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1.
Neotrop Entomol ; 2020 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-32712943

RESUMO

Studies of insect feeding behavior are useful in different areas of entomology such as plant resistance, biology, and insecticide efficacy. For chewing insects, this kind of technique is well established, but for sap-sucking insects, especially tiny ones such as whiteflies, aphids, and psyllids, these tests can be laborious. Manipulation is difficult and can damage the plant, affecting the results. We describe here three types of cages for tests with small insects, one for seedlings in pots, a second for larger plants or plants in the field, and a third for caging insects on part of a leaf. These cages have been useful for different types of studies in addition to feeding behavior and can facilitate research with small phytophagous sucking insects.

2.
Insect Sci ; 2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32426905

RESUMO

Three behaviors of epidemiological importance, namely feeding latency, feeding duration and defecation latency, for six populations of Meccus phyllosomus longipennis (Usinger) from areas of central, western and north-central Mexico with high (HP) and low (LP) prevalence of Trypanosoma cruzi (Chagas) human infection were evaluated in this study. The median feeding latency (the time taken to begin feeding) was highly variable between instars. Within-instar comparisons showed that at least 65% of the LP populations (N3 to adult) started to feed significantly (P < 0.05) later than the HP population, with N1 showing no difference, and N2 from LP populations feeding sooner than those from HP populations. The six populations had similar median feeding durations within instars. A higher (P < 0.05) percentage of the instars from HP populations defecated faster than the respective instars from the three LP populations. Approximately 25% of the young nymphs (N1 to N3) and females in the HP populations defecated < 2 min postfeeding, compared with 4%-6% of the young nymphs and 1.3%-3% of females in the LP populations. Moreover, 17.7%-38.8% of the older nymphs (N4 to N5) in the HP populations and 6.8%-13.4% in the LP populations defecated during or immediately after feeding. Our results indicate that the HP populations have a greater potential than the LP populations to transmit T. cruzi infections, which may underlie the differences in the prevalence of T. cruzi infection in some areas where M. p. longipennis is currently distributed.

3.
J Med Entomol ; 57(5): 1390-1398, 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32307539

RESUMO

Chagas disease is one of the most important vector-borne diseases in Latin America, including Mexico. Recently, autochthonous cases have also been detected in the United States of America. It is suspected that two subspecies of Triatoma rubida (Uhler), T. r. sonoriana (Usinger) and T. r. uhleri (Usinger), considered efficient vectors of Trypanosoma cruzi Chagas in Mexico, could interbreed and potentially generate offspring with superior biological characteristics. In this study, the biological parameters of T. r. sonoriana, T. r. uhleri and their laboratory hybrids were evaluated. Hybrids of the two subspecies surpassed both parental subspecies, T. r. sonoriana and T. r. uhleri, in three (numbers of required blood meals to molt [16-20], feeding [10.5-17 min] and defecation times [˂1 min post-feeding]) of nine studied biological parameters. Moreover, the hybrids surpassed T. r. uhleri in two additional parameters, development time (298 d) and mortality (39-42%). Both the hybrid and the two parental cohorts had comparable results in the remaining four (onset of feeding, number of obtained females, number of eggs laid, and eclosion rate) of nine studied parameters. Thus, we conclude that hybrid vigor could result in an increased risk of T. cruzi transmission to humans and animals.

4.
Nature ; 577(7789): 190-194, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31907402

RESUMO

Fast radio bursts (FRBs) are brief, bright, extragalactic radio flashes1,2. Their physical origin remains unknown, but dozens of possible models have been postulated3. Some FRB sources exhibit repeat bursts4-7. Although over a hundred FRB sources have been discovered8, only four have been localized and associated with a host galaxy9-12, and just one of these four is known to emit repeating FRBs9. The properties of the host galaxies, and the local environments of FRBs, could provide important clues about their physical origins. The first known repeating FRB, however, was localized to a low-metallicity, irregular dwarf galaxy, and the apparently non-repeating sources were localized to higher-metallicity, massive elliptical or star-forming galaxies, suggesting that perhaps the repeating and apparently non-repeating sources could have distinct physical origins. Here we report the precise localization of a second repeating FRB source6, FRB 180916.J0158+65, to a star-forming region in a nearby (redshift 0.0337 ± 0.0002) massive spiral galaxy, whose properties and proximity distinguish it from all known hosts. The lack of both a comparably luminous persistent radio counterpart and a high Faraday rotation measure6 further distinguish the local environment of FRB 180916.J0158+65 from that of the single previously localized repeating FRB source, FRB 121102. This suggests that repeating FRBs may have a wide range of luminosities, and originate from diverse host galaxies and local environments.

5.
Neotrop Entomol ; 49(2): 250-257, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31797306

RESUMO

Huanglongbing (HLB), the most destructive citrus disease worldwide, was first recorded in Brazil in 2004, and since then, more than 50 million trees identified with this disease have been eliminated. The disease is managed mainly by controlling the psyllid vector Diaphorina citri Kuwayama, 1908 (Hemiptera: Liviidae). Although the presence of the insect in commercial citrus groves is low, HLB infection rates increase in areas bordering the groves. The disease is transmitted by psyllids from host citrus plants in areas outside the managed groves, such as abandoned or organic groves and residential trees, and from orange jasmine plants in urban settings. In order to provide information to support HLB control, this study evaluated the biotic and abiotic variables that affect the dynamics of D. citri populations after releases of the parasitoid wasp Tamarixia radiata (Waterston, 1922) (Hymenoptera: Eulophidae) in external sources of HLB inocula. The study was divided into two parts. After releasing the parasitoids in non-commercial areas, we determined the following: (a) the variables that significantly affected the number of nymphs collected on shoots in the same non-commercial area; (b) the variables that significantly affected the number of adult psyllids collected in a neighboring commercial citrus area. Our results indicated that the number of nymphs in external areas was affected only by the host plant and rainfall. However, periodic parasitoid releases significantly reduced the number of adult psyllids collected in the commercial area. The results indicate that the release of parasitoids in external sources of inocula has the potential to maximize actions for D. citri control, contributing to the reduction of psyllid populations in commercial areas. Consequently, this strategy may help to manage the disease infection without an increase in insecticide use.

6.
Eur Arch Paediatr Dent ; 21(1): 129-136, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31214964

RESUMO

AIM: To evaluate changes in the oral health status of children under the age of 14 years with acute lymphoblastic leukaemia (ALL) attending a cancer centre before and after chemotherapy treatment. MATERIALS AND METHODS: A total of 32 children with ALL without distinction of gender were selected for study. The oral cavity of the patients was evaluated before the induction stage and 17 days later. Clinical evaluation of the submandibular, submental, and cervical lymph nodes was performed. Saliva samples were collected during the early morning hours. Bacterial plaque was assessed by using the Silness and Löe plaque index (SLPI) and gingiva status was evaluated with the gingival Löe and Silness index (GLSI). The WHO toxicity oral scale was used to record the degree of oral mucositis. The resulting data were analysed with McNemar's test, t test (for related samples), and Wilcoxon test. RESULTS: There were statistically significant differences for palpable lymph nodes, paleness of oral mucosa, and ecchymoseis, respectively, P ≤ 0.000, P = 0.03, and P = 0.01, with these manifestations decreasing significantly after treatment. Incipient gingivitis had frequencies of 71.9% and 75% before and after treatment, respectively. The mean SLPI score declined significantly from 1.16 ± 0.52 (before treatment) to 0.56 ± 0.36 (after treatment) (P < 0.000); salivary flow increased significantly from 0.54 ± 0.34 to 1.22 ± 1.07 after chemotherapy treatment (P < 0.00). Oral mucositis was present in 24 children (75%) with a 1-2 severity level. CONCLUSIONS: After chemotherapy treatment, there were changes in the oral conditions of children with ALL. Some manifestations decreased after treatment, whereas in others increased.


Assuntos
Gengivite , Leucemia-Linfoma Linfoblástico de Células Precursoras , Criança , Índice de Placa Dentária , Humanos , Saúde Bucal , Índice Periodontal
7.
Diabet Med ; 37(1): 71-74, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31314907

RESUMO

AIM: To compare the effect of targeted interventions to reduce high diabetes distress among adults with Type 1 diabetes with a comparison sample of similar but untreated individuals, and to document the stability of untreated diabetes distress over time. METHODS: A total of 51 adults with Type 1 diabetes with elevated baseline diabetes distress (distress score ≥ 2.0) and HbA1c levels (≥ 58 mmol/mol) were identified from a longitudinal, non-intervention study, and compared with a similar sample of 51 participants in an intervention study. Both groups completed the T1-DDS diabetes distress questionnaire at baseline and 9 months. RESULTS: Large and significant reductions in diabetes distress scores were recorded in the intervention group (mean ± sd change = -0.6 ± 0.6), while minimal change was found in the non-intervention group (-0.2 ± 0.6, group effect P = 0.002; effect size d = 0.67). Additional analyses using the established minimal clinically important difference for the T1-DDS showed that diabetes distress increased significantly (minimal clinically important difference ≥ 1) or persisted at high levels for 51% of participants in the non-intervention group, compared with 23.5% in the intervention group. CONCLUSION: Our results showed that targeted interventions led to dramatic reductions in diabetes distress compared with a lack of treatment. We also conclude that elevated diabetes distress, when left unaddressed, does not resolve over time and often remains chronic. (Clinical Trials Registry no.: NCT02175732).

10.
Neotrop Entomol ; 48(6): 966-973, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31721083

RESUMO

Helicoverpa armigera (Hübner) has attacked several economically important crops since it was first reported in Brazil in 2013. Because insecticides have been used intensively to control H. armigera, resistant populations have been detected more frequently. One alternative to insecticides is the use of biological control with egg parasitoids from the family Trichogrammatidae (Hymenoptera). The present study evaluated the use of different species and strains of these parasitoids to control H. armigera in soybean. Five strains of Trichogramma pretiosum (Riley): RV (Rio Verde, Goiás, Brazil), SO (Sorriso, Mato Grosso, Brazil), 47A (Irvine, CA, USA), PR (Colombo, Paraná, Brazil), and AN (Anhumas, São Paulo, Brazil), and Trichogrammatoidea annulata (De Santis) denominated TR, from Anhumas, were used. The following parasitoid biological parameters were evaluated: parasitism rates (%), offspring viability (%) number of parasitoids emerged per egg, egg-adult duration (days), female longevity, and offspring sex ratio. Strain RV of T. pretiosum from central Brazil performed best.


Assuntos
Agentes de Controle Biológico , Mariposas/parasitologia , Vespas/classificação , Vespas/fisiologia , Animais , Brasil , Feminino , Longevidade , Controle Biológico de Vetores , Razão de Masculinidade , Soja
11.
Neotrop Entomol ; 48(4): 660-667, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30840190

RESUMO

We evaluated the potential of two parasitoids as biocontrol agents of Liriomyza sativae Blanchard in northeastern Brazil. The two species were the koinobiont larval-pupal endoparasitoid Phaedrotoma scabriventris Nixon (Braconidae) and the idiobiont larval endoparasitoid Chrysocharis vonones (Walker) (Eulophidae). The biological parameters evaluated were survivorship, parasitism, and host-feeding, at 25 and 30°C. Differences between the species were observed at 25°C, but not at 30°C. At 25°C, the total parasitism for P. scabriventris (196.1 ± 17.7) and C. vonones (176.6 ± 7.24) was similar and with higher values compared to 30°C, 102.5 ± 8.81 and 89.1 ± 5 66 parasitized larvae, respectively. However, C. vonones showed a 3.97 lower survivorship as well as higher daily parasitism (1.4-fold) and host-feeding means (1.9-fold) than the braconid at 25°C. The results indicate a potential for both natural enemies to be used as biocontrol agents of L. sativae. The differences between species detected at 25°C suggest the best conditions for the application of each parasitoid.


Assuntos
Agentes de Controle Biológico/classificação , Dípteros/parasitologia , Controle Biológico de Vetores , Vespas/fisiologia , Animais , Brasil , Feminino , Herbivoria , Larva/parasitologia , Masculino , Pupa/parasitologia , Vespas/classificação
12.
Neotrop Entomol ; 48(1): 71-77, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30051261

RESUMO

Temperature is an important climate factor that has a direct influence on insect biology and consequently a crucial role in forecasting and integrated pest management. The mealybug Dysmicoccus brevipes (Cockerell) (Hemiptera: Pseudococcidae) is one of the most common species in Brazilian vineyards. Here, development and survival of D. brevipes on leaves of table grapes (Vitis vinifera cv. Itália) were studied at five constant temperatures (15, 20, 25, 28, and 30 ± 1°C) under laboratory conditions. We investigated the developmental time and nymphal survival, temperature thresholds, and the degree-day requirements for each life stage of D. brevipes. The developmental time for the nymphal stage ranged from 32 to 130 days with decreasing the temperature, with the temperatures of 28 and 30°C providing the shorter developmental time. Survival of the entire nymphal stage was affected by the temperature, ranging from 81% at 20°C to 1% at 15°C. The predicted upper lethal temperature was 34.5°C, while the optimal temperature was 28.6°C. The minimum threshold for total development of D. brevipes occurred at 8.2°C. Dysmicoccus brevipes required 678.4 degree-days to complete development from first-instar nymph to adult. The temperature of 30°C was the most suitable for the development of D. brevipes. The thermal thresholds estimated for D. brevipes life cycle suggest that this species can develop in different table grape-producing regions of Brazil, in a temperature range between 8 and 35°C.


Assuntos
Hemípteros/crescimento & desenvolvimento , Estágios do Ciclo de Vida , Temperatura , Vitis , Animais , Brasil , Feminino , Frutas , Controle de Pragas
13.
Neotrop Entomol ; 48(1): 162-170, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30168012

RESUMO

The lethal and sublethal effects of 11 insecticides on the predator Ceraeochrysa cubana (Hagen) were assessed under laboratory conditions. First-instar larvae and adults ≤ 48 h old were sprayed with the highest insecticides doses allowed to control Diaphorina citri Kuwayama in the citrus crop. The survival and duration rates of the different development stages, sex ratio, pre-oviposition period, fecundity, and fertility of the insects were evaluated. In the larval bioassay, chlorpyrifos and malathion had lethal effect which none larvae survived. Azadirachtin, lambda-cyhalothrin + chlorantraniliprole, lambda-cyhalothrin + thiamethoxam, and thiamethoxam had lethal and sublethal effects that did not allow to estimate the life table parameters because the low number of couples formed. Esfenvalerate, imidacloprid WG and SC, phosmet, and pyriproxyfen had sublethal effects which were reflected in the net reproductive rate and in the intrinsic rate of natural increase. In bioassay using adults, none of the individuals survived in the chlorpyrifos, lambda-cyhalothrin + chlorantraniliprole, lambda-cyhalothrin + thiamethoxam, malathion, or thiamethoxam treatments, and the azadirachtin, esfenvalerate, imidacloprid WG and SC, phosmet, and pyriproxyfen treatments were significantly lower compared to the control. None of the insecticides was harmless to first-instar larvae and adults of C. cubana under laboratory conditions showing their potential to reduce the efficiency of this predator.


Assuntos
Hemípteros/efeitos dos fármacos , Inseticidas/toxicidade , Animais , Clorpirifos/toxicidade , Larva/efeitos dos fármacos , Limoninas/toxicidade , Malation/toxicidade , Neonicotinoides/toxicidade , Nitrilos/toxicidade , Nitrocompostos/toxicidade , Piretrinas/toxicidade , Piridinas/toxicidade , Distribuição Aleatória , Tiametoxam/toxicidade , Testes de Toxicidade
14.
Facts Views Vis Obgyn ; 10(1): 29-36, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30510665

RESUMO

Objective: The purpose of this study was to compare the efficacy of prophylactic and rescue cervical cerclages for pregnant patients with an incompetent cervix, and to assess the neonatal outcomes of both clinical conditions. Methods: This was a retrospective observational study of all women who had an elective or rescue cerclage between January 2008 and December 2016 in our institution. Prophylactic cerclage was defined as a cerclage before 16 weeks of gestation, while rescue cerclages were performed between 16 and 23 weeks of gestation. Results: In total, we analyzed the outcomes of 212 cervical interventions; 71% of the recruited patients experienced prophylactic cerclage, while 29% underwent rescue cerclage. Most of the patients delivered vaginally (70%) and were able to leave the hospital with a healthy newborn (78%). The mean pregnancy prolongation time after cerclage in the prophylactic and rescue groups were 21 weeks and 10 weeks, respectively. Conclusion: Prophylactic cerclage interventions are most likely to be associated with a reduction of fetal demise because of the correlation between fetal prognosis and the gestational age at which cerclage is performed. Once the diagnosis of cervical insufficiency is confirmed, cerclage should be recommended as this will help to prolong the pregnancy.

15.
Neurología (Barc., Ed. impr.) ; 33(5): 290-300, jun. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-175907

RESUMO

INTRODUCCIÓN: El objetivo del proyecto EPICON es desarrollar una serie de recomendaciones sobre la forma adecuada de realizar el cambio de carbamazepina (CBZ) y oxcarbazepina (OXC) a acetato de eslicarbazepina (ESL) en determinados pacientes con epilepsia. MÉTODOS: Un comité coordinador preparó un cuestionario con 56 preguntas en relación con el cambio de CBZ u OXC a ESL en la práctica clínica (metodología y situaciones del cambio). Posteriormente, se consultó a 54 expertos en epilepsia con el empleo de metodología Delphi (2 rondas de consulta). Se definió un consenso en acuerdo o desacuerdo si las respuestas para el ítem estudiado alcanzaban una mediana ≥ 7 o ≤ 3, respectivamente, y un rango intercuartílico relativo ≤ 0,40. Se analizaron los resultados y se formularon las conclusiones. RESULTADOS: Las recomendaciones fundamentales fueron: el cambio de CBZ a ESL debe ser realizado en 1-3 semanas, con una equivalencia de dosis CBZ:ESL de 1:1.3, siendo recomendado en pacientes con olvidos de medicación, trabajos por turnos, polimedicados, problemas cognitivos, osteoporosis-osteopenia severa, dislipidemia o enfermedad hepática (ausencia de fallo hepático grave), así como en varones con disfunción eréctil causada por CBZ. El cambio de OXC a ESL puede realizarse de un día para otro con una equivalencia de dosis 1:1 y es recomendado en pacientes con olvidos de medicación, trabajos por turnos, polimedicados o problemas cognitivos. Se desaconsejó el cambio en caso de rash con CBZ u OXC. CONCLUSIÓN: El proyecto EPICON proporciona algunas recomendaciones sobre el manejo clínico del cambio de CBZ u OXC a ESL, mediante el empleo de la metodología Delphi


INTRODUCTION: The objective of the EPICON Project is to develop a set of recommendations on how to adequately switch from carbamazepine (CBZ) and oxcarbazepine (OXC) to eslicarbazepine acetate (ESL) in some patients with epilepsy. METHODS: A steering committee drafted a questionnaire of 56 questions regarding the transition from CBZ or OXC to ESL in clinical practice (methodology and change situation). The questionnaire was then distributed to 54 epilepsy experts in 2 rounds using the Delphi method. An agreement/disagreement consensus was defined when a median ≥ 7 points or ≤ 3 was achieved, respectively, and a relative interquartile range ≤ 0.40. We analysed the results obtained to reach our conclusions. RESULTS: Our main recommendations were the following: switching from CBZ to ESL must be carried out over a period of 1 to 3 weeks with a CBZ:ESL dose ratio of 1:1.3 and is recommended for patients who frequently forget to take their medication, those who work rotating shifts, polymedicated patients, subjects with cognitive problems, severe osteoporosis-osteopaenia, dyslipidaemia, or liver disease other than acute liver failure, as well as for men with erectile dysfunction caused by CBZ. The transition from OXC to ESL can take place overnight with an OXC:ESL dose ratio of 1:1 and it is recommended for patients who frequently forget to take their medication, those who work rotating shifts, polymedicated patients, or those with cognitive problems. The transition was not recommended for patients with prior rash due to CBZ or OXC use. CONCLUSION: The EPICON Project offers a set of recommendations about the clinical management of switching from CBZ or OXC to ESL, using the Delphi method


Assuntos
Humanos , Consenso , Dibenzazepinas/uso terapêutico , Substituição de Medicamentos/métodos , Epilepsia/tratamento farmacológico , Guias como Assunto , Canais de Sódio Disparados por Voltagem/uso terapêutico , Anticonvulsivantes/uso terapêutico , Carbamazepina/análogos & derivados , Carbamazepina/uso terapêutico , Técnica Delfos , Neurologistas , Inquéritos e Questionários
16.
Behav Neurol ; 2018: 9684129, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29808100

RESUMO

Frontotemporal dementia (FTD) affects behavior, language, and personality. This study aims to explore functional connectivity changes in three FTD variants: behavioral (bvFTD), semantic (svPPA), and nonfluent variant (nfvPPA). Seventy-six patients diagnosed with FTD by international criteria and thirty-two controls were investigated. Functional connectivity from resting functional magnetic resonance imaging (fMRI) was estimated for the whole brain. Two types of analysis were done: network basic statistic and topological measures by graph theory. Several hubs in the limbic system and basal ganglia were compromised in the behavioral variant apart from frontal networks. Nonfluent variants showed a major disconnection with respect to the behavioral variant in operculum and parietal inferior. The global efficiency had lower coefficients in nonfluent variants than behavioral variants and controls. Our results support an extensive disconnection among frontal, limbic, basal ganglia, and parietal hubs.


Assuntos
Afasia Primária Progressiva/fisiopatologia , Conectoma/métodos , Demência Frontotemporal/fisiopatologia , Rede Nervosa/fisiopatologia , Idoso , Afasia Primária Progressiva/diagnóstico por imagem , Feminino , Demência Frontotemporal/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Rede Nervosa/diagnóstico por imagem , Afasia Primária Progressiva não Fluente/diagnóstico por imagem , Afasia Primária Progressiva não Fluente/fisiopatologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-29396242

RESUMO

BACKGROUND: Despite the improvement in the prognosis of lupus nephritis (LN), the cardiovascular morbimortality remains high. The early recognition and remission of flares, while trying to avoid the metabolic adverse effects of medication, must be mandatory. AIM: The aim of our study was to assess the cardiovascular (CV) risk profile in a cohort of lupus patients with preserved kidney function after a nephritis episode, compared to patients without a nephritis flare. METHODS: 130 patients diagnosed of SLE (32 with previous nephritis flare and 98 without) were studied in order to evaluate the CV risk profile, despite the preserved kidney function. RESULTS: The most prevalent risk factors were sedentary lifestyle (57.6%), overweight/obesity (38.3%) and dyslipidemia (36%), followed by smoking (32%) and hypertension (16%). Though more than a half (53.1%) was taking CV medication, a high percentage did not reach a therapeutic target value, especially regarding obesity (11.5%) and cholesterol levels (LDL-C of 16%). The prevalence of dyslipidemia (53.1% vs 30.6%), smoking (46.6% vs 27.5%), left ventricular hypertrophy (LVH) (21.4% vs 6.4%) and lower HDL-C (48.6mg/dL vs 55.4mg/dL) were significantly different in the group with previous nephritis flare. Moreover, young patients with lupus nephritis, received more pulses of corticosteroids and cyclophosphamide, had higher prevalence of hypertension, LVH, higher proteinuria, hospital admissions and waist circumference, constituting the subgroup of patients with greater aggregation of CV risk factors. CONCLUSIONS: Patients with previous nephritis flare showed a poor control of CV risk factors despite the preserved renal function, these patients would require a closer therapeutic management.

19.
Neurologia ; 2018 Jan 12.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29338936

RESUMO

OBJECTIVES: To compare the characteristics of patients undergoing treatment with continuous intestinal infusion of levodopa-carbidopa (CIILC) for advanced Parkinson's disease and the data on the effectiveness and safety of CIILC in the different autonomous communities (AC) of Spain. METHODS: A retrospective, longitudinal, observational study was carried out into 177 patients from 11 CAs who underwent CIILC between January 2006 and December 2011. We analysed data on patients' clinical and demographic characteristics, variables related to effectiveness (changes in off time/on time with or without disabling dyskinesia; changes in Hoehn and Yahr scale and Unified Parkinson's Disease Rating Scale scores; non-motor symptoms; and Clinical Global Impression scale scores) and safety (adverse events), and the rate of CIILC discontinuation. RESULTS: Significant differences were observed between CAs for several baseline variables: duration of disease progression prior to CIILC onset, off time (34.9-59.7%) and on time (2.6-48.0%; with or without disabling dyskinesia), Hoehn and Yahr score during on time, Unified Parkinson's Disease Rating Scale-III score during both on and off time, presence of≥ 4 motor symptoms, and CIILC dose. Significant differences were observed during follow-up (> 24 months in 9 of the 11 CAs studied) for the percentage of off time and on time without disabling dyskinesia, adverse events frequency, and Clinical Global Impression scores. The rate of CIILC discontinuation was between 20-40% in 9 CAs (78 and 80% in remaining 2 CAs). CONCLUSIONS: This study reveals a marked variability between CAs in terms of patient selection and CIILC safety and effectiveness. These results may have been influenced by patients' baseline characteristics, the availability of multidisciplinary teams, and clinical experience.

20.
Neurologia ; 33(5): 290-300, 2018 Jun.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27349151

RESUMO

INTRODUCTION: The objective of the EPICON Project is to develop a set of recommendations on how to adequately switch from carbamazepine (CBZ) and oxcarbazepine (OXC) to eslicarbazepine acetate (ESL) in some patients with epilepsy. METHODS: A steering committee drafted a questionnaire of 56 questions regarding the transition from CBZ or OXC to ESL in clinical practice (methodology and change situation). The questionnaire was then distributed to 54 epilepsy experts in 2 rounds using the Delphi method. An agreement/disagreement consensus was defined when a median ≥ 7 points or ≤ 3 was achieved, respectively, and a relative interquartile range ≤ 0.40. We analysed the results obtained to reach our conclusions. RESULTS: Our main recommendations were the following: switching from CBZ to ESL must be carried out over a period of 1 to 3 weeks with a CBZ:ESL dose ratio of 1:1.3 and is recommended for patients who frequently forget to take their medication, those who work rotating shifts, polymedicated patients, subjects with cognitive problems, severe osteoporosis-osteopaenia, dyslipidaemia, or liver disease other than acute liver failure, as well as for men with erectile dysfunction caused by CBZ. The transition from OXC to ESL can take place overnight with an OXC:ESL dose ratio of 1:1 and it is recommended for patients who frequently forget to take their medication, those who work rotating shifts, polymedicated patients, or those with cognitive problems. The transition was not recommended for patients with prior rash due to CBZ or OXC use. CONCLUSION: The EPICON Project offers a set of recommendations about the clinical management of switching from CBZ or OXC to ESL, using the Delphi method.


Assuntos
Consenso , Dibenzazepinas/uso terapêutico , Substituição de Medicamentos/métodos , Epilepsia/tratamento farmacológico , Guias como Assunto , Bloqueadores do Canal de Sódio Disparado por Voltagem/uso terapêutico , Anticonvulsivantes/uso terapêutico , Carbamazepina/análogos & derivados , Carbamazepina/uso terapêutico , Técnica Delfos , Humanos , Neurologistas , Oxcarbazepina , Inquéritos e Questionários
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