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BACKGROUND: The organ-specific effects of gender-affirming sex hormone treatment (GAHT) in transgender women (TW) and transgender men (TM) are insufficiently explored. This study investigated the effects of GAHT on adipose tissue function. METHODS: In a single-center interventional prospective study, 32 adults undergoing GAHT, 15 TW and 17 TM, were examined with anthropometry and abdominal subcutaneous adipose tissue biopsies obtained before initiation of treatment, 1 month after endogenous sex hormone inhibition and three and 11 months after initiated GAHT. Fat cell size, basal/stimulated lipolysis and cytokine secretion in adipose tissue were analyzed. RESULTS: TW displayed an increase in complement component 3a and retinol-binding protein 4 (RBP4) secretion after sex hormone inhibition, which returned to baseline following estradiol treatment. No changes in lipolysis were seen in TW. TM showed downregulation of RBP4 after treatment, but no changes in basal lipolysis. In TM, the estrogen suppression led to higher noradrenaline stimulated (NA) lipolysis that was normalized following testosterone treatment. At 11 months, the ratio of NA/basal lipolysis was lower compared to baseline. There were no significant changes in fat cell size in either TW or TM. CONCLUSION: In TW, gonadal hormone suppression results in transient changes in cytokines and in TM there are some changes in NA-stimulated lipolysis following testosterone treatment. However, despite the known metabolic effects of sex hormones, the overall effects of GAHT on adipose tissue function are small and likely have limited clinical relevance, but larger studies with longer follow-up are needed to confirm these findings. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02518009, Retrospectively registered 7 August 2015.
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AIMS: This study tested the hypothesis that high doses of anti-inflammatory drugs would attenuate the adaptive response to resistance training compared with low doses. METHODS: Healthy men and women (aged 18-35 years) were randomly assigned to daily consumption of ibuprofen (IBU; 1200 mg; n = 15) or acetylsalicylic acid (ASA; 75 mg; n = 16) for 8 weeks. During this period, subjects completed supervised knee-extensor resistance training where one leg was subjected to training with maximal volitional effort in each repetition using a flywheel ergometer (FW), while the other leg performed conventional (work-matched across groups) weight-stack training (WS). Before and after training, muscle volume (MRI) and strength were assessed, and muscle biopsies were analysed for gene and protein expression of muscle growth regulators. RESULTS: The increase in m. quadriceps volume was similar between FW and WS, yet was (averaged across legs) greater in ASA (7.5%) compared with IBU (3.7%, group difference 34 cm3 ; P = 0.029). In the WS leg, muscle strength improved similarly (11-20%) across groups. In the FW leg, increases (10-23%) in muscle strength were evident in both groups yet they were generally greater (interaction effects P < 0.05) for ASA compared with IBU. While our molecular analysis revealed several training effects, the only group interaction (P < 0.0001) arose from a downregulated mRNA expression of IL-6 in IBU. CONCLUSION: Maximal over-the-counter doses of ibuprofen attenuate strength and muscle hypertrophic adaptations to 8 weeks of resistance training in young adults. Thus, young individuals using resistance training to maximize muscle growth or strength should avoid excessive intake of anti-inflammatory drugs.
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Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/efeitos adversos , Força Muscular/efeitos dos fármacos , Músculo Esquelético/efeitos dos fármacos , Treinamento Resistido , Adaptação Fisiológica/efeitos dos fármacos , Adolescente , Adulto , Aspirina/administração & dosagem , Aspirina/efeitos adversos , Feminino , Humanos , Ibuprofeno/administração & dosagem , Ibuprofeno/efeitos adversos , Masculino , Adulto JovemRESUMO
AIMS: To investigate whether the presence of glutamic acid decarboxylase (GAD) autoantibodies post-partum in women with prior gestational diabetes mellitus was associated with changes in metabolic characteristics, including ß-cell function and insulin sensitivity. METHODS: During 1997-2010, 407 women with gestational diabetes mellitus were offered a 3-month post-partum follow-up including anthropometrics, serum lipid profile, HbA1c and GAD autoantibodies, as well as a 2-h oral glucose tolerance test (OGTT) with blood glucose, serum insulin and C-peptide at 0, 30 and 120 min. Indices of insulin sensitivity and insulin secretion were estimated to assess insulin secretion adjusted for insulin sensitivity, disposition index (DI). RESULTS: Twenty-two (5.4%) women were positive for GAD autoantibodies (GAD+ve) and the remainder (94.6%) were negative for GAD autoantibodies (GAD-ve). The two groups had similar age and prevalence of diabetes mellitus. Women who were GAD+ve had significantly higher 2-h OGTT glucose concentrations during their index-pregnancy (10.5 vs. 9.8 mmol/l, P = 0.001), higher fasting glucose (5.2 vs. 5.0 mmol/l, P = 0.02) and higher 2-h glucose (7.8 vs. 7.1 mmol/l, P = 0.05) post-partum. Fasting levels of C-peptide and insulin were lower in GAD+ve women compared with GAD-ve women (520 vs. 761 pmol/l, P = 0.02 and 33 vs. 53 pmol/l, P = 0.05) Indices of insulin sensitivity were similar in GAD+ve and GAD-ve women, whereas all estimates of DI were significantly reduced in GAD+ve women. CONCLUSION: GAD+ve women had higher glucose levels and impaired insulin secretion adjusted for insulin sensitivity (DI) compared with GAD-ve women. The combination of OGTT and GAD autoantibodies post-partum identify women with impaired ß-cell function. These women should be followed with special focus on development of Type 1 diabetes.
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Autoanticorpos/análise , Doenças Autoimunes/diagnóstico , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Gestacional/fisiopatologia , Glutamato Descarboxilase/imunologia , Células Secretoras de Insulina/metabolismo , Insulina/metabolismo , Adulto , Doenças Autoimunes/epidemiologia , Doenças Autoimunes/etiologia , Doenças Autoimunes/imunologia , Biomarcadores/sangue , Estudos de Coortes , Dinamarca/epidemiologia , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 1/etiologia , Diabetes Mellitus Tipo 1/imunologia , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etiologia , Diabetes Mellitus Tipo 2/imunologia , Diabetes Gestacional/sangue , Diabetes Gestacional/imunologia , Diagnóstico Diferencial , Diagnóstico Precoce , Feminino , Seguimentos , Glutamato Descarboxilase/antagonistas & inibidores , Humanos , Insulina/sangue , Resistência à Insulina , Secreção de Insulina , Células Secretoras de Insulina/imunologia , Período Pós-Parto , Gravidez , Prevalência , Estudos ProspectivosRESUMO
BACKGROUND: No published studies on the prevalence of paediatric otitis media at primary healthcare clinics (PHCs) in South Africa (SA) are available. OBJECTIVE: To examine the point prevalence of otitis media in a paediatric population in a PHC in Johannesburg, SA, using otomicroscopy. METHODS: A sample of 140 children aged 2 - 16 years (mean 6.4; 44.1% females) were recruited from patients attending the PHC. Otomicroscopy was completed for each of the participants' ears by a specialist otologist using a surgical microscope. RESULTS: Cerumen removal was necessary in 36.0% of participants (23.5% of ears). Otitis media with effusion was the most frequent diagnosis (16.5%). Chronic suppurative otitis media (CSOM) was diagnosed in 6.6% of children and was the most common type of otitis media in participants aged 6 - 15 years. Acute otitis media was only diagnosed in the younger 2 - 5-year age group (1.7%). Otitis media was significantly more prevalent among younger (31.4%) than older children (16.7%). CONCLUSION: CSOM prevalence, as classified by the World Health Organization, was high. Consequently diagnosis, treatment and subsequent referral protocols may need to be reviewed to prevent CSOM complications.
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Gerenciamento Clínico , Otite Média/epidemiologia , Atenção Primária à Saúde/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Masculino , Otite Média/terapia , Estudos Retrospectivos , África do Sul/epidemiologiaRESUMO
INTRODUCTION: A truncated PGC-1α splice variant (PGC-1α4) has been implicated in the regulation of resistance exercise (RE)-induced muscle hypertrophy, and basal expression levels said to be augmented in response to concurrent aerobic (AE) and RE training. AIM: The current study investigated human muscle truncated and non-truncated PGC-1α transcripts in response to both acute and chronic RE, and with or without preceding AE (AE+RE). METHODS: Ten men performed 5 weeks of unilateral AE+RE and RE training. Before (untrained) and after (trained) this intervention, PGC-1α transcripts were assessed in vastus lateralis muscle biopsies obtained before and 3 h after acute RE, with or without preceding AE. Additionally, samples were collected 72 h after the last exercise bout of the training programme. RESULTS: The truncated splice variant increased (P < 0.05) its expression after acute exercise regardless of mode. However, the expression was greater (P < 0.05) after AE+RE than RE. Other PGC-1α transcripts showed similar response. Truncated transcripts originated from both the alternative and proximal promoter, and AE+RE increased PGC-1α expression from both promoter sites. RE induced transcripts from the alternative promoter only. PGC-1α expressions after acute exercise were comparable across isoforms in both untrained and trained muscle. Steady-state levels of isoforms were unchanged after 5-week training (P > 0.05). Exercise-induced expression of PGC-1α variants did not correlate with changes in muscle size or strength (P > 0.05). CONCLUSION: Our results do not support the view that truncated PGC-1α coordinates exercise-induced hypertrophy in human skeletal muscle. Rather, all PGC-1α isoforms appear to be regulated transiently in response to acute exercise and regardless of mode.
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Exercício Físico/fisiologia , Músculo Esquelético/metabolismo , Treinamento Resistido , Fatores de Transcrição/genética , Adulto , Humanos , Hipertrofia/genética , Hipertrofia/metabolismo , Masculino , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo , Isoformas de Proteínas/genética , Isoformas de Proteínas/metabolismo , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fatores de Transcrição/metabolismo , Adulto JovemRESUMO
AIM: This study assessed and compared acute muscle molecular responses before and after 5-week training, employing either aerobic (AE) and resistance exercise (RE) or RE only. METHODS: Ten men performed one-legged RE, while the contralateral limb performed AE followed by RE 6 h later (AE+RE). Before (untrained) and after (trained) the intervention, acute bouts of RE were performed with or without preceding AE. Biopsies were obtained from m. vastus lateralis of each leg pre- and 3 h post-RE to determine mRNA levels of VEGF, PGC-1α, MuRF-1, atrogin-1, myostatin and phosphorylation of mTOR, p70S6K, rpS6 and eEF2. RESULTS: PGC-1α and VEGF expression increased (P < 0.05) after acute RE in the untrained, but not the trained state. These markers showed greater response after AE+RE than RE in either condition. Myostatin was lower after AE+RE than RE, both before and after training. AE+RE showed higher MuRF-1 and atrogin-1 expression than RE in the untrained, not the trained state. Exercise increased (P < 0.05) p70S6K phosphorylation both before and after training, yet this increase tended to be more prominent for AE+RE than RE before training. Phosphorylation of p70S6K was greater in trained muscle. Changes in these markers did not correlate with exercise-induced alterations in strength or muscle size. CONCLUSION: Concurrent exercise in untrained skeletal muscle prompts global molecular responses consistent with resulting whole muscle adaptations. Yet, training blunts the more robust anabolic response shown after AE+RE compared with RE. This study challenges the concept that single molecular markers could predict training-induced changes in muscle size or strength.
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Exercício Físico/fisiologia , Regulação da Expressão Gênica/fisiologia , Músculo Esquelético/metabolismo , Treinamento Resistido , Adulto , Biópsia , Humanos , Masculino , Proteínas Musculares/metabolismo , Músculo Esquelético/patologia , Miostatina/metabolismo , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo , Proteínas Quinases S6 Ribossômicas 70-kDa/metabolismo , Proteínas Ligases SKP Culina F-Box/metabolismo , Fatores de Transcrição/metabolismo , Proteínas com Motivo Tripartido , Ubiquitina-Proteína Ligases/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismoRESUMO
OBJECTIVE: Quetiapine is a novel antipsychotic agent with many atypical features, including low D(2) and higher 5HT(2A) affinity in vitro, low propensity to induce extra-pyramidal side effects and minimal effects on prolactin levels. The purpose of this study was to investigate, using positron emission tomography (PET), the relationship between plasma concentrations of different doses of quetiapine and occupancy of D(2) and 5HT(2A) receptors in schizophrenic patients. METHODS: Five patients were treated with quetiapine (titrated to 750 or 450 mg/day) for 28 days, subsequently reduced weekly in a descending-dose schedule. Dopamine D(2) and 5HT(2A) occupancies were determined using [(11)C] raclopride and [(11)C] N-methylspiperone as ligands, respectively, and PET imaging. RESULTS: Mean D(2) receptor occupancies of 41 and 30% were observed at quetiapine doses of 750 and 450 mg/day. At lower dose levels no occupancy could be determined. Quetiapine induced a consistently higher degree of 5HT(2A) receptor occupancy, with mean occupancies of 74 and 57% at doses of 750 and 450 mg/day, respectively. No EPS emerged during the trial and most of the pre-trial EPS resolved during the study. CONCLUSIONS: In clinically effective doses, quetiapine induced low occupancy at D(2) receptors, which is consistent with atypical antipsychotics such as clozapine, and probably explains the lack of EPS observed in this trial. Correlations between receptor occupancy and plasma concentrations of quetiapine could not be calculated, although receptor occupancy increased with higher plasma concentrations for the 450 and 750 mg doses.
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Antipsicóticos/farmacocinética , Dibenzotiazepinas/farmacocinética , Receptores de Dopamina D2/metabolismo , Receptores de Serotonina/metabolismo , Esquizofrenia/metabolismo , Adulto , Antipsicóticos/administração & dosagem , Antipsicóticos/uso terapêutico , Dibenzotiazepinas/administração & dosagem , Dibenzotiazepinas/uso terapêutico , Humanos , Masculino , Fumarato de Quetiapina , Receptor 5-HT2A de Serotonina , Esquizofrenia/tratamento farmacológico , Tomografia Computadorizada de EmissãoRESUMO
BACKGROUND: The aim of the present study was to investigate dopamine synthesis in the brain of drug-free schizophrenic patients, not only in the striatum but also in extrastriatal areas like the prefrontal cortex, brain areas that for a long time has been in focus of interest in the pathophysiology of schizophrenia. METHODS: PET was performed in 12 drug-free (10 drug-naive) psychotic schizophrenic patients and 10 healthy volunteers matched for age and gender using 11C-labelled L-DOPA as the tracer. The time-radioactivity curve from occipital cortex (located within Brodman area 17 and 18) was used as input function to calculate L-DOPA influx rate, Ki images, that were matched to a common brain atlas. A significant overall increase of the Ki values was found in the schizophrenic group as compared with healthy controls. RESULTS: In particular, significantly higher Ki were found in the schizophrenic patients compared to the controls in the caudate nucleus, putamen and in parts of medial prefrontal cortex (Brod 24). The Ki value reflect an increased utilization of L-DOPA, presumably due to increased activity of the amino acid decarboxylate enzyme. CONCLUSIONS: The results indicate that the synthesis of dopamine is elevated within the striatum and parts of medial prefrontal cortex in schizophrenia.
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Corpo Estriado/metabolismo , Dopamina/biossíntese , Levodopa/farmacocinética , Córtex Pré-Frontal/metabolismo , Esquizofrenia/metabolismo , Tomografia Computadorizada de Emissão , Adulto , Corpo Estriado/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Córtex Pré-Frontal/diagnóstico por imagem , Esquizofrenia/diagnóstico por imagem , Fatores de TempoRESUMO
Quetiapine (Seroquel) is a novel antipsychotic with an atypical profile in animal models and a relatively short plasma half-life of 2.5 5 h. In the present study, we used PET to compare the time course of blockade of dopamine D2 and serotonin 5HT2 receptors of quetiapine using C11-raclopride and C11-N-methyl-spiperone as ligands, parallel to monitoring plasma drug concentrations. It was an open study in 11 schizophrenic men using a fixed dose of 450 mg quetiapine. Eight men completed the 29 days treatment, followed by four PET scans performed over a 26-h period after withdrawal of the compound. Quetiapine was shown to bind to dopamine D2 receptors in striatum and 2 h (t[max]) after the last dose, 44% receptor occupancy was calculated. After 26 h it had dropped to the same level as was found in untreated healthy volunteers. Serotonin 5HT2 receptor blockade in the frontal cortex was 72% after 2 h, which declined to 50% after 26 h. The terminal plasma half-life of quetiapine was 5.3 h. Clinically, our eight patients had good antipsychotic effect without any extrapyramidal side-effects. Our data shows that quetiapine has a relatively low affinity for dopamine D2 receptors, with an occupancy half-life (10 h), which was about twice as long as that for plasma. A more prolonged blockade of the serotonin 5HT2 receptors was found in the frontal cortex, with receptor occupancy half-life of 27 h. Compared to clozapine, as demonstrated in other studies, quetiapine has much the same ratio of D2/5HT2 occupancy. This could suggest that the combination of D2/5HT2 receptor blockade contributes to the antipsychotic effect and a low incidence of EPS seen with quetiapine in comparative phase three trials. Our results also confirm the clinical data that quetiapine can be administered twice daily.
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Antipsicóticos/farmacocinética , Encéfalo/metabolismo , Dibenzotiazepinas/farmacocinética , Receptores de Dopamina D2/metabolismo , Receptores de Serotonina/metabolismo , Esquizofrenia/metabolismo , Adulto , Animais , Antipsicóticos/uso terapêutico , Área Sob a Curva , Encéfalo/diagnóstico por imagem , Radioisótopos de Carbono , Dibenzotiazepinas/uso terapêutico , Antagonistas de Dopamina , Antagonistas dos Receptores de Dopamina D2 , Meia-Vida , Humanos , Masculino , Taxa de Depuração Metabólica , Fumarato de Quetiapina , Racloprida , Salicilamidas , Esquizofrenia/diagnóstico por imagem , Esquizofrenia/tratamento farmacológico , Tomografia Computadorizada de EmissãoRESUMO
The aim of this study was to find out patients' experience of pain and discomfort in connection with removal of lower third molars under local anaesthesia. Patients consecutively referred to the Oral and Maxillofacial Unit in Halmstad for removal of lower impacted third molars were the selection for this study. Three surgeons operated 294 lower third molars under local anaesthesia. The Visual Analogue Scale was used to register pain at several occasions during the surgical performance. The patients experienced the operation as an acceptable procedure and the most painful event during the operation was the injection of local anaesthetic solution. The study showed that the surgical procedure was very well tolerated by the patients with only a minor incident of inconvenience or excessive pain.
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Dente Serotino/cirurgia , Satisfação do Paciente , Extração Dentária , Adolescente , Adulto , Idoso , Anestesia Dentária/métodos , Anestesia Local/métodos , Feminino , Humanos , Masculino , Mandíbula , Pessoa de Meia-Idade , Medição da Dor/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Caracteres Sexuais , Inquéritos e Questionários , Extração Dentária/estatística & dados numéricosRESUMO
Controlled clinical trials have shown that the atypical neuroleptic clozapine is highly effective in schizophrenic patients who are unresponsive to conventional neuroleptic agents. The long-term outcome of clozapine treatment was studied in 122 patients who were treated between 1974 and 1991. The mean duration of treatment was 5.2 years. At follow-up, 74 patients (61%) were still receiving clozapine. Only 11 patients discontinued treatment because of adverse events and eight because of poor compliance. Clinical improvement was seen in 87% of patients; 40% had resumed employment after 2 years' treatment. About one-third of patients who received clozapine for 5-10 years continued to improve during this time; this was probably because of a continuing process of socialisation. Thus, clozapine offers important advantages in schizophrenic patients resistant to conventional neuroleptics in terms of long-term efficacy and lack of extrapyramidal side-effects.
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The specific binding of N-methyl-11C-clozapine in the human brain was studied in five healthy volunteers with positron emission tomography (PET). Four of the volunteers were reexamined after treatment with the dopamine D1 and D2 receptor antagonist flupenthixol, and all five volunteers were reexamined after pretreatment with the serotonin2 receptor antagonist ritanserin. The examinations after flupenthixol and ritanserin treatment were performed on different occasions. In the flupenthixol part of the study, two of the subjects were given an oral dose of 1 mg flupenthixol 2-3 h before the posttreatment study with PET. The other two subjects received 0.5 mg orally three times during the 24 h preceding the posttreatment PET study, with the last dose being administered < or = 4 h before the scan. All five ritanserin-treated subjects followed the same dosing regimen. During the 5 days preceding the posttreatment PET study, they were given a 10-mg tablet of ritanserin in the evening. The last dose was administered 2-1/2 hours before the study. Both flupenthixol and ritanserin pretreatment were associated with decreased binding of N-methyl-11C-clozapine in dorsolateral and medial frontal cortical regions. These results support previous findings that clozapine has affinity for both dopamine D1 and serotonin 5-HT2 receptors in the human frontal cortex. No consistent change of binding was observed in striatal regions following flupenthixol or ritanserin pretreatment. The clinical aspects of this feature are discussed, both with respect to efficacy and side effects.
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Sítios de Ligação , Clozapina/farmacocinética , Corpo Estriado/diagnóstico por imagem , Corpo Estriado/metabolismo , Antagonistas de Dopamina/farmacocinética , Dopamina/metabolismo , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/metabolismo , Antagonistas da Serotonina/farmacocinética , Serotonina/metabolismo , Tomografia Computadorizada de Emissão , Adulto , Clozapina/efeitos adversos , Clozapina/farmacologia , Antagonistas de Dopamina/efeitos adversos , Antagonistas de Dopamina/farmacologia , Sinergismo Farmacológico , Feminino , Flupentixol/metabolismo , Humanos , Masculino , Ritanserina/efeitos adversos , Ritanserina/metabolismo , Antagonistas da Serotonina/efeitos adversos , Antagonistas da Serotonina/farmacologiaRESUMO
This open study was undertaken to investigate the outcome of autotransplanted teeth over a 6-year period. The subjects were 296 patients who underwent autotransplantation in the 6-year period September 1986-August 1992 and outcome was measured by considering root formation, occlusion, endodontal and periodontal complications. 18 patients were excluded because of inadequate notes or radiographs (n = 3) or because they were lost to follow-up (n = 15). The groups were divided into open apex and closed apex, and duration of follow up was 6 months-5 years. Aplasia was the indication for operation in 158 (77 percent) of the open apex group but only 10 (14 percent) of the closed apex group, whereas caries and associated disease was the most common in the latter (n = 45, 61 percent compared with 20, 10 percent). There were 24 complete failures, 12 in each group (p <0.01). Only 7 teeth in total developed full roots, and 159 showed incomplete growth. In the open apex group 112 teeth were in occlusal contact and 4 were extracted for severe infraocclusion. In the closed apex group there were 10 cases of mild infraocclusion, none of which required treatment. There were 7 cases of pulp necrosis in the open apex group, 4 of which required extraction. Two teeth in the closed apex group were extracted for endodontic reasons. Only 1 tooth (in the closed apex group) had to be extracted for periodontal reasons. Autotransplantation is a reliable method with a good prognosis for donor teeth with both open and closed apexes. The technique is applicable whatever the aetiology of the agenesis, and is worthy of consideration should there be a suitable donor tooth.
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Dente/transplante , Adolescente , Adulto , Anodontia/terapia , Cárie Dentária/terapia , Oclusão Dentária , Necrose da Polpa Dentária/etiologia , Feminino , Seguimentos , Humanos , Masculino , Má Oclusão/etiologia , Má Oclusão/terapia , Odontogênese , Doenças Periodontais/etiologia , Bolsa Periodontal/etiologia , Complicações Pós-Operatórias , Prognóstico , Reprodutibilidade dos Testes , Reabsorção da Raiz/etiologia , Ápice Dentário/anatomia & histologia , Ápice Dentário/crescimento & desenvolvimento , Doenças Dentárias/etiologia , Extração Dentária , Raiz Dentária/fisiologia , Transplante Autólogo , Resultado do TratamentoRESUMO
The production of neuropeptide Y (NPY) in lymphocytes obtained from human tonsils was investigated using radioimmunoassay. While unstimulated lymphocytes did not produce detectable amounts of NPY, NPY synthesis was induced after cell activation. Our results show that the addition of nerve growth factor (NGF) to unstimulated lymphocytes has an effect similar to that of mitogens, both leading to production of NPY. The study of purified B and T cells confirmed that only activated cells are able to synthesize NPY. The stimulatory effect of NGF on NPY production is not a common characteristic of all lymphocytes: only unstimulated T cells respond to NGF by synthesizing NPY. No such effects is seen in purified B cells.
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Linfócitos/metabolismo , Fatores de Crescimento Neural/farmacologia , Neuropeptídeo Y/biossíntese , Linfócitos B/efeitos dos fármacos , Linfócitos B/metabolismo , Citometria de Fluxo , Humanos , Técnicas In Vitro , Ativação Linfocitária/efeitos dos fármacos , Ativação Linfocitária/fisiologia , Linfócitos/efeitos dos fármacos , Mitógenos/farmacologia , Tonsila Palatina/citologia , Radioimunoensaio , Estimulação Química , Linfócitos T/efeitos dos fármacos , Linfócitos T/metabolismoRESUMO
The acute inflammatory reaction elicited after implantation of polymer membranes used clinically to promote bone healing and augmentation was studied in a soft tissue titanium chamber model. The two materials compared were non-degradable expanded polytetrafluoroethylene (ePTFE) and degradable polyglactin 910, a copolymer of 90% polyglycolic acid and 10% polylactic acid. The membranes were implanted in the titanium chamber for 24 h and 6 d. The number of leucocytes increased for both materials, whereas the leukotriene B4 (LTB4) content decreased over time. In both groups polymorphonuclear granulocytes predominated. The number of leucocytes was significantly higher in chambers with polyglactin 910 than ePTFE. In contrast, the LTB4 content was higher in chambers with ePTFE than polyglactin 910. No differences in cell viability were observed between the materials tested. This study shows that both degradable and non-degradable polymers elicit a marked influx and activation of inflammatory cells during early healing in soft tissues.
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Leucócitos/efeitos dos fármacos , Leucotrieno B4/metabolismo , Poliglactina 910/farmacologia , Politetrafluoretileno/farmacologia , Próteses e Implantes , Animais , Biodegradação Ambiental , Tecido Conjuntivo/efeitos dos fármacos , Tecido Conjuntivo/fisiologia , Células do Tecido Conjuntivo , Implantes Dentários , Masculino , Membranas Artificiais , Neutrófilos , Ratos , Ratos Sprague-Dawley , Fatores de Tempo , TitânioRESUMO
OBJECTIVE: To determine the efficacy of a 22-mg nicotine patch combined with the National Cancer Institute program for physician advice and nurse follow-up in providing withdrawal symptom relief, 1-year smoking cessation outcome, and percentage of nicotine replacement. DESIGN: Randomized, double-blind, placebo-controlled trial. SUBJECTS: Two-hundred forty healthy volunteers who were smoking at least 20 cigarettes per day. INTERVENTIONS: Based on the National Cancer Institute program, subjects received smoking cessation advice from a physician. Follow-up and relapse prevention were provided by a study nurse during individual counseling sessions. Subjects were randomly assigned to 8 weeks of a 22-mg nicotine or placebo patch. MAIN OUTCOME MEASURES: Abstinence from smoking was verified by expired air carbon monoxide levels. Withdrawal symptoms were recorded during patch therapy, and the percentage of nicotine replacement was calculated by dividing serum nicotine and cotinine levels at week 8 of patch therapy by levels obtained while smoking. RESULTS: Higher smoking cessation rates were observed in the active nicotine patch group at 8 weeks (46.7% vs 20%) (P < .001) and at 1 year (27.5% vs 14.2%) (P = .011). Higher smoking cessation rates were also observed in subjects assigned to the active patch who had lower serum levels of nicotine and cotinine at baseline, and withdrawal symptom relief was better in the active patch group compared with placebo. CONCLUSIONS: Clinically significant smoking cessation can be achieved using nicotine patch therapy combined with physician intervention, nurse counseling, follow-up, and relapse prevention. Smokers with lower baseline nicotine and cotinine levels had better cessation rates, which provides indirect evidence that they had more adequate nicotine replacement with this fixed dose of transdermal nicotine than those smokers with higher baseline levels.
Assuntos
Aconselhamento/métodos , Nicotina/administração & dosagem , Abandono do Hábito de Fumar/métodos , Fumar/terapia , Administração Cutânea , Adulto , Idoso , Testes Respiratórios , Monóxido de Carbono/análise , Cotinina/sangue , Método Duplo-Cego , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Nicotina/efeitos adversos , Nicotina/sangue , Enfermeiras e Enfermeiros , Papel do Médico , Abandono do Hábito de Fumar/estatística & dados numéricos , Síndrome de Abstinência a Substâncias/terapia , Resultado do TratamentoRESUMO
A controlled study of different modes of acupuncture stimulation was conducted on patients fulfilling clinical criteria for chronic low back pain of nociceptive origin. Forty patients were randomly entered into the study. Thirty had three trial treatments with manual stimulation of needles (MS), electrical low frequency stimulation at 2 Hz (LF), and high-frequency stimulation at 80 Hz (HF), and then continued treatment with the mode they felt most benefitted them. Ten patients were put on the waiting list for treatment but served as the untreated control group. The results were evaluated after 6 weeks and at 6 months for: activity related to pain; mobility; verbal descriptors of pain and the patient's subjective assessment of his condition. After 6 weeks, patients receiving treatment showed significant improvement (P < 0.05 to P < 0.001) on three of the four measures compared to the untreated controls. After 6 months a similar measure of significant improvement was seen in patients continuing with low-frequency (LF) acupuncture, but not in those groups continuing with manual stimulation (MS) or high-frequency (HF) acupuncture. The results suggest that 2 Hz electrical stimulation is the mode of choice when using acupuncture in the treatment of chronic nociceptive low back pain.
Assuntos
Analgesia por Acupuntura , Dor Lombar/terapia , Atividades Cotidianas , Humanos , Nociceptores/fisiologia , Resultado do TratamentoRESUMO
506 patients with schizophrenia, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria, were included in a long term treatment programme with remoxipride, a selective dopamine (D2)-receptor antagonist. This overview includes pooled data from all patients who have been treated long term with remoxipride in clinical trials, focusing on patients treated for more than 6 months (n = 283). Remoxipride was administered in daily doses of 75 to 600mg. The assessment tools were Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI), Simpson and Angus scale, Abnormal Involuntary Movements Scale (AIMS) for abnormal involuntary movements, adverse events/symptoms using a 26-item checklist, clinical chemistry, and haematology and cardiovascular investigations. The majority of patients had a long duration of illness (median 11 years). 67% of patients (340/506) withdrew from treatment before 12 months and 44% (223/506) stopped treatment before 6 months. The median BPRS total score decreased during the first 3 months from 23 to 12, and this level of improvement was maintained throughout the 12-month period. Treatment-emergent adverse events reported by more than 5% of the patients were insomnia, tiredness, drowsiness and tremor in the group treated for 6 to 12 months. No symptoms, including checklist extrapyramidal symptoms (EPS), were reported by more than 5% of patients treated for 12 months. Low frequencies of EPS according to the Simpson and Angus scale were seen in patients treated for more than 6 months (n = 147). A small but statistically significant reduction of the mean total AIMS score from baseline to last rating was observed. There were infrequent changes in heart rate, resting diastolic blood pressure and electrocardiogram (ECG). Clinical chemistry and haematology data showed no evidence of clinically significant changes over time during the 12 months of treatment. Among 506 patients, 7 suicides and 7 suicide attempts occurred during the study period. Other serious adverse events were abnormal liver function test (2 cases), gastrointestinal, urinary retention, status epilepticus (psychotic polydipsia), granulocytopenia (1 each) and myocardial infarction (5 cases). Remoxipride is of potential value as a drug which is both effective and well tolerated in the long term management of patients with schizophrenia.