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1.
Acta Ophthalmol ; 100(2): e521-e531, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34085771

RESUMO

PURPOSE: To assess the effect of clinical factors on the development and progression of atrophy and fibrosis in patients with neovascular age-related macular degeneration (nAMD) receiving long-term treatment in the real world. METHODS: An ambispective 36-month multicentre study, involving 359 nAMD patients from 17 Spanish hospitals treated according to the Spanish Vitreoretinal Society guidelines, was designed. The influence of demographic and clinical factors, including the presence and location of retinal fluid, on best-corrected visual acuity (BCVA) and progression to atrophy and/or fibrosis were analysed. RESULTS: After 36 months of follow-up and an average of 13.8 anti-VEGF intravitreal injections, the average BCVA gain was +1.5 letters, and atrophy and/or fibrosis were present in 54.8% of nAMD patients (OR = 8.54, 95% CI = 5.85-12.47, compared to baseline). Atrophy was associated with basal intraretinal fluid (IRF) (OR = 1.87, 95% CI = 1.09-3.20), whereas basal subretinal fluid (SRF) was associated with a lower rate of atrophy (OR = 0.40, 95% CI = 0.23-0.71) and its progression (OR = 0.44, 95% CI = 0.26-0.75), leading to a slow progression rate (OR = 0.34, 95% CI = 0.14-0.83). Fibrosis development and progression were related to IRF at any visit (p < 0.001). In contrast, 36-month SRF was related to a lower rate of fibrosis (OR = 0.49, 95% CI = 0.29-0.81) and its progression (OR = 0.50, 95% CI = 0.31-0.81). CONCLUSION: Atrophy and/or fibrosis were present in 1 of 2 nAMD patients treated for 3 years. Both, especially fibrosis, lead to vision loss. Subretinal fluid (SRF) was associated with good visual outcomes and lower rates of atrophy and fibrosis, whereas IRF yields worse visual results and a higher risk of atrophy and especially fibrosis in routine clinical practice.


Assuntos
Degeneração Macular/fisiopatologia , Líquido Sub-Retiniano/metabolismo , Idoso , Idoso de 80 Anos ou mais , Inibidores da Angiogênese , Atrofia/fisiopatologia , Atrofia/prevenção & controle , Progressão da Doença , Feminino , Fibrose/fisiopatologia , Fibrose/prevenção & controle , Humanos , Injeções Intravítreas , Masculino , Estudos Prospectivos , Estudos Retrospectivos
3.
J Alzheimers Dis ; 83(3): 1017-1023, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34366349

RESUMO

One of the mutations in the microtubule-associated protein tau, P301S, is causative for dominantly inherited frontotemporal dementia characterized by extensive tau pathology for which no licensed treatment is available. Hydromethylthionine is a potent tau aggregation inhibitor. We report treatment of an asymptomatic carrier of the P301S mutation using hydromethylthionine over a 5-year period beginning at the mean age of onset of clinical decline in the family. During the period of treatment, the rates of progression of cerebral atrophy were reduced by 61%-66% in frontal and temporal lobes, and the patient remained clinically asymptomatic.


Assuntos
Atrofia , Portador Sadio , Demência Frontotemporal , Azul de Metileno/análogos & derivados , Mutação/genética , Proteínas tau/genética , Adulto , Atrofia/patologia , Atrofia/prevenção & controle , Encéfalo/patologia , Demência Frontotemporal/tratamento farmacológico , Demência Frontotemporal/genética , Humanos , Imageamento por Ressonância Magnética , Masculino , Azul de Metileno/administração & dosagem , Fatores de Tempo
4.
Clin Transl Sci ; 14(6): 2139-2145, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34080307

RESUMO

Mechanical ventilation (MV) is a clinical tool providing adequate alveolar ventilation in patients that require respiratory support. Although a life-saving intervention for critically ill patients, prolonged MV results in the rapid development of inspiratory muscle weakness due to both diaphragmatic atrophy and contractile dysfunction; collectively known as "ventilator-induced diaphragm dysfunction" (VIDD). VIDD is a severe clinical problem because diaphragmatic weakness is a risk factor for difficulties in weaning patients from MV. Currently, no standard treatment to prevent VIDD exists. Nonetheless, growing evidence reveals that hydrogen sulfide (H2 S) possesses cytoprotective properties capable of protecting skeletal muscles against several hallmarks of VIDD, including oxidative damage, accelerated proteolysis, and mitochondrial damage. Therefore, we used an established animal model of MV to test the hypothesis that treatment with sodium sulfide (H2 S donor) will defend against VIDD. Our results confirm that sodium sulfide was sufficient to protect the diaphragm against both MV-induced fiber atrophy and contractile dysfunction. H2 S prevents MV-induced damage to diaphragmatic mitochondria as evidenced by protection against mitochondrial uncoupling. Moreover, treatment with sodium sulfide prevented the MV-induced activation of the proteases, calpain, and caspase-3 in the diaphragm. Taken together, these results support the hypothesis that treatment with a H2 S donor protects the diaphragm against VIDD. These outcomes provide the first evidence that H2 S has therapeutic potential to protect against MV-induced diaphragm weakness and to reduce difficulties in weaning patients from the ventilator. Study Highlights WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC? Mechanical ventilation (MV) results in diaphragm atrophy and contractile dysfunction, known as ventilator-induced diaphragm dysfunction (VIDD). VIDD is important because diaphragm weakness is a risk factor for problems in weaning patients from MV. Currently, no accepted treatment exists to protect against VIDD. Growing evidence reveals that hydrogen sulfide (H2 S) donors protect skeletal muscle against ischemia-reperfusion-induced injury. Nonetheless, it is unknown if treatment with a H2 S donor can protect against VIDD. WHAT QUESTION DID THIS STUDY ADDRESS? Can treatment with an H2 S donor protect against VIDD? WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE? This study provides the first evidence that treatment with a H2 S donor protects against VIDD. HOW MIGHT THIS CHANGE CLINICAL PHARMACOLOGY OR TRANSLATIONAL SCIENCE? These new findings provide the basis for further exploration of H2 S donors as a therapy to prevent VIDD and reduce the risk of problems in weaning patients from MV.


Assuntos
Atrofia/prevenção & controle , Sulfeto de Hidrogênio/metabolismo , Sulfeto de Hidrogênio/farmacologia , Contração Muscular/efeitos dos fármacos , Respiração Artificial/efeitos adversos , Animais , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley
5.
J Clin Psychopharmacol ; 41(3): 244-249, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33814546

RESUMO

PURPOSE/BACKGROUND: Hippocampal volume loss in early schizophrenia has been linked with markers of inflammation and oxidative stress, and with less response of negative symptoms. Aripiprazole has been reported to preserve hippocampal volume and to reduce inflammation. METHODS/PROCEDURES: Study 1 was a 12-month multicenter randomized placebo-controlled trial of citalopram added to clinician-determined second-generation antipsychotic medication in 95 patients with first-episode schizophrenia (FES), 19 of whom received aripiprazole. We compared participants taking aripiprazole with those on other antipsychotics to determine whether those on aripiprazole had less hippocampal volume loss. We also examined peripheral biomarker data from medication-naive patients with schizophrenia receiving 8 weeks of antipsychotic treatment (n = 24) to see whether markers of inflammation and oxidative stress that previously predicted hippocampal volume differed between aripiprazole (n = 9) and other antipsychotics (study 2). FINDINGS/RESULTS: Aripiprazole was associated with a mean increase in hippocampal volume of 0.35% (SD, 0.80%) compared with a 0.53% decrease (SD, 1.2%) with other antipsychotics during the first year of maintenance treatment in patients with FES. This difference was significant after adjusting for age, sex, citalopram treatment, and baseline Brief Psychiatric Rating Scale score (B = 0.0079, P = 0.03). Aripiprazole was also associated with reduced concentrations of the inflammatory cytokines interleukin-8 and tumor necrosis factor (P < 0.01) during the first 8 weeks of treatment in medication-naive patients with FES. IMPLICATIONS/CONCLUSIONS: These results suggest that aripiprazole may protect against hippocampal atrophy via an anti-inflammatory mechanism, but these results require replication in larger, randomized trials, and the clinical relevance of hippocampal volume loss is not established.


Assuntos
Antipsicóticos/administração & dosagem , Aripiprazol/administração & dosagem , Hipocampo/efeitos dos fármacos , Esquizofrenia/tratamento farmacológico , Adolescente , Adulto , Antipsicóticos/farmacologia , Aripiprazol/farmacologia , Atrofia/prevenção & controle , Escalas de Graduação Psiquiátrica Breve , Feminino , Hipocampo/patologia , Humanos , Inflamação/tratamento farmacológico , Inflamação/patologia , Masculino , Estresse Oxidativo/efeitos dos fármacos , Esquizofrenia/fisiopatologia , Resultado do Tratamento , Adulto Jovem
6.
Sci Rep ; 11(1): 5017, 2021 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-33658541

RESUMO

The mammillary bodies (MB) and hippocampi are important for memory function and are often affected following neonatal hypoxic ischemic encephalopathy (HIE). The aim of this study was to assess neurodevelopmental outcome in 10-year-old children with HIE with and without therapeutic hypothermia. Additional aims were to assess the associations between MB atrophy, brain volumes (including the hippocampi), white matter microstructure and neurodevelopmental outcome at school-age. Ten-year-old children with HIE were included, who were treated with therapeutic hypothermia (n = 22) or would have qualified but were born before this became standard of care (n = 28). Children completed a neuropsychological and motor assessment and MRI. Mammillary bodies were scored as normal or atrophic at 10 years. Brain volumes were segmented on childhood MRI and DTI scans were analysed using tract-based spatial statistics. Children with HIE suffered from neurocognitive and memory problems at school-age, irrespective of hypothermia. Hippocampal volumes and MB atrophy were associated with total and performance IQ, processing speed and episodic memory in both groups. Normal MB and larger hippocampi were positively associated with global fractional anisotropy. In conclusion, injury to the MB and hippocampi was associated with neurocognition and memory at school-age in HIE and might be an early biomarker for neurocognitive and memory problems.


Assuntos
Atrofia/fisiopatologia , Hipocampo/fisiopatologia , Hipotermia Induzida/métodos , Hipóxia-Isquemia Encefálica/fisiopatologia , Corpos Mamilares/fisiopatologia , Substância Branca/fisiopatologia , Anisotropia , Atrofia/diagnóstico por imagem , Atrofia/patologia , Atrofia/prevenção & controle , Criança , Imagem de Tensor de Difusão , Feminino , Hipocampo/diagnóstico por imagem , Hipocampo/patologia , Humanos , Hipóxia-Isquemia Encefálica/diagnóstico por imagem , Hipóxia-Isquemia Encefálica/patologia , Hipóxia-Isquemia Encefálica/terapia , Recém-Nascido , Masculino , Corpos Mamilares/diagnóstico por imagem , Corpos Mamilares/patologia , Memória/fisiologia , Países Baixos , Testes Neuropsicológicos , Desempenho Psicomotor/fisiologia , Estudos Retrospectivos , Instituições Acadêmicas , Estudantes , Substância Branca/diagnóstico por imagem , Substância Branca/patologia
7.
Psychol Med ; 51(7): 1201-1210, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-31983348

RESUMO

BACKGROUND: Lithium (Li) is the gold standard treatment for bipolar disorder (BD). However, its mechanisms of action remain unknown but include neurotrophic effects. We here investigated the influence of Li on cortical and local grey matter (GM) volumes in a large international sample of patients with BD and healthy controls (HC). METHODS: We analyzed high-resolution T1-weighted structural magnetic resonance imaging scans of 271 patients with BD type I (120 undergoing Li) and 316 HC. Cortical and local GM volumes were compared using voxel-wise approaches with voxel-based morphometry and SIENAX using FSL. We used multiple linear regression models to test the influence of Li on cortical and local GM volumes, taking into account potential confounding factors such as a history of alcohol misuse. RESULTS: Patients taking Li had greater cortical GM volume than patients without. Patients undergoing Li had greater regional GM volumes in the right middle frontal gyrus, the right anterior cingulate gyrus, and the left fusiform gyrus in comparison with patients not taking Li. CONCLUSIONS: Our results in a large multicentric sample support the hypothesis that Li could exert neurotrophic and neuroprotective effects limiting pathological GM atrophy in key brain regions associated with BD.


Assuntos
Antimaníacos/uso terapêutico , Atrofia/prevenção & controle , Transtorno Bipolar/tratamento farmacológico , Substância Cinzenta/patologia , Compostos de Lítio/uso terapêutico , Adulto , Estudos de Casos e Controles , Feminino , Giro do Cíngulo/patologia , Hipocampo/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Lobo Temporal/patologia
8.
Clin Transl Sci ; 14(2): 481-486, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33222389

RESUMO

Mechanical ventilation (MV) is a life-saving intervention for many critically ill patients. Unfortunately, prolonged MV results in the rapid development of inspiratory muscle weakness due to diaphragmatic atrophy and contractile dysfunction (termed ventilator-induced diaphragm dysfunction (VIDD)). Although VIDD is a major risk factor for problems in weaning patients from MV, a standard therapy to prevent VIDD does not exist. However, emerging evidence suggests that pharmacological blockade of angiotensin II type 1 receptors (AT1Rs) protects against VIDD. Nonetheless, the essential characteristics of AT1R blockers (ARBs) required to protect against VIDD remain unclear. To determine the traits of ARBs that are vital for protection against VIDD, we compared the efficacy of two clinically relevant ARBs, irbesartan and olmesartan; these ARBs differ in molecular structure and effects on AT1Rs. Specifically, olmesartan blocks both angiotensin II (AngII) binding and mechanical activation of AT1Rs, whereas irbesartan prevents only AngII binding to AT1Rs. Using a well-established preclinical model of prolonged MV, we tested the hypothesis that compared with irbesartan, olmesartan provides greater protection against VIDD. Our results reveal that irbesartan does not protect against VIDD whereas olmesartan defends against both MV-induced diaphragmatic atrophy and contractile dysfunction. These findings support the hypothesis that olmesartan is superior to irbesartan in protecting against VIDD and are consistent with the concept that blockade of mechanical activation of AT1Rs is a required property of ARBs to shield against VIDD. These important findings provide a foundation for future clinical trials to evaluate ARBs as a therapy to protect against VIDD.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem , Diafragma/patologia , Respiração Artificial/efeitos adversos , Animais , Atrofia/etiologia , Atrofia/prevenção & controle , Diafragma/efeitos dos fármacos , Modelos Animais de Doenças , Avaliação Pré-Clínica de Medicamentos , Feminino , Humanos , Imidazóis/administração & dosagem , Irbesartana/administração & dosagem , Ratos , Respiração Artificial/instrumentação , Tetrazóis/administração & dosagem , Ventiladores Mecânicos/efeitos adversos
9.
Braz. J. Pharm. Sci. (Online) ; 57: e18976, 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1345448

RESUMO

Phosphodiesterase-5 inhibitors (PDE-5Is) exert positive effects on bone healing and mineralization by activation the nitric oxide/cyclic guanosine monophosphate/protein kinase-G (NO/cGMP/PKG) signaling pathway. In this study, the effects of zaprinast and avanafil, two PDE-5Is, on the NO signaling pathway, estrogen levels, selected bone formation and destruction marker levels, whole-body bone mineral density (WB-BMD), right femur trabecular bone thickness (RF-TBT) and epiphyseal bone width, angiogenesis in the bone-marrow, and selected oxidative stress parameter levels were investigated in rats with ovariectomy-induced osteoporosis. Twenty four adult rats (8 months old) were equally divided into four groups. The first group was the sham operated group. Groups 2, 3 and 4 included ovariectomized rats. At six months after ovariectomy, the 3rd and 4th groups were administered 10 mg/kg zaprinast and avanafil daily as a single dose for 60 days, respectively. Increases in the activity of the NO/cGMP/PKG signalling-pathway, C-terminal collagen peptide levels, angiogenesis in the bone marrow, RF-TBT, epiphyseal bone width and WB-BMD were observed compared to the ovariectomized positive control group (OVX), while the pyridinoline and deoxypyridinoline levels were decreased in the OVX+zaprinast and OVX+avanafil groups (p<0.05). The malondialdehyde, ubiquinone10/ubiquinol10 and 8-hydroxy-2-deoxyguanosine/106deoxyguanosine levels were also increased in the ovariectomized groups compared to the sham group (p<0.05). Based on these results, the levels of bone atrophy and some markers of oxidative stress were increased due to acute estrogen deficiency induced by ovariectomy, but zaprinast and avanafil administration significantly prevented these changes


Assuntos
Animais , Masculino , Feminino , Ratos , Proteínas Quinases , Osso e Ossos , Nucleotídeo Cíclico Fosfodiesterase do Tipo 5 , Osteoporose/complicações , Atrofia/prevenção & controle , Ovariectomia/classificação , Densidade Óssea/fisiologia , Dose Única/classificação , Estresse Oxidativo
10.
Nutrients ; 12(10)2020 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-33086629

RESUMO

BACKGROUND: Cachexia induced by cancer is a systemic wasting syndrome and it accompanies continuous body weight loss with the exhaustion of skeletal muscle and adipose tissue. Cancer cachexia is not only a problem in itself, but it also reduces the effectiveness of treatments and deteriorates quality of life. However, effective treatments have not been found yet. Although Arctii Fructus (AF) has been studied about several pharmacological effects, there were no reports on its use in cancer cachexia. METHODS: To induce cancer cachexia in mice, we inoculated CT-26 cells to BALB/c mice through subcutaneous injection and intraperitoneal injection. To mimic cancer cachexia in vitro, we used conditioned media (CM), which was CT-26 colon cancer cells cultured medium. RESULTS: In in vivo experiments, AF suppressed expression of interleukin (IL)-6 and atrophy of skeletal muscle and adipose tissue. As a result, the administration of AF decreased mortality by preventing weight loss. In adipose tissue, AF decreased expression of uncoupling protein 1 (UCP1) by restoring AMP-activated protein kinase (AMPK) activation. In in vitro model, CM increased muscle degradation factors and decreased adipocytes differentiation factors. However, these tendencies were ameliorated by AF treatment in C2C12 myoblasts and 3T3-L1 cells. CONCLUSION: Taken together, our study demonstrated that AF could be a therapeutic supplement for patients suffering from cancer cachexia.


Assuntos
Tecido Adiposo/patologia , Arctium/química , Caquexia/tratamento farmacológico , Músculo Esquelético/patologia , Fitoterapia , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Redução de Peso/efeitos dos fármacos , Células 3T3-L1 , Proteínas Quinases Ativadas por AMP/metabolismo , Animais , Atrofia/prevenção & controle , Caquexia/etiologia , Caquexia/genética , Expressão Gênica/efeitos dos fármacos , Interleucina-6/genética , Interleucina-6/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Neoplasias/complicações , Extratos Vegetais/isolamento & purificação , Células Tumorais Cultivadas , Proteína Desacopladora 1/genética , Proteína Desacopladora 1/metabolismo
11.
Cell Mol Gastroenterol Hepatol ; 10(3): 561-579, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32376420

RESUMO

BACKGROUND & AIMS: The association between chronic inflammation and gastric carcinogenesis is well established, but it is not clear how immune cells and cytokines regulate this process. We investigated the role of interleukin 27 (IL27) in the development of gastric atrophy, hyperplasia, and metaplasia (preneoplastic lesions associated with inflammation-induced gastric cancer) in mice with autoimmune gastritis. METHODS: We performed studies with TxA23 mice (control mice), which express a T-cell receptor against the H+/K+ adenosine triphosphatase α chain and develop autoimmune gastritis, and TxA23xEbi3-/- mice, which develop gastritis but do not express IL27. In some experiments, mice were given high-dose tamoxifen to induce parietal cell atrophy and spasmolytic polypeptide-expressing metaplasia (SPEM). Recombinant IL27 was administered to mice with mini osmotic pumps. Stomachs were collected and analyzed by histopathology and immunofluorescence; we used flow cytometry to measure IL27 and identify immune cells that secrete IL27 in the gastric mucosa. Single-cell RNA sequencing was performed on immune cells that infiltrated stomach tissues. RESULTS: We identified IL27-secreting macrophages and dendritic cell in the corpus of mice with chronic gastritis (TxA23 mice). Mice deficient in IL27 developed more severe gastritis, atrophy, and SPEM than control mice. Administration of recombinant IL27 significantly reduced the severity of inflammation, atrophy, and SPEM in mice with gastritis. Single-cell RNA sequencing showed that IL27 acted almost exclusively on stomach-infiltrating CD4+ T cells to suppress expression of inflammatory genes. CONCLUSIONS: In studies of mice with autoimmune gastritis, we found that IL27 is an inhibitor of gastritis and SPEM, suppressing CD4+ T-cell-mediated inflammation in the gastric mucosa.


Assuntos
Doenças Autoimunes/tratamento farmacológico , Mucosa Gástrica/patologia , Gastrite/tratamento farmacológico , Interleucinas/administração & dosagem , Lesões Pré-Cancerosas/prevenção & controle , Animais , Atrofia/imunologia , Atrofia/patologia , Atrofia/prevenção & controle , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/imunologia , Doenças Autoimunes/patologia , Linfócitos T CD4-Positivos/efeitos dos fármacos , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD4-Positivos/metabolismo , Doença Crônica/tratamento farmacológico , Modelos Animais de Doenças , Feminino , Mucosa Gástrica/citologia , Mucosa Gástrica/efeitos dos fármacos , Mucosa Gástrica/imunologia , Gastrite/diagnóstico , Gastrite/imunologia , Gastrite/patologia , Humanos , Masculino , Metaplasia/imunologia , Metaplasia/patologia , Metaplasia/prevenção & controle , Camundongos , Camundongos Knockout , Antígenos de Histocompatibilidade Menor/genética , Lesões Pré-Cancerosas/imunologia , Lesões Pré-Cancerosas/patologia , Receptores de Citocinas/genética , Proteínas Recombinantes/administração & dosagem , Índice de Gravidade de Doença
12.
Nutrients ; 12(1)2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31936294

RESUMO

Chronic stress can impair the health of human brains. An important strategy that may prevent the accumulation of stress may be the consumption of functional foods. When senescence-accelerated mice prone 10 (SAMP10), a stress-sensitive strain, were loaded with stress using imposed male mouse territoriality, brain volume decreased. However, in mice that ingested theanine (6 mg/kg), the main amino acid in tea leaves, brain atrophy was suppressed, even under stress. On the other hand, brain atrophy was not clearly observed in a mouse strain that aged normally (Slc:ddY). The expression level of the transcription factor Npas4 (neuronal PAS domain protein 4), which regulates the formation and maintenance of inhibitory synapses in response to excitatory synaptic activity, decreased in the hippocampus and prefrontal cortex of stressed SAMP10 mice, but increased in mice that ingested theanine. Lipocalin 2 (Lcn2), the expression of which increased in response to stress, was significantly high in the hippocampus and prefrontal cortex of stressed SAMP10 mice, but not in mice that ingested theanine. These data suggest that Npas4 and Lcn2 are involved in the brain atrophy and stress vulnerability of SAMP10 mice, which are prevented by the consumption of theanine, causing changes in the expression of these genes.


Assuntos
Encefalopatias/prevenção & controle , Glutamatos/farmacologia , Estresse Psicológico , Chá/química , Animais , Atrofia/prevenção & controle , Glutamatos/química , Hipocampo/efeitos dos fármacos , Abrigo para Animais , Masculino , Camundongos
13.
Andrologia ; 52(1): e13477, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31713875

RESUMO

The purpose of this study was to follow up patients who underwent testicular torsion orchiopexies in order to observe whether testicular atrophy had occurred and to identify any influencing factors regarding atrophy. Patient data collected in this study included age, symptom duration, pre-operative preparation time, cryptorchidism testicular torsion, spermatic cord torsion degree, ultrasound findings at least 6 months after orchiopexy, testicular atrophy, mean platelet volume (MPV), address and medical insurance. Twenty-nine patients with a mean age of 147 (126.5-163) months involved in our study. The duration of follow-up ranged from 6 to 33 months with a median follow-up duration of 12 (8.5-21) months. Only MPV was significantly different between the atrophy group and nonatrophic group (p = .022) and the receiver operating characteristic (ROC) curve revealed that the cut-off value for MPV atrophy was 9.9 fl, with a sensitivity of 81.8% and a specificity of 70.6%. In conclusion, we found that 41.4% patients eventually experienced testicular atrophy after performing the testicular salvage procedure. MPV might be used as an indicator of testicular atrophy after an operation; however, the accuracy of MPV needs to be confirmed using significant follow-up prospective studies.


Assuntos
Criptorquidismo/cirurgia , Orquidopexia , Terapia de Salvação/métodos , Torção do Cordão Espermático/cirurgia , Testículo/patologia , Atrofia/sangue , Atrofia/diagnóstico , Atrofia/etiologia , Atrofia/prevenção & controle , Criança , Criptorquidismo/complicações , Seguimentos , Humanos , Masculino , Volume Plaquetário Médio , Prognóstico , Estudos Prospectivos , Torção do Cordão Espermático/complicações , Testículo/diagnóstico por imagem , Testículo/cirurgia , Resultado do Tratamento , Ultrassonografia
14.
J Am Acad Dermatol ; 83(2): 440-446, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31626881

RESUMO

BACKGROUND: Cutaneous eruptions in neonatal lupus erythematosus (NLE) are thought to be self-resolving. Limited literature suggests cutaneous changes may persist. OBJECTIVE: To characterize cutaneous residua in NLE and identify predictors for their development. METHODS: A retrospective cohort study of patients with cutaneous NLE born between January 1980 and May 2017 was performed. Primary outcome was the proportion of patients with cutaneous residua. Secondary outcomes included associations/predictors of sequelae. RESULTS: At the last follow-up, at a mean age of 4 years (range, 0.5-18.7 years), 34% of 106 patients had cutaneous sequelae, 13% had telangiectasia, 17% had dyspigmentation, and 9% had atrophic scarring. Scarring at the last follow-up was significantly associated with the presence of skin lesions at birth (P < .001). LIMITATIONS: This study was limited by the retrospective design, short follow-up duration in a subset of patients, and small sample size. CONCLUSION: Cutaneous NLE can exhibit long-term cutaneous residua. These findings underlie the importance of accurate diagnosis, long-term monitoring, and appropriate counseling.


Assuntos
Cicatriz/epidemiologia , Lúpus Eritematoso Sistêmico/congênito , Transtornos da Pigmentação/epidemiologia , Pele/patologia , Telangiectasia/epidemiologia , Adolescente , Atrofia/epidemiologia , Atrofia/imunologia , Atrofia/patologia , Atrofia/prevenção & controle , Criança , Pré-Escolar , Cicatriz/imunologia , Cicatriz/patologia , Cicatriz/prevenção & controle , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/imunologia , Lúpus Eritematoso Sistêmico/terapia , Masculino , Transtornos da Pigmentação/imunologia , Transtornos da Pigmentação/prevenção & controle , Estudos Retrospectivos , Pele/imunologia , Telangiectasia/imunologia , Telangiectasia/prevenção & controle
15.
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 30(5): 222-227, sept.-oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183875

RESUMO

Introducción: Existen diferentes técnicas para reconstrucción del músculo temporal (MT) en el abordaje pterional (AP) con el objetivo de evitar y disminuir la atrofia, hasta el momento ninguna ha logrado evitarla en su totalidad. La administración de bupivacaína genera regeneración de fibras musculares. Aún no existe en la literatura médica estudios que evalúen el tiempo de manipulación del MT y que den uso a la bupivacaína para el tratamiento de la atrofia después de un abordaje pterional, el presente estudio pretende describir los efectos de estas variables. Pacientes y métodos: Estudio longitudinal, incluyendo pacientes de 18-80 años y sometidos a abordaje pterional en los años 2016-2017. Evaluamos los efectos de la manipulación del MT y la administración de bupivacaína al 0,5% sobre el trofismo y la función del MT. Resultados: Veintinueve pacientes fueron sometidos a AP; 16(55,17%) contaron con criterios para infiltración con bupivacina al 0,5%. Se encontró una correlación negativa entre los tiempos de manipulación y el trofismo, no estadísticamente significativo (p>0,05). Se evalúo los índices de disfunción de Helkimo y Fonseca prequirúrgicos y posquirúrgicos encontrándose un incremento estadísticamente significativo en la disfunción (p<0,05). En pacientes infiltrados con bupivacaína al 0,5% se observó una diferencia media del espesor de MT de 0,275±1,18mm, en contraste con los no infiltrados de 2,39±1,30mm (t[27] = -5,118, p=0,0001). Conclusiones: La manipulación del MT durante el abordaje pterional, condiciona un impacto sobre la calidad de vida de acuerdo con los índices de disfunción, debido a la atrofia. Esta investigación presenta que la administración de bupivacaína al 0,5% durante la cirugía ofrece una disminución en la atrofia del MT


Introduction: There are different techniques for the reconstruction of the temporal muscle (TM) in the pterional approach (PA) in order to avoid and reduce atrophy, it has not been able to avoid it in its entirety. The administration of bupivacaine generates regeneration of muscle fibres. There are no studies in the medical literature that evaluate the time of TM manipulation and the use of bupivacaine for the treatment of atrophy after pterional approach, the present investigation aim is to describe the effects of these variables. Patient and methods: Longitudinal study, including patients from 18-80 years old with pterional approach at 2016-2017. We evaluated the effects of the TM manipulation times and the administration of 0.5% bupivacaine on the trophism and function of TM. Results: Twenty-nine patients underwent a PA; 16(55.17%) count with criteria for 0.5% bupivacain infiltration. We found a negative correlation between manipulation times and trophism, with no statistically significance (p>.05). We evaluated presurgical and postsurgical index of Helkimo and Fonseca's index, finding an increase of disfunction with statistically significance (p<.05). In patients who were infiltrated with 0.5% bupivacaine we observed a mean difference in the TM's trophism of 0.275±1.18mm, in contrast with no infiltrated which was 2.39±1.30mm (t[27] = -5.118, p=.0001). Conclusions: The manipulation of the TM during a pterional approach conditioned an impact on the quality of life according to the disfunction indexes, due to atrophy. This investigation exhibits that de administration of 0.5% bupivacaine during surgery offers a decrease in the TM atrophy


Assuntos
Humanos , Músculo Temporal/cirurgia , Atrofia/prevenção & controle , Atrofia/cirurgia , Bupivacaína/administração & dosagem , Craniotomia/métodos , Músculo Temporal/efeitos dos fármacos , Fibras Musculares Esqueléticas , Estudos Longitudinais , Retalhos Cirúrgicos
16.
BMC Pulm Med ; 19(1): 103, 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170951

RESUMO

BACKGROUND: This study assessed the effects of ursolic acid (UA) on airway-vessel remodeling and muscle atrophy in cigarette smoke (CS)-induced emphysema rats and investigated potential underlying mechanisms. METHODS: Emphysema was induced in a rat model with 3 months of CS exposure. Histology and immunohistochemistry (IHC) stains were used to assess airway-vessel remodeling and muscle atrophy-associated changes. Levels of cleaved-caspase3, 8-OHdG, and S100A4 were measured in airways and associated vessels to evaluate cell apoptosis, oxidant stress, epithelial-to-mesenchymal transition (EMT), and endothelial-to-mesenchymal transition (EndMT)-associated factors. Western blot and/or IHC analyses were performed to measure transforming growth factor-beta 1(TGF-ß1)/Smad2.3, alpha-smooth muscle actin (α-SMA), and insulin-like growth factor 1 (IGF1) expression. We also gave cultured HBE and HUVEC cells Cigarette Smoke Extract (CSE) administration and UA intervention. Using Western blot method to measure TGF-ß1/Smad2.3, α-SMA, S100A4, and IGF1 molecules expression. RESULTS: UA decreased oxidant stress and cell apoptosis in airway and accompanying vascular walls of cigarette smoke-induced emphysema model rats. UA alleviated EMT, EndMT, changes associated with airway-vessel remodeling and muscle atrophy. The UA effects were associated with IGF1 and TGF-ß1/Smad2.3 pathways. CONCLUSIONS: UA reduced EMT, EndMT, airway-vessel remodeling, and musculi soleus atrophy in CS-induced emphysema model rats at least partly through IGF1 and TGF-ß1/Smad2.3 signaling pathways.


Assuntos
Remodelação das Vias Aéreas/efeitos dos fármacos , Fumar Cigarros/efeitos adversos , Músculo Esquelético/patologia , Enfisema Pulmonar/prevenção & controle , Transdução de Sinais/efeitos dos fármacos , Triterpenos/farmacologia , Animais , Atrofia/etiologia , Atrofia/prevenção & controle , Inibidores de Ciclo-Oxigenase/farmacologia , Transição Epitelial-Mesenquimal/fisiologia , Fator de Crescimento Insulin-Like I/metabolismo , Masculino , Enfisema Pulmonar/etiologia , Ratos , Ratos Wistar , Proteína Smad2/metabolismo , Fumaça/efeitos adversos , Fator de Crescimento Transformador beta1/metabolismo , Ácido Ursólico
17.
Am J Clin Dermatol ; 20(5): 725-732, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31209851

RESUMO

BACKGROUND: Scarring is a frequent consequence of acne. OBJECTIVES: Our objective was to evaluate the effect of up to 48 weeks' treatment with adapalene 0.3%/benzoyl peroxide 2.5% (A0.3/BPO2.5) gel on atrophic scars in moderate or severe acne vulgaris. METHODS: In Part 1 of this two-part study, A0.3/BPO2.5 gel or vehicle was applied on each half-face for 24 weeks in a randomized, investigator-blinded, split-face design. Part 2 was a 24-week, open-label extension phase during which A0.3/BPO2.5 gel was applied on both sides of the face. Assessments included investigator atrophic acne scar count, Scar Global Assessment (SGA), acne lesion count, local tolerability, and safety. RESULTS: Of the 45 subjects entering Part 2, 41 completed the 48-week study. At baseline (Part 1), most subjects had moderate acne (93.3%) with mild scars (62.2%). The scar count decrease from baseline was 21.7% at week 24 and 26.9% at week 48 on the half-face treated for 48 weeks with A0.3/BPO2.5. For the half-face treated with vehicle followed by 24 weeks' A0.3/BPO2.5, scar count increased by 16.7% at week 24 (under vehicle) and decreased by 22.7% between weeks 24 and 48. The half-face that received 48 weeks' A0.3/BPO2.5 had a lower final atrophic scar count (mean 8.4 vs. 9.9 for the half-face with 24 weeks' vehicle then 24 weeks' A0.3/BPO2.5) and a higher percentage of SGA clear/almost clear. High reductions in acne lesions between baseline and week 48 were observed for both sides of the face. Long-term treatment with A0.3/BPO2.5 was safe and well-tolerated. CONCLUSIONS: Reductions in atrophic acne scars and acne lesions observed after 24 weeks of treatment with A0.3/BPO2.5 gel were maintained with treatment up to 48 weeks. The additional improvement in atrophic scar count with 48 weeks' A0.3/BPO2.5 treatment, compared to delayed application at 24 weeks, highlights the importance of early initiation of effective acne treatment to prevent and reduce the formation of acne scars. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT02735421.


Assuntos
Acne Vulgar/tratamento farmacológico , Combinação Adapaleno e Peróxido de Benzoil/administração & dosagem , Anti-Inflamatórios não Esteroides/administração & dosagem , Cicatriz/prevenção & controle , Pele/patologia , Acne Vulgar/complicações , Acne Vulgar/diagnóstico , Combinação Adapaleno e Peróxido de Benzoil/efeitos adversos , Administração Cutânea , Adolescente , Adulto , Anti-Inflamatórios não Esteroides/efeitos adversos , Atrofia/etiologia , Atrofia/prevenção & controle , Cicatriz/etiologia , Feminino , Géis , Humanos , Masculino , Índice de Gravidade de Doença , Pele/efeitos dos fármacos , Fatores de Tempo , Tempo para o Tratamento , Resultado do Tratamento , Adulto Jovem
18.
PLoS One ; 14(5): e0216726, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31095617

RESUMO

Dystrophic neurites and activated microglia are one of the main neuropathological characteristics of Alzheimer's disease (AD). Although the use of supplements with omega-3 fatty acids has been associated with reduced risk and lessened AD pathology, it still remains elusive whether such a treatment could affect dystrophic neurites (DNs) formation and microglia/macrophage behavior in the early phase of disease. We analyzed the effects of short-term (3 weeks) fish oil supplementation on DNs formation, tau hyperphosphorylation, Amyloid-beta peptide 1-42 (Aß42) levels and microglial/macrophage response to AD pathology in the parietal cortex of 4-month-old 5xFAD mice, a mouse model of AD. The present study shows for the first time that short-term FO supplementation applied in presymptomatic stage of AD, alters the behaviour of microglia/macrophages prompting them to establish a physical barrier around amyloid plaques. This barrier significantly suppresses DNs formation through the reduction of both Aß content and tau hyperphosphorylation. Moreover, the short-term FO treatment neither suppresses inflammation nor enhances phagocytic properties of microglia/macrophages in the response to Aß pathology, the effects most commonly attributed to the fish oil supplementation. Our findings suggest that fish oil consumption may play an important role in modulating microglial/macrophage response and ameliorating the AD pathology in presymptomatic stage of Alzheimer's disease.


Assuntos
Doença de Alzheimer/patologia , Doenças Assintomáticas , Óleos de Peixe/farmacologia , Macrófagos/efeitos dos fármacos , Microglia/efeitos dos fármacos , Neuritos/patologia , Lobo Parietal/patologia , Doença de Alzheimer/imunologia , Doença de Alzheimer/metabolismo , Peptídeos beta-Amiloides/metabolismo , Animais , Atrofia/prevenção & controle , Contagem de Células , Citocinas/metabolismo , Suplementos Nutricionais , Modelos Animais de Doenças , Macrófagos/imunologia , Camundongos , Microglia/patologia , Neuritos/efeitos dos fármacos , Lobo Parietal/efeitos dos fármacos , Fragmentos de Peptídeos/metabolismo , Fagocitose/efeitos dos fármacos , Fosfoproteínas/metabolismo , Fatores de Tempo , Proteínas tau/metabolismo
19.
Technol Health Care ; 27(S1): 175-184, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31045537

RESUMO

BACKGROUND: Physical exercises have been shown to be a surprisingly effective strategy to take advantage of the brain's natural capacity for plasticity, and prevent brain degeneration in mouse histological studies. In vivo magnetic resonance microscopy (MRM) provides highly resolved anatomical images and allows quantitative assessment of brain atrophy in the aged mouse model. OBJECTIVE: The aim of the present study was to investigate, through the effects of 10 weeks voluntary wheel running, the mouse's brain atrophy. METHODS: Sixteen C57BL/6J mice, aged 21 months, were randomized to the exercise or sedentary group. Each mouse was scanned in a 7.0-T MRM scanner at two time points: 22 months old baseline and a follow-up three months later. Multi-atlas based brain segmentation approach was used to obtain volumes of 39 brain regions. RESULTS: The results showed that mice in the exercise group had less brain atrophy compared with the mice in the sedentary group. CONCLUSIONS: The results provide new insights into exercise induced brain plasticity in aged animals.


Assuntos
Encéfalo/patologia , Atividade Motora/fisiologia , Condicionamento Físico Animal , Animais , Atrofia/prevenção & controle , Camundongos , Camundongos Endogâmicos C57BL , Plasticidade Neuronal
20.
Behav Brain Res ; 367: 194-200, 2019 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-30953658

RESUMO

Subarachnoid hemorrhage (SAH) may lead to brain atrophy and cognitive dysfunction. This study aimed to compare the efficacy of nimodipine and deferoxamine on these sequelae of SAH. A rat model of SAH was established by the double-hemorrhage method. These rats were injected with saline (intraperitoneal, IP), nimodipine (IP), or deferoxamine (IP and intranasal) every 12 h for 5 days after SAH. The MRI scanning, including magnetic resonance angiography, diffusion tensor imaging, T2-weighted imaging, was performed to detect the brain structure. The levels of iron metabolism-related proteins were examined by Western blot analysis. The Morris water maze (MWM) test was used to assess the cognitive function. Then, then neurons in the cortex and hippocampus were counted on hematoxylin and eosin-stained brain sections. Significant cerebral vasospasm (CVS) was found in the saline and deferoxamine groups, but not in the nimodipine group. Cerebral peduncle injury was detected in the saline and nimodipine groups, but not significantly in the deferoxamine group. Compared with nimodipine, deferoxamine reduced transferrin (Tf), Tf receptor, and ferritin levels after SAH. The MWM performances were significantly worse in the saline and nimodipine groups than that in the deferoxamine group. Brain atrophy and neuronal losses were more significant in the saline and nimodipine groups than in the deferoxamine group. Nimodipine significantly ameliorated CVS, but it did not improve the late changes in brain structure and cognitive function. Deferoxamine effectively reduced neuronal cell death and ameliorated cognitive function after SAH.


Assuntos
Disfunção Cognitiva/prevenção & controle , Desferroxamina/farmacologia , Ferritinas/efeitos dos fármacos , Aprendizagem em Labirinto/efeitos dos fármacos , Nimodipina/farmacologia , Receptores da Transferrina/efeitos dos fármacos , Sideróforos/farmacologia , Hemorragia Subaracnóidea/tratamento farmacológico , Transferrina/efeitos dos fármacos , Vasodilatadores/farmacologia , Vasoespasmo Intracraniano/prevenção & controle , Animais , Atrofia/prevenção & controle , Disfunção Cognitiva/etiologia , Modelos Animais de Doenças , Masculino , Nimodipina/administração & dosagem , Ratos , Ratos Sprague-Dawley , Solução Salina/farmacologia , Sideróforos/administração & dosagem , Hemorragia Subaracnóidea/complicações , Vasodilatadores/administração & dosagem , Vasoespasmo Intracraniano/etiologia
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