RESUMO
INTRODUCTION: Eslicarbazepine acetate is a novel sodium channel blocker for use in the treatment of focal onset seizures. Prospective studies on its effectiveness in monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice are scarce. AIM: To evaluate the effectiveness of eslicarbazepine as initial monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice. PATIENTS AND METHODS: A prospective, multicentre, post-authorisation study. Patients with newly diagnosed partial epilepsy aged 18 years or older without previous treatment were included. The efficacy variables were: percentage of seizure-free patients, responders and reduction in monthly frequency of seizures. The safety variables analyse the 12-month retention rate and the occurrence of adverse effects. RESULTS: Fifty-three patients were included. The retention rate was 77.4%. At the end of the observation period, 83% of patients were seizure-free and 92.5% had reduced their baseline frequency by 50% or more. In addition, 68% of the patients reported some adverse effect and 7.5% of them dropped out of the study for this reason. The effectiveness analysis of the subgroup of patients aged 65 years or more showed no differences with respect to the overall population. CONCLUSION: Eslicarbazepine monotherapy in patients with newly diagnosed partial epilepsy, both in the general population and in the population over 65 years old, is effective and safe in routine clinical practice.
TITLE: Alzemon: estudio de seguimiento prospectivo del acetato de eslicarbacepina en monoterapia en pacientes con epilepsia de diagnóstico reciente.Introducción. El acetato de eslicarbacepina es un nuevo bloqueante de los canales de sodio en el tratamiento de las crisis de inicio focal. Los estudios prospectivos sobre su efectividad en monoterapia en pacientes con epilepsia parcial de reciente diagnóstico en la práctica clínica habitual son escasos. Objetivo. Evaluar la efectividad de la eslicarbacepina en monoterapia de inicio en pacientes con epilepsia parcial de reciente diagnóstico en la práctica clínica habitual. Pacientes y métodos. Estudio postautorización prospectivo y multicéntrico. Se incluyó a pacientes con epilepsia parcial de reciente diagnóstico de 18 años o más sin tratamiento previo. Las variables de eficacia fueron: porcentaje de pacientes libres de crisis, respondedores y reducción en la frecuencia mensual de crisis. Las variables de seguridad analizan la tasa de retención a los 12 meses y la aparición de efectos adversos. Resultados. Se incluyó a 53 pacientes. La tasa de retención fue del 77,4%. Al final del período de observación, el 83% de los pacientes se encontraba libre de crisis y el 92,5% había reducido en un 50% o más su frecuencia basal. El 68% de los pacientes notificó algún efecto adverso y el 7,5% de ellos abandonó el estudio por este motivo. El análisis de efectividad del subgrupo de 65 años o más no mostró diferencias respecto a la población global. Conclusión. La eslicarbacepina en monoterapia en pacientes con epilepsia parcial de reciente diagnóstico, tanto en la población general como en la población de más de 65 años, es eficaz y segura en la práctica clínica habitual.
Assuntos
Anticonvulsivantes/uso terapêutico , Dibenzazepinas/uso terapêutico , Epilepsia/tratamento farmacológico , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
Introducción: El acetato de eslicarbacepina es un nuevo bloqueante de los canales de sodio en el tratamiento de las crisis de inicio focal. Los estudios prospectivos sobre su efectividad en monoterapia en pacientes con epilepsia parcia l de reciente diagnóstico en la práctica clínica habitual son escasos.Objetivo: Evaluar la efectividad de la eslicarbacepina en monoterapia de inicio en pacientes con epilepsia parcial de reciente diagnóstico en la práctica clínica habitual.Pacientes y métodos: Estudio postautorización prospectivo y multicéntrico. Se incluyó a pacientes con epilepsia parcial de reciente diagnóstico de 18 años o más sin tratamiento previo. Las variables de eficacia fueron: porcentaje de pacientes libres de crisis, respondedores y reducción en la frecuencia mensual de crisis. Las variables de seguridad analizan la tasa de retención a los 12 meses y la aparición de efectos adversos.Resultados: Se incluyó a 53 pacientes. La tasa de retención fue del 77,4%. Al final del período de observación, el 83% de los pacientes se encontraba libre de crisis y el 92,5% había reducido en un 50% o más su frecuencia basal. El 68% de los pacientes notificó algún efecto adverso y el 7,5% de ellos abandonó el estudio por este motivo. El análisis de efectividad del subgrupo de 65 años o más no mostró diferencias respecto a la población global.Conclusión: La eslicarbacepina en monoterapia en pacientes con epilepsia parcial de reciente diagnóstico, tanto en la población general como en la población de más de 65 años, es eficaz y segura en la práctica clínica habitual.(AU)
Introduction: Eslicarbazepine acetate is a novel sodium channel blocker for use in the treatment of focal onset seizures. Prospective studies on its effectiveness in monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice are scarce. Aim: To evaluate the effectiveness of eslicarbazepine as initial monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice. Patients and methods: A prospective, multicentre, post-authorisation study. Patients with newly diagnosed partial epilepsy aged 18 years or older without previous treatment were included. The efficacy variables were: percentage of seizure-free patients, responders and reduction in monthly frequency of seizures. The safety variables analyse the 12-month retention rate and the occurrence of adverse effects. Results: Fifty-three patients were included. The retention rate was 77.4%. At the end of the observation period, 83% of patients were seizure-free and 92.5% had reduced their baseline frequency by 50% or more. In addition, 68% of the patients reported some adverse effect and 7.5% of them dropped out of the study for this reason. The effectiveness analysis of the subgroup of patients aged 65 years or more showed no differences with respect to the overall population. Conclusion: Eslicarbazepine monotherapy in patients with newly diagnosed partial epilepsy, both in the general population and in the population over 65 years old, is effective and safe in routine clinical practice.(AU)
Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Anticonvulsivantes/uso terapêutico , Epilepsia/tratamento farmacológico , Neurologia , Doenças do Sistema Nervoso , Convulsões , Estudos ProspectivosRESUMO
BACKGROUND: Perampanel (PER) is an effective adjunctive therapy for controlling focal-onset seizures (FOS), but few studies have examined its effects as an early add-on for the treatment of FOS in daily clinical practice. METHODS: Our retrospective, multicenter, observational study evaluated the effectiveness and safety of PER as an early add-on in 77 patients with FOS, with and without focal to bilateral tonic-clonic seizures (FBTCS) after 3, 6 and 12 months in a real-world setting. RESULTS: After 12 months of treatment (median dose 6 [4,8] mg/day), the retention rate was 79.2 % and 60 % of patients (39/65) experienced a ≥50 % reduction in seizure frequency relative to baseline. The seizure-free rate was 38.5 % for all seizures (25/65) and 60 % for FBTCS (12/20). The responder rate at 12 months was significantly higher when PER was given with one concomitant AED (72.2 %) compared to when PER was given with two concomitant AEDs (44.8 %). Drug-related adverse events (AEs) were reported in 40.3 % of patients, most of them being mild (64.2 %). Twelve patients (15.6 %) discontinued treatment because of AEs. CONCLUSIONS: PER is an effective and safe early add-on for patients with refractory FOS, especially for those with FBTCS.
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Anticonvulsivantes , Piridonas , Anticonvulsivantes/efeitos adversos , Quimioterapia Combinada , Humanos , Nitrilas , Piridonas/efeitos adversos , Estudos Retrospectivos , Convulsões/tratamento farmacológico , Resultado do TratamentoRESUMO
BACKGROUND: . Intravitreal administration of topotecan shows activity against tumor vitreous seeding in the conservative treatment of retinoblastoma, a malignant tumor originated in the retina of small children. Adequate storage of the intravitreal topotecan solution would allow immediate availability for patients at health care institutions. The goal of the work was to address the stability of the intravitreal topotecan formulation upon reconstitution. MATERIALS AND METHODS: . Intravitreal topotecan solutions were reconstituted (at a concentration of 0.2 mg topotecan in 1 mL saline solution vehicle, aliquoted in 1 mL plastic syringes) and stored either frozen or at room temperature for different times. Topotecan content was analyzed at time zero and at different conditions using a high performance liquid chromatography method to quantify topotecan lactone (active) and to detect its pH-dependent hydrolysis product, the open carboxylate. RESULTS: . We found that intravitreal topotecan syringes remained stable at room temperature at least for 24 h, at least for 167 days upon stored frozen at -20°C, and up to 8 h after thawing at day 6. The degradation carboxylate product did not appear in the analyzed thawed samples during the whole study. CONCLUSIONS: . This study confirms the stability of frozen intravitreal topotecan syringes and will help optimize the use of this chemotherapy modality at institutions with low resources. Storage of aliquots will also help reduce personnel exposure to chemotherapy at hospital pharmacies.
Assuntos
Estabilidade de Medicamentos , Armazenamento de Medicamentos/normas , Inibidores da Topoisomerase I/química , Inibidores da Topoisomerase I/metabolismo , Topotecan/química , Topotecan/metabolismo , Humanos , Injeções Intravítreas , Inibidores da Topoisomerase I/análise , Topotecan/análiseRESUMO
INTRODUCTION: The study aims to quantify the types of antiepileptic drugs (AED) prescribed in neurology consultations. MATERIAL AND METHOD: This descriptive, observational study included a sample of 559 patients older than 14 years, diagnosed with epilepsy, and receiving pharmacological treatment. Data were collected at outpatient consultations by 47 Spanish neurologists in May 2016. Epilepsy was defined based on the International League Against Epilepsy classification. According to the year of marketing, AEDs were categorised as classic (before 1990) or new (after 1990). We performed a descriptive analysis of qualitative and quantitative variables. RESULTS: Female patients accounted for 54.6% of the sample. Mean age was 42.7 years; mean age of onset was 22.4. Regarding epilepsy type, 75.7% of patients experienced partial seizures, 51.5% were symptomatic,32.4% had refractory epilepsy, 35.6% had been seizure-free for the previous year, and 59.2% had associated comorbidities.A total of 1103 AED prescriptions were made; 64.6% of prescriptions were for new AEDs; 85.4% of patients received new AEDs. Patients received a mean of 2 AEDs (range, 1-5). A total of 59.6% of patients received polytherapy.The most frequently prescribed AEDs were levetiracetam (42.6%), valproic acid (25.4%), lamotrigine (19.5%), carbamazepine (17.9%), and lacosamide (17.5%). No AED was employed exclusively as monotherapy. The most frequently prescribed AEDs for generalised and partial seizures were valproic acid (48.2%) and levetiracetam (43.2%), respectively. Valproic acid was less frequently prescribed to female patients. Patients with refractory epilepsy or with associated comorbidities were more frequently prescribed a combination of new and classic AEDs (48.7% and 45.6%, respectively) than only one type of AED. CONCLUSIONS: The majority of patients received new AEDs. The combination of classic and new AEDs was more frequently prescribed to patients with refractory epilepsy or with associated comorbidities.
Assuntos
Anticonvulsivantes , Epilepsia , Neurologia , Encaminhamento e Consulta , Adulto , Anticonvulsivantes/classificação , Anticonvulsivantes/uso terapêutico , Quimioterapia Combinada , Epilepsia/tratamento farmacológico , Feminino , Humanos , Lamotrigina/uso terapêutico , Levetiracetam/uso terapêutico , Masculino , Convulsões/tratamento farmacológico , Espanha , Ácido Valproico/uso terapêuticoRESUMO
AIM: The aim of the study was to evaluate the effectiveness and tolerability of eslicarbazepine acetate (ESL) when used as monotherapy for 1â¯year or more in routine clinical use in patients with focal seizures in epilepsy clinics in Spain. METHODS: This is a retrospective, observational, noninterventional study. Eligible patients were aged ≥18â¯years, had focal seizures, and started on ESL ≥1â¯year before database closure. Primary endpoint was the following: proportion seizure-free for ≥6â¯months at 1 and 2â¯years. Secondary endpoints included retention on ESL monotherapy at 1 and 2â¯years, seizure frequency change, seizure worsening, and side effects. Other analyses included seizure freedom from baseline to 1 and 2â¯years and outcomes in special populations. RESULTS: Four hundred thirty-five patients were included (127 on first-line monotherapy and 308 converting to ESL monotherapy): median daily dose was 800â¯mg at all time points; 63.2% were seizure-free at 1â¯year, 65.1% at 2â¯years, and 50.3% for the entire follow-up. Mean duration of ESL monotherapy was 66.7â¯months; retention was 88.0% at 1â¯year and 81.9% at 2â¯years. Mean reduction in seizure frequency was 75.5% at last visit. Over the entire follow-up, seizure worsening was seen in 22 patients (5.1%), side effects in 28.0%, considered severe in 1.8%, and leading to discontinuation in 5.7%. Dizziness, hyponatremia (sodium <135â¯mEq/l), and somnolence were the most frequent side effects. Outcomes in special populations (patients aged ≥65â¯years and those with psychiatric history or learning difficulty) were consistent with the overall population. CONCLUSIONS: Patients with focal seizures taking ESL monotherapy had excellent retention, high seizure-free rates, and good tolerability up to 2â¯years.
Assuntos
Anticonvulsivantes/uso terapêutico , Dibenzazepinas/uso terapêutico , Epilepsia/tratamento farmacológico , Convulsões/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticonvulsivantes/efeitos adversos , Dibenzazepinas/efeitos adversos , Tontura/induzido quimicamente , Feminino , Humanos , Hiponatremia/induzido quimicamente , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sonolência , Adulto JovemRESUMO
In the past, hepatic blood flow in cows was invasively characterized to investigate different pathologies and physiological conditions. However, hepatic blood flow can be easily evaluated with transabdominal Doppler ultrasound. Sixteen healthy adult non-lactating, non-pregnant Holstein-Friesian cows were examined using B-mode and Doppler ultrasound between the right flank and 9th intercostal space to establish the best approach to the different parts of the portal and hepatic vein systems, and determine normal blood flow characteristics. The main portal vein was characterized by a turbulent, high-velocity flow due to the opposing confluence of the splenic and cranial mesenteric veins, while hepatic and caudal vena cava veins have laminar blood flow, in which the phasicity is considered mainly respiratory in origin. Reference values were determined in relation to the anatomical point of observation. In conclusion, transabdominal Doppler ultrasound of the portal system is a simple technique that allows non-invasive characterization of portal and hepatic blood haemodynamics in cows.
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INTRODUCTION: Lacosamide is a sodium channel blocker antiepileptic drug authorized as an adjunctive therapy for focal seizures in adolescents and adults. AIM: To analyze the efficacy and safety of lacosamide in Galicia according to its use in daily clinical practice. PATIENTS AND METHODS: Retrospective observational study in patients who started treatment with lacosamide between January 2014 and June 2013 in 10 hospitals in Galicia, Spain. Its efficacy and safety at 3, 6 and 12 months after starting lacosamide was assessed. RESULTS: We included 184 patients with a mean age of 44.2 ± 17.4 years old; 56.5% (n = 104) were male; 173 patients constituted the efficacy population. Mean duration of epilepsy was 18.8 ± 15.5 years. Seizure frequency was 2.5 ± 1.6 episodes/month. After 12 months, 68.2% of patients (n = 118) had >= 50% improvement (responders) and among them, 54 (45.8% of responder patients) were seizure free. Twenty-three percent (n = 43) suffered from adverse events after 12 months, being dizziness (10.3%) and instability (3.3%) the most frequently reported. After the 12 month visit, 87.5% of patients (n = 161) continued treatment with lacosamide. CONCLUSIONS: Lacosamide provides a very good efficacy and safety profile for patients with focal refractory epilepsy. High percentage of responders may be related to a less refractory population compared to other daily clinical practice studies. It constitutes an attractive therapeutic option for the treatment of focal epilepsies.
TITLE: Experiencia clinica con lacosamida en Galicia: estudio GALACO.Introducción. La lacosamida es un fármaco antiepiléptico bloqueante de los canales de sodio, autorizado en adolescentes y adultos como tratamiento coadyuvante en crisis de inicio focal. Objetivo. Analizar los resultados de eficacia y seguridad de la lacosamida en Galicia en su uso de acuerdo con la práctica clínica habitual. Pacientes y métodos. Estudio retrospectivo observacional en pacientes que iniciaron tratamiento con lacosamida entre enero de 2013 y junio de 2014 en 10 hospitales de Galicia. Se evaluó su eficacia y seguridad a los 3, 6 y 12 meses del inicio del tratamiento. Resultados. Se incluyeron 184 pacientes con edad media de 44,2 ± 17,4 años; el 56,5% (n = 104) eran varones. Conforman la población de eficacia 173 pacientes. El tiempo medio de evolución de la epilepsia fue de 18,8 ± 15,5 años. La frecuencia de crisis era de 2,5 ± 1,6 episodios/mes. A los 12 meses, el 68,2% de los pacientes (n = 118) presentaba una mejoría igual o superior al 50% (pacientes respondedores) y, de ellos, 54 (el 45,8% de los respondedores) estaban libres de crisis. El 23,4% (n = 43) refirió efectos adversos a los 12 meses, principalmente mareos (10,3%) e inestabilidad (3,3%). Después de la visita de los 12 meses, continuaba con lacosamida el 87,5% de los pacientes (n = 161). Conclusiones. La lacosamida ofrece un perfil de eficacia y seguridad muy favorable para pacientes con epilepsia focal refractaria. El elevado porcentaje de respondedores podría atribuirse a una población de epilépticos menos refractarios que en otros estudios de práctica clínica. Constituye una opción terapéutica atractiva para el tratamiento de epilepsias de inicio focal.
Assuntos
Acetamidas/uso terapêutico , Anticonvulsivantes/uso terapêutico , Epilepsia/tratamento farmacológico , Acetamidas/efeitos adversos , Adulto , Anticonvulsivantes/efeitos adversos , Quimioterapia Combinada , Feminino , Humanos , Lacosamida , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/induzido quimicamente , Estudos Retrospectivos , Bloqueadores dos Canais de Sódio/efeitos adversos , Bloqueadores dos Canais de Sódio/uso terapêutico , EspanhaRESUMO
Introducción. La lacosamida es un fármaco antiepiléptico bloqueante de los canales de sodio, autorizado en adolescentes y adultos como tratamiento coadyuvante en crisis de inicio focal. Objetivo. Analizar los resultados de eficacia y seguridad de la lacosamida en Galicia en su uso de acuerdo con la práctica clínica habitual. Pacientes y métodos. Estudio retrospectivo observacional en pacientes que iniciaron tratamiento con lacosamida entre enero de 2013 y junio de 2014 en 10 hospitales de Galicia. Se evaluó su eficacia y seguridad a los 3, 6 y 12 meses del inicio del tratamiento. Resultados. Se incluyeron 184 pacientes con edad media de 44,2 ± 17,4 años; el 56,5% (n = 104) eran varones. Conforman la población de eficacia 173 pacientes. El tiempo medio de evolución de la epilepsia fue de 18,8 ± 15,5 años. La frecuencia de crisis era de 2,5 ± 1,6 episodios/mes. A los 12 meses, el 68,2% de los pacientes (n = 118) presentaba una mejoría igual o superior al 50% (pacientes respondedores) y, de ellos, 54 (el 45,8% de los respondedores) estaban libres de crisis. El 23,4% (n = 43) refirió efectos adversos a los 12 meses, principalmente mareos (10,3%) e inestabilidad (3,3%). Después de la visita de los 12 meses, continuaba con lacosamida el 87,5% de los pacientes (n = 161). Conclusiones. La lacosamida ofrece un perfil de eficacia y seguridad muy favorable para pacientes con epilepsia focal refractaria. El elevado porcentaje de respondedores podría atribuirse a una población de epilépticos menos refractarios que en otros estudios de práctica clínica. Constituye una opción terapéutica atractiva para el tratamiento de epilepsias de inicio focal (AU)
Introduction. Lacosamide is a sodium channel blocker antiepileptic drug authorized as an adjunctive therapy for focal seizures in adolescents and adults. Aim. To analyze the efficacy and safety of lacosamide in Galicia according to its use in daily clinical practice. Patients and methods. Retrospective observational study in patients who started treatment with lacosamide between January 2014 and June 2013 in 10 hospitals in Galicia, Spain. Its efficacy and safety at 3, 6 and 12 months after starting lacosamide was assessed. Results. We included 184 patients with a mean age of 44.2 ± 17.4 years old; 56.5% (n = 104) were male; 173 patients constituted the efficacy population. Mean duration of epilepsy was 18.8 ± 15.5 years. Seizure frequency was 2.5 ± 1.6 episodes/month. After 12 months, 68.2% of patients (n = 118) had ≥ 50% improvement (responders) and among them, 54 (45.8% of responder patients) were seizure free. Twenty-three percent (n = 43) suffered from adverse events after 12 months, being dizziness (10.3%) and instability (3.3%) the most frequently reported. After the 12 month visit, 87.5% of patients (n = 161) continued treatment with lacosamide. Conclusions. Lacosamide provides a very good efficacy and safety profile for patients with focal refractory epilepsy. High percentage of responders may be related to a less refractory population compared to other daily clinical practice studies. It constitutes an attractive therapeutic option for the treatment of focal epilepsies (AU)
Assuntos
Adulto , Feminino , Humanos , Masculino , Anticonvulsivantes/uso terapêutico , Epilepsia/tratamento farmacológico , Relação Dose-Resposta a Droga , Anticonvulsivantes/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/tratamento farmacológico , Resultado do Tratamento , Avaliação de Eficácia-Efetividade de Intervenções , Estudos Retrospectivos , Convulsões/tratamento farmacológico , Estudos ProspectivosRESUMO
BACKGROUND: Determinants of risk of myocardial infarction (MI) after transient ischaemic attack (TIA) are not well defined. The aim of our study was to determine the risk and risk factors for MI after TIA. METHODS: We prospectively recruited patients within 24 h of transient ischaemic cerebrovascular events between October 2006 and January 2013. A total of 628 TIA patients were followed for six months or more. MI and stroke recurrence (SR) were recorded. The duration and typology of clinical symptoms, vascular risk factors and aetiological work-ups were prospectively recorded and established prognostic scores (ABCD2, ABCD2I, ABCD3I, Essen Stroke Risk Score, California Risk Score and Stroke Prognosis Instrument) were calculated. RESULTS: Twenty-eight (4.5%) MI and 68 (11.0%) recurrent strokes occurred during a median follow-up period of 31.2 months (16.1-44.9). In Cox proportional hazards multivariate analyses, we identify previous coronary heart disease (CHD) (hazard ratio [HR] 5.65, 95% confidence interval [CI] 2.45-13.04, P < 0.001) and sex male (HR 2.72, 95% CI 1.02-7.30, P = 0.046) as independent predictors of MI. Discrimination for the prognostic scores only ranged from 0.60 to 0.71. The incidence of MI did not vary among the different aetiological subtypes. Positive diffusion weighted imaging (DWI) (7.5% vs 2.5%, P = 0.007), and ECG abnormalities (Q wave or ST-T wave changes) (13.6% vs 3.6%, P = 0.001) were associated to MI. CONCLUSION: According to our results, discrimination was poor for all previous risk prediction models evaluated. Variables such as previous CHD, male sex, DWI and ECG abnormalities should be considered in new prediction models.
Assuntos
Ataque Isquêmico Transitório/complicações , Infarto do Miocárdio/epidemiologia , Idoso , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Risco , Fatores de RiscoRESUMO
A chemical study was conducted from 2009 to 2012 to examine spatial and seasonal variability of red Vitis vinifera Mencía located in different geographic areas (Amandi, Chantada, Quiroga-Bibei, Ribeiras do Sil and Ribeiras do Miño) from NW Spain. Mencía samples were analysed for phenolic, (flavan-3-ols, flavonols, anthocyanins, acids and resveratrol), nitrogen (TAC, TAN, YAN and TAS) and volatiles compounds (alcohols, C6 compounds, ethyl esters, terpenes, aldehydes, acids, lactones, volatile phenols and carbonyl compounds) by GC-MS and HPLC. Results showed that the composition of Mencía cultivar was more affected by the vintage than the geographic area. The amino acid composition was less affected by both geographic origin and vintage, showing more varietal stability. Application of Principal Component Analysis (PCA) to experimental data showed a good separation of Mencía grape according to geographical origin and vintages. PCA also showed high correlations between the ripening ratio and C6 compounds, resveratrol and carbonyl compounds.
Assuntos
Vitis/química , Vinho/análise , Antocianinas/análise , Cromatografia Líquida de Alta Pressão , Flavonóis/análise , Cromatografia Gasosa-Espectrometria de Massas , Geografia , Fenóis/análise , Polifenóis/análise , Resveratrol , Espanha , Estilbenos/análiseRESUMO
Cancer is the leading cause of death in economically developed countries and the second leading cause of death in developing countries. This global burden of cancer continues to increase largely because of the aging and growth of the world population. Although very much progress has been attained in the development of new therapies, there is a clear need of more efficient and selective antitumor drugs for the effective treatment of many types of cancer. Among the different strategies developed to create new antitumor drugs, pleiotropic non-genotoxic effectors have gained interest since this approach is less susceptible to known resistance mechanisms. The cell nucleus is the subcellular compartment where the genetic information and the transcription machinery reside and accordingly where numerous therapeutic agents efficiently work. Hence, nuclear-targeted drugs are expected to kill cancer cells more directly and efficiently. In this review, we discuss the potential of nuclear-targeted drugs as antineoplastic therapeutics and reason the benefits of the strategy to endow ribonucleases with cytotoxic properties based on its targeting into the nucleus.
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Núcleo Celular/metabolismo , Ribonucleases/metabolismo , Antineoplásicos/metabolismo , Antineoplásicos/uso terapêutico , Antineoplásicos/toxicidade , Núcleo Celular/efeitos dos fármacos , Humanos , Carioferinas/metabolismo , Neoplasias/tratamento farmacológico , Proteínas Recombinantes/biossíntese , Proteínas Recombinantes/uso terapêutico , Proteínas Recombinantes/toxicidade , Ribonucleases/genética , Ribonucleases/uso terapêuticoRESUMO
Foram testados os efeitos de dois níveis de extrato etéreo à base de óleo de arroz no concentrado em 30 cabras Saanen durante a fase inicial de lactação. A alimentação baseou-se na relação 60% de volumoso (feno de alfafa) e 40% de concentrado comercial com dois níveis de extrato etéreo (3% e 5%). As variáveis estudadas foram a quantificação e qualificação do perfil de ácidos graxos do leite total e frente ao tempo de lactação. O acréscimo de óleo de arroz na dieta diminuiu (P<0,05) a concentração de ácidos graxos saturados e aumentou (P<0,05) a concentração de ácidos graxos poli-insaturados no leite caprino. O ácido linoleico conjugado (ALC) também é afetado positivamente pelo acréscimo de óleo de arroz na dieta. A inclusão de óleo de arroz nos níveis de 3% e 5% da matéria seca, na dieta de cabras leiteiras da raça Saanen, influencia o perfil de ácidos graxos do leite, com ênfase no ALC, até a 11ª semana de lactação.
The effects of two levels of ether extract based on rice oil concentrate in 30 Saanen goats during early lactation were evaluated. The feeding was based on the ratio of 60% forage (alfalfa hay) and 40% commercial concentrate with two levels of lipids (3% and 5%). The variables were the quantification and qualification of the fatty acid profile of whole milk and forward to the time of lactation. The addition of rice bran oil in the diet decreased significantly (P<0.05) the concentration of saturated fatty acids and increased (P<0.05) the concentration of polyunsaturated fatty acids in goats' milk. The linoleic acid was also positively affected by the addition of rice bran oil in the diet. The inclusion of rice bran oil at levels of 3% and 5% of dry matter in the diet of Saanen dairy goats influences the fatty acid profile of milk, with emphasis on linoleic acid until the 11th week of lactation.
Assuntos
Animais , Dieta , Ácidos Graxos , Cabras , Leite , Lactação/metabolismo , Lipídeos/análiseRESUMO
The aroma and volatile composition of wines from five red cultivars from NW Spain (Brancellao, Mencía, Merenzao, Mouratón and Sousón) have been studied by gas chromatography-mass spectrometry (GC-MS) and sensory descriptive analysis (SDA) during three consecutive vintages (2007-2009) in order to characterize these wines. In addition, relationships between the instrumental (volatile) and sensory variables were analyzed through the application of partial least squares regression (PLSR). Results revealed that the effect of "cultivar" was very important as a third of compounds (16 in total) varied significantly (P≤0.05) among varieties. Mencía wines presented the highest concentrations of γ-nonalactone, whereas Sousón wines were the richest in monoterpene compounds. On the contrary, no significant difference was observed with respect to the esters content, probably as a consequence of using the same yeast for all vinifications. Twenty out of 51 quantified volatile compounds were present in some samples at concentrations higher than their corresponding odor thresholds (OAV>1), thus contributing to the final wine aroma. Partial least square (PLS) regression was applied to volatile compounds with OAV>0.2 and aroma descriptors with %GM>10. PLSR yielded a satisfactory model for the prediction of four important aroma descriptors in this set of wines--aroma quality, aroma intensity, herbaceous and red fruit--from instrumental analysis data. This work contributes to gaining knowledge about the sensory profiles and its relation to the volatile composition of minority Galician red grape cultivars.
Assuntos
Cromatografia Gasosa-Espectrometria de Massas , Limiar Sensorial , Vitis/química , Compostos Orgânicos Voláteis/análise , Vinho/análise , Análise Discriminante , Análise dos Mínimos Quadrados , Odorantes , EspanhaRESUMO
UNLABELLED: The Catalan Agency for Health Technology Assessment and Research (AETIM) proposed, in 2001, criteria for performing a bone densitometry (BD) for use in the consultations of the public health system. OBJECTIVE: To determine the sensitivity, specificity, positive predictive value and negative predictive value of the criteria to indicate BD. MATERIAL AND METHODS: Five groups of volunteers (premenopausal women aged 46 to 65 years, postmenopausal women aged 46 to 65 years, postmenopausal women aged> 65 years and men 46 to 65 years and> 65 years) underwent BD and a questionnaire on risk factors. The results obtained with the AETIM criteria are related to criteria for indication of BD proposed by the World Health Organization (1999 and 2003 criteria), the National Osteoporosis Foundation (1998 amd 2010 criteria) and the International Committee of Clinical Guidelines on Osteoporosis. RESULTS: Criteria from the Catalan Agency have low sensitivity to detect both low bone mass (T index<-1) and osteoporosis (T index<-2.5), specificity varied according to the group. The positive predictive value is low, but the negative predictive value for osteoporosis is high in all groups (except for postmenopausal women aged> 65 years). The remaining criteria have a high negative predictive value and, in women, good sensitivity and low specificity, especially for identifying patients with osteoporosis. CONCLUSION: Catalan Agency criteria are useful for selecting patients who would not need BD, but lack sufficient sensitivity to identify individuals with low bone mass. The other criteria also have a high negative predictive value for osteoporosis, and a better sensitivity.
Assuntos
Densitometria , Osteoporose/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Valor Preditivo dos Testes , Medição de Risco , Fatores de Risco , Sensibilidade e Especificidade , Espanha , Inquéritos e QuestionáriosRESUMO
Objetivo. La Agencia de Evaluación de Tecnologías e Investigación Médicas (AETIM) de Cataluña propuso en 2001 unos criterios de indicación de densitometría ósea (DO) para su uso en la consultas del sistema sanitario público. El objetivo fue conocer la sensibilidad, la especificidad, el valor predictivo positivo (VPP) y valor predictivo negativo (VPN) de los criterios de indicación de DO de la AETIM. Material y método. Cinco grupos de voluntarios (mujeres premenopáusicas de 46 a 65 años, posmenopáusicas de 46 a 65 años y posmenopáusicas de > 65 años, y varones de 46 a 65 años y de > 65 años) a los que se realizó DO y una encuesta sobre factores de riesgo. Se calcularon la sensibilidad, la especificidad, el VPP y el VPN de los criterios de la AETIM, y los resultados se compararon con los criterios de indicación de DO propuestos por la Organización Mundial de la Salud (en 1999 y 2003), la National Osteoporosis Foundation (en 1998 y 2010) y el Comité Internacional de Guías Clínicas en Osteoporosis. Resultados. Los criterios de la AETIM tienen una baja sensibilidad tanto para detectar baja masa ósea (índice T<−1) como osteoporosis (índice T<−2,5); la especificidad varía según el grupo. El VPP es bajo, pero el VPN para osteoporosis es alto en todos los grupos (excepto el de mujeres posmenopáusicas > 65 años). El resto de los criterios tienen un VPN alto y, en mujeres, buena sensibilidad y muy baja especificidad, especialmente para identificar pacientes con osteoporosis. Conclusiones. Los criterios de la AETIM son útiles para seleccionar pacientes a los que no sería necesario realizar una DO, pero carecen de sensibilidad suficiente para identificar individuos con baja masa ósea. El resto de criterios tienen también un VPN alto para osteoporosis y una sensibilidad algo mejor (AU)
The Catalan Agency for Health Technology Assessment and Research (AETIM) proposed, in 2001, criteria for performing a bone densitometry (BD) for use in the consultations of the public health system. Objective. To determine the sensitivity, specificity, positive predictive value and negative predictive value of the criteria to indicate BD. Material and methods. Five groups of volunteers (premenopausal women aged 46 to 65 years, postmenopausal women aged 46 to 65 years, postmenopausal women aged> 65 years and men 46 to 65 years and> 65 years) underwent BD and a questionnaire on risk factors. The results obtained with the AETIM criteria are related to criteria for indication of BD proposed by the World Health Organization (1999 and 2003 criteria), the National Osteoporosis Foundation (1998 amd 2010 criteria) and the International Committee of Clinical Guidelines on Osteoporosis. Results. Criteria from the Catalan Agency have low sensitivity to detect both low bone mass (T index<−1) and osteoporosis (T index<−2.5), specificity varied according to the group. The positive predictive value is low, but the negative predictive value for osteoporosis is high in all groups (except for postmenopausal women aged> 65 years). The remaining criteria have a high negative predictive value and, in women, good sensitivity and low specificity, especially for identifying patients with osteoporosis. Conclusion. Catalan Agency criteria are useful for selecting patients who would not need BD, but lack sufficient sensitivity to identify individuals with low bone mass. The other criteria also have a high negative predictive value for osteoporosis, and a better sensitivity (AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Sensibilidade e Especificidade , Valor Preditivo dos Testes , Densitometria/estatística & dados numéricos , Densitometria/tendências , Fatores de Risco , Osteoporose/diagnóstico , Técnicas e Procedimentos Diagnósticos , Densitometria/métodos , Densitometria , Reações Falso-Negativas , Reações Falso-Positivas , Menopausa/fisiologia , Pré-Menopausa/fisiologia , Estudos TransversaisRESUMO
O rebanho de ovinos no Brasil está estimado em mais de 16 milhões de cabeças. Embora o consumo da carne desta espécie ainda seja pequeno, comparado ao de outros países, o consumo de carne, inclusive ovina, tem sido associado às doenças transmitidas por alimentos, em especial a salmonelose. No presente estudo, investigou-se a ocorrência de salmonelas em linfonodos mesentéricos e conteúdo intestinal de 175 ovinos ao abate. "Pools" constituído por cinco amostras de contéudo fecal ou 5 amostras de linfonodos de 25 g foram pre-enriquecidos em 250 mL de água peptonada tamponada e incubados a 37° C por 18-24 horas. Uma alíquota de 0,1 mL do préenriquecimento foi transferida para 9,9 mL de caldo de enriquecimento Rappaport-Vassiliadis e 1,0 mL do pré-enriquecimento foi transferido para 10 mL de caldo tetrationato Muller-Kaufmann, incubados a 42° C for 24h. 10 µL do caldo de enriquecimento foi semeado superfície de placas de ágar BPLS e ágar XLT4 incubadas a 37º C for 24-48h. Colônias suspeitas de salmonela foram testadas por provas bioquímicas e serologicas. Os testes bioquímicos utilizados para identificação de Salmonella foram TSI (triple sugar iron àgar), LIA (lysine iron àgar) e ágar ureia. Sorotipagem foi realizada no Laboratório de Enterobactérias do Instituto Osvaldo Cruz. Isolou-se Salmonella Tiphymurium de um pool de linfonodos mesentéricos, provenientes de cinco animais. O fato de se observar a ocorrência de salmonela em ovino portador sadio alerta para necessidade de monitorar este micro-organismo também nesta espécie, especialmente quando destinada ao abate, com vistas à produção de alimentos seguros.
The ovine flock in Brazil is estimated at over 16 million head. Despite that meat consumption of this species is still small when compared to other countries, general meat consumption, including mutton, has been associated to food borne diseases, especially salmonellosis. In the present study, the occurrence of salmonella in mesenteric lymph nodes and intestinal content of 175 ovines during slaughter was investigated. A pool of 5 feces samples or 5 lymph node samples of 25 grams was pre-enriched in 250 mL of buffered peptone water at 37° C for 18-24h. Following this, 0.1 mL of pre-enriched broth was transferred to 9.9 mL of Rappaport-Vassiliadis enrichment broth and 1.0 mL of pre-enriched broth was transferred to 10 mL of Muller-Kaufmann tetrationate broth, incubated at 42° C for 24h. Then, a 10 µL of the enrichment broth was spread on the surface of a BPLS and an XLT4 plate, both incubated at 37º C for 24-48h. Suspected Salmonella colonies were picked from the agar and tested with biochemical and serological methods. Biochemical testing was carried out for the identification of Salmonella, using the TSI (triple sugar iron agar), LIA (lysine iron agar) and urea agar tests. Serotyping was done at the Laboratory of Enterobactérias of the Instituto Osvaldo Cruz. Salmonella Tiphymurium was isolated from a pool of mesenteric lymph nodes from 5 animals. That Salmonella was observed in healthy carrier ovines points out the necessity of monitoring this microorganism in this species as well, especially when animals are destined to slaughter, so to assure safe food production.
Assuntos
Animais , Salmonelose Animal/diagnóstico , Salmonella typhimurium/isolamento & purificação , Ovinos/microbiologia , Linfonodos/microbiologia , Abate de AnimaisRESUMO
INTRODUCTION: Pregnancy registries provide trustworthy information about the risks associated to antiepileptic drugs (AEDs). EURAP is a Prospective International Registry which include patients who takes AEDs at the time of conception. The data of the Spanish centers which are contributing to EURAP reflects the reality of our milieu. OBJECTIVES: To study the incidence of major congenital malformations (MCM) /and/or fetal-perinatal death (MFP) and determine his relationship to AEDs in the Spanish EURAP registry. METHODS: After informed consent, patients were included in the prospective Registry and evaluated: at the beginning, at the end of the second and third trimester, after delivery and one year after birth. A variety of variables were collected: demographic, type of epilepsy, frequency of seizures during pregnancy, AEDs and dose, potential toxics, folate use and dose, obstetric complications and information of the newborn. After 6 years of recruitment (June 2001-October 2007) we analyzed the results of this Registry in Spain with special attention on the incidence of major congenital malformations and foetal-perinatal death. RESULTS: Of a whole of 540 cases included in the Registry, 490 were prospective (included before the 16th week), of these we had complete information in 368 cases. Major congenital maLformations were present in 5% (n=13) of the child exposed to monotherapy and 12% (n=6) of those exposed to polytherapy (p=0.08). All polytherapy combinations with MCM, contained valproate. Of the variables analyzed only low weight at birth and the AEDs used showed statistically significant association with MCM and MFP. The percentage of MCM was superior for valproate, particularly at doses equal or superior of 1000 mg/day (16%), although differences were not statistically significant. The majority of ours patients were on monotherapy (83%) with AEDs at low doses and were taking 5 mg of folate. CONCLUSIONS: Patients on polytherapy, particularly those with valproate in combination present more risk of MCM. For monotherapy exposures only weight at birth and the AEDs used have association statistically significant with MC/MFP. Valproate in our series presents more risk than lamotrigine and does not show differences with regard to carbamazepine.
Assuntos
Anticonvulsivantes/efeitos adversos , Anormalidades Congênitas/etiologia , Morte Fetal/induzido quimicamente , Feto/anormalidades , Adulto , Quimioterapia Combinada/efeitos adversos , Feminino , Humanos , Estudos Multicêntricos como Assunto , Gravidez , Complicações na Gravidez/induzido quimicamente , Estudos Prospectivos , Sistema de Registros , Fatores de Risco , EspanhaRESUMO
CLINICAL CASE: Female in her eighties is admitted suffering from unilateral ocular pain. On examination we observed, as well as corneal abrasion, a bilateral iridoschisis with a frayed iris, unfolded between its stromal layers. DISCUSSION: This rare case is related either to senile degenerative change or to angle-closure glaucoma. However, it is also associated with congenital syphilis with or without the presence of interstitial keratitis. Infant conjunctivitis and a "salt and pepper" appearance of the fundus oculi complete the diagnosis. It is confirmed that the patient had suffered from congenital late syphilis, cured by the age of 80: this confirmation is reached by treponemal (RPR-) and non-treponemal (TPHA+) serological tests.
Assuntos
Doenças da Íris/etiologia , Sífilis Congênita/complicações , Idoso de 80 Anos ou mais , Feminino , Humanos , Sífilis Congênita/sangueRESUMO
Caso clínico: Mujer octogenaria que acude pordolor ocular unilateral. En la exploración observamos,además de una abrasión corneal, una iridosquisisbilateral con un iris desflecado, desdobladoentre sus capas estromales.Discusión: Esta rara entidad está relacionada conlos cambios degenerativos seniles o al glaucoma deángulo cerrado. Sin embargo, también es asociado ala sífilis congénita con o sin la coexistencia de queratitisintersticial. Las conjuntivitis en la infancia yel fondo de ojo en «sal y pimienta» complementanel diagnóstico de sospecha. Confirmándose, a los80 años una sífilis congénita tardía curada, por lostest serológicos treponémicos (RPR-) y no treponémicos(TPHA+)(AU)
Clinical case: Female in her eighties is admittedsuffering from unilateral ocular pain. On examinationwe observed, as well as corneal abrasion, abilateral iridoschisis with a frayed iris, unfoldedbetween its stromal layers.Discussion: This rare case is related either to seniledegenerative change or to angle-closure glaucoma.However, it is also associated with congenital syphiliswith or without the presence of interstitial keratitis.Infant conjunctivitis and a «salt and pepper» appearanceof the fundus oculi complete the diagnosis.It is confirmed that the patient had suffered fromcongenital late syphilis, cured by the age of 80: thisconfirmation is reached by treponemal (RPR-) andnon-treponemal (TPHA+) serological tests(AU)