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1.
J Phys Condens Matter ; 32(43): 435402, 2020 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-32526710

RESUMO

Pb(Hf1-x Sn x )O3 single crystals with x = 0.23 were characterized using single-crystal x-ray diffraction in the wide temperature range. The information on the structure of two intermediate phases, situated between low temperature antiferroelectric and high temperature paraelectric phases, has been obtained. The lower-temperature intermediate AFE2 phase is characterized by incommensurate displacive modulations in the Pb sublattice. The higher temperature intermediate IM phase is characterized by rotations of oxygen octahedra, primarily in the form of anti-phase tilts, which are also present in the lower-temperature AFE2 phase. For the same crystal, 119Sn Mossbauer effect in the temperature range from 300 K to 600 K has been used to study phase transitions mechanism. Two kinds of quadruple splitting have been found. It implies that two different environments of the central Sn ion exist. The observed two kinds of quadruple splitting do not disappear in the whole investigated temperature range which confirm that even far above T C the structure of paraelectric phase is locally non-centrosymmetric.

2.
Plant Cell Rep ; 38(1): 85-99, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30406280

RESUMO

KEY MESSAGE: Two lines of Taxus × media hairy roots harbouring or not the TXS transgene demonstrated diverse gene expression and taxane yield during cultivation in PFD-supported two liquid-phase culture system. Two lines of Taxus × media hairy roots were subjected to single or twice-repeated supplementation with methyl jasmonate, sodium nitroprusside, L-phenylalanine, and sucrose feeding. One line harboured transgene of taxadiene synthase (ATMA), while the second (KT) did not. Both hairy root lines were cultured in two-phase culture systems containing perfluorodecalin (PFD) in aerated or degassed form. The relationship between TXS (taxadiene synthase), BAPT (baccatin III: 3-amino, 3-phenylpropanoyltransferase), and DBTNBT (3'-N-debenzoyl-2-deoxytaxol-N-benzoyltransferase) genes and taxane production was analysed. The ATMA and KT lines differed in their potential for taxane accumulation, secretion, and taxane profile. In ATMA biomass, both paclitaxel and baccatin III were detected, while in KT roots only paclitaxel. The most suitable conditions for taxane production for ATMA roots were found in single-elicited supported with PFD-degassed cultures (2 473.29 ± 263.85 µg/g DW), whereas in KT roots in single-elicited cultures with PFD-aerated (470.08 ± 25.15 µg/g DW). The extracellular levels of paclitaxel never exceeded 10% for ATMA roots, while for KT increased up to 76%. The gene expression profile was determined in single-elicited cultures supported with PFD-degassed, where in ATMA roots, the highest taxane yield was obtained, while in KT the lowest one. The gene expression pattern in both investigated root lines differed substantially what resulted in taxane yield characterized particular lines. The highest co-expression of TXS, BAPT and DBTNBT genes noted for ATMA roots harvested 48 h after elicitation corresponded with their higher ability for taxane production in comparison with the effects observed for KT roots.


Assuntos
Fluorocarbonos/metabolismo , Isomerases/metabolismo , Raízes de Plantas/metabolismo , Taxus/metabolismo , Regulação da Expressão Gênica de Plantas , Isomerases/genética , Raízes de Plantas/genética , Taxus/genética
4.
Vitam Horm ; 103: 295-326, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28061974

RESUMO

Elements (bioelements) are necessary factors required for the physiological function of organisms. They are critically involved in fundamental processes of life. Extra- and intracellular message and metabolic pathway factors as well as structural components include one or many elements in their functional structure. Recent years have seen an intensification in terms of knowledge gained about the roles of elements in anxiety disorders. In this chapter we present a review of the most important current data concerning the involvement of zinc, magnesium, copper, lithium, iron, and manganese, and their deficiency, in the pathophysiology and treatment of anxiety.


Assuntos
Transtornos de Ansiedade/etiologia , Ansiedade/etiologia , Deficiências Nutricionais/fisiopatologia , Modelos Animais de Doenças , Oligoelementos/deficiência , Animais , Ansiedade/prevenção & controle , Transtornos de Ansiedade/prevenção & controle , Deficiências Nutricionais/dietoterapia , Deficiências Nutricionais/psicologia , Suplementos Nutricionais , Humanos , Magnésio/uso terapêutico , Deficiência de Magnésio/dietoterapia , Deficiência de Magnésio/fisiopatologia , Deficiência de Magnésio/psicologia , Oligoelementos/uso terapêutico , Zinco/deficiência , Zinco/uso terapêutico
5.
Conserv Biol ; 23(4): 834-40, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19627315

RESUMO

Oceania is a diverse region encompassing Australia, Melanesia, Micronesia, New Zealand, and Polynesia, and it contains six of the world's 39 hotspots of diversity. It has a poor record for extinctions, particularly for birds on islands and mammals. Major causes include habitat loss and degradation, invasive species, and overexploitation. We identified six major threatening processes (habitat loss and degradation, invasive species, climate change, overexploitation, pollution, and disease) based on a comprehensive review of the literature and for each developed a set of conservation policies. Many policies reflect the urgent need to deal with the effects of burgeoning human populations (expected to increase significantly in the region) on biodiversity. There is considerable difference in resources for conservation, including people and available scientific information, which are heavily biased toward more developed countries in Oceania. Most scientific publications analyzed for four threats (habitat loss, invasive species, overexploitation, and pollution) are from developed countries: 88.6% of Web of Science publications were from Australia (53.7%), New Zealand (24.3%), and Hawaiian Islands (10.5%). Many island states have limited resources or expertise. Even countries that do (e.g., Australia, New Zealand) have ongoing and emerging significant challenges, particularly with the interactive effects of climate change. Oceania will require the implementation of effective policies for conservation if the region's poor record on extinctions is not to continue.


Assuntos
Biodiversidade , Conservação dos Recursos Naturais , Meio Ambiente , Animais , Poluição Ambiental , Humanos , Oceania
6.
J Neurol Sci ; 283(1-2): 127-33, 2009 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-19268969

RESUMO

OBJECTIVE: To investigate whether quantitative EEG may be useful in differential diagnosis of AD and SVD and to determine the correlation between dementia and abnormalities in EEG. MATERIALS AND METHODS: The group under study was consisted of 62 patients with AD (mean age: 73.6 yrs; M 51%), 31 with SVD (mean age: 75.2 yrs, M 43%) and a control group of 14 healthy subjects (mean age: 69.5 yrs, M 43%). The patients were divided into subgroups of those with mild, moderate and marked dementia. EEG findings were classified using eight-degree scale according to the presence of slow waves, and then quantitative analysis was carried out by calculating the alpha/slow wave power ratios and the mean frequencies in all and some selected derivations. RESULTS: A significant difference between visual EEGs and QEEGs in AD and SVD was found. Only QEEG parameters differed in AD and SVD subgroups with the same degree of cognitive impairment: the mean wave frequencies of waves in temporal derivations in subgroups with mild and moderate dementia and alpha/delta waves power ratio in subgroups with moderate dementia. CONCLUSIONS: Visual EEGs and QEEGs could be used in addition to the differential diagnosis between AD and SVD, but only selected parameters of QEEG could be useful in differentiating between AD and SVD subgroups with the same degree of dementia.


Assuntos
Doença de Alzheimer/diagnóstico , Doença de Alzheimer/fisiopatologia , Encéfalo/fisiopatologia , Demência Vascular/diagnóstico , Demência Vascular/fisiopatologia , Eletroencefalografia , Idoso , Ritmo alfa , Ritmo Delta , Diagnóstico Diferencial , Eletroencefalografia/métodos , Potenciais Evocados Visuais , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Ritmo Teta
7.
J Neurol Sci ; 257(1-2): 11-6, 2007 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-17337009

RESUMO

UNLABELLED: The aim of this study was to determine if the results of visual and quantitative EEG (QEEG) parameters reveal a correlation with mental impairment in subcortical vascular dementia (SVD), one of the most frequent causes of cognitive impairment in the elderly. In SVD, like in Alzheimer's disease disturbances were found in cholinergic transmission. The cholinergic deficit as manifested in changes of synaptic potentials is reflected in EEG signals. MATERIAL: 31 patients with probable SVD (according to NINCDS-AIREN and T. Erkinjuntii's criteria) and mean age 72.3 yrs;(M--43%, F--57%) and 14 healthy control subjects with mean age of 72.3 yrs (M-57%, F-43%). According to the Mini Mental Scale Examination (MMSE) the SVD group was divided into two subgroups with mild and moderate dementia, their EEGs being recorded with a Medelec and Neuroscan 4.2 system. Visual EEG findings were classified with the use of eight-degree scale of pathological changes by the presence of slow waves. Then QEEGs were made. The following parameters were calculated: alpha/slow wave power ratios, the mean wave frequency in all and in some selected derivations. RESULTS: A significant difference was found between QEEGs in SVD subgroups with mild and moderate dementia (p<0.05), but there was no significant difference between visual EEGs. A significant correlation between QEEG parameters such as alpha/slow wave ratio or mean wave frequency and mental impairment (according to MMSE results) was found (p<0.001), but there was no significant correlation between degree of EEG abnormalities in visual analysis and MMSE results. CONCLUSION: Only QEEGs are correlated with mental impairment in SVD. Visual EEG technique as a less precise tool does not reflect the mental impairment in SVD due to cholinergic deficit.


Assuntos
Demência Vascular/diagnóstico , Demência Vascular/fisiopatologia , Avaliação da Deficiência , Eletroencefalografia/métodos , Transtornos Neurocognitivos/diagnóstico , Transtornos Neurocognitivos/fisiopatologia , Acetilcolina/deficiência , Idoso , Idoso de 80 Anos ou mais , Núcleo Basal de Meynert/metabolismo , Núcleo Basal de Meynert/patologia , Núcleo Basal de Meynert/fisiopatologia , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/fisiopatologia , Demência Vascular/psicologia , Progressão da Doença , Eletroencefalografia/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas Mielinizadas/metabolismo , Fibras Nervosas Mielinizadas/patologia , Transtornos Neurocognitivos/etiologia , Testes Neuropsicológicos , Estimulação Luminosa , Valor Preditivo dos Testes , Transmissão Sináptica/fisiologia , Telencéfalo/irrigação sanguínea , Telencéfalo/patologia , Telencéfalo/fisiopatologia
8.
Cephalalgia ; 26(5): 578-88, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16674767

RESUMO

We set out to examine selected clinical characteristics of migraine patients referred to neurologists specializing in headache in Canada, and to document their pharmacological therapy both before and after consultation with the neurologist. Demographic, clinical and pharmacotherapy data were collected at the time of consultation for 606 patients referred to five headache clinics and who were given a migraine diagnosis by the neurologist. Data were analysed as part of the Canadian Headache Outpatient Registry and Database (CHORD) Project. The mean age of the migraine patients was 39.7 years; and 82.5% were female. The majority of patients suffered severe impact from their headaches. Prior to consultation, 48.7% were taking a triptan; after consultation, 97.2% were on a triptan. Before consultation, 30.9% were on a prophylactic drug; after consultation, 70.4% were. 20.8% of patients were medication overusers. Of these medication overusers, 42.4% were overusing an opiate, usually in combination with other analgesics; 21.6% were overusing a triptan. Medication changes made by the neurologists at consultation included a large increase in the use of both triptans and prophylactic medications. Medication overuse, particularly opiate overuse, remains a significant problem in patients with migraine in Canada.


Assuntos
Analgésicos/uso terapêutico , Transtornos de Enxaqueca/prevenção & controle , Padrões de Prática Médica/estatística & dados numéricos , Adolescente , Adulto , Canadá , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neurologia , Médicos de Família , Encaminhamento e Consulta
9.
Can J Neurol Sci ; 28(1): 30-41, 2001 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11252291

RESUMO

OBJECTIVE: A systematic review of the literature was undertaken, to consolidate evidence concerning the efficacy and safety of triptans currently available in Canada (sumatriptan, rizatriptan, naratriptan, zolmitriptan), and to provide guidelines for selection of a triptan. METHODS: Data from published, randomized, placebo-controlled trials were pooled and a combined number needed to treat (NNT) and number needed to harm (NNH) was generated for each triptan. Direct comparative trials of triptans were also examined. RESULTS: The lowest NNT for headache response/pain-free at one/two hours is observed with subcutaneous sumatriptan. Among the oral formulations, the lowest NNT is observed with rizatriptan and the highest NNT with naratriptan. The lowest NNH is observed with subcutaneous sumatriptan. CONCLUSIONS: Triptans are relatively safe and effective medications for acute migraine attacks. However, differences among them are relatively small. Considerations in selecting a triptan include individual patient response/tolerance, characteristics of the attacks, relief of associated symptoms, consistency of response, headache recurrence, delivery systems and patient preference.


Assuntos
Transtornos de Enxaqueca/tratamento farmacológico , Agonistas do Receptor de Serotonina/uso terapêutico , Sumatriptana/análogos & derivados , Sumatriptana/uso terapêutico , Doença Aguda , Interações Medicamentosas , Humanos , Agonistas do Receptor de Serotonina/efeitos adversos , Agonistas do Receptor de Serotonina/farmacocinética , Sumatriptana/efeitos adversos , Sumatriptana/farmacocinética
10.
Expert Opin Investig Drugs ; 10(10): 1869-74, 2001 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11772292

RESUMO

Eletriptan (Relpax, Pfizer) is one of a group of anti-migraine medications commonly referred to as 'triptans'. It is a potent serotonin agonist at the 5-HT(1B/1D) receptor and is indicated for the acute treatment of migraine headaches. Eletriptan is administered orally. It is rapidly absorbed and has a bioavailability of 50% compared to 14% for sumatriptan. The relatively high lipophilicity of eletriptan compared to sumatriptan may explain its faster oral absorption and shorter time to onset of action. Results from comparative studies between oral eletriptan and sumatriptan indicate that eletriptan 80 mg was superior to sumatriptan 100 mg in onset of action, headache response rate, pain free response rate and relief of associated migraine symptoms at the 1 or 2 h time intervals. Although there was a modest increase in adverse events with eletriptan 80 mg than with sumatriptan 100 mg, eletriptan received a high patient acceptability rating (84%).


Assuntos
Indóis/uso terapêutico , Transtornos de Enxaqueca/tratamento farmacológico , Pirrolidinas/uso terapêutico , Agonistas do Receptor de Serotonina/uso terapêutico , Ensaios Clínicos como Assunto , Humanos , Indóis/efeitos adversos , Indóis/farmacocinética , Indóis/farmacologia , Pirrolidinas/efeitos adversos , Pirrolidinas/farmacocinética , Pirrolidinas/farmacologia , Agonistas do Receptor de Serotonina/efeitos adversos , Agonistas do Receptor de Serotonina/farmacocinética , Agonistas do Receptor de Serotonina/farmacologia , Triptaminas
11.
J Clin Neurophysiol ; 18(6): 570-5, 2001 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11779971

RESUMO

The aim of our study was to analyze EEG changes in patients with Alzheimer disease (AD) and to determine how closely EEG reflects the progression of mental impairment in people with AD. Ninety-five patients with probable AD according to National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association criteria treated in our Clinic for Memory Disorders were selected for this study. Patients were divided into three subgroups with mild, marked, and severe dementia according to the results of psychometric scales. The EEG findings were classified using an eight-degree scale according to the background activity, presence and amount of theta and delta waves, focal changes, lateralization of focal changes, synchronization, and presence of sharp and spike waves. A significant correlation between the degree of EEG abnormalities and cognitive impairment was found. We did not observe any correlation between the presence of delta waves and the results of neuropsychological tests. Our study revealed an important diagnostic value of EEG in the estimation of the severity of dementia parallel to psychometric scales.


Assuntos
Doença de Alzheimer/diagnóstico , Eletroencefalografia , Entrevista Psiquiátrica Padronizada , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/fisiopatologia , Córtex Cerebral/fisiopatologia , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes
12.
Neurology ; 54(9): 1832-9, 2000 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-10802793

RESUMO

OBJECTIVE: To evaluate the efficacy and tolerability of oral zolmitriptan 5 mg and 10 mg and placebo in cluster headache. METHODS: A multicenter, double-blind, randomized, three-period, crossover, outpatient study. Adult patients received placebo and zolmitriptan 5 mg and 10 mg orally for the acute treatment of episodic or chronic cluster headache. Headache intensity was rated by a five-point scale: none, mild, moderate, severe, or very severe. Patients only treated moderate to very severe headaches. The primary efficacy measure was headache response (two-point or greater reduction from baseline in the cluster headache rating scale) at 30 minutes. Secondary efficacy measures included proportion of patients with initial headache relief within 15 and 30 minutes, mild or no pain at 30 minutes, meaningful headache relief, and use of escape medication. RESULTS: A total of 124 patients took at least one dose of study medication, with 73% having episodic and 27% chronic cluster headache. For the primary endpoint, there was a treatment-by-cluster-headache-type interaction (p = 0.0453). Therefore, results are presented separately for chronic and episodic cluster headache. In patients with episodic cluster headache, the difference between zolmitriptan 10 mg and placebo at 30 minutes reached significance (47% versus 29%; p = 0.02). Mild or no pain at 30 minutes was reported by 60%, 57%, and 42% patients treated with zolmitriptan 10 mg, zolmitriptan 5 mg, and placebo (both p

Assuntos
Cefaleia Histamínica/tratamento farmacológico , Oxazóis/administração & dosagem , Oxazolidinonas , Agonistas do Receptor de Serotonina/administração & dosagem , Doença Aguda , Administração Oral , Adulto , Idoso , Estudos Cross-Over , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oxazóis/efeitos adversos , Medição da Dor , Agonistas do Receptor de Serotonina/efeitos adversos , Resultado do Tratamento , Triptaminas
13.
Cephalalgia ; 20 Suppl 2: 33-8, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-11206864

RESUMO

Patients present with specific problems against a background of their particular situation. The applicability of a treatment to a specific case may be difficult to assess in the light of the information available on that treatment. Evidence-based medicine is a discipline developed to achieve the best informed treatment decisions in clinical situations. In this paper, we illustrate a logical approach to reaching a decision regarding which of two migraine treatments should be used in a clearly defined patient. The information evaluated is a comparative trial between sumatriptan (100 mg), rizatriptan (5 and 10 mg) and placebo. The use of the analytical tools of evidence-based medicine is demonstrated in this exercise. The example was chosen because this is an area of great current interest in the field of neurology.


Assuntos
Ensaios Clínicos como Assunto , Medicina Baseada em Evidências , Transtornos de Enxaqueca/tratamento farmacológico , Adulto , Feminino , Humanos , Sumatriptana/administração & dosagem , Triazóis/administração & dosagem , Triptaminas
14.
J Neurol Sci ; 169(1-2): 43-8, 1999 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-10540006

RESUMO

Pathological laughing and crying (PLC) frequently occurs in amyotrophic lateral sclerosis (ALS). The etiology of the syndrome is unclear, but frontal-subcortical circuits are implicated, given their known association with mood and affect regulation. Ten ALS patients with PLC, eight patients without, and ten healthy controls were compared on a number of psychometric measures. Three indices of prefrontal cortical function were given: the Wisconsin Card Sort Test (WCST), the novel 'Gambling task' and a measure of olfactory discrimination. Global cognitive ability, psychiatric symptoms, and illness variables were also examined. No significant between-groups differences emerged with respect to global cognitive ability, mood, olfaction, and performance on the Gambling task. On the WCST, however, patients with PLC made significantly more total errors than the other two groups, and showed a strong trend in a similar direction for perseverative errors. A discriminant function analysis revealed that the WCST variable 'total errors' correctly predicted the presence or absence of pathological affect in 75% of cases. Thus, PLC appears to be associated with impairment in the functional integrity of the prefrontal cortex. Although this was not found for all prefrontal measures, further investigation of this area appears warranted.


Assuntos
Esclerose Lateral Amiotrófica , Choro/fisiologia , Riso/fisiologia , Córtex Pré-Frontal/fisiologia , Psicometria/estatística & dados numéricos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
15.
Can J Clin Pharmacol ; 6 Suppl A: 20A-4A, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10494008

RESUMO

In the past 10 years, new compounds have been developed for the acute treatment of migraine. Studies of a group of compounds called the triptans are summarized. The triptans are derived from the serotonin molecule and act on the 5-hydroxytryptamine 1B/1D receptors. The receptors are on the blood vessels, trigeminal neurons and trigeminal nucleus caudalis. Activation of these receptors causes constriction of extracerebral intracranial vessels, abolition of the dural extravasation and neurogenic inflammation, and inhibition of trigeminal neuronal discharge. The drugs are sumatriptan, zolmitriptan, naratriptan, rizatriptan and eletriptan. Their pharmacology and clinical properties are reviewed and compared.


Assuntos
Transtornos de Enxaqueca/tratamento farmacológico , Agonistas do Receptor de Serotonina/uso terapêutico , Humanos
16.
Med Care ; 37(1): 15-26, 1999 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10413388

RESUMO

OBJECTIVES: Recent trials of amyotrophic lateral sclerosis (ALS) therapies have included the Sickness Impact Profile (SIP) to evaluate health-related quality of life (HQL). The purpose of this study was to assess the feasibility, psychometric properties, and interpretation of the Sickness Impact Profile in this setting. METHODS: The Sickness Impact Profile was administered at baseline, 3, 6, and 9 months during a double-blind, placebo-controlled study of recombinant human insulin-like growth factor I. The frequency of missing Sickness Impact Profile data and administration time were recorded. Patients' scores on the Appel ALS (AALS) Rating Scale were used to identify a stable subgroup for reliability testing and clinically distinct groups for validity testing. Internal consistency reliability and reproducibility were evaluated using Cronbach's alpha and intraclass correlation coefficients, respectively. Analysis of variance (ANOVA) models and t tests were used to assess validity. Effect sizes and the responsiveness index were used to assess responsiveness. RESULTS: At baseline, 259 (97%) patients completed a 30-minute Sickness Impact Profile interview. At subsequent assessments, response rates ranged from 92% to 97% and mean administration times ranged from 25 to 27 minutes. The overall Sickness Impact Profile score demonstrated alpha reliability and 3-month stability coefficients of 0.94 and 0.80, respectively. Baseline overall Sickness Impact Profile scores discriminated between patients in the two AALS-defined groups with a mean of 13.0+/-7.8 and 24.0+/-11.7 in the better and worse AALS groups, respectively. Similarly, mean overall SIP change scores discriminated patients progressing at different rates (slow to moderate = 4.00+/-7.97; rapid = 10.74+/-8.76). With few exceptions, dimension and category scores met similar criteria. Responsiveness statistics for the physical and overall Sickness Impact Profile scores were lower at 3 months and higher at 6 and 9 months. CONCLUSIONS: The feasibility, psychometric, and interpretive findings support the validity of the Sickness Impact Profile for assessing outcomes of amyotrophic lateral sclerosis and its treatment. Based on these findings, we recommend including the Sickness Impact Profile in future amyotrophic lateral sclerosis clinical trials.


Assuntos
Esclerose Lateral Amiotrófica/psicologia , Ensaios Clínicos como Assunto/psicologia , Qualidade de Vida , Perfil de Impacto da Doença , Atividades Cotidianas , Esclerose Lateral Amiotrófica/fisiopatologia , Esclerose Lateral Amiotrófica/terapia , Análise de Variância , Efeitos Psicossociais da Doença , Análise Discriminante , Progressão da Doença , Estudos de Viabilidade , Feminino , Humanos , Fator de Crescimento Insulin-Like I/uso terapêutico , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes
19.
CMAJ ; 159(1): 47-54, 1998 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-9679487

RESUMO

OBJECTIVE: To provide physicians and allied health care professionals with guidelines for the nonpharmacologic management of migraine in clinical practice. OPTIONS: The full range and quality of nonpharmacologic therapies available for the management of migraine. OUTCOMES: Improvement in the nonpharmacologic management of migraine. EVIDENCE AND VALUES: The creation of the guidelines followed a needs assessment by members of the Canadian Headache Society and included a statement of objectives; development of guidelines by multidisciplinary working groups using information from literature reviews and other resources; comparison of alternative clinical pathways and description of how published data were analysed; definition of the level of evidence for data in each case; evaluation and revision of the guidelines at a consensus conference held in Ottawa on Oct. 27-29, 1995; redrafting and insertion of tables showing key variables and data from various studies and tables of data with recommendations; and reassessment by all conference participants. BENEFITS, HARMS AND COSTS: Augmentation of the use of nonpharmacologic therapies for the acute and prophylactic management of migraine is likely to lead to substantial benefits in both human and economic terms. RECOMMENDATIONS: Both the avoidance of migraine trigger factors and the use of nonpharmacologic therapies have a part to play in overall migraine management. VALIDATION: The guidelines are based on consensus of Canadian experts in neurology, emergency medicine, psychiatry, psychology and family medicine, and consumers. Previous guidelines did not exist. Field testing of the guidelines is in progress.


Assuntos
Transtornos de Enxaqueca/terapia , Psicoterapia , Terapia por Acupuntura , Medicina Clínica , Humanos , Transtornos de Enxaqueca/etiologia , Estimulação Elétrica Nervosa Transcutânea
20.
Headache ; 38(7): 516-22, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-15613167

RESUMO

Butorphanol tartrate is a synthetic mixed agonist-antagonist opioid analgesic. Its transnasal dosage form, which may be self-administered when the use of an opioid analgesic is appropriate, was previously shown to provide rapid relief of migraine pain. In this double-blind, parallel-group, outpatient study, we compared butorphanol nasal spray 1 mg followed in 1 hour by an optional second 1-mg dose with the orally administered analgesic, Fiorinal with Codeine (one capsule containing butalbital 50 mg, caffeine 40 mg, aspirin 325 mg, and codeine phosphate 30 mg). Patients (N=321) were assigned by randomization to one of two treatment groups (butorphanol or Fiorinal with Codeine) and instructed to self-administer medication when migraine pain reached an intensity of moderate or severe and to record study-related events in a diary for 24 hours posttreatment. Efficacy analyses were performed on data from 275 patients who took study medication and returned a patient diary; 136 in the butorphanol group and 139 in the Fiorinal with Codeine group. During the first 2 hours after treatment, butorphanol was more effective than Fiorinal with Codeine in treating migraine pain as measured by pain intensity difference scores, percentage of responders (pain decreased to mild or none), percentage of pain-free patients, and degree of pain relief, with a more rapid time to onset of 15 minutes. A similar percentage of patients in the two groups used rescue medication during the first 4 hours, after which more butorphanol-treated than Fiorinal with Codeine-treated patients used rescue medication. Butorphanol patients had more side effects, less improvement in digestive symptoms, and less improvement in functional ability than Fiorinal with Codeine patients.


Assuntos
Analgésicos Opioides/administração & dosagem , Aspirina/uso terapêutico , Barbitúricos/uso terapêutico , Butorfanol/administração & dosagem , Cafeína/uso terapêutico , Codeína/administração & dosagem , Transtornos de Enxaqueca/tratamento farmacológico , Administração Intranasal , Adolescente , Adulto , Aerossóis , Idoso , Método Duplo-Cego , Combinação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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