found that children treated with atropine plus multifocal spectacles progressed 0.78 D (95% CI 0.54 to 1.02) less than children treated with placebo plus SVLs (n = 191; moderate-certainty evidence). One study reported -0.37 mm (95% CI -0.47 to -0.27) axial elongation for atropine and multifocal spectacles when compared with placebo plus SVLs (n = 127; moderate-certainty evidence). Compared with children treated with cyclopentolate plus SVLs, those treated with atropine plus multifocal spectacles progressed 0.36 D less (95% CI 0.11 to 0.61; n = 64; moderate-certainty evidence). Bifocal spectacles showed small or negligible effect compared with SVLs plus timolol drops in one study (MD 0.19 D, 95% CI 0.06 to 0.32; n = 97; moderate-certainty evidence). One study comparing tropicamide plus bifocal spectacles versus SVLs reported no statistically significant differences between groups without quantitative results. No serious adverse events were reported across all interventions. Participants receiving antimuscarinic topical medications were more likely to experience accommodation difficulties (Risk Ratio [RR] 9.05, 95% CI 4.09 to 20.01) and papillae and follicles (RR 3.22, 95% CI 2.11 to 4.90) than participants receiving placebo (n=387; moderate-certainty evidence). AUTHORS' CONCLUSIONS: Antimuscarinic topical medication is effective in slowing myopia progression in children. Multifocal lenses, either spectacles or contact lenses, may also confer a small benefit. Orthokeratology contact lenses, although not intended to modify refractive error, were more effective than SVLs in slowing axial elongation. We found only low or very low-certainty evidence to support RGPCLs and sperical aberration SCLs.


Assuntos
Miopia Degenerativa/terapia , Soluções Oftálmicas/uso terapêutico , Atropina/uso terapêutico , Criança , Lentes de Contato , Ciclopentolato/uso terapêutico , Humanos , Antagonistas Muscarínicos/uso terapêutico , Pirenzepina/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto
5.
Ann Neurol ; 87(1): 84-96, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31675128

RESUMO

OBJECTIVE: Generalized convulsive status epilepticus is associated with high mortality. We tested whether α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor plasticity plays a role in sustaining seizures, seizure generalization, and mortality observed during focal onset status epilepticus. We also determined whether modified AMPA receptors generated during status epilepticus could be targeted with a drug. METHODS: Electrically induced status epilepticus was characterized by electroencephalogram and behavior in GluA1 knockout mice and in transgenic mice with selective knockdown of the GluA1 subunit in hippocampal principal neurons. Excitatory and inhibitory synaptic transmission in CA1 neurons was studied using patch clamp electrophysiology. The dose response of N,N,H,-trimethyl-5-([tricyclo(3.3.1.13,7)dec-1-ylmethyl]amino)-1-pentanaminiumbromide hydrobromide (IEM-1460), a calcium-permeable AMPA receptor antagonist, was determined. RESULTS: Global removal of the GluA1 subunit did not affect seizure susceptibility; however, it reduced susceptibility to status epilepticus. GluA1 subunit knockout also reduced mortality, severity, and duration of status epilepticus. Absence of the GluA1 subunit prevented enhancement of glutamatergic synaptic transmission associated with status epilepticus; however, γ-aminobutyric acidergic synaptic inhibition was compromised. Selective removal of the GluA1 subunit from hippocampal principal neurons also reduced mortality, severity, and duration of status epilepticus. IEM-1460 rapidly terminated status epilepticus in a dose-dependent manner. INTERPRETATION: AMPA receptor plasticity mediated by the GluA1 subunit plays a critical role in sustaining and amplifying seizure activity and contributes to mortality. Calcium-permeable AMPA receptors modified during status epilepticus can be inhibited to terminate status epilepticus. ANN NEUROL 2020;87:84-96.


Assuntos
Plasticidade Neuronal/fisiologia , Receptores de AMPA/fisiologia , Estado Epiléptico/fisiopatologia , Adamantano/análogos & derivados , Adamantano/farmacologia , Amantadina/farmacologia , Animais , Atropina/farmacologia , Região CA1 Hipocampal/fisiologia , Relação Dose-Resposta a Droga , Estimulação Elétrica , Feminino , Técnicas de Silenciamento de Genes , Hipocampo/fisiologia , Masculino , Camundongos , Camundongos Knockout , Receptores de AMPA/antagonistas & inibidores , Receptores de AMPA/genética , Estado Epiléptico/mortalidade , Transmissão Sináptica/fisiologia
6.
Gen Comp Endocrinol ; 285: 113294, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31585115

RESUMO

Motilin and ghrelin were identified in the pheasant by molecular cloning, and the actions of both peptides on the contractility of gastrointestinal (GI) strips were examined in vitro. Molecular cloning indicated that the deduced amino acid sequences of the pheasant motilin and ghrelin were a 22-amino acid peptide, FVPFFTQSDIQKMQEKERIKGQ, and a 26-amino acid peptide, GSSFLSPAYKNIQQQKDTRKPTGRLH, respectively. In in vitro studies using pheasant GI strips, chicken motilin caused contraction of the proventriculus and small intestine, whereas the crop and colon were insensitive. Human motilin, but not erythromycin, caused contraction of small intestine. Chicken motilin-induced contractions in the proventriculus and ileum were not inhibited by a mammalian motilin receptor antagonist, GM109. Neither atropine (a cholinergic receptor antagonist) nor tetrodotoxin (a neuron blocker) inhibited the responses of chicken motilin in the ileum but both drugs decreased the responses to motilin in the proventriculus, suggesting that the contractile mechanisms of motilin in the proventriculus was neurogenic, different from that of the small intestine (myogenic). On the other hand, chicken and quail ghrelin did not cause contraction in any regions of pheasant GI tract. Since interaction of ghrelin and motilin has been reported in the house musk shrew, interaction of two peptides was examined. The chicken motilin-induced contractions were not modified by ghrelin, and ghrelin also did not cause any contraction under the presence of motilin, suggesting the absence of interaction in both peptides. In conclusion, both the motilin system and ghrelin system are present in the pheasant. Regulation of GI motility by motilin might be common in avian species. However, absence of ghrelin actions in any GI regions suggests the avian species-related difference in regulation of GI contractility by ghrelin.


Assuntos
Aves/metabolismo , Trato Gastrointestinal/fisiologia , Grelina/farmacologia , Motilina/farmacologia , Contração Muscular/efeitos dos fármacos , Sequência de Aminoácidos , Animais , Atropina/farmacologia , Sequência de Bases , Galinhas , Clonagem Molecular , Feminino , Motilidade Gastrointestinal/efeitos dos fármacos , Motilidade Gastrointestinal/fisiologia , Trato Gastrointestinal/efeitos dos fármacos , Grelina/química , Grelina/genética , Humanos , Masculino , Motilina/química , Motilina/genética , Proventrículo/efeitos dos fármacos , Codorniz , Ratos , Receptores dos Hormônios Gastrointestinais/metabolismo , Receptores de Neuropeptídeos/metabolismo , Tetrodotoxina/farmacologia
9.
Int J Med Sci ; 16(12): 1652-1667, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31839753

RESUMO

This study has two novel findings: it is not only the first to deduct potential genes involved in scleral growth repression upon atropine instillation from a prevention point of view, but also the first to demonstrate that only slight changes in scleral gene expression were found after atropine treatment as side effects and safety reasons of the eye drops are of concern. The sclera determines the final ocular shape and size, constituting of scleral fibroblasts as the principal cell type and the major regulator of extracellular matrix. The aim of our study was to identify differentially expressed genes and microRNA regulations in atropine-treated scleral fibroblasts that are potentially involved in preventing the onset of excessive ocular growth using next-generation sequencing and bioinformatics approaches. Differentially expressed genes were functionally enriched in anti-remodeling effects, comprising of structural changes of extracellular matrix and metabolic pathways involving cell differentiation. Significant canonical pathways were correlated to inhibition of melatonin degradation, which was compatible with our clinical practice as atropine eye drops are instilled at night. Validation of the dysregulated genes with previous eye growth-related arrays and through microRNA-mRNA interaction predictions revealed the association of hsa-miR-2682-5p-KCNJ5 and hsa-miR-2682-5p-PRLR with scleral anti-remodeling and circadian rhythmicity. Our findings present new insights into understanding the anti-myopic effects of atropine, which may assist in prevention of myopia development.


Assuntos
Atropina/farmacologia , Miopia/tratamento farmacológico , Esclera/efeitos dos fármacos , Transcriptoma/genética , Ritmo Circadiano/efeitos dos fármacos , Biologia Computacional , Matriz Extracelular/genética , Fibroblastos/efeitos dos fármacos , Canais de Potássio Corretores do Fluxo de Internalização Acoplados a Proteínas G/genética , Regulação da Expressão Gênica/efeitos dos fármacos , Redes Reguladoras de Genes/genética , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , MicroRNAs/genética , Miopia/genética , Miopia/patologia , RNA Mensageiro/genética , Esclera/crescimento & desenvolvimento , Esclera/patologia
11.
BMJ Case Rep ; 12(11)2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31753823

RESUMO

A 54-year-old man with a history of schizophrenia presented to the emergency room for weakness with associated lacrimosis, drooling, nausea, emesis, diarrhoea, diplopia and burning sensation on his skin that began 6 hours after spraying five cans of Raid on his carpet. He was noted to have miotic pupils and hyperactive bowel sounds. Given the clinical presentation, the patient was diagnosed with organophosphate (OP) toxicity. After being admitted, he developed symptoms associated with his OP toxicity and was successfully treated with atropine and pralidoxime. Most Raid products contain pyrethroids; however, both OPs and pyrethroids are available in commercial pesticides and patients may misidentify ingestions. There are limited data reporting the toxicity of pyrethroid overdose in humans and to guide its subsequent treatment. It is crucial to keep a low threshold for diagnosing and treating patients with acute onset of symptoms suspicious for an OP or pyrethroid toxidrome.


Assuntos
Produtos Domésticos/envenenamento , Inseticidas/envenenamento , Intoxicação por Organofosfatos/diagnóstico , Piretrinas/envenenamento , Antídotos/uso terapêutico , Atropina/uso terapêutico , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Intoxicação por Organofosfatos/tratamento farmacológico , Compostos de Pralidoxima/uso terapêutico
13.
Asia Pac J Ophthalmol (Phila) ; 8(5): 360-365, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31478936

RESUMO

PURPOSE: Atropine eye drops is an emerging therapy for myopia control. This article reviews the recent clinical trials to provide a better understanding of the use of atropine eye drops on myopia progression. METHODS: All randomized clinical trials of atropine eye drops for myopia progression in the literatures were reviewed. RESULTS: Atropine eye drops 1% conferred the strongest efficacy on myopia control. However, its use was limited by the side effects of blurred near vision and photophobia. ATOM 2 study evaluated 0.5%, 0.1%, and 0.01% atropine on 400 myopic children, and suggested that 0.01% is the optimal concentration with good efficacy and minimal side effects. Since then, the use of atropine eye drops has been transitioned from high-concentration to low-concentration worldwide. Recent Low-concentration Atropine for Myopia Progression (LAMP) study evaluated 0.05%, 0.025%, 0.01% atropine eye drops and placebo group in 438 myopic children. The study firstly provided placebo-compared evidence of low-concentration atropine eye drops in myopia control. Furthermore, both efficacy and side effects followed a concentration-dependent response within 0.01% to 0.05% atropine. Among them, 0.05% atropine was the optimal concentration to achieve best efficacy and safety profile. CONCLUSIONS: Low concentration atropine is effective in myopia control. The widespread use of low-concentration atropine, especially in East Asia, may help prevent the myopia progression for the high-risk children. Further investigations on the rebound phenomenon following drops cessation, and longer-term individualized treatment approach should be warranted.


Assuntos
Atropina/administração & dosagem , Miopia Degenerativa/tratamento farmacológico , Progressão da Doença , Relação Dose-Resposta a Droga , Humanos , Midriáticos/administração & dosagem , Miopia Degenerativa/fisiopatologia , Soluções Oftálmicas , Refração Ocular/efeitos dos fármacos , Refração Ocular/fisiologia
14.
Toxicology ; 426: 152285, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31479693

RESUMO

Clothianidin (CLO) is a neonicotinoid insecticide that produces toxic effects in experimental animals and humans. These effects are associated primarily to its action as a nicotinic agonist, acting on insect and vertebrate nicotinic acetylcholine receptors (nAChRs), but little is known about the mechanisms of action on the mammalian nervous system. In the rat striatum, CLO induces increases in the dopamine overflow in a concentration-dependent manner. In the present study, we evaluate, using in vivo brain microdialysis in adult Sprague-Dawley rats, the participation of specific nAChRs and muscarinic cholinergic receptors (mAChRs) on CLO-induced striatal dopamine release. We investigate the effects of selective antagonists of α4ß2 heteromeric, ß2 subunit, α7 nAChRs, and of broad-spectrum antagonist of mAChRs (atropine) on CLO-induced dopamine release. Intrastriatal administration of antagonists of α4ß2 N-n-decilonicotinium iodide (NDNI), and of α7 methylcaconitine (MLA) significantly decreased the CLO-induced dopamine overflow in a concentration-dependent form, whereas pretreatment with the antagonist of ß2 subunit DHßE not having effect. Pretreatment with the muscarinic antagonist atropine also blocked the increases in the extracellular dopamine levels. Taken together, these results suggest that the stimulatory effect of CLO on in vivo dopamine from rat striatum depends on the activation of α4ß2 present in dopaminergic terminals and α7 nAChRs subtypes expressed in glutamatergic terminals in the striatum. On the other hand, the CLO-induced dopamine release also appears to involve the activation of mAChRs.


Assuntos
Corpo Estriado/metabolismo , Dopamina/metabolismo , Guanidinas/toxicidade , Inseticidas/toxicidade , Neonicotinoides/toxicidade , Receptores Muscarínicos/efeitos dos fármacos , Receptores Nicotínicos/efeitos dos fármacos , Tiazóis/toxicidade , Receptor Nicotínico de Acetilcolina alfa7/agonistas , Animais , Atropina/farmacologia , Corpo Estriado/efeitos dos fármacos , Neurônios Dopaminérgicos/efeitos dos fármacos , Feminino , Microdiálise , Antagonistas Muscarínicos/farmacologia , Terminações Pré-Sinápticas/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley
15.
Pediatr Int ; 61(11): 1151-1154, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31520503

RESUMO

BACKGROUND: I.v. atropine (IA) for infantile hypertrophic pyloric stenosis (IHPS) is a good alternative to pyloromyotomy but has not been broadly accepted. The lower success rate is one of the greatest disadvantages of IA. We investigated the risk factors for unsuccessful results following IA for IHPS. METHODS: Medical records of patients with IHPS who were admitted to Kimitsu Chuo Hospital between 2002 and 2016 and were initially given atropine sulfate were retrospectively reviewed. Atropine was given i.v. (0.1 mg/kg/day in eight divided doses). Oral feeding of milk was started with a small amount and increased in a stepwise fashion to full feed. IA therapy was defined as unsuccessful in the presence of projectile vomiting more than three times a day or intolerance to a predetermined amount of milk. RESULTS: Of the 48 patients with IHPS, 33 patients were successfully treated with IA and 15 patients needed surgical intervention. On univariate analysis the risk factors for unsuccessful IA therapy were younger age, lower bodyweight, and shorter duration of symptoms before diagnosis. On multivariate analysis age at diagnosis < 30 days was the only significant risk factor for unsuccessful IA therapy (OR, 5.7 l P = 0.03). CONCLUSIONS: Age at diagnosis < 30 days is a risk factor for unsuccessful IA therapy in IHPS. This might be considered when IA therapy is used for neonates with IHPS.


Assuntos
Atropina/administração & dosagem , Estenose Pilórica Hipertrófica/tratamento farmacológico , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Infusões Intravenosas , Masculino , Antagonistas Muscarínicos/administração & dosagem , Prognóstico , Estenose Pilórica Hipertrófica/diagnóstico , Estenose Pilórica Hipertrófica/cirurgia , Piloro/cirurgia , Estudos Retrospectivos , Fatores de Risco , Falha de Tratamento , Ultrassonografia
16.
Am J Case Rep ; 20: 1418-1421, 2019 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-31554781

RESUMO

BACKGROUND Pyridostigmine is a quaternary amine parasympathomymetic which inhibits acetylcholinesterase for the treatment of various conditions such as myasthenia gravis. Previously, no cases of pyridostigmine toxicity in human beings have been reported except the cases reported among the troops of Persian Gulf War. CASE REPORT A 47-year-old female intentionally ingested a high dose of pyridostigmine (Mestinon) and developed its toxic symptoms within 1 hour of ingestion. She was treated with injections of atropine and pralidoxime. The patient made an excellent recovery and responded to the classical treatment using atropine and pralidoxime. She was discharged on the second day of admission. CONCLUSIONS The authors demonstrated that pyridostigmine poisoning is self-limiting and well tolerated by young adults; however, unwanted effects of pyridostigmine on the heart has still to be considered which may become profound to the point of generating heart failure, syncope, or stress particularly in elderly patients. As the literature on human toxicity with pyridostigmine is scarce, not much data is available on its toxicity. However, prompt and specific management of pyridostigmine toxicity promises safety.


Assuntos
Inibidores da Colinesterase/efeitos adversos , Miastenia Gravis , Brometo de Piridostigmina/efeitos adversos , Tentativa de Suicídio , Atropina/administração & dosagem , Reativadores da Colinesterase/administração & dosagem , Feminino , Humanos , Pessoa de Meia-Idade , Antagonistas Muscarínicos/administração & dosagem , Miastenia Gravis/tratamento farmacológico , Compostos de Pralidoxima/administração & dosagem
17.
Vet Anaesth Analg ; 46(6): 729-735, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31551138

RESUMO

OBJECTIVES: To describe alfentanil-propofol admixture for induction of anaesthesia for canine radiotherapy and compare it to alfentanil-atropine followed by propofol induction in terms of heart rate (HR), mean arterial pressure (MAP), recovery duration and quality. STUDY DESIGN: Prospective, masked, randomized clinical crossover trial. ANIMALS: A group of 40 client-owned dogs anaesthetized from October 2017 to June 2018. METHODS: Dogs were randomly assigned to be administered one of two protocols. For both protocols, IV preanaesthetic medication was given 30 seconds before rapid IV administration of a set volume of induction agent, with further induction agent administered as needed to permit intubation. For protocol ADMIX, the preanaesthetic medication was 0.04 mL kg-1 0.9% sodium chloride and the induction agent was 0.2 mL kg-1 propofol-alfentanil admixture. For protocol ATRO, the preanaesthetic medication was 10 µg kg-1 alfentanil with 12 µg kg-1 atropine (0.04 mL kg-1 total volume) and the induction agent was 0.2 mL kg-1 propofol. Anaesthesia was maintained with sevoflurane. Cardiorespiratory variables, agitation, hypotension, or inadequate depth of anaesthesia requiring supplemental boluses of propofol or increased vaporizer settings were recorded. Time to extubation, sternal recumbency and walking was noted. Videos were recorded for recovery quality scoring. Owner questionnaires gave feedback about recoveries at home. The other protocol was administered for the next radiotherapy session. RESULTS: The only significantly different variable between protocols was mean HR during anaesthesia, which was lower in ADMIX (p < 0.001). Hypotension was recorded in seven (17.5%) dogs in ATRO and three (7.5%) in ADMIX, with an association (p < 0.005) between ATRO and hypotension. Owners reported animals recovered 'normal' behaviour and appetite by the next morning. CONCLUSIONS AND CLINICAL RELEVANCE: Both protocols were acceptable for dogs undergoing radiotherapy, with minimal differences in anaesthetic quality, recovery duration and quality. Although MAP did not differ overall, the incidence of hypotension was higher in ATRO.


Assuntos
Alfentanil/farmacologia , Anestesia/veterinária , Atropina/farmacologia , Doenças do Cão/radioterapia , Propofol/farmacologia , Radioterapia/veterinária , Adjuvantes Anestésicos/administração & dosagem , Adjuvantes Anestésicos/farmacologia , Alfentanil/administração & dosagem , Anestésicos Intravenosos/administração & dosagem , Anestésicos Intravenosos/farmacologia , Animais , Atropina/administração & dosagem , Estudos Cross-Over , Cães , Feminino , Masculino , Medicação Pré-Anestésica/veterinária , Propofol/administração & dosagem
18.
Medicina (Kaunas) ; 55(9)2019 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-31540331

RESUMO

Background and Objectives: Atropine is a nonselective muscarinic antagonist which has been used to prevent worsening of myopia in children. Different concentrations of atropine were used for myopia, ranging from 0.01% to 1.0%. However, there are still potential toxicity of different doses of atropine to the cornea. Here, we present a study of investigating novel genes potentially involved in the effects of very low dose atropine treatment (0.003%) on corneal epithelial cells using next-generation sequencing (NGS) and bioinformatics approaches. Materials and Methods: Human corneal epithelial cells were treated with 0.003% atropine, cultured until confluence, and RNA extracted for differential expression profiling of mRNA and microRNA (miRNA) between control and atropine-treated corneal epithelial cells. The functional enrichment analysis for differentially expressed genes was performed using two bioinformatics databases, including Database for Annotation, Visualization and Integrated Discovery (DAVID) and Ingenuity® Pathway Analysis (IPA). In addition, potential miRNA-mRNA interactions involved in atropine-treated corneal epithelial cells were predicted and validated using different miRNA target prediction databases. Results: Our results showed 0.003% atropine might suppress the apoptosis of corneal epithelial cells, potentially through Ras and protein kinase A signaling pathways. We also validated the possible miRNA regulations by using TargetScan and miRDB databases. Hsa-miR-651-3p-EPHA7, hsa-miR-3148-TMEM108 and hsa-miR-874-5p-TBX6 were validated as possible miRNA regulations involved in corneal epithelial cells treated with 0.003% atropine. Conclusions: These findings may contribute novel insights into therapeutic strategies for treating cornea with 0.003% atropine.


Assuntos
Atropina/farmacologia , Córnea/citologia , Células Epiteliais/efeitos dos fármacos , MicroRNAs/genética , Antagonistas Muscarínicos/farmacologia , Atropina/uso terapêutico , Biologia Computacional , Perfilação da Expressão Gênica , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , MicroRNAs/efeitos dos fármacos , Antagonistas Muscarínicos/uso terapêutico , Miopia/tratamento farmacológico
19.
Arq Bras Oftalmol ; 82(5): 425-428, 2019 08 29.
Artigo em Inglês | MEDLINE | ID: mdl-31482961

RESUMO

A rare case of bilateral congenital microcoria associated with antimetropia in a 47-year-old man is here described. The patient presented with a chief complaint of progressive vision loss in his right eye over the past five years. A slit-lamp examination and ultrasound biomicroscopy confirmed congenital microcoria and cataracts. Phacoemulsification was performed using an iris expansion device and the anterior capsule was stained using the "trypan down under" technique. Preoperative considerations, the surgical approach, and postoperative management are discussed.


Assuntos
Atropina/administração & dosagem , Extração de Catarata , Catarata/complicações , Soluções Oftálmicas/administração & dosagem , Facoemulsificação/métodos , Distúrbios Pupilares/congênito , Adulto , Humanos , Masculino , Microscopia Acústica , Pessoa de Meia-Idade , Distúrbios Pupilares/complicações , Distúrbios Pupilares/cirurgia
20.
Saudi Med J ; 40(9): 907-913, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31522218

RESUMO

OBJECTIVES: To evaluate  the effectiveness of sugammadex in reducing or eliminating postoperative agitation levels, early respiratory complications and nausea/vomiting in children undergoing adenotonsillectomy. METHODS: A total of 70 patients (age range: 5-13 years) who underwent an adenotonsillectomy  in the Otolaryngology Clinic, Sakarya University, Sakarya, Turkey between May 2015 and September 2017 were included in the study. The patients were randomized into a sugammadex group (Group S) and a neostigmine + atropine (Group N); each group contained 35 patients. Time to extubation, postoperative agitation levels, and early postoperative complications were evaluated and recorded. Data from both groups were statistically evaluated and compared. RESULTS: The time to extubation was significantly shorter in Group S than Group N (p less than 0.05). Agitation scores during recovery were significantly lower in Group S than Group N (p less than 0.05). More complications were observed in Group N than in Group S; the number of patients seen coughing and experiencing nausea/vomiting in Group S was statistically significantly lower (p less than 0.05). CONCLUSION: This study demonstrated that the use of sugammadex results in less time to recovery and less agitation in comparison to conventional administration of neostigmine + atropine in the reversal of neuromuscular blocking after adenotonsillectomy.


Assuntos
Anestesia Geral/métodos , Tosse/epidemiologia , Delírio do Despertar/epidemiologia , Náusea e Vômito Pós-Operatórios/epidemiologia , Sugammadex/uso terapêutico , Adenoidectomia/métodos , Adolescente , Atropina/uso terapêutico , Criança , Pré-Escolar , Método Duplo-Cego , Delírio do Despertar/fisiopatologia , Feminino , Humanos , Masculino , Neostigmina/uso terapêutico , Complicações Pós-Operatórias/epidemiologia , Índice de Gravidade de Doença , Apneia Obstrutiva do Sono/cirurgia , Tonsilectomia/métodos , Tonsilite/cirurgia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA