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1.
Parasitol Res ; 123(8): 303, 2024 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-39160298

RESUMO

This study investigates the efficacy of nebivolol (NBV) in experimental models of toxoplasmosis, focusing on parasite burden reduction and neuronal protection. In the acute model of experimental toxoplasmosis, Swiss mice infected with RH strain tachyzoites received oral NBV chlorhydrate doses of 2 mg/kg/day and 4 mg/kg/day for 8 days. Treatment with NBV significantly reduced parasite burden compared to vehicle and standard drug (PYR) groups. In the chronic model of experimental toxoplasmosis, C57/BL6 mice infected with the ME49 strain received NBV chlorhydrate 41 days post-infection and were evaluated after 10 days of treatment. NBV chlorhydrate effectively reduced cyst number and area, as well as bradyzoite burden compared to controls. Histological analysis demonstrated that NBV chlorhydrate preserved neuronal count, with the 4 mg/kg/day dose yielding counts similar to non-infected mice. Statistical analysis confirmed significant differences compared to control groups. Furthermore, immunohistochemical analysis revealed a significant reduction in iNOS labeling in the brains of mice treated with NBV chlorhydrate, indicating a decrease in nitric oxide production compared to control groups. These findings suggest NBV's potential as a promising candidate for toxoplasmosis treatment, highlighting its ability to reduce parasite burden and protect neuronal integrity. Further research is warranted to elucidate NBV's mechanisms of action and its clinical application in managing toxoplasmosis.


Assuntos
Encéfalo , Modelos Animais de Doenças , Camundongos Endogâmicos C57BL , Nebivolol , Carga Parasitária , Toxoplasmose Animal , Animais , Nebivolol/farmacologia , Nebivolol/uso terapêutico , Camundongos , Toxoplasmose Animal/tratamento farmacológico , Toxoplasmose Animal/parasitologia , Encéfalo/parasitologia , Encéfalo/patologia , Encéfalo/efeitos dos fármacos , Feminino , Neurônios/efeitos dos fármacos , Neurônios/parasitologia , Etanolaminas/farmacologia , Etanolaminas/uso terapêutico , Antiprotozoários/farmacologia , Antiprotozoários/uso terapêutico , Antiprotozoários/administração & dosagem , Benzopiranos/farmacologia , Benzopiranos/uso terapêutico , Resultado do Tratamento , Óxido Nítrico/metabolismo , Toxoplasma/efeitos dos fármacos , Óxido Nítrico Sintase Tipo II/metabolismo
2.
PeerJ ; 12: e17642, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38978754

RESUMO

Background: Gingivitis is an inflammation of the gums that is the initial cause of the development of periodontal disease by the activity of Nuclear Factor-kappa B (NF-κB), Interleukin-1ß (IL-1ß), Interleukin-6 (IL-6), p38, and Tumor Necrosis Factor-α (TNF-α). Unaddressed chronic inflammation can lead to persistent disturbances in other parts of the body. Brazilin is a naturally occurring plant chemical that may have antibacterial and anti-inflammatory effects. Treatment based on the natural plant compound, brazilin, is developed in the form of a topical cream for easy application. Objective: The aim is to develop the natural compound brazilin in the form of a topical cream as an anti-inflammatory agent to reduce NF-κB expression through Imunohistochemistry (IHC) methods, and the expression of pro-inflammatory genes IL-1ß, IL-6, p38, and TNF-α. Methods: Male Sprague-Dawley rats were induced with gingivitis using P. gingivalis bacteria. The observed groups included rats treated with a single application of brazilin cream and rats treated with two applications of brazilin cream. The treatment was administered for 15 days. On days 3, 6, 9, 12, and 15, anatomical wound observations and wound histology using hematoxylin-eosin and Masson's Trichrome staining were performed. NF-κB protein expression was analyzed using the IHC method. Gingival inflammation gene expression of NF-κB, IL-1ß, IL-6, p38, and TNF-α was measured using q-RTPCR. Results: Single and double applications of brazilin cream increased angiogenesis and decreased NF-κB protein expression, in addition to the IL-1ß, IL-6, p38, and TNF-α gene expressions. Conclusion: In a rat gingivitis model, Brazilin cream may function as an anti-inflammatory agent in the gingival tissue.


Assuntos
Benzopiranos , Caesalpinia , Gengivite , NF-kappa B , Ratos Sprague-Dawley , Animais , Caesalpinia/química , Masculino , Ratos , Benzopiranos/farmacologia , Benzopiranos/administração & dosagem , Benzopiranos/uso terapêutico , NF-kappa B/metabolismo , Gengivite/tratamento farmacológico , Gengivite/patologia , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Doenças Periodontais/tratamento farmacológico , Interleucina-1beta/metabolismo , Interleucina-1beta/genética , Modelos Animais de Doenças , Fator de Necrose Tumoral alfa/metabolismo , Fator de Necrose Tumoral alfa/genética , Interleucina-6/metabolismo , Interleucina-6/genética , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo
3.
Reprod Toxicol ; 126: 108608, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38735593

RESUMO

Tripterygium wilfordii (TW) preparations have been utilized in China for treating rheumatoid arthritis and autoimmune diseases. However, their clinical use is limited due to reproductive toxicity, notably premature ovarian failure (POF). Our study aimed to investigate the effect and mechanism of bergenin in attenuating POF induced by triptolide in mice. POF was induced in female ICR mice via oral triptolide administration (50 µg/kg) for 60 days. Mice received bergenin (25, 50, 100 mg/kg, i.g.) or estradiol valerate (EV) (0.1 mg/kg, i.g.) daily, 1 h before triptolide treatment. In vitro, ovarian granulosa cells (OGCs) were exposed to triptolide (100 nM) and bergenin (1, 3, 10 µM). Antioxidant enzyme activity, protein expression, apoptosis rate, and reactive oxygen species (ROS) levels were assessed. The results showed that triptolide-treated mice exhibited evident atrophy, along with an increase in atretic follicles. Bergenin (50, 100 mg/kg) and EV (0.1 mg/kg), orally administered, exerted significant anti-POF effect. Bergenin and EV also decreased apoptosis in mouse ovaries. In vitro, bergenin (1, 3, 10 µM) attenuated triptolide-induced OGCs apoptosis by reducing levels of apoptosis-related proteins. Additionally, bergenin reduced oxidative stress through downregulation of antioxidant enzymes activity and overall ROS levels. Moreover, the combined use with Sh-Nrf2 resulted in a reduced protection of bergenin against triptolide-induced apoptosis of OGCs. Together, bergenin counteracts triptolide-caused POF in mice by inhibiting Nrf2-mediated oxidative stress and preventing OGC apoptosis. Combining bergenin with TW preparations may effectively reduce the risk of POF.


Assuntos
Antioxidantes , Apoptose , Benzopiranos , Diterpenos , Compostos de Epóxi , Células da Granulosa , Camundongos Endogâmicos ICR , Fenantrenos , Insuficiência Ovariana Primária , Espécies Reativas de Oxigênio , Animais , Feminino , Insuficiência Ovariana Primária/induzido quimicamente , Insuficiência Ovariana Primária/tratamento farmacológico , Insuficiência Ovariana Primária/prevenção & controle , Diterpenos/farmacologia , Fenantrenos/toxicidade , Fenantrenos/farmacologia , Compostos de Epóxi/toxicidade , Antioxidantes/farmacologia , Apoptose/efeitos dos fármacos , Benzopiranos/farmacologia , Benzopiranos/uso terapêutico , Espécies Reativas de Oxigênio/metabolismo , Células da Granulosa/efeitos dos fármacos , Células da Granulosa/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Fator 2 Relacionado a NF-E2/metabolismo , Camundongos , Células Cultivadas
4.
Medicina (Kaunas) ; 60(4)2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38674192

RESUMO

Background and Objective: Sapropel, a biologically active sedimentary deposit, is high in organic matter and minerals and has been shown to offer health benefits. Its constituents, humic acid (HA) and fulvic acid (FA), have been found to have some therapeutic applications. The aim of this study was to determine the potential therapeutically significant properties of freshwater sapropel extracts: their polyacid content, antioxidative (AO) status, and biological activity in cell culture. Materials and Methods: Freshwater lakes from the southeast region of Latvia were investigated layer by layer. The total organic carbon (TOC) was determined through combustion using the catalytic oxidation method, HA and FA were measured via acid perspiration, and the total polyphenol content (TPC) and total antioxidant status (TAS) was analysed spectrophotometrically. Sapropel extracts' regenerative abilities were tested in vitro using a Cell-IQ real-time monitoring system on mouse BALB/c 3T3 fibroblasts and human keratinocyte HaCaT cell lines. Cytotoxicity was measured through neutral red uptake assessment as a concentration-dependent reduction in the uptake of neutral red dye relative to a vehicle control or untreated cells. Results: The highest AO activity was observed in sapropel extracts with elevated concentrations of HA and TPC from Audzelu Lake (1.08 ± 0.03 mmol/L), and the lowest activity was found in extracts from Ivusku Lake (0.31 ± 0.01 mmol/L). Correspondingly, the concentrations of HA in Audzelu and Ivusku Lakes were recorded as 45.2 and 27.4 mg/g, respectively. High concentrations of HA promoted in vitro cell growth upon short-term exposure (up to 6 h). Conclusions: The results show that high TPC correlates with AO status and sapropel extracts with higher concentrations of HA exhibit greater AO activity and promote in vitro cell growth, suggesting a perspective use for short-term topical therapeutic skin applications. However, higher concentrations over longer durations showed cytotoxic effects, indicating the need for further investigation.


Assuntos
Antioxidantes , Animais , Antioxidantes/farmacologia , Antioxidantes/análise , Antioxidantes/uso terapêutico , Camundongos , Humanos , Higiene da Pele/métodos , Substâncias Húmicas/análise , Benzopiranos/análise , Benzopiranos/farmacologia , Benzopiranos/uso terapêutico , Água Doce/análise , Técnicas In Vitro , Células HaCaT
5.
Proc Natl Acad Sci U S A ; 121(13): e2306814121, 2024 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-38513102

RESUMO

Triple-negative breast cancer (TNBC) is a subtype of breast cancer with aggressive behavior and poor prognosis. Current therapeutic options available for TNBC patients are primarily chemotherapy. With our evolving understanding of this disease, novel targeted therapies, including poly ADP-ribose polymerase (PARP) inhibitors, antibody-drug conjugates, and immune-checkpoint inhibitors, have been developed for clinical use. Previous reports have demonstrated the essential role of estrogen receptor ß (ERß) in TNBC, but the detailed molecular mechanisms downstream ERß activation in TNBC are still far from elucidated. In this study, we demonstrated that a specific ERß agonist, LY500307, potently induces R-loop formation and DNA damage in TNBC cells. Subsequent interactome experiments indicated that the residues 151 to 165 of U2 small nuclear RNA auxiliary factor 1 (U2AF1) and the Trp439 and Lys443 of ERß were critical for the binding between U2AF1 and ERß. Combined RNA sequencing and ribosome sequencing analysis demonstrated that U2AF1-regulated downstream RNA splicing of 5-oxoprolinase (OPLAH) could affect its enzymatic activity and is essential for ERß-induced R-loop formation and DNA damage. In clinical samples including 115 patients from The Cancer Genome Atlas (TCGA) and 32 patients from an in-house cohort, we found a close correlation in the expression of ESR2 and U2AF1 in TNBC patients. Collectively, our study has unraveled the molecular mechanisms that explain the therapeutic effects of ERß activation in TNBC, which provides rationale for ERß activation-based single or combined therapy for patients with TNBC.


Assuntos
Processamento Alternativo , Benzopiranos , Receptor beta de Estrogênio , Estruturas R-Loop , Fator de Processamento U2AF , Neoplasias de Mama Triplo Negativas , Humanos , Receptor beta de Estrogênio/agonistas , Receptor beta de Estrogênio/metabolismo , Fator de Processamento U2AF/química , Fator de Processamento U2AF/genética , Fator de Processamento U2AF/metabolismo , Neoplasias de Mama Triplo Negativas/tratamento farmacológico , Neoplasias de Mama Triplo Negativas/genética , Neoplasias de Mama Triplo Negativas/metabolismo , Terapia Combinada , Células MDA-MB-231 , Processamento Alternativo/efeitos dos fármacos , Benzopiranos/farmacologia , Benzopiranos/uso terapêutico , Ligação Proteica , Sítios de Ligação
6.
Eur J Med Chem ; 267: 116205, 2024 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-38350361

RESUMO

In this study, a series of novel 4-Aryl-4H-chromene derivatives (D1-D31) were designed and synthesized by integrating quinoline heterocycle to crolibulin template molecule based on the strategy of molecular hybridization. One of these compounds D19 displayed positive antiproliferative activity against U87 cancer cell line (IC50 = 0.90 ± 0.03 µM). Compound D19 was verified as the microtubule-targeting agent through downregulating tubulin related genes of U87 cells, destroying the cytoskeleton of tubulins and interacting with the colchicine-binding site to inhibit the polymerization of tubulins by transcriptome analysis, immune-fluorescence staining, microtubule dynamics and EBI competition assays as well as molecular docking simulations. Moreover, compound D19 induced G2/M phase arrest, resulted in cell apoptosis and inhibited the migration of U87 cells by flow cytometry analysis and wound healing assays. Significantly, compound D19 dose-dependently inhibited the tumor growth of orthotopic glioma xenografts model (GL261-Luc) and effectively prolonged the survival time of mice, which were extremely better than those of positive drug temozolomide (TMZ). Compound D19 exhibited potent in vivo antivascular activity as well as no observable toxicity. Furthermore, the results of in silico simulation studies and P-gp transwell assays verified the positive correlation between compound D19's Blood-Brain Barrier (BBB) permeability and its in vivo anti-GBM activity. Overall, compound D19 can be used as a promising anti-GBM lead compound for the treatment of glioblastoma.


Assuntos
Antineoplásicos , Glioblastoma , Humanos , Camundongos , Animais , Glioblastoma/tratamento farmacológico , Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Antineoplásicos/química , Relação Estrutura-Atividade , Simulação de Acoplamento Molecular , Linhagem Celular Tumoral , Ensaios de Seleção de Medicamentos Antitumorais , Microtúbulos/metabolismo , Tubulina (Proteína)/metabolismo , Moduladores de Tubulina/farmacologia , Benzopiranos/farmacologia , Benzopiranos/uso terapêutico , Proliferação de Células
7.
Rev. bras. cir. cardiovasc ; 29(4): 581-587, Oct-Dec/2014. tab
Artigo em Inglês | LILACS | ID: lil-741736

RESUMO

Objective: Postoperative atrial fibrillation is a common complication after cardiac surgery, with an incidence as high as 20-50%. Increased age is associated with a significant increase in postoperative atrial fibrillation risk. This common complication is associated with higher morbidity and mortality rates. The aim of this study was to assess the efficacy of nebivolol in preventing atrial fibrillation following coronary artery bypass surgery in patients over 60 years of age. Methods: In this prospective randomized study, 200 patients who were candidates for elective coronary artery bypass surgery were divided into two groups. The first group was administered with nebivolol and the second group was administered with metoprolol. Treatment was initiated four days prior to surgery, and patients were monitored for atrial fibrillation until discharge. Forty-one patients recieved 50 mg metoprolol succinate daily, which was initiated minimum 4 days before surgery. Results: Demographic data were similar in both groups. The incidence of postoperative atrial fibrillation in both groups was similar, with no significant difference being identified [n=20 (20%); n=18 (18%), P=0.718; respectively]. There were not any mortality at both groups during study. Inotropic agent requirement at ICU was similar for both groups [n=12 (12%), n=18 (18%), P=0.32]. Conclusion: We compared the effectiveness of nebivolol and metoprolol in decreasing the incidence of postoperative atrial fibrillation, and determined that nebivolol was as effective as metoprolol in preventing postoperative atrial fibrillation at patients. Nebivolol may be the drug of choice due to its effects, especially after elective coronary artery bypass surgery. .


Objetivo: Pós-operatório fibrilação atrial é uma complicação comum após a cirurgia cardíaca, com uma incidência tão elevada quanto 20-50%. O aumento da idade está associado com elevação significativa no risco de pós-operatório da fibrilação atrial. Esta complicação comum é associada com taxas de morbidade e mortalidade. O objetivo deste estudo foi avaliar a eficácia do nebivolol na prevenção da fibrilação atrial após cirurgia de revascularização do miocárdio de pacientes acima de 60 anos de idade. Métodos: Neste estudo prospectivo e randomizado, duzentos pacientes candidatos à cirurgia de revascularização do miocárdio foram divididos em dois grupos. O primeiro grupo foi administrado com nebivolol e o segundo grupo, com metoprolol. O tratamento foi iniciado quatro dias antes da cirurgia, e os pacientes foram monitorados para fibrilação atrial até a alta. Quarenta e um pacientes receberam 50 mg de sucinato de metoprolol diário, que foi iniciado, no mínimo, 4 dias antes da cirurgia. Resultados: Os dados demográficos foram semelhantes nos dois grupos. A incidência de fibrilação atrial pós-operatória em ambos os grupos foi semelhante, com nenhuma diferença significativa sendo identificado [n=20 (20%); n=18 (18%), P=0,718; respectivamente]. Não houve mortalidade em ambos os grupos durante o estudo. A necessidade de agente inotrópico em UTI foi semelhante nos dois grupos [n=12 pessoas (12%), n=18 (18%), P=0,32]. Conclusão: Nós comparamos a eficácia do nebivolol e metoprolol na diminuição da incidência de fibrilação atrial no pós-operatório, e verificamos que nebivolol foi tão eficaz como metoprolol na prevenção de fibrilação atrial no pós-operatório em pacientes. Nebivolol pode ser a droga de escolha devido aos seus efeitos, especialmente depois da cirurgia revascularização do miocárdio. .


Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antagonistas de Receptores Adrenérgicos beta 1/uso terapêutico , Fibrilação Atrial/prevenção & controle , Benzopiranos/uso terapêutico , Ponte de Artéria Coronária/efeitos adversos , Etanolaminas/uso terapêutico , Metoprolol/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Fatores Etários , Antiarrítmicos/uso terapêutico , Fibrilação Atrial/tratamento farmacológico , Nebivolol , Período Pós-Operatório , Estudos Prospectivos , Complicações Pós-Operatórias/tratamento farmacológico , Reprodutibilidade dos Testes , Fatores de Risco , Estatísticas não Paramétricas , Resultado do Tratamento
8.
São Paulo med. j ; 132(5): 290-296, 08/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-721013

RESUMO

CONTEXT AND OBJECTIVES: Assessment of central blood pressure (BP) has grown substantially over recent years because evidence has shown that central BP is more relevant to cardiovascular outcomes than peripheral BP. Thus, different classes of antihypertensive drugs have different effects on central BP despite similar reductions in brachial BP. The aim of this study was to investigate the effect of nebivolol, a β-blocker with vasodilator properties, on the biochemical and hemodynamic parameters of hypertensive patients. DESIGN AND SETTING: Experimental single cohort study conducted in the outpatient clinic of a university hospital. METHODS: Twenty-six patients were recruited. All of them underwent biochemical and hemodynamic evaluation (BP, heart rate (HR), central BP and augmentation index) before and after 3 months of using nebivolol. RESULTS: 88.5% of the patients were male; their mean age was 49.7 ± 9.3 years and most of them were overweight (29.6 ± 3.1 kg/m2) with large abdominal waist (102.1 ± 7.2 cm). There were significant decreases in peripheral systolic BP (P = 0.0020), diastolic BP (P = 0.0049), HR (P < 0.0001) and central BP (129.9 ± 12.3 versus 122.3 ± 10.3 mmHg; P = 0.0083) after treatment, in comparison with the baseline values. There was no statistical difference in the augmentation index or in the biochemical parameters, from before to after the treatment. CONCLUSIONS: Nebivolol use seems to be associated with significant reduction of central BP in stage I hypertensive patients, in addition to reductions in brachial systolic and diastolic BP. .


CONTEXTO E OBJETIVOS: A avaliação da pressão arterial central (PAc) tem crescido substancialmente nos últimos anos porque as evidências mostraram que PAc central é mais relevante para os desfechos cardiovasculares do que pressão arterial (PA) periférica. Assim, diferentes classes de anti-hipertensivos têm efeitos diferentes sobre PAc apesar de reduções semelhantes na PA braquial. O objetivo foi investigar o efeito do nebivolol, β-bloqueador com propriedades vasodilatadoras, nos parâmetros bioquímicos e hemodinâmicos de pacientes hipertensos. TIPO DE ESTUDO E LOCAL: Estudo de coorte única experimental realizado em ambulatório de hospital universitário. MÉTODOS: Todos os 26 pacientes recrutados foram submetidos à avaliação bioquímica e hemodinâmica (PA, frequência cardíaca, FC, PAc, augmentation index) antes e após três meses usando nebivolol. RESULTADOS: 88,5% dos indivíduos eram do sexo masculino, com média de idade de 49,7 ± 9,3 anos, predominância de sobrepeso (29,6 ± 3,1 kg/m2) e aumento da cintura abdominal (102,1 ± 7,2 cm). Houve diminuição significativa da PA sistólica periférica (P = 0,0020) e diastólica (P = 0,0049), da FC (P < 0,0001) e da PAc (129,9 ± 12,3 x 122,3 ± 10,3 mmHg, P = 0,0083) após o tratamento em comparação aos valores basais. Não houve diferença no augmentation index, nem nos parâmetros bioquímicos antes e após o período de tratamento. CONCLUSÕES: O uso de nebivolol parece estar associado à redução significativa da PAc em hipertensos estágio 1, além da redução da pressão sistólica e diastólica braquial. .


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antagonistas de Receptores Adrenérgicos beta 1/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Benzopiranos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Etanolaminas/uso terapêutico , Hipertensão/tratamento farmacológico , Artéria Braquial/efeitos dos fármacos , Estudos de Coortes , Seguimentos , Frequência Cardíaca , Pacientes Ambulatoriais , Análise de Onda de Pulso
9.
Rehabilitación (Madr., Ed. impr.) ; 40(2): 86-95, mar. 2006. tab
Artigo em Es | IBECS | ID: ibc-044249

RESUMO

Objetivo. Investigar y contrastar la efectividad de los diferentes linfofármacos utilizados en el tratamiento del linfedema del miembro superior, secundario a radioterapia y/o cirugía por cáncer de mama. Estrategia de búsqueda. Se ha realizado una búsqueda en las bases de datos IME, MD-CONSULT, MEDSCAPE, EXCERPTA MEDICA, OVID, MEDLINE, COCHRANE DATABASE OF SYSTEMATIC REWIEWS, CINAHL, CANCERLIT y Sociedades Científicas relacionadas con el manejo del linfedema desde 1978 hasta junio de 2004. No hemos seguido ningún protocolo de búsqueda en las bases más extensas por temor a perder información, ni hemos contado con expertos en la estrategia de búsqueda, que ha sido muy laboriosa con introducción de numerosos sinónimos y probables. Selección de artículos. Encontramos 26 trabajos que evaluaban la efectividad de cualquier modalidad de tratamiento farmacológico. Para facilitar su comprensión y lectura se han clasificado en tres grandes grupos en relación con el diseño del estudio, elaborando tablas que recogen las características metodológicas y análisis de datos de cada uno de ellos. En los ensayos clínicos se especifica si hay conflicto de intereses con la industria farmacéutica y/o promotores. Selección de resultados. Se han analizado y seleccionado en función de la calidad metodológica, diseño, tipo de intervención y resultados principales. Síntesis de resultados. Existen muy pocos estudios con suficiente calidad metodológica para extraer conclusiones y sus resultados son contradictorios. Conclusiones. En esta revisión sistemática de la literatura científica no encontramos pruebas fehacientes para recomendar el uso de los linfofármacos en el tratamiento del linfedema postmastectomía


Objective. Investigate and compare the effectiveness of the different lymphodrugs used in the treatment of lymphedema of the upper limb, secondary to radiotherapy and/or surgery due to breast cancer. Search strategy. A search was performed in the following databases IME, MD-CONSULT, MEDSCAPE, EXCERPTA MEDICA, OVID, MEDLINE, COCHRANE DATABASE OF SYSTEMATIC REWIEWS, CINAHL, CANCERLIT and Scientific Societies related with the management of lymphedema from 1978 to June 2004. We have not followed any search protocol in the most extensive bases for fear of losing information nor have we counted on experts in search strategy, which was very arduous with the introduction of many synonyms and probable synonyms. Article selection. We found 26 papers that evaluated effectivity of any drug treatment modality. To facilitate its understanding and reading, they were classified into three large groups in relationship with the study design, elaborating tables that collect the methodological characteristics and data analysis of each one of them. It is specified in the clinical trials if there is a conflict of interest with the pharmaceutical industry and/or sponsors. Result selection. They were analyzed and selected based on methodology quality, design, type of intervention and main results. Result synthesis. There are very few studies with sufficient methodological quality to draw conclusions and their results are contradictory. Conclusions. There is no clear evidence in this systematic review of the scientific literature to recommend the use of lymphodrugs in the treatment of postmastectomy lymphedema


Assuntos
Feminino , Humanos , Linfedema/tratamento farmacológico , Linfedema/etiologia , Mastectomia/efeitos adversos , Benzopiranos/uso terapêutico , Neoplasias da Mama/cirurgia
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