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1.
Pain Manag Nurs ; 2020 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-32253093

RESUMO

AIM: Develop and evaluate the implementation of a protocol for comprehensive management of pain in advanced dementia. METHOD: Quasi-experimental study carried out between September 2015 and May 2016 in an acute geriatric unit. Following development of the protocol and nurse training, 22 participants were recruited through consecutive sampling to form the intervention group (IG). Pain assessment was performed using the Pain Assessment in Advanced Dementia Spanish version (PAINAD-Sp) instrument and by nurse report-rating using the Numeric Rating Scale (NRS) and control group, with pain assessment through nurse-report using an NRS. Interventions carried out following perception of pain were done according to the actions algorithm created for this purpose. Follow-up was carried out daily during the hospital stay. RESULTS: Some 98% of the actions were performed correctly following the protocol. All (100%) of patients had a scheduled prescription for analgesics. Significant differences between mean pain scores at admission and discharge were found through PAINAD-Sp using a Wilcoxon sign test of -2.9543 (p = .004). Analysis of pain perception scores revealed a statistically significant positive correlation between the number of nonpharmacological actions performed and the pain score values obtained in the IG (rho Spearman: 0.617, p < .001) and the control group (rho Spearman: 0.922, p < .001). A high correlation was also observed in the IG between assessments conducted using PAINAD-Sp and NRS (intraclass correlation coefficient: 0.921). CONCLUSIONS: The implementation of an agreed-upon, standardized protocol for comprehensive pain management in advanced dementia, including nurse training, leads to systematic application of all the protocol stages, and therefore better pain management.

3.
J Adv Nurs ; 76(3): 787-802, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31808211

RESUMO

AIM: To assess the effectiveness of psychoeducational interventions with respect to burden, anxiety and depression in family caregivers of People With Dementia living at home. BACKGROUND: In dementia, the family assumes the role of main caregiver, maintaining the patient in a good state of health. Nevertheless, burden, anxiety and depression may have negative repercussions in caregivers. Therefore, professional supports through psychoeducational programmes are recommended as interventions for improving caregivers' health. DESIGN: A quantitative systematic review. DATA SOURCES: Electronic searches were performed in CINAHL/AMED/CENTRAL/Web of Science/LILACS/PUBMED from January 2005-August 2018. REVIEW METHODS: The review was conducted using the JADAD scale to assess bias risk and the quality of the randomized controlled trials (RCTs) and the CONSORT instrument to assess study quality report. The extracted data were reviewed by independent reviewer pairs. The review was reported using PRISMA. RESULTS: A total of 18 RCTs met inclusion criteria. Seven were classified as Technology-based Interventions and 11 as Group-based Interventions. CONCLUSION: Psychoeducational interventions for caregivers allow them to increase their knowledge of the illness, develop problem-solving skills and facilitate social support. Technology-based Interventions significantly affect burden while Group-based Interventions affect anxiety, depression, insomnia and burden and quality of life and self-efficacy. IMPACT: Research findings can be used to classify caregivers in future interventions according to illness stage to obtain more precise results.

5.
Nutrients ; 11(8)2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31370154

RESUMO

Abscisic acid (ABA) can improve glucose homeostasis and reduce inflammation in mammals by activating lanthionine synthetase C-like 2 (LANCL2). This study examined the effects of two fig fruit extracts (FFEs), each administered at two different ABA doses, on glycemic index (GI) and insulinemic index (II) to a standard glucose drink. In a randomized, double-blind crossover study, 10 healthy adults consumed 4 test beverages containing FFE with postprandial glucose and insulin assessed at regular intervals over 2 h to determine GI and II responses. Test beverages containing 200 mg FFE-50× and 1200 mg FFE-10× significantly reduced GI values by -25% (P = 0.001) and -24% (P = 0.002), respectively. Two lower doses of FFE also reduced GI values compared with the reference drink (by approximately -14%), but the differences did not reach statistical significance. Addition of FFE to the glucose solution significantly reduced II values at all dosages and displayed a clear dose-response reduction: FFE-50× at 100 mg and 200 mg (-14% (P < 0.05) and -24% (P = 0.01), respectively) and FFE-10× at 600 mg and 1200 mg (-16% (P < 0.05) and -24% (P = 0.01), respectively). FFE supplementation is a promising nutritional intervention for the management of acute postprandial glucose and insulin homeostasis, and it is a possible adjunctive treatment for glycemic management of chronic metabolic disorders such as prediabetes and type 2 diabetes mellitus.


Assuntos
Ácido Abscísico/farmacologia , Glicemia/efeitos dos fármacos , Ficus/química , Insulina/sangue , Extratos Vegetais/farmacologia , Período Pós-Prandial , Ácido Abscísico/química , Adulto , Estudos Cross-Over , Método Duplo-Cego , Feminino , Frutas/química , Humanos , Masculino , Extratos Vegetais/química , Adulto Jovem
6.
J Occup Environ Med ; 60(5): 449-456, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29135840

RESUMO

AIMS: We analyzed indirect costs related to loss of labor productivity (LLP) in informal caregivers (ICs) of people with dementia (PwD) and the associated caregiver burden and patients' clinical variables. METHODS: Multicenter cohort study of PwD and their ICs (n = 287) focused on two groups: (1) home care and (2) institutional long-term care. The costs of LLP were assessed using the Resource Utilization Dementia instrument and a human capital approach. RESULTS: The cost for LLP was 378&OV0556;/month or 4.536&OV0556;/year. Greater disease severity increased the likelihood of reducing working hours and missing a working day. There was a significant association between partial absenteeism and burden in employed informal caregiver in both the home and institutional setting. CONCLUSION: Cognitive impairment contributes to the cost of LLP in IC especially in home-care. LLP has a negative impact on IC burden.


Assuntos
Cuidadores/psicologia , Efeitos Psicossociais da Doença , Demência , Agências de Assistência Domiciliar , Casas de Saúde , Desempenho Profissional , Absenteísmo , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Humanos , Pessoa de Meia-Idade , Espanha , Inquéritos e Questionários
7.
Gac. sanit. (Barc., Ed. impr.) ; 31(6): 518-523, nov.-dic. 2017. tab
Artigo em Espanhol | IBECS | ID: ibc-168543

RESUMO

Objetivo: Describir la aplicación del modelo Balance of Care en la toma de decisiones acerca del mejor cuidado para las personas con demencia en el contexto español. Métodos: Se utilizó el modelo Balance of Care, que consistió en 1) la descripción del perfil de los casos más habituales de personas con demencia y sus cuidadores, 2) la identificación del emplazamiento más adecuado (domiciliario o centro sociosanitario) para cada caso, 3) el diseño de planes de cuidados específicos para cada caso, y 4) la evaluación del coste de los planes de cuidados. Resultados: En el diseño de los casos participaron 1641 personas con demencia y sus cuidadores de ocho países europeos. La evaluación de los casos la realizaron 20 profesionales expertos en demencia de distintos ámbitos asistenciales. En España, los resultados indican que inicialmente el lugar más idóneo para cuidar de las personas con demencia es el domicilio, pero en los casos con mayor dependencia para las actividades de la vida diaria el centro sociosanitario era el emplazamiento con mejor prestación de cuidados. Los recursos escogidos en el plan de cuidados fueron ayuda profesional para realizar las actividades de la vida diaria e instrumentales, centro de día, equipo de atención domiciliaria, apoyo económico, enfermera de enlace y trabajador/a social. Discusión: El modelo Balance of Care permite evaluar de manera sistemática, objetiva y mediante un equipo multidisciplinario el emplazamiento más adecuado para las personas con demencia. Se deberían incluir otras intervenciones coste-eficientes para mejorar la situación domiciliaria de estas personas (AU)


Objective: To describe the implementation of the Balance of Care model in decision-making regarding the best care for patients with dementia in Spain. Methods: The Balance of Care model was used, which consists of (1) describing the profile of the typical cases of people with dementia and their caregivers, (2) identifying the most suitable care setting for each of the cases (home-care or long-term care institution), (3) designing specific care plans for each case, and (4) evaluating the cost of the proposed care plans. Results: A total of 1,641 people with dementia and their caregivers from eight European countries were used in the case design. The evaluation of cases was conducted by 20 experts in different medical fields of dementia. In Spain, the results indicated that initially the most suitable placement to take care of people with dementia was the home, however in cases with higher dependency in activities of daily living, the long-term care setting was the best option. For the best care plan, the following resources were chosen: professional help to perform basic activities; day center; multidisciplinary home care team; financial support; community nurse; and social worker. Discussion: The Balance of Care method allows us to assess the most appropriate place of care for people with dementia systematically, objectively and with a multidisciplinary team. Other cost-effective interventions should be integrated in patients with dementia care in order to improve home care (AU)


Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Tomada de Decisões , Técnicas de Apoio para a Decisão , Demência/epidemiologia , Cuidadores/organização & administração , Visitadores Domiciliares , Serviços de Assistência Domiciliar/organização & administração , Gestor de Saúde , Europa (Continente)/epidemiologia , Assistência Domiciliar/organização & administração
8.
Gac Sanit ; 31(6): 518-523, 2017.
Artigo em Espanhol | MEDLINE | ID: mdl-27751643

RESUMO

OBJECTIVE: To describe the implementation of the Balance of Care model in decision-making regarding the best care for patients with dementia in Spain. METHODS: The Balance of Care model was used, which consists of (1) describing the profile of the typical cases of people with dementia and their caregivers, (2) identifying the most suitable care setting for each of the cases (home-care or long-term care institution), (3) designing specific care plans for each case, and (4) evaluating the cost of the proposed care plans. RESULTS: A total of 1,641 people with dementia and their caregivers from eight European countries were used in the case design. The evaluation of cases was conducted by 20 experts in different medical fields of dementia. In Spain, the results indicated that initially the most suitable placement to take care of people with dementia was the home, however in cases with higher dependency in activities of daily living, the long-term care setting was the best option. For the best care plan, the following resources were chosen: professional help to perform basic activities; day center; multidisciplinary home care team; financial support; community nurse; and social worker. DISCUSSION: The Balance of Care method allows us to assess the most appropriate place of care for people with dementia systematically, objectively and with a multidisciplinary team. Other cost-effective interventions should be integrated in patients with dementia care in order to improve home care.


Assuntos
Tomada de Decisões , Demência/terapia , Modelos Teóricos , Idoso , Idoso de 80 Anos ou mais , Análise Custo-Benefício , Feminino , Serviços de Assistência Domiciliar/economia , Humanos , Institucionalização/economia , Masculino , Testes de Estado Mental e Demência , Equipe de Assistência ao Paciente
9.
J Agric Food Chem ; 64(23): 4716-24, 2016 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-27214068

RESUMO

Fifteen essential oils, four essential oil fractions, and three pure compounds (thymol, carvacrol, and eugenol), characterized by gas chromatography and gas chromatography-mass spectrometry, were investigated for biological and nonbiological antioxidant activity. Clove oil and eugenol showed strong DPPH (2,2-diphenyl-1-picrylhydrazyl) free-radical scavenging activity (IC50 = 13.2 µg/mL and 11.7 µg/mL, respectively) and powerfully inhibited reactive oxygen species (ROS) production in human neutrophils stimulated by PMA (phorbol 12-myristate 13-acetate) (IC50 = 7.5 µg/mL and 1.6 µg/mL) or H2O2 (IC50 = 22.6 µg/mL and 27.1 µg/mL). Nutmeg, ginger, and palmarosa oils were also highly active on this test. Essential oils from clove and ginger, as well as eugenol, carvacrol, and bornyl acetate inhibited NO (nitric oxide) production (IC50 < 50.0 µg/mL). The oils of clove, red thyme, and Spanish oregano, together with eugenol, thymol, and carvacrol showed the highest myeloperoxidase inhibitory activity. Isomers carvacrol and thymol displayed a disparate behavior in some tests. All in all, clove oil and eugenol offered the best antioxidant profile.


Assuntos
Antioxidantes/química , Antioxidantes/farmacologia , Óleos Voláteis/química , Óleos Voláteis/farmacologia , Avaliação Pré-Clínica de Medicamentos/métodos , Humanos , Leucócitos/efeitos dos fármacos , Óxido Nítrico/metabolismo , Espécies Reativas de Oxigênio/metabolismo
10.
Am J Alzheimers Dis Other Demen ; 31(3): 223-30, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26340965

RESUMO

BACKGROUND: The aim of this study is to identify the barriers and facilitators in dementia care with respect to information provision, communication, and collaboration from the perspectives of the person with dementia, family caregivers, and health care professionals over the course of the illness. METHODS: A qualitative study using Focus-Group methodology was carried out in people with dementia, family caregivers, and health care providers. RESULTS: The categories that emerged from the analysis were insufficient information provided, specific dementia care needs, and acceptance of long-term care institutionalization from the people with dementia and caregivers' groups and insufficient communication between health care providers, differential information according to disease stage, and home care coordination from the health care providers' groups. CONCLUSION: The family is a key element in successful care coordination during dementia care provision. New effective strategies including self-management and emergent roles, such as case managers, could bring great benefits to people with dementia, caregivers, and health care providers.


Assuntos
Demência/enfermagem , Família/psicologia , Assistência de Longa Duração , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Relações Profissional-Família , Idoso , Idoso de 80 Anos ou mais , Cuidadores , Grupos Focais , Pessoal de Saúde , Humanos , Pessoa de Meia-Idade , Pesquisa Qualitativa , Espanha
11.
Int J Nurs Stud ; 55: 39-49, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26632506

RESUMO

BACKGROUND: Due to the high prevalence of dementia, health care needs are increasing beyond existing formal resources. In Spain, it is the family that takes care of this disease. AIMS: To analyze the direct (health and non-health) and indirect economic costs related to care of people with dementia living with their informal caregiver in the home care/community environment, from the perspective of illness severity, associated comorbidity and social impact. DESIGN: Multicentric, descriptive study. SETTING: Three primary care public health centers associated with Hospital Clínic, Barcelona (Spain). PARTICIPANTS: Patients over 65 years old with a diagnosis of dementia, and included in a home care program. INCLUSION CRITERIA: People with a diagnosis of dementia made by a specialist neurologist; aged 65 years or older; a score ≤ 24 on the Mini-Mental State Examination, and identification of an informal caregiver. EXCLUSION CRITERIA: Patients unable to identify an informal caregiver, and those with primary psychiatric pathology or Korsakoff's syndrome. MEASUREMENTS: Use of Resources in Dementia to assess costs; Mini-Mental State Examination to evaluate cognitive capacity; Katz-Index to measure functional capacity; Neuropsychiatric Index for neuropsychiatric symptoms, and the Charlson-Index for comorbidity. Data collection took place between November, 2010 and April, 2012. RESULTS: The average estimated monthly care costs for people with dementia in the home setting are 1956.2€ (SD 1463.9). Informal care was the major contributor to this with a mean estimated cost of 1214.86 (SD 902.68)€/month. Greater illness severity, dependency in activities of daily living, comorbidity and behavioral disturbance are associated with higher costs. Behavioral disturbance appeared as the only factor independently associated with cost in dementia care. The group of people with dementia with severe behavioral disturbance requires the most care resources with an average cost of 2545.2 (SD 1753.2)€/month. CONCLUSIONS: There is a direct association between dementia severity and increased costs. In addition, informal caregivers looking after people with dementia in Spain represent an important social cost. The independent factor associated with an increase in the total costs of patient care was neuropsychiatric symptoms.


Assuntos
Efeitos Psicossociais da Doença , Demência/enfermagem , Serviços de Assistência Domiciliar/economia , Idoso , Estudos Transversais , Demência/economia , Humanos , Espanha
12.
Int J Nurs Stud ; 52(5): 980-7, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25776735

RESUMO

BACKGROUND: Dementia is a progressive neurological disorder that causes a high degree of dependency. This dependency has been defined as an increased need for assistance due to deterioration in cognition and physical functioning, and changes in behavior. Highly dependent people with dementia are more likely to be institutionalized. OBJECTIVES: To investigate the association between specific categories of physical dependency and the presence of neuropsychiatric symptoms in people with dementia admitted to a long-term care institution. DESIGN: A prospective observational cohort study. SETTINGS: Home care and long-term care institutions in eight European countries. PARTICIPANTS: People with dementia living at home but at risk of institutionalization and recently institutionalized people with dementia. METHOD: Baseline and 3-month follow-up interviews were performed between November, 2010 and April, 2012. The sample consisted of 116 recently institutionalized dementia sufferers and 949 people with dementia still living at home. Physical dependency was measured using the Katz Activity of Daily Living index, and neuropsychiatric symptoms were assessed through The Neuropsychiatric Inventory. Specific categories of dependency were analyzed by performing a logistic regression analysis. This followed examination of baseline characteristics to define the degree of physical dependency, as factors associated with institutionalization, and evaluation of the same characteristics at 3-month follow-up to detect changes in the degree of physical dependency and neuropsychiatric symptoms associated with recent admission to a long-term care institution. RESULTS: Toileting, dressing and continence dependency was higher in institutionalized people than in those receiving home-care. Delusion, hallucination, agitation, anxiety, apathy, motor-disturbances, night-time behavior and eating disorders were also worse in the institutionalized. Logistic regression analysis showed that independent factors significantly associated with being recently institutionalized were toileting (odds ratio=2.3; 95% confidence interval=1.43-3.71) and motor disturbances (odds ratio=1.81; 95% confidence interval=1.15-2.87). CONCLUSIONS: This study supports the association between type and degree of physical dependency in people with dementia and long-term institutionalization. Institutionalization is associated with physical dependency and the presence of neuropsychiatric symptoms.


Assuntos
Demência/enfermagem , Casas de Saúde/organização & administração , Admissão do Paciente , Idoso , Idoso de 80 Anos ou mais , Demência/fisiopatologia , Demência/psicologia , Europa (Continente) , Feminino , Humanos , Assistência de Longa Duração , Masculino , Estudos Prospectivos
13.
J Pharm Pharmacol ; 67(5): 666-72, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25556861

RESUMO

OBJECTIVES: This study aimed to evaluate the possible antioxidant activity of Tween-20 and Tween-80, two amphipathic nonionic surfactants commonly used as solubilizers and stabilizers, whose pharmacological effects have been ignored to a large degree. METHODS: Antioxidant activity was investigated in vitro measuring the scavenging activity on the stable free radical 2,2-diphenyl-1-picrylhydrazyl (DPPH(●) ), the production of reactive oxygen species (ROS) in activated human neutrophils using flow cytometry and the myeloperoxidase (MPO) inhibitory activity. KEY FINDINGS: Tween-20 and Tween-80 did not show scavenging activity on DPPH(●) , while produced a decrease of the ROS production in human neutrophils, being Tween-20 more active than Tween-80. Moreover, Tween-80 and Tween-20 were found to significantly stimulate MPO enzymatic activity. CONCLUSIONS: Our findings raise concerns with regard to the indiscriminate use of Tween-20 and Tween-80 in clinical and laboratory testing, since they could influence the results that are assigned to the tested substance.


Assuntos
Antioxidantes/farmacologia , Polissorbatos/farmacologia , Compostos de Bifenilo/metabolismo , Humanos , Técnicas In Vitro , Neutrófilos/metabolismo , Peroxidase/metabolismo , Picratos/metabolismo , Espécies Reativas de Oxigênio/metabolismo
14.
J Agric Food Chem ; 63(5): 1496-504, 2015 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-25599399

RESUMO

The aim of the present study was to investigate the in vitro activity of 15 essential oils, 4 essential oil fractions, and 3 pure compounds (thymol, carvacrol, and eugenol) on phagocytosis by human neutrophils and on complement system. Samples were characterized by GC and GC-MS. Most of the oils (nutmeg, clove, niaouli, tea tree, bay laurel, lemon, red thyme, ginger), nutmeg terpenes, eugenol, and carvacrol showed mild to moderate inhibition of phagocytosis (25-40% inhibition at doses ranging from 40 to 60 µg/mL); highest inhibitory activity was found for thymol (72% at 56 µg/mL), whereas the mixture of bornyl and isobornyl acetates showed a mild stimulating activity (21% at 56 µg/mL). All samples were inactive in the alternative pathway of complement system, whereas on classical pathway, clove oil, eugenol, palmarosa oil, red thyme oil, tarragon oil, and carvacrol showed the highest activity, with IC50 values ranging from 65 to 78 µg/mL.


Assuntos
Proteínas do Sistema Complemento/imunologia , Óleos Voláteis/farmacologia , Fagocitose/efeitos dos fármacos , Óleos Vegetais/farmacologia , Humanos , Leucócitos/efeitos dos fármacos , Leucócitos/imunologia , Medicago/química , Óleos Voláteis/química , Óleos Vegetais/química , Thymus (Planta)/química
15.
J Adv Nurs ; 71(6): 1417-34, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25250659

RESUMO

AIM: To describe the associations between positive and negative reactions of informal caregivers of people with dementia and health outcomes across eight European Countries. BACKGROUND: Caring for someone with dementia may have implications for the caregiver's own health and for the care recipient. These consequences could be associated with caregivers' reactions to the process of care. DESIGN: Association study based on cross-sectional data. METHODS: Participants were people with dementia and their informal caregivers living at home or in long-term care institutions. Data were collected between November 2010-April 2012 using the Caregiver Reaction Assessment (with dimensions of self-esteem, lack of family support, financial problems, disrupted schedule and health problems) and associations were sought with informal caregiver burden, quality of life and psychological well-being and with dementia sufferers' neuropsychiatric symptoms, comorbidity and dependency in activities of daily living using correlation coefficients. RESULTS: Data from 2014 participants were used. Variability across countries was noted, as well as differences between care at home and in long-term care institutions. In general, self-esteem and lack of family support correlated with caregiver burden and psychological well-being. Associations were also found between disrupted schedule and caregiver burden, psychological well-being and quality of life. Health problems were clearly associated with caregiver burden, psychological well-being and quality of life. CONCLUSION: Study results support links between the reactions of informal caregivers of people with dementia and health outcomes. These may have implications in terms of how services are addressed.


Assuntos
Cuidadores/psicologia , Demência/enfermagem , Estudos Transversais , Europa (Continente) , Serviços de Assistência Domiciliar , Humanos , Qualidade de Vida , Resultado do Tratamento
16.
J Adv Nurs ; 71(6): 1392-404, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25091706

RESUMO

AIMS: To explore the perceptions of informal caregivers and healthcare professionals regarding potential reasons for the institutionalization of older persons with dementia in eight European countries. BACKGROUND: Healthcare professionals may have an important role in facilitating informal caregivers' decision-making regarding institutionalization. Little is known about the perceptions of informal caregivers and healthcare professionals prior to institutionalization. DESIGN: Cross-sectional survey in eight European countries (November 2010-January 2012). METHODS: Healthcare professionals reported why they clinically judged persons with dementia at risk for institutionalization. Informal caregivers reported potential reasons from their perspectives. Answers were openly coded and categorized. Variation between informal caregivers and healthcare professionals was investigated (agreement on at least one potential reason per case/proportion of maximum attainable kappa). RESULTS: Judgements of healthcare professionals and informal caregivers on 1160 persons with dementia were included. A total of 22 categories emerged. Approximately 90% of informal caregivers reported potential reasons. In 41% of the cases, informal caregivers and healthcare professionals agreed on at least one reason. Discrepancy was high for potential reasons related to caregiver burden. For the most frequent categories (caregiver burden, caregiver unable to provide care, neuropsychiatric symptoms, overall deterioration, care dependency), 24-41% of the attainable kappa was achieved. Differences between countries emerged indicating more favourable agreement in Finland, Sweden and Estonia and lowest agreement in England and Spain. CONCLUSION: Agreement between healthcare professionals and informal caregivers on potential reasons for institutionalization was low-to-moderate. Healthcare professionals are challenged to develop a detailed understanding of the perspectives and perceived burden of informal caregivers.


Assuntos
Atitude , Cuidadores/psicologia , Demência/fisiopatologia , Pessoal de Saúde/psicologia , Institucionalização , Idoso , Estudos Transversais , Demência/enfermagem , Europa (Continente) , Humanos , Fatores de Risco
17.
Rev. fitoter ; 14(1): 5-36, jun. 2014. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-125881

RESUMO

El uso racional de la Fitoterapia se asienta en los requisitos de calidad, seguridad y eficacia. Uno de los aspectos que más preocupan al profesional de la salud es conocer las posibles interacciones entre los preparados a base de plantas medicinales y los fármacos de síntesis, especialmente los que tienen un margen terapéutico más estrecho, como los anticoagulantes y los inmunosupresores. Aunque existen multitud de publicaciones sobre el tema, los resultados que ofrecen son a menudo contradictorios y no siempre están basados en evidencias clínicas. En este trabajo mostramos las interacciones descritas en las monografías de referencia en la actualidad: las de la EMA (Agencia Europea del Medicamento) y de ESCOP (European Scientific Cooperative on Phytotherapy), que ofrecen datos relevantes desde el punto de vista clínico, tanto en lo que respecta a indicaciones como a precauciones. Su análisis nos muestra que el número de drogas vegetales que interaccionan con medicamentos es relativamente bajo (menos del 25%) y que las interacciones más frecuentes son con anticoagulantes, corticoides, cardiotónicos, antiarrítmicos, benzodiazepinas, antidepresivos y antivirales. Las drogas y preparados vegetales que muestran un nivel significativo de interacciones son la sumidad de hipérico, los laxantes hidroxiantracénicos, las drogas con mucílagos, la raíz de regaliz, las drogas con taninos, el bulbo de ajo, la hoja de ginkgo y la raíz de ginseng (AU)


The rational Phytotherapy is based on the requirements of quality, safety and efficacy. A major concern of the health care professional is the potential interactions between the herbal preparations and synthetic drugs, especially those with a narrow therapeutic margin, such as anticoagulants and immunosuppressants. Although there are many publications on the subject, the results they provide are often contradictory and they are not always based on clinical evidence. The present paper presents the interactions described in the today’s monographs of reference: those of EMA (European Medicines Agency) and ESCOP (European Scientific Cooperative on Phytotherapy), which provide clinically relevant information both regarding indications and precautions. Their analysis shows that the number of herbal drugs that interact with synthetic drugs is relatively low (below 25%) and that the most frequent interactions are with anticoagulants, corticosteroids, cardiac glycosides, antiarrhythmics, benzodiazepines, antidepressants and antivirals. Herbal drugs and preparations that show a significant level of interactions are: Saint John’s wort, hydroxyanthracene laxatives, mucilage containing preparations, licorice preparations, tannin containing herbal drugs, garlic, ginkgo leaf and ginseng root (AU)


O uso racional da Fitoterapia baseia-se nos requisitos de qualidade, segurança e eficácia. Um dos aspectos que mais preocupam os profissionais de saúde é conhecer as possíveis interacções entre os produtos à base de plantas medicinais e os fármacos de síntese, especialmente aqueles com uma margem terapêutica estreita, tais como os anticoagulantes e os imunossupressores. Embora existam muitas publicações sobre o assunto, os resultados que fornecem são muitas vezes contraditórios e nem sempre são baseados em evidências clínicas. Este trabalho apresenta as interacções descritas nas monografias actualmente reconhecidas como sendo monografias de refe-rência: as da EMA (Agência Europeia do Medicamento) e da ESCOP (European Scientific Cooperative on Phytotherapy), que disponibilizam informações relevantes do ponto de vista clínico, tanto relativamente a indicações terapêuticas como a precauções de utilização. A análise mostra que o número de fármacos vegetais que interagem com medicamentos é relativamente baixo (inferior a 25%) e que as interacções mais frequentes são com anticoagulantes, corticosteroides, cardiotónicos, antiarrítmicos, benzodiazepinas, antidepres-sivos e antivíricos. Os fármacos e preparações de origem vegetal que apresentam um nível significativo de interacções são as sumidades floridas de hipericão, os laxantes hidroxiantracénicos, os fármacos com mucilagens, as preparações de alcaçuz, os fármacos com taninos, o bolbo de alho, a folha de ginkgo e a raiz de ginseng


Assuntos
Humanos , Masculino , Feminino , Preparações de Plantas/administração & dosagem , Preparações de Plantas/efeitos adversos , Preparações de Plantas/farmacologia , Preparações de Plantas/metabolismo , Preparações de Plantas/farmacocinética , Preparações de Plantas/uso terapêutico , Farmacognosia/métodos , Farmacognosia/normas , Farmacognosia/tendências , Fitoterapia/métodos , Fitoterapia/tendências , Fitoterapia
18.
Arch Esp Urol ; 63(6): 422-30, 2010.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-20820081

RESUMO

OBJECTIVES: The American cranberry proanthocyanidins (PACs) are the main responsible for its efficacy in urinary tract infections. Their mechanism of action is related to inhibition of Escherichia coli to urothelial cells. Cysticlean contains an extract of American cranberry which provides 118 mg of PACs per dose. The activity of Cysticlean tablets on Escherichia Coli adherence to bladder epithelial cells has been studied in vitro. Moreover, the activity of Cistyclean both in powder for oral suspension and tablets has been compared ex-vivo. METHODS: The rats received both Cysticlean preparations per orem, and urine from each animal was collected during the following 16 hours and preincubated with E. coli. Subsequently, bacteria were incubated with T24 cells. After 1 hour the number of bacteria adhered per cell was calculated. For the in vitro study, E. Coli preincubated at various concentrations of the products were incubated with T24 cells and the same process previously referred was carried out. RESULTS: Urine samples from rats taking Cysticlean powder for oral suspension and tablets (118 mg PACs/animal) showed an important inhibition of E. Coli adherence (83% and 52%respectively). The inferior dose of 59 mg PACs/animal also showed marked inhibition of E. Coli adherence (29% after Cysticlean tablets intake and 40% for powder). In vitro, Cysticlean showed inhibition of bacterial adherence in all tested concentrations: 5, 25 and 75 PACs mg/ml, diminishing the number og bacteria adhered to epithelial cells by 25%, 36% and 34% respectively. CONCLUSIONS: Cysticlean shows a significant inhibition of E. Coli adherence to urothelial cells. Cysticlean powder for suspensión preparation is more effective tha tablets. Cysticlean powder for suspensión is well tolerated, and compliance has been observed. Its use is very recommendable in pediatric urinary tract infection prophylaxis. Due to the variety of products with American cranberry extracts in the market, with different proanthocyanidins declared content, it would be interesting to compare their activity using established pharmacological methods.


Assuntos
Aderência Bacteriana/efeitos dos fármacos , Células Epiteliais/microbiologia , Escherichia coli/efeitos dos fármacos , Escherichia coli/fisiologia , Extratos Vegetais/farmacologia , Proantocianidinas/farmacologia , Vaccinium macrocarpon , Animais , Células Cultivadas , Feminino , Ratos , Ratos Wistar , Bexiga Urinária/citologia
19.
Arch. esp. urol. (Ed. impr.) ; 63(6): 422-430, jul.-ago. 2010. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-87807

RESUMO

OBJETIVO: Las proantocianidinas (PACs) del arándano americano son las principales responsables de su eficacia en infecciones del tracto urinario. Su mecanismo de acción está relacionado con la inhibición de la adherencia de Escherichia coli a las células uroepiteliales. Cysticlean® contiene un extracto de arándano americano que proporciona 118 mg de PACs por comprimido o sobre. Se ha estudiado in vitro, la actividad de Cysticlean® comprimidos sobre la adherencia de Escherichia coli a células epiteliales de vejiga. Además, se ha comparado, ex vivo, la actividad de Cysticlean® sobres y comprimidos.MÉTODOS: Las ratas recibieron por vía oral los dos productos de Cysticlean®, y durante las 16 horas posteriores se recogió la orina de cada animal, que fue preincubada con E. coli. Posteriormente, las bacterias se incubaron con células T24. Después de una 1 hora, se calcula el número de bacterias adheridas por célula. Para el estudio in vitro, E. coli preincubadas con varias concentraciones de los diferentes productos, se incuban con células T24 y se sigue el proceso anterior.RESULTADOS: Las muestras de orina de ratas que habían ingerido Cysticlean® sobres y comprimidos (118 mg PACs/animal) muestran una importante inhibición de la adherencia de E.coli (83% y 52%, respectivamente). A la dosis inferior de 59 mg PACs/animal, también presenta una destacada inhibición (29% tras el consumo de Cysticlean® comprimidos y 40% tras el consumo de Cysticlean® sobres). In vitro, Cysticlean® ha mostrado inhibición de la adherencia bacteriana a todas las concentraciones ensayadas. A las concentraciones de 5, 25 y 75 mg de PACs/mL, disminuye un 25%, 36% y 34%, respectivamente, el número de bacterias adheridas a las células epiteliales(AU)


CONCLUSIONES: Cysticlean® muestra una importante inhibición de la adherencia de E. coli a las células uroepiteliales. Cysticlean® sobres es más efectivo que Cysticlean® comprimidos. Con el uso de Cysticlean® sobres, se ha observado buena tolerancia, fidelidad en el tratamiento y su uso es también muy recomendable en la profilaxis de infecciones urinarias en pediatría. Dada la heterogeneidad de productos a base de extractos de arándano americano en el mercado, y su diferente contenido declarado de proantocianidinas, resulta de interés la comparación de su actividad por métodos farmacológicos establecidos(AU)


OBJECTIVES: The American cranberry proanthocyanidins (PACs) are the main responsible for its efficacy in urinary tract infections. Their mechanism of action is related to inhibition of Escherichia coli to urothelial cells. Cysticlean ® contains an extract of American cranberry which provides 118 mg of PACs per dose. The activity of Cysticlean® tablets on Escherichia Coli adherence to bladder epithelial cells has been studied in vitro. Moreover, the activity of Cistyclean® both in powder for oral suspension and tablets has been compared ex-vivo.METHODS: The rats received both Cysticlean® preparations per orem, and urine from each animal was collected during the following 16 hours and pre-incubated with E. coli. Subsequently, bacteria were incubated with T24 cells. After 1 hour the number of bacteria adhered per cell was calculated. For the in vitro study, E. Coli pre-incubated at various concentrations of the products were incubated with T24 cells and the same process previously referred was carried out.RESULTS: Urine samples from rats taking Cysticlean® powder for oral suspension and tablets (118 mg PACs/animal) showed an important inhibition of E. Coli adherence (83% and 52% respectively). The inferior dose of 59 mg PACs/animal also showed marked inhibition of E. Coli adherence (29% after Cysticlean® tablets intake and 40% for powder). In vitro, Cysticlean® showed inhibition of bacterial adherence in all tested concentrations: 5, 25 and 75 PACs mg/ml, diminishing the number og bacteria adhered to epithelial cells by 25%, 36% and 34% respectively(AU)


CONCLUSIONS: Cysticlean® shows a significant inhibition of E. Coli adherence to urothelial cells. Cysticlean® powder for suspensión preparation is more effective tha tablets. Cysticlean® powder for suspensión is well tolerated, and compliance has been observed. Its use is very recommendable in pediatric urinary tract infection prophylaxis. Due to the variety of products with American cranberry extracts in the market, with different proanthocyanidins declared content, it would be interesting to compare their activity using established pharmacological methods(AU)


Assuntos
Animais , Ratos , Escherichia coli , Escherichia coli/patogenicidade , Células Epiteliais , Células Epiteliais/patologia , Bexiga Urinária/anatomia & histologia , Bexiga Urinária/patologia , Eficácia/métodos , Infecções Urinárias/diagnóstico , Infecções Urinárias/patologia , Infecções Urinárias/terapia
20.
Rev. fitoter ; 5(2): 101-114, dic. 2005. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-051268

RESUMO

La sangre de drago es el látex rojo exudado al realizar incisiones en la corteza de diversas especies vegetales tropicales, especialmente de Croton lechleri Müll. Arg. Su uso en Medicina Tradicional está muy extendido en Sudamérica, sobre todo como cicatrizante. El látex de C. lechleri es rico en catequinas y proantocianidinas oligoméricas, y contiene 3',4-0-dimetilcedrusina (lignano) y taspina (alcaloide). Se ha demostrado su actividad cicatrizante, antiviral, antimicrobiana, antiinflamatoria, antiulcerosa, antidiarreica e inmunomoduladora. Muchas de estas actividades son coherentes con el uso tradicional y algunas ya han sido estudiadas clínicamente


Sangre de drago (dragon's blood) is the blood red latex that flows after tearing the bark of certain tropical plant species, especially Croton lechleri Müll. Arg. It is widely used in Traditional Medicine in South America, as wound healing. The latex of C. lechleri has catechins and oligomeric proanthocyanidins as major constituents, and it also contains 3'-4-0-dimethylcedrusin (lignan) and taspine (alkaloid). It has shown cicatrizing, antiviral, antimicrobial, anti-inflammatory, antiulcer, antidiarrhoeic and immunomodulatory activities. Many of these activities are in line with its traditional use and some of them have been clinically studied


Assuntos
Humanos , Preparações de Plantas/uso terapêutico , Croton/química , Croton/classificação , Fitoterapia
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