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1.
Toxicol Lett ; 318: 104-113, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31672611

RESUMO

BACKGROUND: Bupivacaine (BP) is commonly used as a local anaesthetic(LA) in the clinic, but it can also cause neurotoxicity, especially in patients with diabetes. Previous studies have found that high-glucose environments can aggravate BP-induced DNA damage in nerve cells. Ku70 is subunit of the DNA damage repair enzyme DNA-PK. This study was designed to determine whether high-glucose conditions enhance BP neurotoxicity and DNA damage by inhibiting Ku70 expression. METHODS: We examined the effect of BP on apoptosis and DNA damage in murine dorsal root ganglion (DRG) neurons under hyperglycaemic conditions. Untreated DRG cells and DRG cells pretreated with NU7441, a DNA-PK inhibitor, were cultured for 3 days under normal culture conditions or with 50 mM glucose, and the cells were then treated with BP for 3 h. DNA damage was investigated via comet assays, the ratio of early to late apoptotic cells was assessed by Annexin V-FITC/PI staining, and cell viability was measured by CCK-8 assays. The protein expression levels of DNA-PK, Ku70, Bax, Bcl-2 and γH2ax were measured by immunofluorescence or Western blotting. RESULTS: Compared to its effect under normal culture conditions, BP treatment led to decreased cell viability and increased DNA damage in DRG cells grown under high-glucose conditions. The rate of DRG cell apoptosis and the expression of γH2ax, the ratio of Bax to Bcl-2 also increased under the high-glucose conditions. Furthermore, Ku70 expression was inhibited. The DNA-PK inhibitor, NU7441, could significantly inhibit DNA-PK and Ku70 expression, simultaneously further aggravating BP-induced apoptosis and DNA damage under high-glucose conditions. CONCLUSION: These data indicate that hyperglycaemia may enhance BP-induced neurotoxicity and DNA damage by inhibiting the DNA repair protein Ku70.


Assuntos
Anestésicos Locais/toxicidade , Apoptose/efeitos dos fármacos , Bupivacaína/toxicidade , Cromonas/toxicidade , Inibidores Enzimáticos/toxicidade , Gânglios Espinais/efeitos dos fármacos , Glucose/toxicidade , Autoantígeno Ku/antagonistas & inibidores , Morfolinas/toxicidade , Síndromes Neurotóxicas/etiologia , Animais , Células Cultivadas , Dano ao DNA , Gânglios Espinais/enzimologia , Gânglios Espinais/patologia , Autoantígeno Ku/metabolismo , Camundongos , Síndromes Neurotóxicas/enzimologia , Síndromes Neurotóxicas/patologia , Transdução de Sinais/efeitos dos fármacos
2.
Einstein (Sao Paulo) ; 18: eAO4876, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31576909

RESUMO

OBJECTIVE: To investigate the effects of sericin extracted from silkworm Bombyx mori cocoon on morphophysiological parameters in mice with obesity induced by high-fat diet. METHODS: Male C57Bl6 mice aged 9 weeks were allocated to one of two groups - Control and Obese, and fed a standard or high-fat diet for 10 weeks, respectively. Mice were then further subdivided into four groups with seven mice each, as follows: Control, Control-Sericin, Obese, and Obese-Sericin. The standard or high fat diet was given for 4 more weeks; sericin (1,000mg/kg body weight) was given orally to mice in the Control-Sericin and Obese-Sericin Groups during this period. Weight gain, food intake, fecal weight, fecal lipid content, gut motility and glucose tolerance were monitored. At the end of experimental period, plasma was collected for biochemical analysis. Samples of white adipose tissue, liver and jejunum were collected and processed for light microscopy analysis; liver fragments were used for lipid content determination. RESULTS: Obese mice experienced significantly greater weight gain and fat accumulation and had higher total cholesterol and glucose levels compared to controls. Retroperitoneal and periepididymal adipocyte hypertrophy, development of hepatic steatosis, increased cholesterol and triglyceride levels and morphometric changes in the jejunal wall were observed. CONCLUSION: Physiological changes induced by obesity were not fully reverted by sericin; however, sericin treatment restored jejunal morphometry and increased lipid excretion in feces in obese mice, suggesting potential anti-obesity effects.


Assuntos
Fármacos Antiobesidade/uso terapêutico , Dieta Hiperlipídica , Obesidade/tratamento farmacológico , Sericinas/uso terapêutico , Tecido Adiposo/patologia , Animais , Fármacos Antiobesidade/farmacologia , Peso Corporal/efeitos dos fármacos , Colesterol/análise , Dieta Hiperlipídica/efeitos adversos , Ingestão de Alimentos/efeitos dos fármacos , Fígado Gorduroso/patologia , Trânsito Gastrointestinal/efeitos dos fármacos , Teste de Tolerância a Glucose , Fígado/metabolismo , Masculino , Camundongos Endogâmicos C57BL , Camundongos Obesos , Obesidade/etiologia , Obesidade/fisiopatologia , Reprodutibilidade dos Testes , Sericinas/farmacologia , Fatores de Tempo , Resultado do Tratamento , Triglicerídeos/análise , Ganho de Peso/efeitos dos fármacos
3.
Adv Exp Med Biol ; 1131: 1031-1063, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31646544

RESUMO

The calcium-sensing receptor (CaSR) is a G protein-coupled receptor that plays a key role in calcium homeostasis, by sensing free calcium levels in blood and regulating parathyroid hormone secretion in response. The CaSR is highly expressed in parathyroid gland and kidney where its role is well characterised, but also in other tissues where its function remains to be determined. The CaSR can be activated by a variety of endogenous ligands, as well as by synthetic modulators such as Cinacalcet, used in the clinic to treat secondary hyperparathyroidism in patients with chronic kidney disease. The CaSR couples to multiple G proteins, in a tissue-specific manner, activating several signalling pathways and thus regulating diverse intracellular events. The multifaceted nature of this receptor makes it a valuable therapeutic target for calciotropic and non-calciotropic diseases. It is therefore essential to understand the complexity behind the pharmacology, trafficking, and signalling characteristics of this receptor. This review provides an overview of the latest knowledge about the CaSR and discusses future hot topics in this field.


Assuntos
Cálcio , Hiperparatireoidismo Secundário , Receptores de Detecção de Cálcio , Cálcio/metabolismo , Cinacalcete/uso terapêutico , Humanos , Hiperparatireoidismo Secundário/tratamento farmacológico , Hiperparatireoidismo Secundário/etiologia , Rim/metabolismo , Glândulas Paratireoides/metabolismo , Receptores de Detecção de Cálcio/química , Receptores de Detecção de Cálcio/metabolismo , Insuficiência Renal Crônica/complicações
4.
Med Clin North Am ; 104(1): 1-14, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31757229

RESUMO

Physicians may encounter blood or tissue eosinophilia through a routine complete blood count with differential or a tissue pathology report. In this article, the basic biology of eosinophils is reviewed and definitions of blood eosinophilia, as well as the challenges of defining tissue eosinophilia, are discussed. Conditions associated with eosinophilia are briefly discussed as well as a general approach to evaluating eosinophilia. Future challenges include determining which eosinophil-associated diseases benefit from eosinophil-targeted therapy and identifying biomarkers for disease activity and diagnosis.


Assuntos
Eosinofilia/diagnóstico , Eosinófilos/metabolismo , Biomarcadores/sangue , Eosinofilia/sangue , Eosinofilia/etiologia , Humanos , Contagem de Leucócitos , Índice de Gravidade de Doença
5.
Med Clin North Am ; 104(1): 109-128, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31757230

RESUMO

Drug hypersensitivity reactions (DHRs) may be classified based on timing (immediate vs delayed), mechanisms, and pattern of clinical manifestations. Management may include selection of alternative, non-cross reactive agents, drug allergy testing, graded challenge and/or desensitization. Immediate skin testing only identifies risk for immediate-type allergic DHR and has a negative predictive value for only a limited number of drugs (eg, penicillin). Desensitization induces a temporary state of tolerance that is maintained only so long as the drug is continued. This article discusses special considerations about antibiotics, angiotensin-converting enzyme inhibitors, anesthetic agents, aspirin and nonsteroidal antiinflammatory drugs, radiocontrast media, and chemotherapeutic agents.


Assuntos
Dessensibilização Imunológica/métodos , Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade a Drogas/terapia , Testes Cutâneos/estatística & dados numéricos , Anestésicos/efeitos adversos , Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Antibacterianos/efeitos adversos , Anti-Inflamatórios não Esteroides/efeitos adversos , Aspirina/efeitos adversos , Hipersensibilidade a Drogas/etiologia , Humanos , Valor Preditivo dos Testes
6.
Med Clin North Am ; 104(1): 129-143, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31757231

RESUMO

Stinging insect allergy is uncommon but can be life threatening. Diagnosis requires clinical history and confirmative skin or blood testing by an allergist. Baseline serum tryptase level can be used to stratify risk. Treatment is supportive for all reactions except for anaphylaxis, which is treated with intramuscular epinephrine, recumbent posture, and adjunct measures such as IV fluids, and oxygen. Venom immunotherapy is most effective for long-term management in patients with a history of anaphylaxis. Venom immunotherapy rapidly reduces the risk of sting anaphylaxis by up to 98% and maintenance treatment can be stopped after 5 years in most cases.


Assuntos
Anafilaxia/tratamento farmacológico , Epinefrina/uso terapêutico , Hipersensibilidade/tratamento farmacológico , Mordeduras e Picadas de Insetos/complicações , Anafilaxia/etiologia , Animais , Humanos , Hipersensibilidade/etiologia , Imunoterapia/métodos , Peçonhas/uso terapêutico
7.
Med Clin North Am ; 104(1): 15-24, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31757233

RESUMO

Urticaria is a common presenting problem to the primary care provider. Acute urticaria lasting less than 6 weeks may be associated with a drug or food allergens. Chronic urticaria lasting more than 6 weeks is often associated without a known underlying cause. Inducible stimuli causing hives should be excluded using specific provocation testing. Treatment follows a standardized algorithmic approach as outlined by the Joint Task Force Practice Parameter and/or International Urticaria guidelines. Patients not responsive to steps 1 or 2 should be referred to an urticaria specialist for further evaluation and treatment. The prognosis and outcome of urticaria is generally very favorable for most patients.


Assuntos
Atenção Primária à Saúde/métodos , Urticária/diagnóstico , Doença Aguda , Comitês Consultivos/normas , Doença Crônica , Hipersensibilidade a Drogas/complicações , Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade Alimentar/complicações , Hipersensibilidade Alimentar/diagnóstico , Humanos , Guias de Prática Clínica como Assunto , Atenção Primária à Saúde/normas , Prognóstico , Encaminhamento e Consulta , Urticária/etiologia
8.
Med Clin North Am ; 104(1): 77-94, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31757239

RESUMO

This article evaluates the role of allergen immunotherapy (AIT) in the treatment of allergic rhinitis (AR). AIT has been shown to be effective in treating AR symptoms with resultant improvements in overall quality of life, comorbid illnesses, and medication requirements. Persistent clinical benefits have been shown years after AIT treatment discontinuation. AIT may prevent the progression of AR to asthma. AIT may more cost-effective than pharmacotherapy. Multiple individual studies and systematic reviews provide strong evidence for the clinical effectiveness of AIT in the treatment of AR. Cost-effectiveness and disease modification of AIT compared with standard drug treatment are additional advantages.


Assuntos
Dessensibilização Imunológica/estatística & dados numéricos , Rinite Alérgica/terapia , Asma/etiologia , Asma/prevenção & controle , Análise Custo-Benefício , Dessensibilização Imunológica/métodos , Humanos , Qualidade de Vida , Rinite Alérgica/complicações , Resultado do Tratamento
9.
Surg Clin North Am ; 100(1): 1-12, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31753105

RESUMO

The incidence of melanoma continues to increase worldwide. In the United States, melanoma is the fifth most common cancer in men and the sixth most common cancer in women. The risk factors contributing to melanoma have largely remained unchanged, but there is a new focus on modifiable risk factors including sun exposure and ultraviolet light. A large public initiative supported by the Centers for Disease Control focuses on educating the public on the risks of sun exposure and indoor tanning. Early detection and resection of melanoma lesions is necessary to prevent metastasis and reduce medical costs.


Assuntos
Melanoma/epidemiologia , Neoplasias Cutâneas/epidemiologia , Raios Ultravioleta/efeitos adversos , Humanos , Melanoma/etiologia , Fatores de Risco , Neoplasias Cutâneas/etiologia , Banho de Sol , Luz Solar/efeitos adversos , Estados Unidos/epidemiologia
10.
Food Chem ; 302: 125333, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31416005

RESUMO

This study was performed to determine Parvalbumin (PV), a well-known fish allergenic protein, digestion kinetics and immunoreactivity of digestion products with Immunoglobulin G/Immunoglobulin E recognition to understand its allergic potential with or without lipid emulsion process. PV was subjected to simulated gastrointestinal digestion in emulsified condition. Digestion kinetics of the protein was analysed by electrophoresis, IgG/IgE binding ability by immunoblotting and indirect ELISA. Lipid emulsion significantly (p < 0.01) reduced the degree of PV hydrolysis by 52.10% for gastric digestion. Immune fragments of gastric digestion were detectable for 90-120 min longer in emulsified condition showing resistance. Consequently, lipid emulsion decreased the digestive ability of PV in stomach, increasing resistance to gastrointestinal digestion by pepsin proteases. It also altered IgG/IgE binding ability of digestion products, thereby indicating that PV with lipid emulsion was resistant to digestion and possessed increased IgE binding ability resulting in higher risk of allergy among sensitized individuals.


Assuntos
Alérgenos/farmacocinética , Emulsões/farmacocinética , Proteínas de Peixes da Dieta/farmacocinética , Hipersensibilidade Alimentar/imunologia , Parvalbuminas/farmacocinética , Alérgenos/imunologia , Alérgenos/metabolismo , Animais , Digestão , Emulsões/química , Ensaio de Imunoadsorção Enzimática , Feminino , Proteínas de Peixes da Dieta/imunologia , Linguados , Hipersensibilidade Alimentar/etiologia , Immunoblotting , Imunoglobulina E/imunologia , Imunoglobulina E/metabolismo , Imunoglobulina G/imunologia , Imunoglobulina G/metabolismo , Lipídeos/química , Lipídeos/farmacocinética , Camundongos Endogâmicos BALB C , Parvalbuminas/imunologia , Parvalbuminas/metabolismo , Pepsina A/metabolismo
11.
Orthop Clin North Am ; 51(1): 121-130, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31739875

RESUMO

Peroneal tendon pathology is becoming an increasingly recognized source of lateral-sided ankle pain. High clinical suspicion, along with judicious physical examination coupled with confirmatory advanced imaging modalities, are necessary to make an accurate diagnosis and aid in guiding treatment. Peroneal pathology encompasses several distinct conditions. Peroneal tendon tears and injuries to the peroneal retinaculum must be identified to guide treatment. Patients with peroneal pathology report high levels of satisfaction after surgical management with most returning to their preinjury level of function. An early and accurate diagnosis, along with treatment tailored to the individual, is necessary to obtain optimal outcomes.


Assuntos
Traumatismos do Tornozelo/cirurgia , Traumatismos dos Tendões/cirurgia , Transferência Tendinosa/métodos , Tendões/cirurgia , Tornozelo/anatomia & histologia , Tornozelo/diagnóstico por imagem , Tornozelo/patologia , Traumatismos do Tornozelo/diagnóstico por imagem , Traumatismos do Tornozelo/patologia , Fenômenos Biomecânicos , Cadáver , Humanos , Incidência , Instabilidade Articular/epidemiologia , Instabilidade Articular/etiologia , Instabilidade Articular/cirurgia , Imagem por Ressonância Magnética , Medidas de Resultados Relatados pelo Paciente , Radiografia , Recuperação de Função Fisiológica , Estudos Retrospectivos , Ruptura , Traumatismos dos Tendões/diagnóstico por imagem , Traumatismos dos Tendões/patologia , Tendões/anatomia & histologia , Tendões/patologia
12.
Orthop Clin North Am ; 51(1): 37-53, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31739878

RESUMO

In situ pinning of slipped capital femoral epiphysis (SCFE) is a safe and effective treatment modality, but often results in residual deformity leading to femoroacetabular impingement, which may limit patient activities and predispose to early onset arthritis. Enhanced understanding of the implications of femoroacetabular impingement and new surgical techniques have prompted interest in treating post-slipped capital femoral epiphysis deformity to both improve current symptoms and delay or prevent hip arthrosis.


Assuntos
Coxa Magna/cirurgia , Quadril/diagnóstico por imagem , Osteoartrite do Quadril/prevenção & controle , Escorregamento das Epífises Proximais do Fêmur/cirurgia , Artroscopia/métodos , Pinos Ortopédicos/efeitos adversos , Pinos Ortopédicos/normas , Impacto Femoroacetabular/etiologia , Impacto Femoroacetabular/cirurgia , Fêmur/cirurgia , Quadril/cirurgia , Luxação do Quadril/cirurgia , Humanos , Procedimentos Ortopédicos/métodos , Osteoartrite do Quadril/cirurgia , Osteotomia/métodos , Cuidados Pós-Operatórios , Estudos Retrospectivos , Resultado do Tratamento
13.
Orthop Clin North Am ; 51(1): 77-86, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31739882

RESUMO

Scapholunate ligament injuries are common and can lead to a predictable pattern of arthritis (scaphoid lunate advanced collapse wrist) if unrecognized or untreated. This article describes the relevant anatomy, biomechanics, and classification system, and provides an up-to-date literature-based review of treatment options, including acute repair and various reconstruction techniques. It also helps guide surgeons in making decisions regarding a systematic treatment algorithm for these injuries.


Assuntos
Ligamentos Articulares/lesões , Ligamentos Articulares/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Traumatismos do Punho/complicações , Artrite/epidemiologia , Artrite/etiologia , Fenômenos Biomecânicos , Articulações do Carpo/lesões , Articulações do Carpo/patologia , Articulações do Carpo/cirurgia , Humanos , Ligamentos Articulares/anatomia & histologia , Osso Semilunar/lesões , Osso Semilunar/patologia , Osso Semilunar/cirurgia , Radiografia/métodos , Amplitude de Movimento Articular , Osso Escafoide/lesões , Osso Escafoide/patologia , Osso Escafoide/cirurgia , Resultado do Tratamento , Traumatismos do Punho/diagnóstico por imagem , Traumatismos do Punho/cirurgia , Articulação do Punho/patologia , Articulação do Punho/cirurgia
14.
Emerg Med Clin North Am ; 38(1): 207-222, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31757251

RESUMO

A systematic approach is required for patients with a suspected concussion. Although standardized tools can aid in assessment, the diagnosis of concussion remains a clinical one. At the time of diagnosis, patients should be given both verbal and written review of the common symptoms of concussion, expected course of recovery, as well as strategies to manage symptoms. Most patients benefit from a brief period of rest, followed by a gradual reintroduction of activities, and a graduated return-to-sport protocol. Patients with prolonged recovery from a concussion may benefit from exercise, vestibular, and cognitive rehabilitation programs.


Assuntos
Traumatismos em Atletas/terapia , Concussão Encefálica/terapia , Diagnóstico por Imagem/métodos , Gerenciamento Clínico , Emergências , Medicina Esportiva/métodos , Traumatismos em Atletas/complicações , Traumatismos em Atletas/diagnóstico , Concussão Encefálica/diagnóstico , Concussão Encefálica/etiologia , Humanos , Índices de Gravidade do Trauma
15.
Emerg Med Clin North Am ; 38(1): 223-241, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31757252

RESUMO

Pain management in acute orthopedic injury needs to be tailored to the presentation and patient. Subjective and objective assessment, in conjunction with pathophysiology, should be used to provide symptom control. Ideally, treatment should be administered in an escalating fashion, attempting to manage pain with the lowest dose of the safest medication available. There are also adjunctive therapies, including those that are nonpharmacologic, that can provide additional relief.


Assuntos
Analgesia/métodos , Manejo da Dor/métodos , Medição da Dor/métodos , Dor/etiologia , Ferimentos e Lesões/complicações , Humanos , Dor/diagnóstico , Ferimentos e Lesões/diagnóstico
16.
Radiol Clin North Am ; 58(1): 133-150, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31731897

RESUMO

Imaging plays a central role in the evaluation of patients following cardiothoracic surgery, both for monitoring in the early postoperative period and for assessing for suspected complications. Patients with postsurgical complications can develop a range of signs and symptoms, from hypotension and tachycardia, as the result of severe bleeding, to fever and leukocytosis because of infection. The radiologist is an important member of the care team in the postoperative period, helping identify and manage complications of cardiothoracic surgery. This article reviews the common complications of cardiothoracic surgery focusing on the role of imaging and clues to diagnosis.


Assuntos
Cardiopatias/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Doenças Respiratórias/diagnóstico por imagem , Procedimentos Cirúrgicos Torácicos/efeitos adversos , Tomografia Computadorizada por Raios X/métodos , Doenças Vasculares/diagnóstico por imagem , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Cardiopatias/etiologia , Humanos , Complicações Pós-Operatórias/etiologia , Radiografia/métodos , Doenças Respiratórias/etiologia , Doenças Vasculares/etiologia
17.
Radiol Clin North Am ; 58(1): 19-44, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31731901

RESUMO

Gastrointestinal tract perforation involving the stomach, duodenum, small intestine, or large bowel occurs as a result of full-thickness gastrointestinal wall injury with release of intraluminal contents into the peritoneal or retroperitoneal cavity. Most cases are associated with high mortality and morbidity, requiring urgent surgical evaluation. Initial patient presentations can be nonspecific with a broad differential, which can delay timely management. This article provides brief overviews of different causes of perforation. Various imaging modalities and protocols are discussed, along with direct and indirect imaging findings of perforation. Specific findings associated with different causes are also described to aid in the diagnosis.


Assuntos
Diagnóstico por Imagem/métodos , Gastroenteropatias/complicações , Trato Gastrointestinal/diagnóstico por imagem , Trato Gastrointestinal/lesões , Perfuração Intestinal/diagnóstico por imagem , Perfuração Intestinal/etiologia , Gastroenteropatias/patologia , Trato Gastrointestinal/patologia , Humanos , Perfuração Intestinal/patologia
18.
Adv Exp Med Biol ; 1179: 1-16, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31741331

RESUMO

Hepatitis B virus (HBV) is a DNA virus, belonging to the Hepadnaviridae family. It is a partially double-stranded DNA virus with a small viral genome (3.2 kb). Chronic HBV infection remains a global public health problem. If left untreated, chronic HBV infection can progress to end-stage liver disease, such as liver cirrhosis and hepatocellular carcinoma (HCC). In recent years, tremendous advances in the field of HBV basic and clinical research have been achieved, ranging from the HBV biological characteristics, immunopathogenesis, and animal models to the development of new therapeutic strategies and new drugs against HBV. In this overview, we begin with a brief history of HBV discovery and treatment milestones. We then briefly summarize the HBV research advances, which will be detailed in the following chapters.


Assuntos
Carcinoma Hepatocelular , Vírus da Hepatite B , Hepatite B Crônica , Cirrose Hepática , Neoplasias Hepáticas , Animais , Carcinoma Hepatocelular/etiologia , Hepatite B/complicações , Vírus da Hepatite B/fisiologia , Hepatite B Crônica/complicações , Cirrose Hepática/etiologia , Neoplasias Hepáticas/etiologia , Pesquisa/tendências
19.
Acta Neurochir Suppl ; 127: 15-19, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31407057

RESUMO

Aneurysmal subarachnoid hemorrhage (aSAH) remains a significant cause of stroke disability despite gradual reductions in physical morbidity and mortality. Heparin is an effective anti-inflammatory agent and may potentially prevent delayed neurological injury in the days to weeks after the hemorrhage. Various human studies have shown the safety of a continuous infusion of low-dose unfractionated heparin in the setting of subarachnoid hemorrhage as well as its efficacy in minimizing delayed neurological deficits including symptomatic cerebral vasospasm, vasospasm-related infarction, and cognitive dysfunction. Studies have also shown mixed results with low-molecular-weight heparin usage in this patient population. Heparin treatment is not associated with significant hemorrhagic complications; however, vigilance is essential for early detection of heparin-induced thrombocytopenia in order to prevent devastating sequelae. Multicenter randomized controlled trials are necessary for objective characterization of the effects of heparin.


Assuntos
Anticoagulantes , Heparina , Acidente Vascular Cerebral , Hemorragia Subaracnóidea , Vasoespasmo Intracraniano , Anticoagulantes/uso terapêutico , Heparina/uso terapêutico , Humanos , Acidente Vascular Cerebral/etiologia , Hemorragia Subaracnóidea/complicações , Hemorragia Subaracnóidea/tratamento farmacológico , Vasoespasmo Intracraniano/tratamento farmacológico
20.
Acta Neurochir Suppl ; 127: 21-25, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31407058

RESUMO

Epilepsy is a significant worldwide public health problem that leads to reduced quality of life and negative psychosocial consequences and significantly increases mortality rates in those who are affected. The development of epilepsy from subarachnoid hemorrhage (SAH) has an important negative impact on long-term survival, functional status, and cognitive recovery in patients following aneurysmal rupture. Anticonvulsant medication (AED) administration to prevent the development of epilepsy following SAH is controversial, and studies to date have not shown effectiveness of AED use as prophylaxis. This paper reviews the pathophysiology of SAH in the development of epilepsy, the scope of the problem of epilepsy related to SAH, and the studies that have evaluated AED administration as prophylaxis for seizures and epilepsy.


Assuntos
Epilepsia , Hemorragia Subaracnóidea , Anticonvulsivantes/uso terapêutico , Epilepsia/tratamento farmacológico , Epilepsia/etiologia , Humanos , Qualidade de Vida , Convulsões , Hemorragia Subaracnóidea/complicações , Hemorragia Subaracnóidea/fisiopatologia
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