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1.
Sci Rep ; 14(1): 19581, 2024 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-39179722

RESUMO

The European rabbit has invaded numerous ecosystems worldwide, but rarely steppes. Since its various introduction attempts into the ecosystems of the Magallanes/Fuegian region, the rabbit has become a key player, interacting with species at different trophic levels and generating impacts on ecosystems. To better understand the role of the rabbit in steppe and scrub ecosystems, we characterised the food web in the Magallanes/Fuegian region to understand the identity of their interacting species, the mechanisms and complexities of their interactions to demonstrate that rabbit management may become more complex than just controlling a single species. Based on a bibliographic review and wildlife specialists' opinions, we built the Magellanic/Fuegian food web, evaluated their topological properties and performed a rabbit extinction simulation to assess the possible short-term ecological mechanisms operating in the community. We found that the network had 206 nodes (64% native, 13% exotic, and 22% mixed) and 535 links among nodes. The European rabbit was the most connected node of the food web, had the second largest dietary breadth, and ranked as the seventh prey item with more predators. A rabbit extinction simulation shows a possible release of herbivory pressure on plants, including that on several native plants (e.g., Gunnera tinctoria, Pratia repens, Gavilea lutea, Tetroncium magellanicus), and a possible release of competition for some herbivores that share resources with the rabbit (e.g., Ovis aries, Lama guanicoe, Bos taurus). Although rabbit predators have a broad and generalist diet, some such as the native Galicitis cuja, could face a 20% reduction in their trophic width and could intensify predation on alternative prey. These results show that the European rabbit is strongly embedded in the Magellanic/Fuegian ecosystem and linked to several native species. Therefore, rabbit management should consider ecosystem approaches accompanied by monitoring programs on native fauna and experimental pilot studies on native flora to conserve the Chilean Patagonia community.


Assuntos
Ecossistema , Cadeia Alimentar , Animais , Coelhos , Chile , Espécies Introduzidas , Herbivoria/fisiologia
2.
Philos Trans R Soc Lond B Biol Sci ; 378(1881): 20220189, 2023 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-37246381

RESUMO

Species diversity underpins all ecosystem services that support life. Despite this recognition and the great advances in detecting biodiversity, exactly how many and which species co-occur and interact, directly or indirectly in any ecosystem is unknown. Biodiversity accounts are incomplete; taxonomically, size, habitat, mobility or rarity biased. In the ocean, the provisioning of fish, invertebrates and algae is a fundamental ecosystem service. This extracted biomass depends on a myriad of microscopic and macroscopic organisms that make up the fabric of nature and which are affected by management actions. Monitoring them all and attributing changes to management policies is daunting. Here we propose that dynamic quantitative models of species interactions can be used to link management policy and compliance with complex ecological networks. This allows managers to qualitatively identify 'interaction-indicator' species, which are highly impacted by management policies through propagation of complex ecological interactions. We ground the approach in intertidal kelp harvesting in Chile and fishers' compliance with policies. Results allow us to identify sets of species that respond to management policy and/or compliance, but which are often not included in standardized monitoring. The proposed approach aids in the design of biodiversity programmes that attempt to connect management with biodiversity change. This article is part of the theme issue 'Detecting and attributing the causes of biodiversity change: needs, gaps and solutions'.


Assuntos
Biodiversidade , Ecossistema , Animais , Invertebrados , Biomassa , Peixes
3.
Sci Rep ; 11(1): 1765, 2021 01 19.
Artigo em Inglês | MEDLINE | ID: mdl-33469119

RESUMO

Top-down and bottom-up forces determine ecosystem function and dynamics. Fisheries as a top-down force can shorten and destabilize food webs, while effects driven by climate change can alter the bottom-up forces of primary productivity. We assessed the response of a highly-resolved intertidal food web to these two global change drivers, using network analysis and bioenergetic modelling. We quantified the relative importance of artisanal fisheries as another predator species, and evaluated the independent and combined effects of fisheries and changes in plankton productivity on food web dynamics. The food web was robust to the loss of all harvested species but sensitive to the decline in plankton productivity. Interestingly, fisheries dampened the negative impacts of decreasing plankton productivity on non-harvested species by reducing the predation pressure of harvested consumers on non-harvested resources, and reducing the interspecific competition between harvested and non-harvested basal species. In contrast, the decline in plankton productivity increased the sensitivity of harvested species to fishing by reducing the total productivity of the food web. Our results show that strategies for new scenarios caused by climate change are needed to protect marine ecosystems and the wellbeing of local communities dependent on their resources.

6.
Nature ; 569(7755): 215-221, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31068722

RESUMO

Free-flowing rivers (FFRs) support diverse, complex and dynamic ecosystems globally, providing important societal and economic services. Infrastructure development threatens the ecosystem processes, biodiversity and services that these rivers support. Here we assess the connectivity status of 12 million kilometres of rivers globally and identify those that remain free-flowing in their entire length. Only 37 per cent of rivers longer than 1,000 kilometres remain free-flowing over their entire length and 23 per cent flow uninterrupted to the ocean. Very long FFRs are largely restricted to remote regions of the Arctic and of the Amazon and Congo basins. In densely populated areas only few very long rivers remain free-flowing, such as the Irrawaddy and Salween. Dams and reservoirs and their up- and downstream propagation of fragmentation and flow regulation are the leading contributors to the loss of river connectivity. By applying a new method to quantify riverine connectivity and map FFRs, we provide a foundation for concerted global and national strategies to maintain or restore them.


Assuntos
Mapeamento Geográfico , Rios , Movimentos da Água , Animais , Conservação dos Recursos Naturais , Ecossistema , Peixes , Cooperação Internacional , Reprodutibilidade dos Testes
8.
Trials ; 17(1): 528, 2016 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-27793175

RESUMO

BACKGROUND: The aim of this investigator-initiated trial is to evaluate the safety and efficacy of the novel Luminor® paclitaxel-coated drug-eluting balloon (DEB) catheter (iVascular, S.L.U., Barcelona, Spain) in inhibiting restenosis and in ensuring long-term vascular patency. METHODS/DESIGN: This is a multicenter randomized controlled trial to evaluate the Luminor® paclitaxel-coated DEB catheter for stenotic or occlusive lesions (length ≤15 cm) in the superficial femoral artery (SFA) and the popliteal artery (PA) up to the P1 segment compared to the noncoated, plain old balloon angioplasty (POBA) catheter. In total 172 subjects will be treated with either the DEB catheter or the POBA catheter in 11 German study centers in a 1:1 randomization study design. The primary endpoint is late lumen loss (LLL) at 6 months. Secondary endpoints are patency rate, target lesion/vessel revascularization, quality of life (assessed with the Walking Impairment Questionnaire (WIQ) and the EQ-5D), change of Rutherford stage and ankle-brachial index, major and minor amputation rate at the index limb, number of dropouts and all-cause mortality. DISCUSSION: EffPac represents a randomized controlled trial that will provide evidence on the effectiveness of the Luminor® paclitaxel-coated DEB catheter for the reduction of restenosis compared to the POBA catheter for the SFA and the PA. The results of EffPac will allow direct comparison to other already-completed RCTs applying paclitaxel-coated DEBs from different manufacturers with different coating technologies in the same target vessel. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02540018 , registered on 17 August 2015. Protocol version: CIP Version Final04, 11 February 2016. EUDAMED No: CIV-15-03-013204.


Assuntos
Angioplastia com Balão/instrumentação , Fármacos Cardiovasculares/administração & dosagem , Materiais Revestidos Biocompatíveis , Artéria Femoral , Paclitaxel/administração & dosagem , Doença Arterial Periférica/terapia , Artéria Poplítea , Dispositivos de Acesso Vascular , Angiografia Digital , Angioplastia com Balão/efeitos adversos , Índice Tornozelo-Braço , Fármacos Cardiovasculares/efeitos adversos , Protocolos Clínicos , Angiografia por Tomografia Computadorizada , Constrição Patológica , Tolerância ao Exercício , Feminino , Artéria Femoral/diagnóstico por imagem , Artéria Femoral/fisiopatologia , Alemanha , Humanos , Masculino , Paclitaxel/efeitos adversos , Doença Arterial Periférica/diagnóstico por imagem , Doença Arterial Periférica/fisiopatologia , Artéria Poplítea/diagnóstico por imagem , Artéria Poplítea/fisiopatologia , Qualidade de Vida , Recuperação de Função Fisiológica , Recidiva , Projetos de Pesquisa , Fatores de Risco , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia Doppler Dupla , Grau de Desobstrução Vascular , Caminhada
9.
Artigo em Inglês | MEDLINE | ID: mdl-27407119

RESUMO

INTRODUCTION: An excess of angiotensin II (Ang II) causes hypertension and vascular injury. Activation of mitogen-activated protein kinase p38 (p38-MAPK) plays a substantial role in Ang II-dependent organ damage. Recently, we showed that p38-MAPK activation regulates the pressor response to Ang II. This study evaluates the effect of chronic p38-MAPK inhibition in Ang II-dependent hypertension. MATERIALS AND METHODS: C57Bl/6J mice were infused with Ang II for 14 days and either treated with the p38-MAPK inhibitor BIRB796 (50 mg/kg/day) or the vehicle as the control. We assessed vascular function in the aorta and isolated perfused kidneys. RESULTS: Chronic p38-MAPK inhibition did not alter blood pressure at the baseline, but attenuated Ang II-induced hypertension significantly (baseline: 122 ± 2 versus 119 ± 4 mmHg; Ang II: 173 ± 3 versus 155 ± 3 mmHg; p < 0.001). In addition, BIRB796 treatment improved vascular remodeling by reducing the aortic media-to-lumen ratio and decreasing the expression of the membrane metalloproteinases (MMP) MMP-1 and MMP-9. Moreover, renal vascular dysfunction induced by chronic Ang II infusion was significantly ameliorated in the BIRP796-treated mice. Acute p38-MAPK inhibition also improved vascular function in the aorta and kidneys of Ang II-treated mice, highlighting the important role of p38-MAPK activation in the pathogenesis of vascular dysfunction. CONCLUSIONS: Our findings indicated there is an important role for p38-MAPK in regulating blood pressure and vascular injury, and highlighted its potential as a pharmaceutical target.


Assuntos
Aorta/fisiopatologia , Hipertensão/fisiopatologia , Inibidores de Proteínas Quinases/farmacologia , Remodelação Vascular/efeitos dos fármacos , Proteínas Quinases p38 Ativadas por Mitógeno/antagonistas & inibidores , Angiotensina II , Animais , Aorta/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Hipertensão/enzimologia , Rim/efeitos dos fármacos , Rim/fisiopatologia , Camundongos Endogâmicos C57BL , Perfusão , S-Nitrosoglutationa/farmacologia , Sístole/efeitos dos fármacos
11.
Epidemiol Infect ; 142(5): 1002-7, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-23890292

RESUMO

The epidemiology of varicella is believed to differ between temperate and tropical countries. We conducted a varicella seroprevalence study in elementary and college students in the US territory of American Samoa before introduction of a routine varicella vaccination programme. Sera from 515 elementary and 208 college students were tested for the presence of varicella-zoster virus (VZV) IgG antibodies. VZV seroprevalence increased with age from 76·0% in the 4-6 years group to 97·7% in those aged ⩾23 years. Reported history of varicella disease for elementary students was significantly associated with VZV seropositivity. The positive and negative predictive values of varicella disease history were 93·4% and 36·4%, respectively, in elementary students and 97·6% and 3·0%, respectively, in college students. VZV seroprevalence in this Pacific island appears to be similar to that in temperate countries and suggests endemic VZV circulation.


Assuntos
Anticorpos Antivirais/sangue , Varicela/epidemiologia , Varicela/imunologia , Herpesvirus Humano 3/imunologia , Estudantes/estatística & dados numéricos , Adolescente , Samoa Americana/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Imunoglobulina G/sangue , Masculino , Estudos Soroepidemiológicos , Adulto Jovem
12.
Naturwissenschaften ; 100(8): 779-87, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23817947

RESUMO

Salmon farming is a widespread activity around the world, also known to promote diverse environmental effects on aquatic ecosystems. However, information regarding the impact of salmon farming on bird assemblages is notably scarce. We hypothesize that salmon farming, by providing food subsidies and physical structures to birds, will change their local community structure. To test this hypothesis, we conducted a seasonal monitoring of bird richness, abundance, and composition at paired salmon pen and control plots in two marine and two lake sites in southern Chile, from fall 2002 to summer 2004. Overall, salmon farming had no significant effects on species richness, but bird abundance was significantly and noticeably higher in salmon pens than in controls. Such aggregation was mainly accounted for by the trophic guilds of omnivores, diving piscivores, carrion eaters, and perching piscivores, but not by invertebrate feeders, herbivores, and surface feeders. Species composition was also significantly and persistently different between salmon pens and controls within each lake or marine locality. The patterns described above remained consistent across environment types and seasons indicating that salmon farming is changing the community structure of birds in both lake and marine habitats by promoting functional and aggregation responses, particularly by favoring species with broader niches. Such local patterns may thus anticipate potential threats from the ongoing expansion of the salmon industry to neighboring areas in Chile, resulting in regional changes of bird communities, toward a less diverse one and dominated by opportunistic, common, and generalist species such as gulls, vultures, and cormorants.


Assuntos
Organismos Aquáticos , Biodiversidade , Aves/fisiologia , Ecossistema , Pesqueiros , Lagos , Salmão/fisiologia , Animais , Chile , Oceanos e Mares , Densidade Demográfica , Estações do Ano
13.
J Environ Manage ; 109: 189-99, 2012 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-22819600

RESUMO

As the scientific community has highlighted the plight of freshwater species, there have been increasing calls for protected area (PA) designation and management specific to the conservation of aquatic species and ecosystems. In this study we examined PA management in one relatively well-resourced (high levels of financial and technical resources) part of the world: the Tennessee and Cumberland River Basins, USA. We asked managers their perceptions about the current status of freshwater ecosystems within PAs, the sources of stress that are degrading freshwater ecosystem integrity, the degree to which PAs address these stressors, and the availability of technical, human, and financial resources for management activities that benefit freshwater ecosystems and the species they support. Managers generally perceive that freshwater ecosystems within PAs are under low levels of stress, with less than half reporting any alteration to ecosystem integrity, and very few reporting alterations at medium or high levels. Most PAs have fewer resources dedicated to freshwater conservation and management than to other activities, and some PAs completely lack resources for freshwater management. We recommend a review of every PA's goals and objectives and any needed updates to include the conservation of freshwater ecosystems. We also recommend an analysis to determine the most pressing stressors to aquatic life within each PA, stemming from sources both from within and outside of a PA's boundaries, and that this information be used to guide future management. Finally, we suggest that management resources be prioritized for PAs that include large portions of the catchments of their freshwater systems; that can address the dominant sources of stress within the PA; or that contain representative ecosystems, species assemblages or populations of rare, endemic, and threatened species.


Assuntos
Conservação dos Recursos Naturais/métodos , Água Doce/análise , Rios , Tennessee
14.
Theriogenology ; 72(6): 869-78, 2009 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-19646744

RESUMO

Pregnancy per artificial insemination (AI) was evaluated in dairy cows (Bos taurus) subjected to synchronization and resynchronization for timed AI (TAI). Cows (n=718) received prostaglandin F(2alpha) (PGF) on Days -38 and -24 (Days 39 and 53 postpartum), gonadotropin-releasing hormone (GnRH) on Day -10, PGF on Day -3, and GnRH and TAI on Day 0. Between Days -10 and -3, cows received a progesterone intravaginal insert (CIDR group) or no CIDR (Control group). Between Days 14 and 23, cows received a CIDR (Resynch CIDR group) or no CIDR (Resynch control group), GnRH on Day 23, with pregnancy diagnosis on Day 30. Cows in estrus (between Days 0 and 30) were re-inseminated at detected estrus (RIDE). Nonpregnant cows received PGF on Day 30 and GnRH and TAI on Day 33. Plasma progesterone was determined to be low or high on Days -24 and -10. Pregnancy rates were evaluated 30 and 55 d after AI. The CIDR insert included in the Presynch-Ovsynch protocol did not increase overall pregnancy per AI for first service (36.1% and 33.6% for CIDR; 34.1% and 28.8% for Control) but did decrease pregnancy loss (7.0% for CIDR and 15.6% for Control). The CIDR insert increased pregnancy per AI in cows with high progesterone at the time the CIDR insert was applied. Administration of a CIDR insert between Days 14 and 23 of the estrous cycle after first service did not increase overall pregnancy per AI to second service (24.7% and 22.7% for Resynch CIDR; 28.6% and 25.3% for Resynch control). For second service, RIDE cows had lower pregnancy rates in the Resynch CIDR group than in the Resynch control group. Cows with a CL (corpus luteum) at Day 30 had higher pregnancy rates in the Resynch CIDR group than those in the Resynch control group.


Assuntos
Bovinos/fisiologia , Inseminação Artificial/métodos , Lactação , Animais , Ciclo Estral , Feminino , Hormônio Liberador de Gonadotropina/farmacologia , Gravidez , Taxa de Gravidez , Progesterona/administração & dosagem , Progesterona/sangue , Progesterona/farmacologia , Prostaglandinas/farmacologia
15.
Aktuelle Urol ; 34(6): 410-2, 2003 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-14579190

RESUMO

We report on a male newborn with urinary ascites and perirenal urinoma due to calyceal rupture caused by bladder outlet obstruction and posterior urethral valves. Despite the presence of left-sided high-grade reflux, the "pop-off" mechanism occurred in the non-refluxing right kidney. Impressive normalization of the upper urinary tract anomalies and renal function occurred after surgical treatment of the valves and removal of obstruction.


Assuntos
Ascite/etiologia , Nefropatias/etiologia , Uretra/anormalidades , Obstrução Uretral/congênito , Obstrução do Colo da Bexiga Urinária/congênito , Urina , Ascite/cirurgia , Diagnóstico por Imagem , Seguimentos , Humanos , Recém-Nascido , Cálices Renais , Nefropatias/cirurgia , Testes de Função Renal , Masculino , Complicações Pós-Operatórias/diagnóstico , Ruptura Espontânea , Uretra/cirurgia , Obstrução Uretral/complicações , Obstrução Uretral/cirurgia , Obstrução do Colo da Bexiga Urinária/complicações , Obstrução do Colo da Bexiga Urinária/cirurgia , Urodinâmica/fisiologia
16.
Chem Phys Lipids ; 110(2): 173-81, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11369326

RESUMO

Dextran infusions in humans lead to a reduction of low density lipoproteins (LDL) in the plasma compartment. The interaction of dextran with human LDL was investigated in vitro by static and dynamic light scattering. The experiments were performed with human LDL (apoB concentration 0.75 g l(-1)) and dextran (Mw = 40,000 and 70,000 g mol(-1)) at 25 degrees C. The dextran concentrations after mixing were 10 and 50 g l(-1). The hydrodynamic radius for native LDL was found to be RH = 12.9 nm. The addition of dextran induces the formation of LDL associates with a mean radius of RH approximately 200 nm. These findings show that even non-sulphated polysaccharides interact with LDL. The dextran-dependent formation of LDL associates detected in vitro could be the reason for the in vivo effect of dextran on the lipid metabolism.


Assuntos
Dextranos/química , Lipoproteínas LDL/química , Humanos , Lasers , Lipoproteínas LDL/sangue , Espalhamento de Radiação , Viscosidade
17.
J Mater Sci Mater Med ; 12(3): 225-31, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15348306

RESUMO

This work focuses on basic research into a P/M processed, porous-surfaced and functionally graded material (FGM) destined for a permanent skeletal replacement implant with improved structural compatibility. Based on a perpendicular gradient in porosity the Young's modulus of the material is adapted to the elastic properties of bone in order to prevent stress shielding effects and to provide better long-term performance of the implant-bone system. Using coarse Ti particle fractions the sintering process was accelerated by silicon-assisted liquid-phase sintering (LPS) resulting in a substantial improvement of the neck geometry. A novel evaluation for the strength of the sinter contacts was proposed. The Young's modulus of uniform non-graded stacks ranged from 5 to 80 GPa as determined by ultrasound velocity measurements. Thus, the typical range for cortical bone (10-29 GPa) was covered. The magnitude of the Poisson's ratio proved to be distinctly dependent on the porosity. Specimens with porosity gradients were successfully fabricated and characterized using quantitative description of the microstructural geometry and acoustic microscopy.

18.
Health Phys ; 74(4): 465-71, 1998 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-9525421

RESUMO

In order to test the common quality standards for the performance of measurements of internal radioactivity, the European Commission funded a European intercomparison of whole body counters, which was organized and carried out by the Institut fuer Strahlenhygiene (part of the German Bundesamt fuer Strahlenschutz). Forty-four whole body counting facilities from forty-two institutions in nineteen countries (the fifteen member states of the European Union plus Hungary, the Czech Republic, Switzerland and Norway) took part in this intercomparison, which made it the most comprehensive ever carried out in Europe. For the study, the 70 kg tissue equivalent St Petersburg phantom was used with rods containing 40K, 57Co, 60Co, and 137Cs. The overall results of the whole body counter study were rather good.


Assuntos
Monitoramento de Radiação/normas , Radioisótopos de Césio/análise , Radioisótopos de Cobalto/análise , Europa (Continente) , União Europeia , Humanos , Modelos Anatômicos , Radioisótopos de Potássio/análise
19.
Arch Gen Psychiatry ; 55(3): 250-8, 1998 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-9510219

RESUMO

BACKGROUND: Depressive signs and symptoms during the course of schizophrenia are common and have been associated with impaired recovery and a higher risk of self-harm. Novel antipsychotic agents introduce new pharmacological avenues that may differentially affect schizophrenic signs and symptoms, including depression. METHODS: This was a 17-country investigation of 1996 patients with schizophrenia or a related diagnosis randomly assigned to a blinded, comparative trial of the novel antipsychotic agent olanzapine (5-20 mg/d) or the conventional D2 antagonist haloperidol (5-20 mg/d). Patients were evaluated with the Positive and Negative Syndrome Scale, the Montgomery-Asberg Depression Rating Scale, and the Simpson-Angus Rating Scale. The trial consisted of a 6-week and a 46-week masked responder maintenance period. RESULTS: At least moderate depressive signs and symptoms (Montgomery-Asberg Depression Rating Scale score, > or =16) were seen in slightly more than half of this sample. Although both treatments were associated with short-term baseline-to-end point improvement on the Montgomery-Asberg Depression Rating Scale, olanzapine-associated improvements were significantly superior to those observed with haloperidol (P=.001). Furthermore, the response rate for the group receiving olanzapine (> or =50% improvement on the Montgomery-Asberg Depression Rating Scale after at least 3 weeks of treatment) was also significantly higher (P=.008). Analysis demonstrated that improvement in positive, negative, and/or extrapyramidal symptoms was associated with mood improvement (indirect effect); however, most of the olanzapine treatment effect on mood was a primary direct effect (57%) that alone was significantly greater than that seen with haloperidol treatment (P<.001). CONCLUSIONS: Depressive signs and symptoms in schizophrenia are responsive to treatment. The pleotrophic pharmacological features of olanzapine, through 1 or more non-D2-mediated pathways, likely contribute to its superior treatment effect. Better control of the mood disorders accompanying schizophrenia holds the possibility for improved patient outcomes.


Assuntos
Antipsicóticos/uso terapêutico , Transtorno Depressivo/tratamento farmacológico , Haloperidol/uso terapêutico , Pirenzepina/análogos & derivados , Esquizofrenia/tratamento farmacológico , Adulto , Benzodiazepinas , Comorbidade , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Método Duplo-Cego , Feminino , Humanos , Masculino , Olanzapina , Pirenzepina/uso terapêutico , Estudos Prospectivos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiologia , Psicologia do Esquizofrênico , Índice de Gravidade de Doença , Resultado do Tratamento
20.
Am J Psychiatry ; 154(4): 457-65, 1997 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-9090331

RESUMO

OBJECTIVE: This international, multicenter double-blind trial was designed to compare the therapeutic profile of an atypical antipsychotic, olanzapine, with that of a conventional dopamine D2 antagonist, haloperidol. METHOD: A total of 1,996 patients at 174 sites in Europe and North America were randomly assigned to treatment with olanzapine (N = 1,336) or haloperidol (N = 660) over 6 weeks. The primary efficacy analysis involved the mean change from baseline to endpoint in total scores on the Brief Psychiatric Rating Scale (BPRS). Secondary analyses included comparisons of the mean change in positive and negative symptoms, comorbid depression, extrapyramidal symptoms, and overall drug safety. RESULTS: Olanzapine demonstrated clinical results superior to those of haloperidol on overall improvement according to the BPRS and on every secondary measure, including depression. Olanzapine was also associated with significantly fewer discontinuations of treatment due to lack of drug efficacy or adverse events. Substantially more olanzapine-treated patients (66.5%) than haloperidol-treated patients (46.8%) completed 6 weeks of therapy. Statistically significant advantages of olanzapine treatment were related to 1) change in negative symptoms, 2) extrapyramidal symptom profile, 3) effect on prolactin levels, and 4) response rate. CONCLUSIONS: Olanzapine shows a superior and broader spectrum of efficacy in the treatment of schizophrenic psychopathology, with a substantially more favorable safety profile, than haloperidol. It meets several of the criteria for a novel atypical antipsychotic agent.


Assuntos
Antipsicóticos/uso terapêutico , Haloperidol/uso terapêutico , Pirenzepina/análogos & derivados , Transtornos Psicóticos/tratamento farmacológico , Esquizofrenia/tratamento farmacológico , Adolescente , Adulto , Antipsicóticos/efeitos adversos , Doenças dos Gânglios da Base/induzido quimicamente , Doenças dos Gânglios da Base/epidemiologia , Benzodiazepinas , Comorbidade , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Método Duplo-Cego , Europa (Continente) , Feminino , Haloperidol/efeitos adversos , Humanos , Masculino , América do Norte , Olanzapina , Pacientes Desistentes do Tratamento , Pirenzepina/efeitos adversos , Pirenzepina/uso terapêutico , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologia , Esquizofrenia/epidemiologia , Psicologia do Esquizofrênico , Resultado do Tratamento
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