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1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-47071

RESUMO

Cientistas brasileiras, Ester Sabino, diretora do Instituto de Medicina Tropical da USP e Jaqueline Goes de Jesus, pós-doutoranda na USP, em apenas 48 horas sequenciaram o genoma do coronavírus (COVID-19) do primeiro caso da doença confirmado no Brasil.


Assuntos
Coronavirus , Vacinas/uso terapêutico , Vírus da SARS/patogenicidade , DNA/imunologia , Betacoronavirus
2.
Zhonghua Shao Shang Za Zhi ; 36(2): 117-121, 2020 Feb 20.
Artigo em Chinês | MEDLINE | ID: mdl-32114729

RESUMO

Objective: To explore the effects of recombinant human granulocyte macrophage colony stimulating factor (rhGM-CSF) gel on treatment of thefull-thickness frostbite wounds on foot and hand. Methods: From November 2013 to April 2017, a total of 45 patients of 71 full-thickness frostbite wounds on foot and hand meeting the inclusion criteria were admitted to the First Hospital of Jilin University and the prospective randomized controlled study was done. The patients were divided into rhGM-CSF group of 24 patients with 35 wounds and control group of 21 patients with 36 wounds according to the random number table. There were 20 males and 4 females, aged (38±13) years among patients in rhGM-CSF group, and there were 19 males and 2 females, aged (36±14) years among patients in control group. Patients in 2 groups were performed with the same systemic treatment of rewarming, anti-inflammation, pain relief, anti-infection, anti-coagulation, and thrombolysis. Wounds of patients in rhGM-CSF group and control group were respectively treated with rhGM-CSF gel and aloe vera gel for external usage with 10 mg for every square centimeter and dressing change once every 24 hours, until wounds healed completely. The wound inflammatory response was scored on treatment day (TD) 1, 3, 7, 14, wound secretion was collected for bacteria culture and positive bacteria detection rate was calculated before treatment and on TD 6 and 12, adverse drug reaction after drug use was observed, and the complete wound healing time was recorded. Data were processed with Fisher's exact probability test, analysis of variance for repeated measurement, t test, and Bonferroni correction. Results: The scores of wound inflammatory response of patients in 2 groups on TD 1 and 3 were close (t=0.37, 2.93, P>0.05). The scores of wound inflammatory response of patients on TD 7 and 14 in rhGM-CSF group were significantly higher than those in control group (t=5.77, 5.83, P<0.01). The results of bacteria culture of wound secretion of patients in 2 groups before treatment were negative. The positive bacteria detection rates of wound secretion of patients in rhGM-CSF group on TD 6 and 12 were 5.71% (2/35) and 22.86% (8/35), which were slightly lower than 13.89% (5/36) and 30.56%(11/36) in control group respectively, but there was no significantly statistical difference (P>0.05). No adverse drug response occurred in patients in rhGM-CSF group, while 1 patient in control group had adverse drug response, with symptoms of redness and swelling of wounds and patchy erythema on skin around wounds, which were alleviated by irrigating with normal saline. The complete wound healing time of patients in rhGM-CSF was (12.3±0.5) d, which was significantly shorter than (16.5±0.8) d in control group (t=24.89, P<0.05). Conclusions: The topical rhGM-CSF gel has effects of shortening time of wound healing and reducing inflammatory response of wound on treatment of full-thickness frostbite wounds on foot and hand, which is safe in clinical application.


Assuntos
Congelamento das Extremidades/tratamento farmacológico , Fator Estimulador de Colônias de Granulócitos e Macrófagos/uso terapêutico , Adulto , Bactérias , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Proteínas Recombinantes , Cicatrização , Adulto Jovem
3.
Wiad Lek ; 73(1): 31-35, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32124802

RESUMO

OBJECTIVE: The aim: To study the clinical and spirographic features persistence of the bronchial asthma in schoolchildren against the background of the alternative daily doses of inhaled corticosteroids to increase the effectiveness of anti-inflammatory therapy for this disease. PATIENTS AND METHODS: Materials and methods: A complete comprehensive clinical-paraclinical examination of 65 schoolchildren with persistent asthma was conducted. According to the average daily dose of inhaled corticosteroids (ICS) the patients were divided into two clinical groups. The first (I) group consisted of 46 children who received ICS in the regimen of low-to-medium equipotent doses (253.95±9.98 µg per day), and the second (II) comparison group was formed of 19 patients who controlled the pBA using high doses of ICS (494.74±5.56 µg per day). RESULTS: Results: The patients of the І clinical group compared to patients of the ІІ group have a higher risk of the mild bronchial obstructive syndrome during asthma attacks. In assessing the level of control of persistent bronchial asthma using the CIA-scale, it was found that in II group cases of the controlled course of the disease were observed almost two times less than in children of the I group of comparison. In conducting spirography in children of comparison groups, it was shown that the ratio of indices of bronchospasm (FEV1/FVC) was worse in patients receiving high doses of ICS. CONCLUSION: Conclusions: So, сharacteristic clinical feature of asthma controlled by high doses of ICS is more severe nature of bronchial obstructive syndrome during the period of exacerbation (OR=1.9-3.0). In the management of persistent bronchial asthma, the Gensler index which has high specificity (94.4%) and accuracy (92.2%) should be used for disease control verification.


Assuntos
Antiasmáticos/uso terapêutico , Asma , Administração por Inalação , Corticosteroides , Anti-Inflamatórios , Asma/tratamento farmacológico , Criança , Humanos
4.
Wiad Lek ; 73(1): 46-51, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32124805

RESUMO

OBJECTIVE: The aim: To evaluate the dynamics of structural and functional parameters of the heart, vessels in patients with hypertension of the II-nd stage under the influence of combined antihypertensive treatment depending on the type of the left ventricle remodelling and the profile of blood pressure (BP). PATIENTS AND METHODS: Materials and methods: The study involved 110 patients with hypertension of the II-nd stage. The ambulatory blood pressure monitoring, echocardiography and Doppler examination of the shoulder arteries were performed. Initial treatment included bisoprolol, lisinopril, hydrochlorothiazide. With impossibility of BP lowering to the target level, amlodipine has been added. RESULTS: Results: higher levels of BP in the "non-dipper" patients have led to the development of more pronounced changes in the heart and vessels compared with "dipper" patients. Three-component therapy was effective in patients with lower BP. The prescription of amlodipine has been found to be necessary for the majority of "non-dipper" patients and for the minority of "dipper". Combined therapy effectively controlled the BP at the level of the target and contributed to a decrease in the displays of remodelling of the heart and blood vessels. CONCLUSION: Conclusions: combined therapy used for 6 months reduces displays of disadaptive heart and vascular remodelling, diastolic, endothelial dysfunction. With the lack of efficacy of the therapy, which includes bisoprolol, lisinopril, hydrochlorothiazide, the adding of amlodipine to it can reach the target level of BP.


Assuntos
Anti-Hipertensivos/uso terapêutico , Hipertensão Essencial/tratamento farmacológico , Anlodipino , Pressão Sanguínea , Monitorização Ambulatorial da Pressão Arterial , Ventrículos do Coração , Humanos
5.
Wiad Lek ; 73(1): 63-67, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32124808

RESUMO

OBJECTIVE: The aim: To study the dynamics of markers of angiogenesis based on insulin-like growth factor-1 (IGF-1) and endostatin, as well as to determine 6-month survival in patients taking zofenopril from the first day of AMI with and without obesity. PATIENTS AND METHODS: Materials and methods: using enzyme immunoassay, we determined the level of endostatin and IGF-1 in serum on days 1 and 12 in patients with AMI with the presence and absence of obesity, and a statistical processing of the data obtained. RESULTS: Results: The relationship between obesity and angiogenesis indicators, both activators and inhibitors, was determined, and a significant relationship was found between zofenopril therapy and angiogenesis activator IGF-1. Differences in the survival of patients with complicated AMI were determined depending on the choice of ACE inhibitor in favor of a higher survival rate of patients who took zofenopril. CONCLUSION: Conclusions: patients who underwent complicated AMI, taking zofenopril, have a higher survival rate during the 6-month follow-up period. Zofenopril stimulated angiogenesis in the examined patients, which was expressed in patients with and without obesity.


Assuntos
Captopril/análogos & derivados , Endostatinas/uso terapêutico , Fator de Crescimento Insulin-Like I/uso terapêutico , Infarto do Miocárdio , Obesidade/tratamento farmacológico , Captopril/uso terapêutico , Humanos , Infarto do Miocárdio/tratamento farmacológico
6.
BMJ ; 368: m216, 2020 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-32122882

RESUMO

Guidelines on the treatment of tuberculosis (TB) have essentially remained the same for the past 35 years, but are now starting to change. Ongoing clinical trials will hopefully transform the landscape for treatment of drug sensitive TB, drug resistant TB, and latent TB infection. Multiple trials are evaluating novel agents, repurposed agents, adjunctive host directed therapies, and novel treatment strategies that will increase the probability of success of future clinical trials. Guidelines for HIV-TB co-infection treatment continue to be updated and drug resistance testing has been revolutionized in recent years with the shift from phenotypic to genotypic testing and the concomitant increased speed of results. These coming changes are long overdue and are sorely needed to address the vast disparities in global TB incidence rates. TB is currently the leading cause of death globally from a single infectious agent, but the work of many researchers and the contributions of many patients in clinical trials will reduce the substantial global morbidity and mortality of the disease.


Assuntos
Antituberculosos/uso terapêutico , Tuberculose/tratamento farmacológico , Humanos , Tuberculose Latente/tratamento farmacológico , Guias de Prática Clínica como Assunto , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico
7.
Hautarzt ; 71(3): 227-243, 2020 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-32130433

RESUMO

In Germany, approximately 2% of the population suffers from psoriasis, which is no longer considered only a cutaneous, but rather a systemic disease. Accordingly, common comorbidities and potential joint involvement in psoriasis must be recorded. If necessary, interdisciplinary patient care has to be organized. The use of validated scores is recommended to complete the patient's medical history. The individual treatment should include intensified topical therapies as well as short-term phototherapy in case of an acute phase. In addition to conventional systemic therapies (e.g., fumarates, methotrexate), a number of new therapeutics for psoriasis are in development. Apart from the PDE­4 inhibitor apremilast, targeted therapies are currently available to block TNF-alpha, IL-17A, the IL-17 receptor and IL-23. Decisions on individualized, patient-centered psoriasis management should be based on assessment of disease severity and the existence of comorbidities. Furthermore, economic aspects should be taken into account.


Assuntos
Terapia Biológica/métodos , Terapia de Alvo Molecular , Fototerapia/métodos , Psoríase/diagnóstico , Psoríase/terapia , Administração Oral , Administração Tópica , Adulto , Artrite Psoriásica/diagnóstico , Artrite Psoriásica/terapia , Fármacos Dermatológicos/uso terapêutico , Alemanha , Humanos , Metotrexato/uso terapêutico , Inibidores da Fosfodiesterase 4/uso terapêutico , Índice de Gravidade de Doença , Resultado do Tratamento
8.
BMJ ; 368: m283, 2020 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-32131996

RESUMO

OBJECTIVE: To examine the associations between stopping treatment with opioids, length of treatment, and death from overdose or suicide in the Veterans Health Administration. DESIGN: Observational evaluation. SETTING: Veterans Health Administration. PARTICIPANTS: 1 394 102 patients in the Veterans Health Administration with an outpatient prescription for an opioid analgesic from fiscal year 2013 to the end of fiscal year 2014 (1 October 2012 to 30 September 2014). MAIN OUTCOME MEASURES: A multivariable Cox non-proportional hazards regression model examined death from overdose or suicide, with the interaction of time varying opioid cessation by length of treatment (≤30, 31-90, 91-400, and >400 days) as the main covariates. Stopping treatment with opioids was measured as the time when a patient was estimated to have no prescription for opioids, up to the end of the next fiscal year (2014) or the patient's death. RESULTS: 2887 deaths from overdose or suicide were found. The incidence of stopping opioid treatment was 57.4% (n=799 668) overall, and based on length of opioid treatment was 32.0% (≤30 days), 8.7% (31-90 days), 22.7% (91-400 days), and 36.6% (>400 days). The interaction between stopping treatment with opioids and length of treatment was significant (P<0.001); stopping treatment was associated with an increased risk of death from overdose or suicide regardless of the length of treatment, with the risk increasing the longer patients were treated. Hazard ratios for patients who stopped opioid treatment (with reference values for all other covariates) were 1.67 (≤30 days), 2.80 (31-90 days), 3.95 (91-400 days), and 6.77 (>400 days). Descriptive life table data suggested that death rates for overdose or suicide increased immediately after starting or stopping treatment with opioids, with the incidence decreasing over about three to 12 months. CONCLUSIONS: Patients were at greater risk of death from overdose or suicide after stopping opioid treatment, with an increase in the risk the longer patients had been treated before stopping. Descriptive data suggested that starting treatment with opioids was also a risk period. Strategies to mitigate the risk in these periods are not currently a focus of guidelines for long term use of opioids. The associations observed cannot be assumed to be causal; the context in which opioid prescriptions were started and stopped might contribute to risk and was not investigated. Safer prescribing of opioids should take a broader view on patient safety and mitigate the risk from the patient's perspective. Factors to address are those that place patients at risk for overdose or suicide after beginning and stopping opioid treatment, especially in the first three months.


Assuntos
Analgésicos Opioides/uso terapêutico , Overdose de Drogas/epidemiologia , Suicídio/estatística & dados numéricos , Veteranos/estatística & dados numéricos , Suspensão de Tratamento/estatística & dados numéricos , Adulto , Idoso , Prescrições de Medicamentos , Humanos , Pessoa de Meia-Idade , Padrões de Prática Médica , Modelos de Riscos Proporcionais , Estados Unidos/epidemiologia
9.
S D Med ; 73(2): 72-76, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32135055

RESUMO

IMPORTANCE AND OBJECTIVE: Dietary supplements and herbs (called naturoceuticals) are commonly used by Americans, but little is known about their use in cardiovascular disease patient populations. The objective was to evaluate naturoceutical use in a sample population of cardiovascular disease patients in the U.S. DESIGN, SETTING and PARTICIPANTS: A non-blinded, single medical center clinic open questionnaire was delivered to cardiovascular clinic patients with known cardiovascular diseases. MAIN OUTCOMES AND MEASURES, AND RESULTS: Estimation of naturoceutical usage prevalence and frequency in the sample population of cardiovascular disease patients. A total of 163 patients (n = 99 males, 64 females) participated (mean age: males, 66 years; females, 64 years). Overall, 76.7 percent of participants reported using naturoceuticals. Of them, about 63.2 percent took more than one type, and 90.3 percent reported daily usage. Of the naturoceuticals reportedly being taken, multivitamins containing vitamin K were the most commonly consumed (32.3 percent male, 29.7 percent female), followed by vitamin D (23.2 percent male, 31.3 percent female) and fish oil (24.2 percent male, 15.6 percent female). CONCLUSIONS AND RELEVANCE: The present study revealed that naturoceutical use was very popular in cardiovascular disease patients, largely due to the belief that they could reduce and/or prevent symptoms and disease in general. The benefits and hazards of those naturoceuticals being used concurrent with other prescription medications were discussed.


Assuntos
Doenças Cardiovasculares , Suplementos Nutricionais , Medicamentos sob Prescrição , Idoso , Doenças Cardiovasculares/dietoterapia , Suplementos Nutricionais/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Vitaminas/uso terapêutico
11.
Pneumologie ; 74(3): 149-158, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32143230

RESUMO

INTRODUCTION: Inhalative treatments with metered dose aerosols and dry powder inhalers are the backbone of the pharmacotherapy for asthma and COPD. In the last decade many new and generic inhalative bronchodilators were launched at the German market, both monotherapies and fixed dose double bronchodilator (LABA/LAMA, beta adrenergic and antimuscarinic) or LABA and inhaled corticosteroid (ICS) and triple (LABA/LAMA/ICS) combinations. According to two surveys in 2015 among respiratory physicians we expected a high proportion of patients receiving duplicate prescriptions, e. g. a fixed dose new LABA/LAMA combination in addition to an existing ICS/LABA fixed dose combination. METHODOLOGY: We searched the database of a large mail order pharmacy (DocMorris) to identify duplicate prescriptions of inhalative drugs for a patient by the same or by two or more different physicians during a 3 months period. RESULTS: Unexpectedly, we found as little as around 1 % duplicate prescriptions for the same patient. Duplicate prescriptions involving combination products were found to be much more common than duplicate prescriptions of different mono-products. Irrespective the low percentage number of all prescriptions we saw in just one large mail order pharmacy several thousands of erroneous prescriptions. CONCLUSION: At least in the setting of this mail order pharmacy duplicate (i. e. contraindicated and potentially dangerous) prescriptions are relatively rare. Prescribers and pharmacists should be aware of the issue of duplicates - especially when prescribing or filling prescriptions with combination products.


Assuntos
Corticosteroides/administração & dosagem , Broncodilatadores/administração & dosagem , Prescrições de Medicamentos/estatística & dados numéricos , Padrões de Prática Médica , Medicamentos sob Prescrição/uso terapêutico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Administração por Inalação , Agonistas de Receptores Adrenérgicos beta 2 , Bases de Dados Factuais , Quimioterapia Combinada , Humanos , Antagonistas Muscarínicos
12.
Orv Hetil ; 161(11): 425-433, 2020 Mar.
Artigo em Húngaro | MEDLINE | ID: mdl-32148096

RESUMO

Introduction: Endometrial cancer is the most common invasive gynecologic malignancy in developed countries. The best survival rates are expected after surgical removal, thus the aim of a complex treatment is to achieve resecability in locally and locoregionally advanced disease. Aim: The primary purpose of this study was to evaluate if the neoadjuvant systemic treatment leads to better overall survival compared to irradiation solely. Method: From January 2015 to December 2018, we enrolled 28 patients diagnosed with irresecable, locally and locoregionally advanced high-risk endometrial carcinoma. Patients were treated by neoadjuvant paclitaxel-carboplatin, then radical hysterectomy, bilateral oophorectomy and lymphadenectomy were performed. Results: After administration of 6 cycles of carboplatin-paclitaxel, the control MR test showed tumor shrinkage in all patients. Complete resection was achieved in the case of every patient. Tumor residuum in lymph nodes was verified in 4 cases by pathological evaluation. The 2-year survival and the 2-year progression-free survival rates were 65,1% and 66,1%, respectively. The median overall survival was 16,5 months. Conclusion: Neoadjuvant treatment can be an effective approach in providing the conditions for complete tumor resection, which may result in survival advantage. Despite multimodal treatment, prognosis is poor. Orv Hetil. 2020; 161(11): 425-433.


Assuntos
Carboplatina/uso terapêutico , Neoplasias do Endométrio/tratamento farmacológico , Neoplasias do Endométrio/cirurgia , Terapia Neoadjuvante , Paclitaxel/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica , Cisplatino/uso terapêutico , Neoplasias do Endométrio/mortalidade , Feminino , Humanos , Excisão de Linfonodo , Estadiamento de Neoplasias , Ovariectomia , Taxa de Sobrevida , Resultado do Tratamento
13.
Orv Hetil ; 161(11): 434-436, 2020 Mar.
Artigo em Húngaro | MEDLINE | ID: mdl-32148097

RESUMO

The aVR-sign can indicate left main or multivessel coronary disease, but the sign is not STEMI eqvivalent and is not a sensitive sign for coronary disese. The following case is an example of this. An 89-year-old woman was admitted with chest pain, atrial fibrillation and multiple lead ST-segment depression but ST-segment elevation in lead aVR. The aVR-sign indicated urgent angiography with negative result. A spontaneous sinus conversion was observed with repolarization normalisation. Later the ECG demonstrated SA-blocks, and sinus arrest. Sick sinus syndrome was diagnosed and the patient was treated with pacemaker and oral anticoagulant. Orv Hetil. 2020; 161(11): 434-436.


Assuntos
Anticoagulantes/uso terapêutico , Fibrilação Atrial/etiologia , Dor no Peito/etiologia , Angiografia Coronária/métodos , Eletrocardiografia/métodos , Marca-Passo Artificial , Síndrome do Nó Sinusal/diagnóstico por imagem , Síndrome Coronariana Aguda , Idoso de 80 Anos ou mais , Anticoagulantes/administração & dosagem , Doença da Artéria Coronariana , Diagnóstico Diferencial , Feminino , Humanos , Síndrome do Nó Sinusal/cirurgia , Resultado do Tratamento
14.
Rev Med Suisse ; 16(683): 399-403, 2020 Feb 26.
Artigo em Francês | MEDLINE | ID: mdl-32129016

RESUMO

Recently, comprehension of immune mechanisms involved in anti-tumor responses has permitted the development of new oncologic drugs called immune checkpoint inhibitors. These drugs act by restoring anti-tumor responses. With their increasing use, we note a rise in the incidence rate of immune related adverse events, which can affect many organs. Renal toxicity, more precisely tubulointerstitial nephritis, is still not well understood but an emerging complication.


Assuntos
Fatores Imunológicos/efeitos adversos , Fatores Imunológicos/uso terapêutico , Neoplasias/tratamento farmacológico , Neoplasias/imunologia , Nefrite Intersticial/induzido quimicamente , Humanos
15.
Medicine (Baltimore) ; 99(9): e18997, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118710

RESUMO

BACKGROUND: Glioblastomas are malignant brain tumors associated with high mortality and poor prognosis. Evidence from preclinical studies suggests that statins have an antitumor role, but their effects on the survival of patients with glioblastoma remain controversial. This meta-analysis attempts to assess the association between statins and glioblastoma. METHODS: We searched 4 databases (PubMed, Web of Science, Embase, and Cochrane Library) for articles that evaluate the effect of statins on the survival of patients with glioblastoma. Two reviewers were asked to assess the quality of the studies and extract the data regarding progression-free survival (PFS) and overall survival (OS). RESULT: A total of 5 studies met the inclusion criteria with 430 statin users and 2089 nonstatin users. All 5 studies were retrospectively analyzed. The pooled hazard ratio (HR) and 95% confidence intervals (CIs) were calculated. There was no benefit of statins found pertaining to the survival of glioblastoma patients in both PFS (HR, 0.97; CI, 0.84-1.13) and OS (HR, 0.98; CI, 0.87-1.11). In a subgroup defined by the patterns of statin use, it was determined that usage before glioblastoma diagnosis favored the OS of patients (HR, 0.85). The result, however, failed to demonstrate a statistically significant difference. CONCLUSION: Use of statins was not associated with prolonged survival of patients with glioblastoma. Further well-designed randomized controlled trials are needed to confirm.


Assuntos
Glioblastoma/mortalidade , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Humanos
16.
Medicine (Baltimore) ; 99(9): e19008, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118712

RESUMO

Aspirin therapy has shown protective effects against hepatocellular carcinoma (HCC) in preclinical studies. However, it is unclear whether aspirin therapy lowers the risk of HCC in patients with alcoholic cirrhosis.A retrospective analysis of data from 949 consecutive patients with alcoholic cirrhosis who abstained from alcoholic drinking was performed. The primary and secondary outcomes were development of HCC and gastrointestinal bleeding events, respectively. Risk was compared between patients with aspirin treatment and patients who were not treated (non-aspirin group) using a time-varying Cox proportional hazards model for total population and propensity score-matching analysis.The aspirin group included 224 patients and the non-aspirin group had 725 patients. During the study period of median duration of 3.1 years, 133 patients (13.6%) developed HCC. In time-varying Cox proportional analyses, the aspirin group showed a significantly lower risk of HCC (adjusted hazard ratio [aHR]: 0.13; 95% confidence interval [CI]: 0.08-0.21; P < .001). In propensity score-matched pairs, aspirin therapy significantly reduced the risk of HCC (aHR: 0.14; 95% CI: 0.09-0.22; P < .001). In bleeding risk, treatment with aspirin alone was not significantly associated with a higher bleeding risk (aHR: 0.81; 95% CI: 0.45-1.44; P = .46).Aspirin therapy was associated with the lower risk of HCC in patients with alcoholic cirrhosis.


Assuntos
Aspirina/uso terapêutico , Carcinoma Hepatocelular/etiologia , Cirrose Hepática Alcoólica/complicações , Neoplasias Hepáticas/etiologia , Inibidores da Agregação de Plaquetas/uso terapêutico , Idoso , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/prevenção & controle , Feminino , Humanos , Incidência , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/prevenção & controle , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Estudos Retrospectivos
17.
Medicine (Baltimore) ; 99(9): e19198, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118720

RESUMO

BACKGROUND: Insomnia is a prevalent and bothersome disorder of sleep initiation and maintenance. Although efficacious treatments for insomnia have been available for decades, they all have their own limitations. Guizhi Gancao Longgu Muli Decoction (GGLMD), a popular complementary and alternative therapy, has been widely applied to treat insomnia in some Asian countries for centuries. Yet no systematic reviews have comprehensively assessed the efficacy and safety of GGLMD as a treatment for insomnia. METHODS: A comprehensive search up to November, 2019 will be conducted in the following electronic databases: the Cochrane Library, Embase, PubMed, Web of Science, the Chinese National Knowledge Infrastructure (CNKI), the Chinese Biomedical Literature Database (CBM), the Chinese Scientific Journal Database (VIP), and the Wanfang Database. The primary outcomes will be sleep quality including Pittsburgh Sleep Quality Index (PSQI) and polysomnography (PSG). Stata 15 will be used for data analysis as well. RESULTS: This study will provide the current evidence of insomnia treated with GGLMD from the several points including PSQI and PSG. CONCLUSION: The consequence of this summary will furnish proof to evaluate if GGLMD is effective in the treatment of insomnia. ETHICS AND DISSEMINATION: Without personal information involved, ethical approval and informed consent form is no need. The review will be submitted to a peer-reviewed journal prospectively to spread our findings. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42018118336.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , Humanos , Revisão Sistemática como Assunto
18.
Zhonghua Xue Ye Xue Za Zhi ; 41(2): 138-142, 2020 Feb 14.
Artigo em Chinês | MEDLINE | ID: mdl-32135631

RESUMO

Objective: To reveal the related factors of inhibitors and differences ofhemorrhage and joint disease before and after the production of inhibitors in children with hemophilia A (HA) . Methods: Retrospective analyses of the clinical data of 381 children with HA under the age of 16 registered in the Registration Management Center of Hemophilia in Henan Provincial from January 2015 to August 2018. Results: A total of the 381 children were enrolled with 116 (30.4%) mild, 196 (51.4%) moderate, and 69 (18.1%) severe cases; 54 patients (14.2%) had inhibitors, including 22 high and 32 low titer inhibitors. Positive family history was positively associated with inhibitors[P<0.001, OR=3.299 (95%CI 1.743-5.983) ], and high-intensity exposure was associated with inhibitors[P=0.002, OR=2.587 (95%CI 1.414-4.731) ]. High-intensity exposure was associated with high titer inhibitor production[P=0.001, OR=8.689 (95%CI 2.464-30.638) ], and high-intensity exposure increased the risk of high titer inhibitors in HA patients. After inhibitors occurred in 54 patients with HA, the rates of overall joint annual bleeding (z=-3.440, P=0.001) and traumatic annual bleeding (z=-2.232, P=0.026) increased, but the rates of the annual joint bleeding (z=-1.342, P=0.180) and spontaneous annual bleeding (z=-1.414, P=0.157) remained to be not statistically significant. The joint ultrasound score did not change significantly after the inhibitor information (z=-0.632, P=0.527) . Conclusions: Positive family history and high-intensity exposure could increase the risk of F Ⅷ inhibitors in HA patients, and high-intensity exposure increased the risk of high titer inhibitors. The rates of the overall joint annual bleeding and traumatic annual bleeding increased after the inhibitor information.


Assuntos
Fator VIII/uso terapêutico , Hemofilia A , Criança , Hemartrose , Hemofilia A/tratamento farmacológico , Hemorragia , Humanos , Estudos Retrospectivos
19.
Bratisl Lek Listy ; 121(2): 143-150, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32115968

RESUMO

OBJECTIVES: This study was aimed to explore the effects of follistatin on cisplatin-induced renal dysfunction, histopathological changes, apoptosis, inflammation and oxidative damage in rats. BACKGROUND: Follistatin plays an important role in the developmental and regeneration processes of kidney by blocking the actions of activin, which is a member of transforming growth factor-ß superfamily. METHODS: Twenty seven rats were separated into 4 equal groups: Control, Cp (cisplatin, 6 mg/kg, intrapertoneally (ip)), F1 (cisplatin + 1 µg/day follistatin ip for 4 consecutive days) and F4 (cisplatin + 4 µg/day follistatin ip single dose) groups. Renal health was monitored by blood urea nitrogen, serum creatinine and histological analysis. Apoptosis, inflammation and oxidative stress was investigated in kidney tissue. Activin A levels in serum and kidney were evaluated as well. RESULTS: Follistatin administration showed a considerable nephroprotective effect against cisplatin-induced nephrotoxicity by preventing renal functional and structural abnormalities, apoptosis and inflammation. The activin A levels in both serum and kidney were also suppressed by follistatin administration. CONCLUSION: Exogenous follistatin ameliorates acute kidney injury, by blocking activin A. The renoprotective effect of follistatin against cisplatin-induced nephrotoxicity appears to be associated with its anti-inflammatory, antiapoptotic and direct nephroprotective actions (Tab. 1, Fig. 7, Ref. 23).


Assuntos
Lesão Renal Aguda , Cisplatino , Folistatina , Lesão Renal Aguda/induzido quimicamente , Lesão Renal Aguda/tratamento farmacológico , Animais , Apoptose/efeitos dos fármacos , Cisplatino/efeitos adversos , Folistatina/farmacologia , Folistatina/uso terapêutico , Inflamação , Rim , Estresse Oxidativo , Ratos
20.
Bratisl Lek Listy ; 121(2): 154-158, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32115970

RESUMO

OBJECTIVE: This study aimed to evaluate the effect of Coenzyme Q10 (CoQ10) administration to patients in the early phase of sepsis to determine its effect on the markers of inflammation and the clinical outcomes of septic patients. BACKGROUND: Previous studies showed that CoQ10 levels were decreased in septic patients and worsening of mitochondrial dysfunction was observed. METHODS: In this randomized controlled trial septic patients (n=40) received 100 mg CoQ10 twice a day for seven days added to standard treatment of sepsis. As a primary endpoint levels of Interleukin 6 (IL-6), Tumor Necrosis Factor-α (TNF-α), Glutathione peroxidase and malondialdehyde (MDA) were assessed at baseline, third and 7th day after the intervention. Secondary endpoints included assessment of clinical scores and     in-hospital mortality. RESULTS: There was no difference in baseline inflammatory and oxidative injury markers between the groups. TNF-α and MDA levels decreased significantly in the CoQ10 group on the 7th day of the study (P:0.003 for both). There was a significant difference in the in-hospital mortality in the CoQ10 group compared to the control group (P:0.01). CONCLUSION: These findings suggest that CoQ10 has a positive effect on clinical parameters as well as mitochondrial dysfunction when administered in the early phase of sepsis (Tab. 2, Fig. 1, Ref. 38).


Assuntos
Inflamação , Sepse , Ubiquinona/análogos & derivados , Biomarcadores , Método Duplo-Cego , Humanos , Inflamação/tratamento farmacológico , Malondialdeído , Sepse/tratamento farmacológico , Sepse/imunologia , Ubiquinona/uso terapêutico
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