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1.
Singapore Med J ; 64(6): 385-390, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-35707882

RESUMO

Introduction: Cannabis has consistently been the third most commonly abused drug among drug arrestees in Singapore over the past few years. Accordingly, this study aimed to understand the profile of cannabis users in Singapore and explore the effects of cannabis use on drug progression. Methods: A total of 450 participants who had used cannabis at least once in their lifetime were recruited from the National Addictions Management Service, prisons, the Community Rehabilitation Centre and halfway houses from August 2017 to May 2018. A face-to-face questionnaire was administered and descriptive analyses were conducted. Results: The mean participant age was 40.9 ± 14.51 years, and 93.1% of them were male. The participants generally initiated cannabis use during adolescence, at a mean onset age of 16.5 ± 4.46 years. Most (89.6%) were introduced to cannabis by peers. Approximately half of them (46.9%) had used cannabis before other illicit drugs and 42.1% of them had used heroin as the succeeding drug. Conclusion: In Singapore, cannabis use is often initiated during adolescence, largely under peer influence. Cannabis users may progress to other illicit drugs, particularly heroin, later in life.


Assuntos
Cannabis , Drogas Ilícitas , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Criança , Adulto Jovem , Feminino , Singapura/epidemiologia , Heroína , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
3.
Singapore medical journal ; : 385-390, 2023.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-984217

RESUMO

INTRODUCTION@#Cannabis has consistently been the third most commonly abused drug among drug arrestees in Singapore over the past few years. Accordingly, this study aimed to understand the profile of cannabis users in Singapore and explore the effects of cannabis use on drug progression.@*METHODS@#A total of 450 participants who had used cannabis at least once in their lifetime were recruited from the National Addictions Management Service, prisons, the Community Rehabilitation Centre and halfway houses from August 2017 to May 2018. A face-to-face questionnaire was administered and descriptive analyses were conducted.@*RESULTS@#The mean participant age was 40.9 ± 14.51 years, and 93.1% of them were male. The participants generally initiated cannabis use during adolescence, at a mean onset age of 16.5 ± 4.46 years. Most (89.6%) were introduced to cannabis by peers. Approximately half of them (46.9%) had used cannabis before other illicit drugs and 42.1% of them had used heroin as the succeeding drug.@*CONCLUSION@#In Singapore, cannabis use is often initiated during adolescence, largely under peer influence. Cannabis users may progress to other illicit drugs, particularly heroin, later in life.


Assuntos
Adolescente , Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Criança , Adulto Jovem , Feminino , Cannabis , Singapura/epidemiologia , Heroína , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Drogas Ilícitas
4.
Singapore Med J ; 60(4): 164-167, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31069397

RESUMO

We evaluated the utilisation of a helpline and Web chat system by the public for gambling-related services in Singapore over a period of 12 months. The profile of callers, call characteristics and actions taken were descriptively analysed using aggregate data. The majority of helpline calls and Web chats were from gamblers aged 40-49 years (23.3%, n = 644). Gamblers made 85.4% (n = 8,010) of the calls to the helpline and 73.3% (n = 546) of the Web chats. About four-fifths of the gamblers were Chinese (79.5%, n = 6,381) and employed full time (79.9%, n = 4,125). Table games (67.6%, n = 2,605) were the most popular gambling activity reported by callers, 55.8% of which involved local casinos. Enquiries were mostly casino related (92.4%, n = 5,739). Approximately 1,827 calls were received per month during the study period and 185 referrals were made to the clinic, 80.5% of whom sought treatment.


Assuntos
Jogo de Azar/prevenção & controle , Linhas Diretas , Internet , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Singapura
5.
Singapore medical journal ; : 164-167, 2019.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-776941

RESUMO

We evaluated the utilisation of a helpline and Web chat system by the public for gambling-related services in Singapore over a period of 12 months. The profile of callers, call characteristics and actions taken were descriptively analysed using aggregate data. The majority of helpline calls and Web chats were from gamblers aged 40-49 years (23.3%, n = 644). Gamblers made 85.4% (n = 8,010) of the calls to the helpline and 73.3% (n = 546) of the Web chats. About four-fifths of the gamblers were Chinese (79.5%, n = 6,381) and employed full time (79.9%, n = 4,125). Table games (67.6%, n = 2,605) were the most popular gambling activity reported by callers, 55.8% of which involved local casinos. Enquiries were mostly casino related (92.4%, n = 5,739). Approximately 1,827 calls were received per month during the study period and 185 referrals were made to the clinic, 80.5% of whom sought treatment.

6.
J Atten Disord ; 21(6): 465-474, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25189872

RESUMO

OBJECTIVE: To investigate clinical and functional outcomes in military men with ADHD. METHOD: Clinical outcomes were measured via the Zung Self-Rating Depression Scale (Zung SDS) and the Zung Self-Rating Anxiety Scale (Zung SAS). Functional outcomes were measured using the "Car, Relax, Alone, Forget, Friends, Trouble" (CRAFFT) questionnaire and questionnaires about relationships, conduct problems, substance use, and sleep. RESULTS: Men with ADHD ( n = 52) reported more depressive (34 [67.3%] vs. 19 [38%], p = .008) and anxiety symptoms (31 [61.5%] vs. 14 [28%], p = .009) compared with those without ( n = 50). They had relationships lasting less than 1 year (24 [80%] vs. 9 [37.5%], p = .006), were more likely to smoke (17 [32.7%] vs. 5 [10%], p = .005), were most likely to use illicit substances (6 [11.5%] vs. 0 [0%], p < .001), had more conduct problems at school (27 [51.9%] vs. 5 [10%], p < .001), and had longer sleep latency (53.96 min ± 46.48 vs. 25.78 min ± 25.93, p = .006). CONCLUSION: Military men with ADHD are significantly associated with worse clinical and functional outcomes. They should be screened and monitored for depression, anxiety, sleep disorders, and substance use.


Assuntos
Transtornos de Ansiedade/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno Depressivo/etiologia , Militares/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Estudos Transversais , Humanos , Relações Interpessoais , Masculino , Prognóstico , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Instituições Acadêmicas , Singapura/epidemiologia , Transtornos do Sono-Vigília/etiologia , Inquéritos e Questionários , Adulto Jovem
7.
J Robot Surg ; 9(3): 201-9, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26531200

RESUMO

This study evaluates the oncological outcomes of RARP in a multiracial Asian population from a single institution. All suitable patients from 1st January 2003-30th June 2013 were identified from a prospectively maintained cancer registry. Peri-operative and oncological outcomes were analysed. Significance was defined as p < 0.05. There were n = 725 patients identified with a mean follow-up duration 28 months. The mean operative time, EBL and LOS were 186 min, 215 ml and 3 days, respectively. The pathological stage was pT2 in 68.6% (n = 497/725), pT3 in 31.3% (n = 227/725) and n = 1 patient with pT4 disease. The pathological Gleason scores (GS) were 6 in 27.9% (n = 202/725), GS 7 in 63.6% (n = 461/725) and GS ≥ 8 in 8.0 % (n = 58/725). The node positivity rate was 5.8% (n = 21/360). The positive margin rates were 31.0% (n = 154/497) and 70.9% (n = 161/227) for pT2 and pT3, respectively, and decreasing PSM rates are observed with surgical maturity. The biochemical recurrence rates were 9.7% (n = 48/497) and 34.2% (n = 78/228) for pT2 and pT3/T4, respectively. On multivariate analysis, independent predictors of BCR were pathological T stage and pathological Gleason score. Post-operatively, 78.5% (n = 569/725) of patients had no complications and 17.7% (n = 128/725) had minor (Clavien grade I-II) complications. This series, representing the largest from Southeast Asia, suggests that RARP can be a safe and oncologically feasible treatment for localised prostate cancer in an institution with moderate workload.


Assuntos
Prostatectomia , Neoplasias da Próstata/cirurgia , Procedimentos Cirúrgicos Robóticos , Adulto , Idoso , Povo Asiático , China , Humanos , Índia , Malásia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Prostatectomia/efeitos adversos , Prostatectomia/métodos , Prostatectomia/estatística & dados numéricos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Procedimentos Cirúrgicos Robóticos/métodos , Procedimentos Cirúrgicos Robóticos/estatística & dados numéricos , Resultado do Tratamento
8.
JMIR Mhealth Uhealth ; 2(4): e55, 2014 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-25491323

RESUMO

BACKGROUND: The usage of mobile phones and mobile phone apps in the recent decade has indeed become more prevalent. Previous research has highlighted a method of using just the Internet browser and a text editor to create an app, but this does not eliminate the challenges faced by clinicians. More recently, two methodologies of app development have been shared, but there has not been any disclosures pertaining to the costs involved. In addition, limitations such as the distribution and dissemination of the apps have not been addressed. OBJECTIVE: The aims of this research article are to: (1) highlight a low-cost methodology that clinicians without technical knowledge could use to develop educational apps; (2) clarify the respective costs involved in the process of development; (3) illustrate how limitations pertaining to dissemination could be addressed; and (4) to report initial utilization data of the apps and to share initial users' self-rated perception of the apps. METHODS: In this study, we will present two techniques of how to create a mobile app using two of the well-established online mobile app building websites. The costs of development are specified and the methodology of dissemination of the apps will be shared. The application of the low-cost methodologies in the creation of the "Mastering Psychiatry" app for undergraduates and "Déjà vu" app for postgraduates will be discussed. A questionnaire survey has been administered to undergraduate students collating their perceptions towards the app. RESULTS: For the Mastering Psychiatry app, a cumulative total of 722 users have used the mobile app since inception, based on our analytics. For the Déjà vu app, there has been a cumulative total of 154 downloads since inception. The utilization data demonstrated the receptiveness towards these apps, and this is reinforced by the positive perceptions undergraduate students (n=185) had towards the low-cost self-developed apps. CONCLUSIONS: This is one of the few studies that have demonstrated the low-cost methodologies of app development; as well as student and trainee receptivity toward self-created Web-based mobile phone apps. The results obtained have demonstrated that these Web-based low-cost apps are applicable in the real life, and suggest that the methodologies shared in this research paper might be of benefit for other specialities and disciplines.

9.
Singapore Med J ; 55(8): 411-4; quiz 415, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25189301

RESUMO

The Academy of Medicine (AMS) and the Ministry of Health (MOH) have developed the clinical practice guidelines on Attention Deficit Hyperactivity Disorder (ADHD) to provide doctors and patients in Singapore with evidence-based treatment for ADHD. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on ADHD, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html.The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Cuidadores , Criança , Medicina Baseada em Evidências , Humanos , Metilfenidato/uso terapêutico , Pais , Psiquiatria/métodos , Psiquiatria/normas , Singapura , Sociedades Médicas
10.
Vascul Pharmacol ; 63(2): 63-70, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25139660

RESUMO

Since the discovery of the importance of nitric oxide (NO) to the human body three decades ago, numerous laboratory and clinical studies have been done to explore its potential therapeutic actions on many organs. In the cardiovascular system, NO works as a volatile signaling molecule regulating the vascular permeability and vascular tone, preventing thrombosis and inflammation, as well as inhibiting the smooth muscle hyperplasia. Thus, NO is important in the prevention and treatment of cardiovascular disease. NO is synthesized by NO synthase (NOS) with tetrahydrobiopterin (BH4) as the crucial cofactor. Many studies have been done to form nitric oxide donors so as to deliver NO directly to the vessel walls. In addition, NO moieties have been incorporated into existing therapeutic agents to enhance the NO bioavailability, including statins. Statins are inhibitors of 3-hydroxy-3-methylglutaryl-coenzyme (HMG-CoA), the rate-limiting enzyme of the mevalonate pathway. By inhibiting this pathway, statins lower blood cholesterol and exert their pleiotropic effects through activity in reaction cascades, such as Rho/ROCK and Rac 1/NADPH oxidase pathways. Statins have also been observed to implement their non-lipid effects by promoting BH4 synthesis with increase of NO bioavailability. Furthermore, NO-donating statins in laboratory studies have demonstrated to produce better therapeutic effects than their parent's drugs. They offer better anti-inflammatory, anti-proliferative and antithrombotic actions on cardiovascular system. They also cause better revascularization in peripheral ischemia and produce greater enhancement in limb reperfusion and salvage. In addition, it has been shown that NO-donating statin caused less myotoxicity, the most common side effect related to treatment with statins. The initial studies have demonstrated the superior therapeutic effects of NO-donating statins while producing fewer side effects.


Assuntos
Biopterinas/análogos & derivados , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/metabolismo , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Doadores de Óxido Nítrico/farmacologia , Óxido Nítrico/farmacologia , Animais , Biopterinas/metabolismo , Endotélio Vascular/metabolismo , Humanos , Óxido Nítrico/metabolismo , Óxido Nítrico Sintase/metabolismo , Óxido Nítrico Sintase Tipo III/metabolismo
11.
Singapore medical journal ; : 411-quiz 415, 2014.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-274221

RESUMO

The Academy of Medicine (AMS) and the Ministry of Health (MOH) have developed the clinical practice guidelines on Attention Deficit Hyperactivity Disorder (ADHD) to provide doctors and patients in Singapore with evidence-based treatment for ADHD. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on ADHD, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html.The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.


Assuntos
Criança , Humanos , Transtorno do Deficit de Atenção com Hiperatividade , Diagnóstico , Tratamento Farmacológico , Terapêutica , Cuidadores , Medicina Baseada em Evidências , Metilfenidato , Usos Terapêuticos , Pais , Psiquiatria , Métodos , Padrões de Referência , Singapura , Sociedades Médicas
12.
Vascul Pharmacol ; 58(1-2): 21-30, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23085091

RESUMO

Statins, inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA), are important lipid-lowering agents. After two decades of laboratory and clinical studies, their pleiotropic effects appear well-established. One of these effects is through the regulation of Rac1 and NADPH oxidases. Relatively few human trials have been carried out with regards to the action of statins on Rac1 and NADPH oxidases, but similar positive effects were also observed in blood vessels and myocardium of participants in the trials. Besides, more specific biomarkers for the antioxidation effects of statins have been developed in the recent two years; both monitoring of the progress of disease and the effects of medical therapy will be possible. Further development of the potency and specificity of statin may enhance their therapeutic potential on cardiovascular disease.


Assuntos
Doenças Cardiovasculares/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , NADPH Oxidases/metabolismo , Proteínas rac1 de Ligação ao GTP/metabolismo , Animais , Antioxidantes/farmacologia , Biomarcadores/metabolismo , Doenças Cardiovasculares/fisiopatologia , Ensaios Clínicos como Assunto , Humanos
13.
Singapore medical journal ; : 259-262, 2013.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-359105

RESUMO

<p><b>INTRODUCTION</b>The incidence of lymphoceles - lymphatic collections around a transplanted kidney - can be as high as 20%. We aimed to review the presentation, treatment and outcome of patients with lymphoceles.</p><p><b>METHODS</b>We reviewed a prospective database of 154 patients who underwent renal transplantation at our hospital from January 2005 to November 2008.</p><p><b>RESULTS</b>The mean age of the patients in our cohort was 46 (range 34-58) years. The incidence of lymphoceles in our series was 5.8% (n = 9). The median onset was 19 (range 6-28) days post-transplantation, while the median size of the lymphoceles was 5 (range 1.5-8) cm. Lymphoceles were most commonly found at the lower pole of the transplanted kidney. Eight patients with lymphoceles had received cadaveric transplants. While a majority of these patients did not have hydronephrosis on presentation, four had markedly elevated creatinine. Of the nine patients with lymphoceles, six were on macrolides (tacrolimus, sirolimus or everolimus), two were successfully managed conservatively, three were managed percutaneously and four required surgical drainage via either laparoscopic marsupialisation (n = 1) or open drainage (n = 3). There was no graft loss.</p><p><b>CONCLUSION</b>It remains unknown whether the choice of immunosuppressants increases the risk of lymphocele formation. Intervention is necessary in the case of impaired drainage of the pelvicalyceal system in these patients. Minimally invasive intervention, while effective in treating lymphoceles, does not provide definitive treatment. Surgical intervention should be considered early for the treatment of post-transplantation patients with lymphoceles, so as to shorten hospital stay and prevent further complications.</p>


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Bases de Dados Factuais , Drenagem , Imunossupressores , Usos Terapêuticos , Incidência , Transplante de Rim , Métodos , Laparoscopia , Linfocele , Diagnóstico , Complicações Pós-Operatórias , Estudos Prospectivos , Insuficiência Renal , Terapêutica , Resultado do Tratamento
14.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-160241

RESUMO

BACKGROUND: The ability to achieve a long-term, stricture-free urethral repair is one of the ongoing challenges of reconstructive urologic surgery. A successful initial repair is critical, as repeat procedures are difficult, owing to distortion, scarring, and short urethral stumps. METHODS: We describe a technique in which the gracilis muscle flap is laid on or wrapped around the urethral repair site to provide a well-vascularised soft tissue reinforcement for urethral repair. This technique promotes vascular induction, whereby a new blood supply is introduced to the repair site to improve the outcome of urethral repair or anastomotic urethroplasty. The surface contact between the muscle flap and the repair site is enhanced by the use of fibrin glue to improve adherence and promote inosculation and healing. We employed this technique in 4 patients with different urethral defects. RESULTS: After a follow-up period of 32 to 108 months, all of the urethral repairs were successful without complications. CONCLUSIONS: Our results suggest that the use of a gracilis muscle flap to vascularise urethral repairs can improve the outcome of challenging urethral repairs.


Assuntos
Humanos , Cicatriz , Adesivo Tecidual de Fibrina , Seguimentos , Músculos , Reforço Psicológico , Retalhos Cirúrgicos , Uretra
15.
Open Respir Med J ; 6: 44-53, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22859930

RESUMO

The key feature of respiratory distress syndrome (RDS) is the insufficient production of surfactant in the lungs of preterm infants. As a result, researchers have looked into the possibility of surfactant replacement therapy as a means of preventing and treating RDS. We sought to identify the role of surfactant in the prevention and management of RDS, comparing the various types, doses, and modes of administration, and the recent development. A PubMed search was carried out up to March 2012 using phrases: surfactant, respiratory distress syndrome, protein-containing surfactant, protein-free surfactant, natural surfactant, animal-derived surfactant, synthetic surfactant, lucinactant, surfaxin, surfactant protein-B, surfactant protein-C.Natural, or animal-derived, surfactant is currently the surfactant of choice in comparison to protein-free synthetic surfactant. However, it is hoped that the development of protein-containing synthetic surfactant, such as lucinactant, will rival the efficacy of natural surfactants, but without the risks of their possible side effects. Administration techniques have also been developed with nasal continuous positive airway pressure (nCPAP) and selective surfactant administration now recommended; multiple surfactant doses have also reported better outcomes. An aerosolised form of surfactant is being trialled in the hope that surfactant can be administered in a non-invasive way. Overall, the advancement, concerning the structure of surfactant and its mode of administration, offers an encouraging future in the management of RDS.

16.
World J Nucl Med ; 11(2): 75-8, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-23372441

RESUMO

We present a rare variant of prostate carcinoma. The patient is a 45-year-old male with elevated prostate-specific antigen levels at screening. Magnetic resonance imaging revealed hyperenhancing lesions throughout the axial skeleton. The fluorine-18 fluorocholine (FCH) positron emission tomography/computed tomography (PET/CT) scan showed no abnormal bone findings. Subsequently, a technetium-99 methydiphosphonate (Tc99m-MDP) bone scan was performed, with additional correlative single-photon emission computed tomography (SPECT)/CT imaging of the pelvis and the results were essentially normal. A percutaneous core biopsy of one of the bone lesions in L5 was performed and histology confirmed small cell (neuroendocrine) variant of prostate cancer. Our case illustrates a possible pitfall in molecular imaging of prostate carcinomas, whereby both bone scintigraphy and FCH PET/CT scans showed no definite bone lesions to correlate with marrow signal abnormalities seen on MR imaging. This highlights the need for caution in the diagnostic evaluation of prostate cancers with known small cell variants.

17.
Cytokine Growth Factor Rev ; 22(3): 167-75, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21700485

RESUMO

BACKGROUND: 3-Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, also known as statins, are a drug class that reduce the level of cholesterol in the blood. As a result, statins are used to suppress the progression of cardiovascular disease. Evidence points to another component of statins involving the non-lipid effects of the drug class in preventing cardiovascular disease. One specific mediator of this action is the transforming growth factor ß (TGF-ß) superfamily. The TGF-ß superfamily consists of proteins that include TGF-ß and bone morphogenetic proteins (BMPs). These proteins regulate cellular pathways to mediate effects including immunomodulation, cell cycling, and angiogenesis. One pathway that mediates these effects is Ras. Moreover, within this pathway, different functions are possible depending on the activation of the specific receptor subtype. This review discusses the recent development of the non-lipid effects of statins in preventing cardiovascular disease progression by regulating Ras pathway of the TGF-ß superfamily, especially RhoA/ROCK pathway. METHODS: A systematic PubMed database search of all English-language articles up to 2011 was conducted using the following terms: statin, TGF-ß, Ras, ROCK, GGPP, inducible nitric oxide synthase, endothelial nitric oxide synthase, actin filament formation, PPARγ, MMP-2, and human trials. CONCLUSION: With better understanding of the pathway, various mediators were identified; some of these mediators are important biomarkers producing more specific and accurate assessment of the pleiotropic effects of statins. The review of human trials also highlights that more specific biomarkers are employed in recent studies, and the non-lipid effects on human subjects are more accurately documented. Confirmation of the accuracy of these biomarkers by further large-scale studies and further development of new biomarkers may prove an important path leading to better patient selection for treatment, and thus better cost-effectiveness may be achieved.


Assuntos
Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/metabolismo , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Transdução de Sinais/efeitos dos fármacos , Fator de Crescimento Transformador beta/metabolismo , Animais , Biomarcadores/metabolismo , Proteínas Morfogenéticas Ósseas/metabolismo , Doenças Cardiovasculares/patologia , Humanos
18.
Int J Oncol ; 22(3): 523-8, 2003 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-12579304

RESUMO

5-aminolevulinic acid mediated changes in tissue specific fluorescence were studied in bladder cancer. Bladders of normal patients and also patients diagnosed with cancer were instilled with 5-aminolevulinic acid and the resultant protoporphyrin IX mediated fluorescence intensity was imaged and quantified with confocal laser microscopy and fluorescence image analysis. Urothelial tumour cells were observed to fluoresce more intensely than normal urothelial cells. Submucosa and muscle tissues exhibited minimal fluorescence compared to urothelial cells of malignant origin and also normal urothelial cells. Degree of fluorescence intensity was in the order of malignant urothelium > normal urothelium > normal submucosa > normal muscles. Fluorescence intensity was also found to increase with duration of ALA instillation. Grade 3 malignant cells produced more fluorescence compared to grade 2 and grade 1. Similarly, T1 transitional cell carcinoma (TCC) showed increased fluorescence intensity than that of Ta TCC. Also, tumour blood vessels fluoresced more intensely compared to blood vessels found in normal bladder tissue. Tissue specific ALA mediated PpIX micro fluorescence can be used as a diagnostic technique for early detection of neoplasms and confocal laser microscopy and fluorescence image analysis are advantageous diagnostic tools for the photodynamic diagnosis of bladder neoplasms in vivo.


Assuntos
Ácido Aminolevulínico , Biomarcadores Tumorais/análise , Carcinoma in Situ/ultraestrutura , Carcinoma de Células de Transição/ultraestrutura , Processamento de Imagem Assistida por Computador , Microscopia Confocal/métodos , Microscopia de Fluorescência/métodos , Fármacos Fotossensibilizantes , Protoporfirinas/análise , Neoplasias da Bexiga Urinária/ultraestrutura , Administração Intravesical , Ácido Aminolevulínico/administração & dosagem , Carcinoma in Situ/química , Carcinoma in Situ/diagnóstico , Carcinoma de Células de Transição/química , Carcinoma de Células de Transição/diagnóstico , Humanos , Luz , Mucosa/efeitos dos fármacos , Mucosa/ultraestrutura , Músculo Liso/efeitos dos fármacos , Músculo Liso/ultraestrutura , Fármacos Fotossensibilizantes/administração & dosagem , Protoporfirinas/efeitos da radiação , Neoplasias da Bexiga Urinária/química , Neoplasias da Bexiga Urinária/diagnóstico , Urotélio/efeitos dos fármacos , Urotélio/ultraestrutura
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