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1.
Braz. j. biol ; 83: e244647, 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS, VETINDEX | ID: biblio-1278527

RESUMO

Abstract The essential oil of citronella (Cymbopogon winterianus) has several biological activities, among them the insect repellent action. Some studies showed that cinnamic acid esters can be applied as natural pesticides, insecticides and fungicides. In this context, the objective of the present work was to evaluate the production of esters from citronella essential oil with cinnamic acid via enzymatic esterification. Besides, the essential oil toxicity before and after esterification against Artemia salina and larvicidal action on Aedes aegypti was investigated. Esters were produced using cinnamic acid as the acylating agent and citronella essential oil (3:1) in heptane and 15 wt% NS 88011 enzyme as biocatalysts, at 70 °C and 150 rpm. Conversion rates of citronellyl and geranyl cinnamates were 58.7 and 69.0% for NS 88011, respectively. For the toxicity to Artemia salina LC50 results of 5.29 μg mL-1 were obtained for the essential oil and 4.36 μg mL-1 for the esterified oils obtained with NS 88011. In the insecticidal activity against Aedes aegypti larvae, was obtained LC50 of 111.84 μg mL-1 for the essential oil of citronella and 86.30 μg mL-1 for the esterified oils obtained with the enzyme NS 88011, indicating high toxicity of the esters. The results demonstrated that the evaluated samples present potential of application as bioinsecticide.


Resumo O óleo essencial de citronela (Cymbopogon winterianus) possui diversas atividades biológicas, entre elas a ação repelente a insetos. Alguns estudos mostraram que os ésteres do ácido cinâmico podem ser aplicados como pesticidas naturais, inseticidas e fungicidas. Nesse contexto, o objetivo do presente trabalho foi avaliar a produção de ésteres a partir do óleo essencial de citronela com ácido cinâmico via esterificação enzimática. Além disso, foi investigada a toxicidade do óleo essencial antes e após a esterificação contra Artemia salina e a ação larvicida sobre Aedes aegypti. Os ésteres foram produzidos utilizando ácido cinâmico como agente acilante e óleo essencial de citronela (3: 1) em heptano e 15% em peso da enzima NS 88011 como biocatalisadores, a 70 ° C e 150 rpm. As taxas de conversão de cinamatos de citronelil e geranil foram 58,7 e 69,0% para NS 88011, respectivamente. Para a toxicidade sobre Artemia salina foram obtidos CL50 de 5,29 μg mL-1 para o óleo essencial e 4,36 μg mL-1 para os óleos esterificados com NS 88011. Na atividade inseticida contra larvas de Aedes aegypti, obteve-se CL50 de 111,84 μg mL-1 para o óleo essencial de citronela e 86,30 μg mL-1 para os óleos esterificados com a enzima NS 88011, indicando alta toxicidade dos ésteres. Os resultados demonstraram que as amostras avaliadas apresentam potencial de aplicação como bioinseticida.

2.
BMC Cardiovasc Disord ; 21(1): 338, 2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34256716

RESUMO

PURPOSE: Early adoption of a healthy lifestyle has positive effects on cardiovascular health (CVH) in adulthood. In this study, we aimed to assess CVH metrics in a cohort of healthy teenagers with focus on differences between rural and urban areas. METHODS: The Early Vascular Aging (EVA) Tyrol study is a population-based non-randomized controlled trial, which prospectively enrolled 14- to 19-year-old adolescents in North Tyrol, Austria and South Tyrol, Italy between 2015 and 2018. Data from the baseline and control group (prior to health intervention) are included in the current analysis. CVH determinants (smoking, body mass index, physical activity, dietary patterns, systolic and diastolic blood pressure, total cholesterol and fasting blood glucose) were assessed and analyzed for urban and rural subgroups separately by univariate testing. Significant variables were added in a generalized linear model adjusted for living in urban or rural area with age and sex as covariates. Ideal CVH is defined according to the guidelines of the American Heart Association. RESULTS: 2031 healthy adolescents were enrolled in the present study (56.2% female, mean age 16.5 years). 792 adolescents (39.0%) were from urban and 1239 (61.0%) from rural areas. In 1.3% of adolescents living in urban vs. 1.7% living in rural areas all CVH determinants were in an ideal range. Compared to the rural group, urban adolescents reported significantly longer periods of moderate to vigorous-intensive activity (median 50.0 min/day (interquartile range 30-80) vs. median 40.0 min/day (interquartile range 25-60), p < 0.01). This observation remained significant in a generalized linear model (p < 0.01). There were no significant differences between the study groups regarding all other CVH metrics. CONCLUSION: The low prevalence of ideal CVH for adolescents living in urban as well as rural areas highlights the need for early health intervention. Geographic differences must be taken into account when defining targeted subgroups for health intervention programs.

3.
Braz J Biol ; 83: e244647, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34190758

RESUMO

The essential oil of citronella (Cymbopogon winterianus) has several biological activities, among them the insect repellent action. Some studies showed that cinnamic acid esters can be applied as natural pesticides, insecticides and fungicides. In this context, the objective of the present work was to evaluate the production of esters from citronella essential oil with cinnamic acid via enzymatic esterification. Besides, the essential oil toxicity before and after esterification against Artemia salina and larvicidal action on Aedes aegypti was investigated. Esters were produced using cinnamic acid as the acylating agent and citronella essential oil (3:1) in heptane and 15 wt% NS 88011 enzyme as biocatalysts, at 70 °C and 150 rpm. Conversion rates of citronellyl and geranyl cinnamates were 58.7 and 69.0% for NS 88011, respectively. For the toxicity to Artemia salina LC50 results of 5.29 µg mL-1 were obtained for the essential oil and 4.36 µg mL-1 for the esterified oils obtained with NS 88011. In the insecticidal activity against Aedes aegypti larvae, was obtained LC50 of 111.84 µg mL-1 for the essential oil of citronella and 86.30 µg mL-1 for the esterified oils obtained with the enzyme NS 88011, indicating high toxicity of the esters. The results demonstrated that the evaluated samples present potential of application as bioinsecticide.


Assuntos
Aedes , Cymbopogon , Repelentes de Insetos , Inseticidas , Óleos Voláteis , Animais , Esterificação , Inseticidas/toxicidade , Larva , Óleos Voláteis/toxicidade
4.
Klin Padiatr ; 229(3): 118-125, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27975342

RESUMO

Purpose: Childhood cancer survivors fear that previous therapy could not only impair their own but also their children's health. We examined whether health-related behaviour in children of childhood cancer survivors differs from the general population. Methods: Our first nationwide survey wave (2013-2014) surveyed offspring health in 396 German childhood cancer survivors known to have a child of their own. Answers about health behaviour were analysed using descriptive statistics. Data were collected for 418 offspring and 394 could be integrated for matched-pair analyses with data from the German general population (KIGGS, n=17 641). Results: Teeth-cleaning routine, body-mass-index or subjective body image evaluation by parents were no different from children in the general population. Parents who included a cancer survivor smoked less in the presence of their children (p=0.01). During pregnancy, mothers in cancer survivor parent pairs abstained from drinking alcohol more often (p=0.01) and smoked less (p=0.05). While the calculated effect sizes (Phi) were generally low (0.135-0.247), children from cancer survivors played less outdoors than peers did (p=0.01). Boys participated in sports outside a club more often (p=0.05) and watched less TV on weekdays (p=0.01) and girls spent more time on the computer during weekdays than peers did (p=0.01). Conclusions: This study provides the first data for health-related behaviour in cancer survivors' offspring and sheds light on differences to parenting in the general population. Multivariate analyses in a larger study population are needed to relate these differences to fear issues in cancer survivors.


Assuntos
Sobreviventes de Câncer/psicologia , Saúde da Criança , Filho de Pais Incapacitados/psicologia , Comportamentos Relacionados com a Saúde , Adulto , Imagem Corporal/psicologia , Índice de Massa Corporal , Criança , Exercício Físico/psicologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Higiene Bucal/psicologia , Grupo Associado , Gravidez , Valores de Referência , Abandono do Hábito de Fumar/psicologia
5.
J Med Eng Technol ; 40(3): 72-9, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26785329

RESUMO

Our laboratories are developing treadmill-based gait analysis employing sheep to investigate potential efficacy of intra-dural spinal cord stimulation in the treatment of spinal cord injury and neuropathic pain. As part of efforts to establish the performance characteristics of the experimental arrangement, this study measured the treadmill speed via a tachometer, video belt-marker timing and ambulation-rate observations of the sheep. The data reveal a 0.1-0.3% residual drift in the baseline (unloaded) treadmill speed which increases with loading, but all three approaches agree on final speed to within 1.7%, at belt speeds of ≈ 4 km/h. Using the tachometer as the standard, the estimated upper limit on uncertainty in the video belt-marker approach is ± 0.18 km h(-1) and the measured uncertainty is ± 0.15 km h(-1). Employment of the latter method in determining timing differences between contralateral hoof strikes by the sheep suggests its utility in assessing severity of SCI and responses to therapeutic interventions.


Assuntos
Teste de Esforço , Neuralgia/fisiopatologia , Traumatismos da Medula Espinal/fisiopatologia , Caminhada/classificação , Caminhada/fisiologia , Animais , Modelos Animais de Doenças , Feminino , Ovinos
6.
Klin Padiatr ; 227(6-7): 350-4, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26600178

RESUMO

BACKGROUND: Increased risk for infertility from cancer treatment and fear of health impairment in their offspring may prevent survivors of childhood cancer from having own children. Even though most studies report no increased risk for malformations, in our German fertility study 2008 a higher occurrence of cleft lip and palate was found in offspring of former patients. METHODS: Since 2010 we assess offspring's health in a survey-based multicenter study, comparing diseases, well-being, healthcare utilization and health-related behavior between offspring from survivors, siblings or the general population. Within a first nationwide survey wave survivors who were known to have at least one child by previous fertility studies, received a questionnaire supported by the German Childhood Cancer Registry. Questionnaires were based on the KiGGS study on children's health in the German general population conducted by the Robert-Koch Institute (n=17,641). RESULTS: Questionnaires on 418 children were answered by 65% (254/393) of survivors contacted to participate in the first nationwide offspring study wave. Participants were more likely to be female (p<0.01), to have achieved higher educational levels (p<0.05) and to be a survivor of a soft tissue tumor (p<0.05). Former patients expressed moderate to high anxiety for the occurrence of cancer in 74% and feared other diseases in their children in 20%. CONCLUSION: Offspring health is a topic of major relevance to former patients. Our offspring study is currently being extended to ~1500 offspring of childhood cancer survivors in Europe.


Assuntos
Ensaios Clínicos como Assunto/estatística & dados numéricos , Hematologia/estatística & dados numéricos , Hematologia/tendências , Oncologia/estatística & dados numéricos , Oncologia/tendências , Pediatria/estatística & dados numéricos , Pediatria/tendências , Publicações/estatística & dados numéricos , Publicações/tendências , Adolescente , Criança , Pré-Escolar , Protocolos Clínicos , Estudos de Coortes , Previsões , Alemanha , Humanos , Lactente , Cooperação Internacional , Idioma , Estudos Retrospectivos , Sociedades Médicas/estatística & dados numéricos , Sociedades Médicas/tendências
7.
J Cancer Res Clin Oncol ; 141(1): 135-42, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25081929

RESUMO

PURPOSE: Fertility impairment and recovery after haematopoietic stem cell transplantation (HSCT) have been reported in both sexes, but little is known about how they develop over time. Our aim was to describe the dynamics of fertility impairment and recovery after HSCT. METHODS: We retrieved treatment and fertility data for up to 12 years of 361 paediatric patients with malignant and non-malignant diseases from seven European centres. The patients had been treated with allogeneic HSCT between 2000 and 2005. RESULTS: Development of fertility impairment was observed in males (123/217, 56%) after a median time of 2.6 years (range 0.1-11.4) and in females (82/144, 57%) after 2.3 years (range 0.1-12.0) after HSCT. Different busulfan dosages had only a slight impact on the onset of fertility impairment (busulfan ≥ 16 mg/kg with a median time to fertility impairment of 2.9 vs. 3.9 years after busulfan <14 mg/kg). Recovery from fertility impairment was observed in 17 participants after a median time of 4.1 years (range 1-10.6) in females (10/144, 7%) and 2.0 years (range 1-6.3) in males (7/217, 3 %) after fertility impairment first appeared. CONCLUSIONS: In the light of the dynamics of fertility impairment and recovery in the HSCT patients reviewed, these patients should be counselled comprehensively regarding fertility preservation measures.


Assuntos
Neoplasias Hematológicas/complicações , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Infertilidade/etiologia , Infertilidade/prevenção & controle , Adolescente , Adulto , Criança , Pré-Escolar , Terapia Combinada , Feminino , Seguimentos , Neoplasias Hematológicas/terapia , Humanos , Estudos Longitudinais , Masculino , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Transplante Homólogo , Adulto Jovem
8.
J Cancer Res Clin Oncol ; 140(10): 1759-67, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24841737

RESUMO

PURPOSE: Fertility impairment and recovery after chemo- and radiotherapy have been reported in both male and female childhood cancer survivors, but little is known about the dynamics. Our aim, therefore, was to describe the development of fertility impairment and possible recovery in childhood brain tumour survivors. METHODS: In this longitudinal study, we included 144 survivors, who were treated in two German paediatric oncology centres between 2000 and 2005. Fertility parameters were retrieved from medical records up to 12 years after diagnosis. RESULTS: Participants with age ≥13 years and formerly cranial irradiation ≥30 Gray (n = 23), including 83 % (n = 19) with craniospinal irradiation ≥30 Gray, had a higher median FSH concentration compared to 29 patients without chemoradiotherapy: 8.3 IU/l (IQR 6.5-11.2) versus 4.1 IU/l (IQR 3.2-5.1) 2 years after initial treatment; 8.9 IU/l (IQR 8.5-10.8) versus 4.2 IU/l (IQR 2.4-6.7) after 8 years; and 7.1 IU/l (IQR 6.7-7.7) versus 3.5 IU/l (IQR 2.8-4.2) after 10 years. Altogether, 11/65 women reported the occurrence of amenorrhoea 6.0 years (range 1-10) after diagnosis. Five of these women later developed a regular menstrual cycle without hormone replacement therapy. Patients' chance of recovery from fertility impairment was increased with time since diagnosis (p = 0.074). CONCLUSION: Signs of fertility impairment such as amenorrhoea and elevated FSH levels were observed at variable time points between 1 and 12 years after chemoradiotherapy. Decreasing FSH levels were observed 1-7 years after elevation and were interpreted either as an atrophy of the pituitary gland or as recovery from fertility impairment.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias Encefálicas/terapia , Irradiação Craniana/efeitos adversos , Fertilidade/efeitos dos fármacos , Fertilidade/efeitos da radiação , Infertilidade/sangue , Infertilidade/etiologia , Adulto , Fatores Etários , Amenorreia/etiologia , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Criança , Feminino , Hormônio Foliculoestimulante/sangue , Alemanha/epidemiologia , Humanos , Infertilidade/epidemiologia , Estudos Longitudinais , Hormônio Luteinizante/sangue , Masculino , Tamanho do Órgão , Ovário/efeitos dos fármacos , Ovário/efeitos da radiação , Dosagem Radioterapêutica , Remissão Espontânea , Sobreviventes , Testículo/efeitos dos fármacos , Testículo/patologia , Testículo/efeitos da radiação , Fatores de Tempo
9.
J Physiol Pharmacol ; 64(4): 465-72, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24101392

RESUMO

UNLABELLED: The cellular uptake of oxidized low density lipoprotein (LDL) is mediated through the oxidized LDL receptor-1, LOX-1. We investigated whether circulating factors link LOX-1 expression in endothelial cells and impaired endothelium-dependent vasoreactivity (EDVR) as functional indicator of atherogenesis. EDVR was measured as flow-mediated dilation (FMD) of the brachial artery in 27 patients with a known history of cardiovascular disease. Human umbilical vein endothelial cells (HUVEC) were incubated with bradykinin or prostacyclin in the presence of tumour necrosis factor-alpha (TNF-α) or with serum of each patient for four hours. Total mRNA and protein extracts were analysed for LOX-1 and eNOS expression relative to the expression in medium-treated cells and corrected for GAPDH expression. RESULTS: Prostacyclin and bradykinin did not modulate LOX-1 basal expression but were able to prevent significantly the up-regulation of LOX-1 expression by TNF-α, in HUVEC in vitro. Impaired EDVR was associated significantly with reduced endothelial nitric oxide synthase (eNOS) protein expression in HUVEC (r=0.788, P<0.001), diabetes (P=0.024), and smoking status (yes/no, P=0.047). In contrast, no such association was established with LOX-1 mRNA (r=0.292, P=0.138) or with LOX-1 protein expression in HUVEC (r=0.201, P=0.312). CONCLUSIONS: Using a combination of in vitro experiments with in vivo measurements, we found no evidence that endothelial LOX-1 expression and EDVR mediated through circulating factors were associated.


Assuntos
Doença da Artéria Coronariana/metabolismo , Doença da Artéria Coronariana/fisiopatologia , Endotélio Vascular/fisiopatologia , Receptores Depuradores Classe E/metabolismo , Idoso , Artéria Braquial/fisiologia , Células Cultivadas , Feminino , Células Endoteliais da Veia Umbilical Humana/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Óxido Nítrico Sintase Tipo III/genética , Óxido Nítrico Sintase Tipo III/metabolismo , RNA Mensageiro/metabolismo , Fluxo Sanguíneo Regional , Receptores Depuradores Classe E/genética , Fator de Necrose Tumoral alfa/farmacologia
10.
Klin Padiatr ; 225(6): 320-4, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24158886

RESUMO

As survival rates of patients with childhood brain tumors have increased to 75%, treatment related side effects are of particular importance. The present study evaluated questionnaire-based fertility characteristics in cancer survivors treated with irradiation to the hypo-thalamic-pituitary-axis.A nationwide survey was conducted in collaboration with the German Childhood Cancer Registry. Questionnaire and treatment data could be retrieved for 1110 former childhood cancer patients with cranial irradiation and/or chemotherapy.Survivors receiving ≥30 gray vs. 18-29 gray and 0-17 gray to the pituitary gland reported less pregnancies or less with their partners (7.4% vs. 32.8% vs. 12.4%; p<0.001), were more often infertile (40% vs. 9.4% vs. 12.5%; p<0.001) and the female participants, had a higher frequency of permanent amenorrhea (16.7% vs. 1.7% vs. 0%; p<0.001).Irradiation of the pituitary gland ≥ 30 gray seemed to be associated with less pregnancies and increased permanent amenorrhea in women. Future studies need to be conducted to confirm these results. Increased knowledge of treatment related side effects might help brain tumor patients to improve their family planning if necessary by gonadotropine replacement.


Assuntos
Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/radioterapia , Encéfalo/efeitos da radiação , Irradiação Craniana/efeitos adversos , Sistema Hipotálamo-Hipofisário/efeitos da radiação , Infertilidade/etiologia , Lesões por Radiação/etiologia , Sobreviventes , Adolescente , Adulto , Amenorreia/etiologia , Neoplasias Encefálicas/mortalidade , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Alemanha , Inquéritos Epidemiológicos , Humanos , Lactente , Estudos Longitudinais , Masculino , Gravidez , Dosagem Radioterapêutica , Fatores de Risco , Inquéritos e Questionários , Análise de Sobrevida , Adulto Jovem
11.
Rofo ; 185(8): 720-5, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23696018

RESUMO

PURPOSE: To validate the long-term efficacy of a 90-min. educational mini-course in less-irradiating cardiac interventional techniques. MATERIALS AND METHODS: Before, two months after, and two years after the mini-course (periods I, II, and III), we analyzed the following radiation dose parameters for ten coronary angiographies (CA), performed by each of 7 cardiologists: total dose-area product (DAP), radiographic and fluoroscopic DAP fractions, number of radiographic frames and runs, and fluoroscopy time. RESULTS: The median patient DAP for periods I, II and III was 31.4, 15.8 and 8.5 Gy × cm2, respectively. The long-term effect was related to shorter median fluoroscopy times (180, 172, and 120 s), shorter (57, 52, and 45) and fewer (12, 12, and 10) radiographic runs, consistent collimation and restriction to an adequate image quality. Both radiographic DAP/frame (28.7, 17.0, and 18.4 mGy × cm2) and fluoroscopic DAP/second (45.7, 24.2, and 10.0 mGy × cm2) decreased significantly. The multivariate linear regression analysis confirmed the increasing efficacy of the mini-course itself (-44.6 and -60.7%), and revealed a decreasing influence of the interventionalist's experience (-8.6% and -4.9% per 1,000 CAs, lifelong performed until the mini-course). The number of CAs performed after the mini-course did not influence the long-term DAP results. CONCLUSION: The presented educational mini-course allows a significant, long-lasting, and apparently ongoing reduction of patient radiation exposure due to CA. A self-surveillant documentation of relevant radiation parameters is well suited to monitor and improve each operator's individual long-term radiation-reducing efforts.


Assuntos
Angioplastia Coronária com Balão/efeitos adversos , Angioplastia Coronária com Balão/educação , Cardiologia/educação , Angiografia Coronária/efeitos adversos , Angiografia Coronária/métodos , Educação Médica Continuada , Fluoroscopia/efeitos adversos , Fluoroscopia/métodos , Neoplasias Induzidas por Radiação/prevenção & controle , Doses de Radiação , Lesões por Radiação/prevenção & controle , Idoso , Angioplastia Coronária com Balão/métodos , Currículo , Feminino , Seguimentos , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/etiologia , Lesões por Radiação/etiologia , Radiometria/métodos , Espalhamento de Radiação
12.
Klin Padiatr ; 225(3): 138-44, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23599232

RESUMO

BACKGROUND: Among adult survivors of childhood brain tumors in Germany, we assessed their educational level and examined potentially influencing factors. PATIENTS AND METHODS: A questionnaire was sent to 505 childhood brain tumor survivors listed in the German Childhood Cancer Registry. 203/505 (40.2%) patients with treatment and educational data were included in the analysis.Of the included brain tumor survivors 54.7% (111/203) were male, the median age was 11.0 (1-15) years at diagnosis and 22.0 (19-37) years at the time of the survey. 34.8% (95%-CI 25.1-44.5) of female and 34.9% (26.0-43.8) of male survivors achieved a high school diploma. Survivors who had received irradiation had less likely obtained a high school diploma compared to those without irradiation. However, this association was statistically not significant: for either craniospinal or tumor irradiation adjusted odds ratio was 0.54 (0.08-3.76); for those with a combination of craniospinal and tumor irradiation 0.51 (0.07-3.59). Participants aged 6-10 years at diagnosis achieved a higher educational level 2.24 (0.45-11.25) compared to younger patients. CONCLUSION: A third of the childhood brain tumor survivors who participated in our survey obtained the highest school leaving certificate. This may be biased by an overrepresentation of well-educated survivors without major cancer-related late effects. The influence of the patients' strong motivation following a severe illness combined with the intensive psychosocial and/or pedagogical support on education needs to be examined in future studies.


Assuntos
Neoplasias Encefálicas/psicologia , Neoplasias Encefálicas/terapia , Escolaridade , Sobreviventes/psicologia , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Irradiação Craniana/efeitos adversos , Educação Especial , Feminino , Alemanha , Inquéritos Epidemiológicos , Humanos , Lactente , Estudos Longitudinais , Masculino , Motivação , Prognóstico , Adulto Jovem
13.
Bone Marrow Transplant ; 47(2): 271-6, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21478918

RESUMO

Infertility is a major late effect in patients receiving haematopoietic stem cell transplantation (HSCT). The aim of this study was to determine the proportion of patients having fertility impairment after allogeneic HSCT in childhood/adolescence and to identify the potential risk factors. Treatment and fertility data of paediatric patients with malignant and non-malignant diseases treated with allogeneic HSCT between 2000 and 2005 were collected from seven European centres. Data were obtained for 138 female and 206 male patients after a median follow-up of 6 years (range 3-12). The patients' median age was 13 years (range 4-28) at the time of HSCT and 19 (range 12-35) years at the time of the enquiry. Seven children were born to the overall group, all at term and healthy. Fertility impairment was suspected in 69% males and 83% females. Start of treatment at age 13 years was a risk factor in females (odds ratio (OR) 4.7; 95% confidence interval (CI), 1.5 to 14.9), whereas pre-pubertal therapy was a risk factor in males (OR 0.4; 95% CI, 0.2 to 0.8). The major treatment-related risk factors were BU in females (OR 47.4; 95% CI, 5.4 to 418.1) and TBI in males (OR 7.7; 95% CI, 2.3 to 25.4). In light of the significant proportion of HSCT patients reviewed with impaired fertility, fertility conservation procedures should be considered for all patients undergoing HSCT, particularly those receiving TBI or BU-based preparative regimens.


Assuntos
Fertilidade , Transplante de Células-Tronco Hematopoéticas/métodos , Infertilidade/etiologia , Condicionamento Pré-Transplante/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Masculino , Gravidez , Resultado da Gravidez , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida , Condicionamento Pré-Transplante/efeitos adversos , Transplante Homólogo , Adulto Jovem
14.
Transplant Proc ; 43(5): 1515-9, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21693227

RESUMO

BACKGROUND/PURPOSE: Arachidonic acid and related cardioprotective eicosanoids are released in myocardial ischemia/reperfusion injury. The present study analyzes the effects of the eicosapentaenoic acid derived 17,18-epoxyeicostetraenoic acid on isolated cardiomyocytes and investigates whether 17,18-epoxyeicostetraenoic acid serves as a potential factor in the cardio-depressant postischemic effluent. BASIC PROCEDURES: After 10 minutes of global ex vivo stop-flow ischemia, adult rat hearts were reperfused and coronary postischemic effluent was collected over a period of 30 seconds. Nonischemic effluent was collected prior to ischemia. The effects of 17,18-epoxyeicostetraenoic acid on calcium (Ca(2+)) metabolism and contraction frequency of isolated neonatal rat cardiomyocytes were tested and compared with the effects of prior collected postischemic and nonischemic effluents. Isolated neonatal cardiomyocytes were preincubated with selective (NS-398, SC-560) and nonselective cyclooxygenase inhibitors (indomethacin) to determine whether cardio-depressive effects are mediated by cyclooxygenase. FINDINGS: In contrast to the nonischemic effluent, both 17,18-epoxyeicostetraenoic acid and the postischemic effluent induced a comparable decrease of the Ca(2+) transient and the contraction frequency (P < .05 vs control). The cardio-depressive effects of 17,18-epoxyeicostetraenoic acid and the postischemic effluent were significantly attenuated after preincubation with the unselective cyclooxygenase inhibitor indomethacin and the selective cyclooxygenase-2 inhibitor NS-398 (P < .05 vs control). Selective cyclooxygenase-1 inhibition with SC-560 did not influence the effect of 17,18-epoxyeicostetraenoic acid and the postischemic effluent. CONCLUSIONS: Our data show that the cardio-depressive effects of 17,18-epoxyeicostetraenoic acid are comparable with the postischemic effluent and are mediated by cyclooxygenase-2. Our results suggest a potential cardioprotective role of the eicosanoid 17,18-epoxyeicostetraenoic acid in heart ischemia/reperfusion injury.


Assuntos
Ácidos Araquidônicos/farmacologia , Ciclo-Oxigenase 2/metabolismo , Modelos Animais de Doenças , Traumatismo por Reperfusão/prevenção & controle , Animais , Animais Recém-Nascidos , Ratos , Traumatismo por Reperfusão/metabolismo
15.
Klin Padiatr ; 222(3): 145-9, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20514617

RESUMO

BACKGROUND: Since prevalence of and reasons for infertility were unclear in survivors of childhood cancer we conducted a two centre survey in 2006 and nationwide in 2008. In 2008/2009 we undertook a study entitled "Hormone and Sperm Analyses after Chemo- and Radiotherapy in Childhood and Adolescence". PATIENTS AND METHODS: Letters were sent to 748 former paediatric oncological patients who were at least 18 years of age at the time of the survey. Serum and sperm samples were analysed. RESULTS: We obtained 159 blood samples (86 women, 73 men). 42 men took part in the sperm analyses. The average participants' age at the time of the survey was 25 years. The anti-Mullerian hormone levels (AMH) in 14/86 female participants (16 %) were < 0.1 ng/ml. The follicular reserve of these women seemed manifestly impaired, which is consistent with suspected infertility. The AMH levels in 21/86 women (24 %) were 0.1 - 1.0 ng/ml indicating limited follicular reserve and therefore suspected early ovarian failure. Inhibin B levels of < 80 pg/ml and FSH levels of > 10 IU/L were found in 23/73 male participants (32 %), which may indicate impaired spermiogenesis with increased risk of infertility. 13/42 sperm analyses (31 %) revealed azoospermia. DISCUSSION: Paediatric oncological therapy seems to have led to fertility impairment in about 1/3 of the participants. Considering this serious impairment, patients and their families should be given comprehensive counselling ahead of therapy to enable fertility-preserving measures. For persons who wish to have children after undergoing therapy we recommend a hormone and sperm analysis. An early analysis may enable a more successful family planning.


Assuntos
Hormônios Esteroides Gonadais/sangue , Infertilidade Feminina/etiologia , Infertilidade Masculina/etiologia , Neoplasias/tratamento farmacológico , Neoplasias/radioterapia , Folículo Ovariano/efeitos da radiação , Lesões por Radiação/etiologia , Espermatogênese/efeitos dos fármacos , Espermatogênese/efeitos da radiação , Testículo/efeitos da radiação , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Gravidez , Técnicas de Reprodução Assistida , Fatores de Risco , Adulto Jovem
16.
Clin Pharmacol Ther ; 87(4): 452-8, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20054293

RESUMO

In patients with dilated cardiomyopathy (DCM), cardiac autoantibodies are able to bind with their Fab fragment to epitopes on cardiomyocytes, but thereafter they crosslink through their Fc fragment to cardiac Fc(gamma)-receptor IIa. Polymorphic variability of the Fc(gamma)-receptor IIa is associated with modified affinity of immunoglobin G (IgG) binding and may influence therapeutic effects. In this study, 103 consecutive DCM patients were treated with immunoadsorption (IA) therapy with subsequent IgG substitution (IA/IgG). Echocardiography was performed at baseline and again at 3 and 6 months after IA/IgG. Fc(gamma)-receptor IIa polymorphism R/H131 was genotyped using a nested sequence-specific primer polymerase chain reaction (PCR). Patients with the Fc(gamma)-receptor IIa genotype R/R131 showed significantly greater improvement in left ventricular (LV) function than patients with the R/H131 or H/H131 genotypes did. Irrespective of the Fc(gamma)-receptor polymorphism, patients with shorter disease duration and a more impaired LV function responded with a greater increase in LV ejection fraction (LVEF). Therefore, the Fc(gamma)-receptor polymorphism influences the efficacy of immunomodulatory therapy involving IA/IgG.


Assuntos
Cardiomiopatia Dilatada/fisiopatologia , Imunoglobulina G/imunologia , Polimorfismo Genético , Receptores de IgG/genética , Autoanticorpos/imunologia , Cardiomiopatia Dilatada/genética , Ecocardiografia , Epitopos , Feminino , Seguimentos , Genótipo , Humanos , Técnicas de Imunoadsorção , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Disfunção Ventricular Esquerda/genética , Disfunção Ventricular Esquerda/fisiopatologia
17.
Cardiology ; 113(3): 222-30, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19246898

RESUMO

OBJECTIVES: This report focuses on the design and methods of the 3-centre clinical study of the Transregional Collaborative Research Centre 'Inflammatory Cardiomyopathy--Molecular Pathogenesis and Therapy', which aims to establish a comprehensive research registry on the diagnostics, therapy and disease outcomes of patients with inflammatory cardiomyopathy (CMi). The study goals are to investigate specific disease sub-entities and to develop standardised strategies for diagnostics and treatment. METHODS: All consecutive patients with clinically suspected CMi, post-myocarditic cardiomyopathy and acute myocarditis are included in the research registry. Cardiopulmonary functional tests, clinical and patient data are obtained at baseline and subsequent readmission appointments and are linked to allow for prospective follow-up. Co-morbidities, quality of life, health- related behaviour and sociodemographic variables are ascertained using uniform self-administered questionnaires. PRESENT STATUS: By May 2008, 2,061 cases had been included in the research registry (1,300 data-sets completed). At registration, 335 patients were diagnosed with CMi. The mean age was 50 +/- 13 years and the mean ejection fraction was 39.9 +/- 15.8%. CONCLUSIONS: The broad range of the acquired molecular-biological, histological, immunohistological, clinical and patient data makes this the most comprehensive research registry on patients with CMi to date.


Assuntos
Cardiomiopatias , Miocardite , Doença Aguda , Adulto , Idoso , Cardiomegalia/epidemiologia , Cardiomiopatias/diagnóstico , Cardiomiopatias/epidemiologia , Cardiomiopatias/terapia , Comorbidade , Comportamento Cooperativo , Feminino , Seguimentos , Doenças Genéticas Inatas/epidemiologia , Alemanha , Comportamentos Relacionados com a Saúde , Humanos , Infecções/epidemiologia , Masculino , Pessoa de Meia-Idade , Miocardite/diagnóstico , Miocardite/epidemiologia , Miocardite/terapia , Prognóstico , Qualidade de Vida , Sistema de Registros , Fatores de Risco , Fatores Socioeconômicos
18.
Eur J Clin Invest ; 38(12): 902-9, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19021714

RESUMO

BACKGROUND: After ischaemia and during reperfusion, rat hearts release cardiodepressive substances that are putatively cyclooxygenase-2-dependent. The present study analyses the mechanisms by which these substances mediate their effect downstream of cyclooxygenase-2. MATERIALS AND METHODS: After 10 min of global stop-flow ischaemia, isolated rat hearts were reperfused and post-ischaemic coronary effluent was collected over a period of 30 s. Non-ischaemic effluent collected before ischaemia was used as a control. We investigated the effect of the effluents on cell shortening and Ca(++)-metabolism, by application of fluorescence microscopy of field-stimulated adult rat cardiomyocytes incubated with fura-2. Cells were pre-incubated with inhibitors of protein kinase A and C and with antagonists of protein kinase A-dependent prostaglandin receptors. We examined the expression of prostaglandin receptors in cardiomyocytes by Western blotting. RESULTS: In contrast to non-ischaemic effluent, post-ischaemic effluent induced reduction of Ca(++) transient and cell shortening in the cardiomyocytes. In contrast to protein kinase C inhibitor Myr-PKC [19-27], the protein kinase A inhibitor Rp-cAMPS completely blocked the effect of post-ischaemic effluent. Furthermore, we determined a cyclic adenosine monophosphate increase in cardiomyocytes that were pre-incubated with post-ischaemic effluent. The antagonist of prostaglandin E-receptor EP2 AH6809 and the antagonist of receptor subtype EP4 AH23848 attenuated the effect of post-ischaemic effluent in contrast to other antagonists of prostaglandin D and I receptors, which did not influence the effect. In lysates of adherend cardiomyocytes, expression of prostaglandin D, E and I receptors was detected by Western blotting. CONCLUSIONS: The effect of post-ischaemic effluent is mediated by the protein kinase A-dependent prostaglandin-receptor subtypes EP2 and EP4 downstream of cyclooxygenase-2.


Assuntos
Proteínas Quinases Dependentes de AMP Cíclico/farmacologia , Coração/efeitos dos fármacos , Isquemia Miocárdica/metabolismo , Miócitos Cardíacos/metabolismo , Proteína Quinase C/farmacologia , Receptores de Prostaglandina/fisiologia , Animais , Western Blotting , Proteínas Quinases Dependentes de AMP Cíclico/antagonistas & inibidores , Proteínas Quinases Dependentes de AMP Cíclico/metabolismo , Inibidores de Ciclo-Oxigenase/metabolismo , Reperfusão Miocárdica , Proteína Quinase C/antagonistas & inibidores , Proteína Quinase C/metabolismo , Ratos , Ratos Wistar , Receptores de Prostaglandina/antagonistas & inibidores
20.
Internist (Berl) ; 49(1): 51-6, 2008 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-18071664

RESUMO

Abnormalities of the cellular and humoral immune system have been described in patients with dilated cardiomyopathy (DCM). For patients with DCM, immunochemical analyses of myocardial biopsies have demonstrated myocardial inflammation. Various circulating cardiac antibodies have been detected among DCM patients. Circulating antibodies are extractable by immunoadsorption. Recent open controlled pilot studies showed that removal of antibodies by immunoadsorption induces improvement of cardiac function in DCM. Furthermore, it decreases myocardial inflammation. This may offer a new therapeutic option for patients with severe heart failure due to dilated cardiomyopathy.


Assuntos
Cardiomiopatia Dilatada/imunologia , Cardiomiopatia Dilatada/terapia , Ensaios Clínicos como Assunto , Fatores Imunológicos/administração & dosagem , Fatores Imunológicos/imunologia , Humanos , Técnicas de Imunoadsorção , Resultado do Tratamento
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