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1.
S Afr Med J ; 110(3): 249-254, 2020 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-32657704

RESUMO

BACKGROUND: In South Africa (SA), healthy term newborns are usually discharged ˂72 hours after delivery. Discharged babies remain at risk for severe hyperbilirubinaemia if it is not identified early. Hyperbilirubinaemia is an important cause of readmission, and also leads to neonatal mortality and morbidity. Use of transcutaneous bilirubin (TcB) screening before hospital discharge has been controversial. OBJECTIVES: To test the clinical benefits of TcB screening of healthy newborns before discharge for the outcomes of readmission for jaundice and severe hyperbilirubinaemia in a randomised controlled trial (RCT). METHODS: This was a RCT. We compared predischarge TcB screening with visual assessment (alone) for jaundice in apparently healthy newborns at a public tertiary hospital in Cape Town, SA. Patients or study participants were not involved in the study design and implementation. RESULTS: Of the 1 858 infants, 63% were black, 35% of mixed race and 1% white. There was a significant reduction in the rate of readmission for jaundice (risk ratio (RR) 0.25; 95% confidence interval (CI) 0.14 - 0.46; p<0.0001) and in the incidence of severe hyperbilirubinaemia (RR 0.27; 95% CI 0.08 - 0.97; p=0.05) with the use of TcB screening compared with visual inspection. CONCLUSIONS: Predischarge TcB screening is superior in identifying newborns at risk of severe hyperbilirubinaemia compared with visual inspection. We recommend that every newborn, regardless of skin pigmentation, should receive objective bilirubin screening before hospital discharge. Universal bilirubin screening in newborns could potentially reduce hyperbilirubinaemia-related morbidity and mortality.


Assuntos
Bilirrubina/análise , Hiperbilirrubinemia/diagnóstico , Triagem Neonatal , Readmissão do Paciente/estatística & dados numéricos , Transfusão Total , Feminino , Humanos , Hiperbilirrubinemia/mortalidade , Hiperbilirrubinemia/terapia , Recém-Nascido , Tempo de Internação , Masculino , Fototerapia
2.
J Photochem Photobiol B ; 207: 111891, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32388486

RESUMO

The recent outbreak of COVID-19, which continues to ravage communities with high death tolls and untold psychosocial and catastrophic economic consequences, is a vivid reminder of nature's capacity to defy contemporary healthcare. The pandemic calls for rapid mobilization of every potential clinical tool, including phototherapy-one of the most effective treatments used to reduce the impact of the 1918 "Spanish influenza" pandemic. This paper cites several studies showing that phototherapy has immense potential to reduce the impact of coronavirus diseases, and offers suggested ways that the healthcare industry can integrate modern light technologies in the fight against COVID-19 and other infections. The evidence shows that violet/blue (400-470 nm) light is antimicrobial against numerous bacteria, and that it accounts for Niels Ryberg Finsen's Nobel-winning treatment of tuberculosis. Further evidence shows that blue light inactivates several viruses, including the common flu coronavirus, and that in experimental animals, red and near infrared light reduce respiratory disorders, similar to those complications associated with coronavirus infection. Moreover, in patients, red light has been shown to alleviate chronic obstructive lung disease and bronchial asthma. These findings call for urgent efforts to further explore the clinical value of light, and not wait for another pandemic to serve as a reminder. The ubiquity of inexpensive light emitting lasers and light emitting diodes (LEDs), makes it relatively easy to develop safe low-cost light-based devices with the potential to reduce infections, sanitize equipment, hospital facilities, emergency care vehicles, homes, and the general environment as pilot studies have shown.


Assuntos
Infecções por Coronavirus/terapia , Fototerapia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Helioterapia , Humanos , Raios Infravermelhos , Luz , Terapia com Luz de Baixa Intensidade , Pneumopatias/epidemiologia , Pneumopatias/terapia , Pneumopatias/virologia , Pandemias , Fototerapia/métodos , Pneumonia Viral
3.
JAMA ; 323(19): 1945-1960, 2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32427307

RESUMO

Importance: Approximately 125 million people worldwide have psoriasis. Patients with psoriasis experience substantial morbidity and increased rates of inflammatory arthritis, cardiometabolic diseases, and mental health disorders. Observations: Plaque psoriasis is the most common variant of psoriasis. The most rapid advancements addressing plaque psoriasis have been in its pathogenesis, genetics, comorbidities, and biologic treatments. Plaque psoriasis is associated with a number of comorbidities including psoriatic arthritis, cardiometabolic diseases, and depression. For patients with mild psoriasis, topical agents remain the mainstay of treatment, and they include topical corticosteroids, vitamin D analogues, calcineurin inhibitors, and keratolytics. The American Academy of Dermatology-National Psoriasis Foundation guidelines recommend biologics as an option for first-line treatment of moderate to severe plaque psoriasis because of their efficacy in treating it and acceptable safety profiles. Specifically, inhibitors to tumor necrosis factor α (TNF-α) include etanercept, adalimumab, certolizumab, and infliximab. Other biologics inhibit cytokines such as the p40 subunit of the cytokines IL-12 and IL-13 (ustekinumab), IL-17 (secukinumab, ixekizumab, bimekizumab, and brodalumab), and the p19 subunit of IL-23 (guselkumab, tildrakizumab, risankizumab, and mirikizumab). Biologics that inhibit TNF-α, p40IL-12/23, and IL-17 are also approved for the treatment of psoriatic arthritis. Oral treatments include traditional agents such as methotrexate, acitretin, cyclosporine, and the advanced small molecule apremilast, which is a phosphodiesterase 4 inhibitor. The most commonly prescribed light therapy used to treat plaque psoriasis is narrowband UV-B phototherapy. Conclusions and Relevance: Psoriasis is an inflammatory skin disease that is associated with multiple comorbidities and substantially diminishes patients' quality of life. Topical therapies remain the cornerstone for treating mild psoriasis. Therapeutic advancements for moderate to severe plaque psoriasis include biologics that inhibit TNF-α, p40IL-12/23, IL-17, and p19IL-23, as well as an oral phosphodiesterase 4 inhibitor.


Assuntos
Corticosteroides/administração & dosagem , Fatores Biológicos/uso terapêutico , Fototerapia , Psoríase/terapia , Administração Tópica , Inibidores de Calcineurina/administração & dosagem , Comorbidade , Diagnóstico Diferencial , Humanos , Injeções Subcutâneas , Ceratolíticos/administração & dosagem , Terapia PUVA , Psoríase/diagnóstico , Psoríase/epidemiologia , Psoríase/fisiopatologia , Fatores de Risco , Pele/fisiopatologia , Estados Unidos/epidemiologia , Vitamina D/análogos & derivados
4.
J Appl Oral Sci ; 28: e20190720, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32428059

RESUMO

Objective This study evaluated the clinical effect of violet LED light on in-office bleaching used alone or combined with 37% carbamide peroxide (CP) or 35% hydrogen peroxide (HP). Methodology A total of 100 patients were divided into five groups (n=20): LED, LED/CP, CP, LED/HP and HP. Colorimetric evaluation was performed using a spectrophotometer (ΔE, ΔL, Δa, Δb) and a visual shade guide (ΔSGU). Calcium (Ca)/phosphorous (P) ratio was quantified in the enamel microbiopsies. Measurements were performed at baseline (T 0 ), after bleaching (T B ) and in the 14-day follow-up (T 14 ). At each bleaching session, a visual scale determined the absolute risk (AR) and intensity of tooth sensitivity (TS). Data were evaluated by one-way (ΔE, Δa, ΔL, Δb), two-way repeated measures ANOVA (Ca/P ratio), and Tukey post-hoc tests. ΔSGU and TS were evaluated by Kruskal-Wallis and Mann-Whitney, and AR by Chi-Squared tests (a=5%). Results LED produced the lowest ΔE (p<0.05), but LED/HP promoted greater ΔE, ΔSGU and Δb (T 14 ) than HP (p<0.05). No differences were observed in ΔE and ΔSGU for LED/CP and HP groups (p>0.05). ΔL and Δa were not influenced by LED activation. After bleaching, LED/CP exhibited greater Δb than CP (p>0.05), but no differences were found between these groups at T 14 (p>0.05). LED treatment promoted the lowest risk of TS (16%), while HP promoted the highest (94.4%) (p<0.05). No statistical differences of risk of TS were found for CP (44%), LED/CP (61%) and LED/HP (88%) groups (p>0.05). No differences were found in enamel Ca/P ratio among treatments, regardless of evaluation times. Conclusions Violet LED alone produced the lowest bleaching effect, but enhanced HP bleaching results. Patients treated with LED/CP reached the same efficacy of HP, with reduced risk and intensity of tooth sensitivity and none of the bleaching protocols adversely affected enamel mineral content.


Assuntos
Peróxido de Carbamida/administração & dosagem , Peróxido de Hidrogênio/administração & dosagem , Luz , Fototerapia/métodos , Clareadores Dentários/administração & dosagem , Clareamento Dental/métodos , Adolescente , Adulto , Análise de Variância , Colorimetria , Terapia Combinada , Esmalte Dentário/efeitos dos fármacos , Esmalte Dentário/efeitos da radiação , Sensibilidade da Dentina/induzido quimicamente , Feminino , Humanos , Masculino , Valores de Referência , Fatores de Risco , Espectrofotometria , Estatísticas não Paramétricas , Propriedades de Superfície/efeitos dos fármacos , Propriedades de Superfície/efeitos da radiação , Resultado do Tratamento , Adulto Jovem
5.
Int J Nanomedicine ; 15: 2903-2920, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32425523

RESUMO

Background: The development of highly efficient nanoparticles to convert light to heat for anti-cancer applications is quite a challenging field of research. Methods: In this study, we synthesized unique pimpled gold nanospheres (PGNSs) for plasmonic photothermal therapy (PPTT). The light-to-heat conversion capability of PGNSs and PPTT damage at the cellular level were investigated using a tissue phantom model. The ability of PGNSs to induce robust cellular damage was studied during cytotoxicity tests on colorectal adenocarcinoma (DLD-1) and fibroblast cell lines. Further, a numerical model of plasmonic (COMSOL Multiphysics) properties was used with the PPTT experimental assays. Results: A low cytotoxic effect of thiolated polyethylene glycol (SH-PEG400-SH-) was observed which improved the biocompatibility of PGNSs to maintain 89.4% cell viability during cytometry assays (in terms of fibroblast cells for 24 hrs at a concentration of 300 µg/mL). The heat generated from the nanoparticle-mediated phantom models resulted in ΔT=30°C, ΔT=23.1°C and ΔT=21°C for the PGNSs, AuNRs, and AuNPs, respectively (at a 300 µg/mL concentration and for 325 sec). For the in vitro assays of PPTT on cancer cells, the PGNS group induced a 68.78% lethality (apoptosis) on DLD-1 cells. Fluorescence microscopy results showed the destruction of cell membranes and nuclei for the PPTT group. Experiments further revealed a penetration depth of sufficient PPTT damage in a physical tumor model after hematoxylin and eosin (H&E) staining through pathological studies (at depths of 2, 3 and 4 cm). Severe structural damages were observed in the tissue model through an 808-nm laser exposed to the PGNSs. Conclusion: Collectively, such results show much promise for the use of the present PGNSs and photothermal therapy for numerous anti-cancer applications.


Assuntos
Nanosferas/química , Nanosferas/uso terapêutico , Fototerapia/métodos , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Apoptose/efeitos dos fármacos , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Neoplasias Colorretais/patologia , Neoplasias Colorretais/terapia , Fibroblastos , Ouro/química , Humanos , Lasers , Neoplasias/terapia , Imagens de Fantasmas , Polietilenoglicóis/química
6.
Int J Nanomedicine ; 15: 3235-3250, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32440121

RESUMO

Background: Metal-organic frameworks (MOFs) have attracted intensive research interest in the biomedical field because of their unique properties. However, in order to realize the high loading capacity and therapeutic efficacy, it is still urgent to develop a multifunctional MOFs-based nanoplatform. Materials and Methods: Herein, a pH/near-infrared (NIR) dual-responsive drug delivery system based on zeolitic imidazolate framework-8 (ZIF-8) is constructed for synergistic chemo-photothermal therapy and dual-modal magnetic resonance (MR)/photoacoustic (PA) imaging. The doxorubicin hydrochloride (DOX) is embedded into ZIF-8 through one-pot method, and the resultant ZIF-8/DOX is then successively modified with polydopamine, Mn ions and poly(ethylene glycol). The obtained ZIF-8/DMPP is systematically characterized, and both its in vitro and in vivo biological effects are evaluated in detail. Results: The ZIF-8/DMPP possesses a high drug-loading content of 18.9% and displays appropriate size and morphology. The pH-dependent degradation and drug release behavior of prepared ZIF-8/DMPP are confirmed. Importantly, the results demonstrate that the photothermal effect of ZIF-8/DMPP under NIR laser irradiation can significantly accelerate its drug releasing rate, further improving the intracellular drug concentrations. Thereafter, the augmented chemotherapeutic efficiency by photothermal effect against cancer cells is verified both in vitro and in vivo. Besides, the favorable MR and PA imaging capacity of ZIF-8/DMPP is also evidenced on the tumor model. Conclusion: Taken together, the surface engineering of ZIF-8-based nanocarrier in this work offers a promising strategy for the multifunctional MOFs-based drug delivery system.


Assuntos
Portadores de Fármacos/química , Hipertermia Induzida , Imageamento Tridimensional , Raios Infravermelhos , Estruturas Metalorgânicas/química , Nanopartículas/química , Nanotecnologia/métodos , Fototerapia , Animais , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Doxorrubicina/farmacologia , Sistemas de Liberação de Medicamentos , Liberação Controlada de Fármacos , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Humanos , Concentração de Íons de Hidrogênio , Indóis/química , Camundongos Endogâmicos BALB C , Nanopartículas/ultraestrutura , Polímeros/química , Temperatura
8.
Int J Nanomedicine ; 15: 1903-1914, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32256067

RESUMO

Background: Cancer is one of the major causes of death and is difficult to cure using existing clinical therapies. Clinical cancer treatments [such as surgery, chemotherapy (CHT), radiotherapy (RT) and immunotherapy (IT)] are widely used but they have limited therapeutic effects and unavoidable side effects. Recently, the development of novel nanomaterials offers a platform for combinational therapy (meaning a combination of two or more therapeutic agents) which is a promising approach for cancer therapy. Recent studies have demonstrated several types of nanomaterials suitable for photothermal therapy (PTT) based on a near-infrared (NIR) light-responsive system. PTT possesses favorable properties such as being low in cost, and having high temporospatial control with minimal invasiveness. However, short NIR light penetration depth limits its functions. Methods: In this review, due to their promise, we focus on inorganic nanomaterials [such as hollow mesoporous silica nanoparticles (HMSNs), tungsten sulfide quantum dots (WS2QDs), and gold nanorods (AuNRs)] combining PTT with CHT, RT or IT in one treatment, aiming to provide a comprehensive understanding of PTT-based combinational cancer therapy. Results: This review found much evidence for the use of inorganic nanoparticles for PTT-based combinational cancer therapy. Conclusion: Under synergistic effects, inorganic nanomaterial-based combinational treatments exhibit enhanced therapeutic effects compared to PTT, CHT, RT, IT or PDT alone and should be further investigated in the cancer field.


Assuntos
Nanopartículas/uso terapêutico , Neoplasias/terapia , Animais , Terapia Combinada , Ouro/uso terapêutico , Humanos , Hipertermia Induzida/métodos , Imunoterapia/métodos , Nanopartículas/química , Nanotubos , Fotoquimioterapia/métodos , Fototerapia/métodos , Pontos Quânticos , Radioterapia/métodos
9.
Nat Commun ; 11(1): 1724, 2020 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-32265490

RESUMO

Vesicular photothermal therapy agents (PTAs) are highly desirable in photothermal therapy (PTT) for their excellent light-harvesting ability and versatile hollow compartments. However, up to now, the reported vesicular PTAs are generally self-assembled from small molecules like liposomes, and polymer vesicles have seldom been used as PTAs due to the unsatisfactory photothermal conversion efficiency resulting from the irregular packing of chromophores in the vesicle membranes. Here we report a nano-sized polymer vesicle from hyperbranched polyporphyrins with favorable photothermal stability and extraordinarily high photothermal efficiency (44.1%), showing great potential in imaging-guided PTT for tumors through in vitro and in vivo experiments. These excellent properties are attributed to the in situ supramolecular polymerization of porphyrin units inside the vesicle membrane into well-organized 1D monofilaments driven by π-π stacking. We believe the supramolecular polymerization-enhanced self-assembly process reported here will shed a new light on the design of supramolecular materials with new structures and functions.


Assuntos
Sobrevivência Celular/efeitos dos fármacos , Hipertermia Induzida/métodos , Nanopartículas/química , Fototerapia/métodos , Polímeros/química , Porfirinas/química , Animais , Dicroísmo Circular , Feminino , Humanos , Interações Hidrofóbicas e Hidrofílicas , Células MCF-7 , Membranas Artificiais , Camundongos , Camundongos Nus , Microscopia Eletrônica de Varredura , Simulação de Dinâmica Molecular , Células NIH 3T3 , Nanopartículas/uso terapêutico , Nanopartículas/ultraestrutura , Polimerização , Polímeros/síntese química , Polímeros/farmacocinética , Polímeros/uso terapêutico , Porfirinas/síntese química , Porfirinas/farmacocinética , Porfirinas/uso terapêutico , Ratos , Espectrometria de Fluorescência , Temperatura , Transplante Heterólogo
10.
PLoS One ; 15(3): e0230839, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32226019

RESUMO

Depression is common among cardiac patients and associated with adverse cardiovascular outcomes. Bright light therapy has emerged as a promising treatment for depressive symptoms, however it has not yet been investigated in this population. We conducted a double-blind, randomized, placebo-controlled pilot trial to assess the feasibility of a larger-scale trial testing bright light therapy for depressive symptoms in cardiac patients. Patients hospitalized for an acute coronary syndrome or undergoing cardiac surgery were randomized to either bright light (10,000 lux) or dim light placebo (500 lux) lamps for 30 minutes each day over 4 weeks, beginning in-hospital. Depression was quantified using the Patient Health Questionnaire 9 (PHQ-9) and Depression Anxiety and Stress Scales (DASS-21). The Short-Form Health Survey 36 (SF-36) was used to measure quality of life. A total of 175 patients were screened and 15 were randomized (8 treatment, 7 placebo) (8.6%) over 10 months. Despite protocol amendments which broadened the inclusion criteria, the trial was terminated early for infeasibility based on the rate of enrollment (1-2 participants/month), with 39.5% of the target sample (38 participants) enrolled. Future trials should take into account the timing of the onset of depressive symptoms in these patients, and consider a less conservative approach to eligibility as well as ways to increase the acceptability of bright light therapy in hospitalized cardiac patients. Once enrolled, our findings suggest that most participants will adhere to the assigned treatment and complete follow-up.


Assuntos
Depressão/complicações , Depressão/terapia , Cardiopatias/complicações , Hospitalização , Fototerapia , Adulto , Idoso , Método Duplo-Cego , Feminino , Cardiopatias/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida
11.
Hautarzt ; 71(3): 227-243, 2020 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-32130433

RESUMO

In Germany, approximately 2% of the population suffers from psoriasis, which is no longer considered only a cutaneous, but rather a systemic disease. Accordingly, common comorbidities and potential joint involvement in psoriasis must be recorded. If necessary, interdisciplinary patient care has to be organized. The use of validated scores is recommended to complete the patient's medical history. The individual treatment should include intensified topical therapies as well as short-term phototherapy in case of an acute phase. In addition to conventional systemic therapies (e.g., fumarates, methotrexate), a number of new therapeutics for psoriasis are in development. Apart from the PDE­4 inhibitor apremilast, targeted therapies are currently available to block TNF-alpha, IL-17A, the IL-17 receptor and IL-23. Decisions on individualized, patient-centered psoriasis management should be based on assessment of disease severity and the existence of comorbidities. Furthermore, economic aspects should be taken into account.


Assuntos
Terapia Biológica/métodos , Terapia de Alvo Molecular , Fototerapia/métodos , Psoríase/diagnóstico , Psoríase/terapia , Administração Oral , Administração Tópica , Adulto , Artrite Psoriásica/diagnóstico , Artrite Psoriásica/terapia , Fármacos Dermatológicos/uso terapêutico , Alemanha , Humanos , Metotrexato/uso terapêutico , Inibidores da Fosfodiesterase 4/uso terapêutico , Índice de Gravidade de Doença , Resultado do Tratamento
12.
Wiad Lek ; 73(1): 7-11, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32124798

RESUMO

OBJECTIVE: The aim: The study of skin microbial landscape and immune-endocrine parameters as well as improvement of treatment efficiency in patients with different clinical course of psoriasis by using narrowband UVB phototherapy. PATIENTS AND METHODS: Materials and methods: We examined 89 patients with psoriasis (51 men and 38 women) aged 18-60. The comparison group consisted of 43 psoriasis patients comparable by age, sex and clinical course with those from the main group (46 patients). Cytokine levels IL-4, IL-8, IL-10, TNFα, thyroid peroxidase (TPO) and thyroglobulin (Tg) autoantibodies and microbial flora of skin were determined in patients with psoriasis. RESULTS: Results: The study finds that conventional therapy does not have sufficient corrective impact on immune-endocrine disorders and the use of narrow-band light therapy has shown that it has a focused corrective impact on cytokine production and modulating effect on the level of TPO and Tg autoantibodies and the state of skin automicroflora of lesions in patients suffering from psoriasis. CONCLUSION: Conclusions: Using UVB (311 nm) therapy in patients with psoriasis allows improving efficiency of treatment and limiting clinical signs in the form of achieving remission and significant improvement in patients' health without any negative dynamic changes.


Assuntos
Psoríase , Terapia Ultravioleta , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fototerapia , Pele , Resultado do Tratamento , Adulto Jovem
14.
Nat Commun ; 11(1): 1126, 2020 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-32111847

RESUMO

The efficacy of nano-mediated drug delivery has been impeded by multiple biological barriers such as the mononuclear phagocyte system (MPS), as well as vascular and interstitial barriers. To overcome the abovementioned obstacles, we report a nano-pathogenoid (NPN) system that can in situ hitchhike circulating neutrophils and supplement photothermal therapy (PTT). Cloaked with bacteria-secreted outer membrane vesicles inheriting pathogen-associated molecular patterns of native bacteria, NPNs are effectively recognized and internalized by neutrophils. The neutrophils migrate towards inflamed tumors, extravasate across the blood vessels, and penetrate through the tumors. Then NPNs are rapidly released from neutrophils in response to inflammatory stimuli and subsequently taken up by tumor cells to exert anticancer effects. Strikingly, due to the excellent targeting efficacy, cisplatin-loaded NPNs combined with PTT completely eradicate tumors in all treated mice. Such a nano-platform represents an efficient and generalizable strategy towards in situ cell hitchhiking as well as enhanced tumor targeted delivery.


Assuntos
Quimiotaxia de Leucócito , Sistemas de Liberação de Medicamentos , Nanopartículas/administração & dosagem , Neoplasias/terapia , Neutrófilos/fisiologia , Fototerapia , Animais , Membrana Externa Bacteriana/química , Membrana Externa Bacteriana/imunologia , Materiais Biomiméticos/administração & dosagem , Materiais Biomiméticos/química , Materiais Biomiméticos/farmacocinética , Cisplatino/administração & dosagem , Cisplatino/química , Cisplatino/farmacocinética , Liberação Controlada de Fármacos , Vesículas Extracelulares/química , Vesículas Extracelulares/imunologia , Imunoterapia Adotiva , Inflamação/etiologia , Camundongos , Nanopartículas/química , Nanopartículas/metabolismo , Neoplasias/metabolismo , Neoplasias/patologia , Ativação de Neutrófilo , Infiltração de Neutrófilos , Neutrófilos/imunologia , Neutrófilos/metabolismo , Padrões Moleculares Associados a Patógenos/imunologia , Fototerapia/efeitos adversos , Microambiente Tumoral/efeitos da radiação , Ensaios Antitumorais Modelo de Xenoenxerto
15.
Int J Nanomedicine ; 15: 1409-1420, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32184595

RESUMO

Background: Photothermal therapy with accurate and real-time temperature detection is desired in clinic. Upconversion nanocrystals (UCNs) are candidate materials for simultaneous temperature detection and photothermal agents carrying. However, the weak luminescence and multiple laser excitations of UCNs limit their application in thermal therapy. Materials and Methods: NaYF4:Yb3+,Er3+,Nd3+, PL-PEG-NH2, IR-806 and folic acid are selected as structural components. A nanoprobe (NP) integrated with efficient photothermal conversion and sensitive temperature detection capabilities is synthesized for precise photothermal therapy. The probes are based on near-infrared upconversion nanocrystals doped with Yb, Er and Nd ions, which can be excited by 808 nm light. IR-806 dye molecules are modified on the surface as molecular antennas to strongly absorb near-infrared photons for energy transfer and conversion. Results: The results show that under an 808 nm laser irradiation upconversion luminescence of the nanocrystals is enhanced based on both the Nd ion absorption and the FRET energy transfer of IR-806. The luminescence ratio at 520 and 545 nm is calculated to accurately monitor the temperature of the nanoparticles. The temperature of the nanoprobes increases significantly through energy conversion of the molecular antennas. The nanoparticles are found successfully distributed to tumor cells and tumor tissue due to the modification of the biocompatible molecules on the surface. Tumor cells can be killed efficiently based on the photothermal effect of the NPs. Under the laser irradiation, temperature at mouse tumor site increases significantly, tissue necrosis and tumor cell death can be observed. Conclusion: Precision photothermal therapy can thus be achieved by highly efficient near-infrared light absorption and accurate temperature monitoring, making it promising for tumor treatment, as well as the biological microzone temperature detection.


Assuntos
Nanopartículas/química , Fototerapia/métodos , Termografia/métodos , Animais , Linhagem Celular Tumoral , Érbio/química , Feminino , Raios Infravermelhos , Lasers , Luminescência , Neoplasias Mamárias Experimentais/terapia , Camundongos Endogâmicos BALB C , Neodímio/química , Temperatura , Itérbio/química , Ítrio/química
16.
Int J Nanomedicine ; 15: 1373-1385, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32184592

RESUMO

Background: Photothermal therapy (PTT) has great potential application in the treatment of tumors. However, due to the low penetration of near-infrared light (NIR) and the low concentration of nanomaterials in the tumor site, the application of PTT has been limited. Purpose: The objective of this study was to investigate the therapeutic effect of transcatheter intra-arterial infusion of lecithin-modified Bi nanoparticles (Bi-Ln NPs) combined with interventional PTT (IPTT) on hepatocellular carcinoma. Methods: Bi-Ln NPs were prepared by emulsifying the hydrophobic Bi nanoparticles and lecithin, and the photothermal conversion and cytotoxicity of Bi-Ln NPs were then measured by infrared imaging and MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay, respectively. Twenty-four VX2 hepatic carcinoma rabbits were randomly divided into four groups. Rabbits in group A received Bi-Ln NPs by intra-arterial infusion and NIR laser treatment (IA Bi-Ln NPs + Laser), group B received Bi-Ln NPs by intravenous infusion and NIR laser treatment (IV Bi-Ln NPs + Laser), group C received PBS (phosphate buffer saline) via intra-arterial infusion with NIR laser treatment (IA PBS + Laser), group D received PBS via intra-arterial infusion (IA PBS). Transcatheter intra-arterial infusion was conducted by superselective intubation under digital subtraction angiography (DSA) guidance. IPTT was performed by introducing an NIR optical fiber access to the rabbit VX2 hepatic carcinoma under real-time ultrasound guidance. Magnetic resonance imaging (MRI) was performed to evaluate the tumor size. Hematoxylin and eosin (H&E) stain and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) were conducted 7 days after treatment to evaluate the necrosis rate and viability of tumor, respectively. Results: The Bi-Ln NPs have the advantages of good biological compatibility and high photothermal conversion efficiency. Minimally invasive transcatheter intra-arterial infusion can markedly increase the concentration of Bi-Ln NPs in tumor tissues. IPTT can contribute to the significant improvement in the photothermal efficiency of Bi-Ln NPs. Compared to other groups, the group of IA Bi-Ln NPs + Laser showed a significantly higher tumor inhibition rate (TIR) of 93.38 ± 19.57%, a higher tumor necrosis rate of 83.12 ± 8.02%, and a higher apoptosis rate of (43.26 ± 10.65%) after treatment. Conclusion: Transcatheter intra-arterial infusion combined with interventional PTT (IPTT) is safe and effective in eradicating tumor cells and inhibiting tumor growth and may provide a novel and valuable choice for the treatment of hepatocellular carcinoma in the future.


Assuntos
Bismuto/química , Carcinoma Hepatocelular/terapia , Neoplasias Hepáticas Experimentais/terapia , Nanopartículas Metálicas/administração & dosagem , Fototerapia , Ultrassonografia/métodos , Animais , Apoptose , Carcinoma Hepatocelular/patologia , Terapia Combinada , Feminino , Artéria Hepática , Raios Infravermelhos , Infusões Intra-Arteriais , Lecitinas/química , Neoplasias Hepáticas Experimentais/patologia , Masculino , Nanopartículas Metálicas/química , Necrose , Coelhos
19.
Pediatrics ; 145(4)2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32161111

RESUMO

The nutritional and immunologic properties of human milk, along with clear evidence of dose-dependent optimal health outcomes for both mothers and infants, provide a compelling rationale to support exclusive breastfeeding. US women increasingly intend to breastfeed exclusively for 6 months. Because establishing lactation can be challenging, exclusivity is often compromised in hopes of preventing feeding-related neonatal complications, potentially affecting the continuation and duration of breastfeeding. Risk factors for impaired lactogenesis are identifiable and common. Clinicians must be able to recognize normative patterns of exclusive breastfeeding in the first week while proactively identifying potential challenges. In this review, we provide new evidence from the past 10 years on the following topics relevant to exclusive breastfeeding: milk production and transfer, neonatal weight and output assessment, management of glucose and bilirubin, immune development and the microbiome, supplementation, and health system factors. We focus on the early days of exclusive breastfeeding in healthy newborns ≥35 weeks' gestation managed in the routine postpartum unit. With this evidence-based clinical review, we provide detailed guidance in identifying medical indications for early supplementation and can inform best practices for both birthing facilities and providers.


Assuntos
Aleitamento Materno/métodos , Prática Clínica Baseada em Evidências , Lactação/fisiologia , Leite Humano/fisiologia , Algoritmos , Peso ao Nascer , Glicemia/metabolismo , Peso Corporal/fisiologia , Extração de Leite/métodos , Colostro/fisiologia , Suplementos Nutricionais , Feminino , Glicogênio/metabolismo , Humanos , Hiperbilirrubinemia/terapia , Recém-Nascido , Método Canguru , Transtornos da Lactação/etiologia , Microbiota/fisiologia , Leite Humano/química , Leite Humano/imunologia , Mães , Fototerapia , Fatores de Risco , Fatores de Tempo
20.
Chem Commun (Camb) ; 56(20): 3019-3022, 2020 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-32048647

RESUMO

Nucleus-targeting NPs based on RuO2 (RuO2NPs) were developed by controlling the size and the surface charge of nanoparticles (NPs). This study not only demonstrates a facile approach for the fabrication of ultrasmall CS-RuO2NPs with good biocompatibility and excellent photothermal properties but also their unique potential for the nucleus-targeted low-temperature PTT.


Assuntos
Nanopartículas/química , Imagem Óptica , Óxidos/química , Técnicas Fotoacústicas , Rutênio/química , Temperatura , Núcleo Celular/efeitos dos fármacos , Humanos , Raios Infravermelhos , Células MCF-7 , Óxidos/farmacologia , Tamanho da Partícula , Fototerapia , Rutênio/farmacologia , Propriedades de Superfície
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