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1.
South Med J ; 113(3): 125-129, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32123927

RESUMO

OBJECTIVES: There is limited evidence for the use of salt tablets in the treatment of hyponatremia. This retrospective study evaluated the effectiveness of salt tablet administration in euvolemic hyponatremia. METHODS: This was a single-center, retrospective cohort study. Information on patients' demographics, clinical characteristics, and laboratory data were collected for retrospective review. Treatment for hyponatremia, including the amount of salt tablets, fluid restriction, and diuretics was collected. We compared hyponatremic patients with those who received salt tablets versus those who did not receive salt tablets. The primary outcome of interest was the change in serum sodium at 48 hours between the two groups. RESULTS: A total of 1258 medical records were initially screened with inclusion and exclusion criteria. After screening, there were 83 patients included in the study. Forty-two patients received salt tablets and 41 patients were in the group that did not receive salt tablets. Patients treated with salt tablets were older, more often female, and had lower body weight and lower initial serum sodium. The change in serum sodium after 48 hours was higher in the salt tablet group (5.2 mEq/L) than the non-salt tablet group (3.1 mEq/L; P < 0.001). This difference in serum sodium between the two groups remained statistically significant when adjusted for age, sex, weight, and initial serum sodium. CONCLUSIONS: The use of salt tablets in the treatment of euvolemic hyponatremia is associated with a small but significant improvement in serum sodium compared with patients who did not receive such therapy, even after adjusting for age, sex, weight, and initial serum sodium. This study supports the effectiveness of salt tablets in the treatment of euvolemic hyponatremia in medical patients.


Assuntos
Hiponatremia/tratamento farmacológico , Cloreto de Sódio/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Hawaii/epidemiologia , Humanos , Hiponatremia/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Cloreto de Sódio/normas , Resultado do Tratamento
2.
Clin Ter ; 170(1): e46-e52, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31850484

RESUMO

PURPOSE: It has been customary to explain the dentally beneficial effects of xylitol and certain other natural compound as lysozyme and seas salt in terms of microbiological effects only. Several studies have tested the use of natural ingredients, alcohol and fluoride free, in mouthwashes. The purpose of this study was to evaluate a combined mouthwash formulation containing natural antibiofilm agents in oral care wound healing after routinely oral surgery (extraction) procedures. METHODS: Patients were assigned following a blinded randomized controlled trial and divided into two groups, an experimental group (I = 15) and a control (placebo) group (II = 15). Any infectious complications, wound healing, plaque accumulation in the stitches, and presence of trismus and inflammation were evaluated at ten and thirty days after extraction procedure. Pain and swelling were evaluated using the well-known visual analogue scale (VAS) scale throughout study period following extraction. The mean difference in Pre and Post values were compared among the groups. The change in pre-post score was analyzed using the paired t test. RESULTS: An appreciable wound healing was seen in the experimental group when compared to the control sites, with no reported adverse effects. Four weeks postoperative patient's satisfaction level, to subjective and objective outcome measurements in documenting the result of a mouthwash treatment showed an interesting difference between groups. CONCLUSIONS: Since combined mouthwash formulations, containing natural/bioactive substances, could provide a cheap, safe and acceptable alternative in oral care, further studies will also be required to study these effects and their mechanism of action in detail.


Assuntos
Edema/tratamento farmacológico , Inflamação/tratamento farmacológico , Antissépticos Bucais/uso terapêutico , Muramidase/uso terapêutico , Água do Mar , Cloreto de Sódio/uso terapêutico , Cicatrização/efeitos dos fármacos , Xilitol/uso terapêutico , Adulto , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Antissépticos Bucais/farmacologia , Procedimentos Cirúrgicos Bucais , Método Simples-Cego , Cloreto de Sódio/farmacologia
3.
Am J Case Rep ; 20: 1857-1863, 2019 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-31827062

RESUMO

BACKGROUND Isolated adrenocorticotropic hormone deficiency (IAD) is a rare disorder characterized by central adrenal insufficiency (AI) but normal secretion of pituitary hormones other than adrenocorticotropic hormone. IAD usually presents with unspecific symptoms of AI, such as anorexia and fatigue, but some patients present with a variety of atypical manifestations. Rhabdomyolysis is a potentially life-threatening clinical syndrome caused by skeletal muscle injury with the release of muscle cell contents into the circulation. A wide variety of disorders can cause rhabdomyolysis. Herein, we report an unusual case of IAD presenting with hyponatremia and rhabdomyolysis. CASE REPORT A 67-year-old Japanese woman with a 2-month history of anorexia and fatigue was diagnosed with severe hyponatremia (serum sodium, 118 mEq/L) and rhabdomyolysis (serum creatine phosphokinase, 6968 IU/L), after 2 days of vomiting and muscle weakness. Physical and laboratory findings did not show dehydration or peripheral edema. Her rhabdomyolysis resolved with normalization of serum sodium levels during administration of sodium chloride. However, her anorexia and fatigue remained unresolved. After reducing the amount of sodium chloride administered, the patient still had hyponatremia. Detailed endocrinological examinations indicated IAD; her hyponatremia was associated with inappropriately high plasma arginine vasopressin levels. The patient received corticosteroid replacement therapy, which resolved her anorexia, fatigue, excessive arginine vasopressin, and hyponatremia. CONCLUSIONS This case highlights the importance of considering the possibility of central AI in patients with hyponatremia and excessive arginine vasopressin levels. In addition, rhabdomyolysis associated with hyponatremia can be an important manifestation of IAD.


Assuntos
Insuficiência Adrenal/complicações , Hiponatremia/etiologia , Rabdomiólise/etiologia , Insuficiência Adrenal/tratamento farmacológico , Idoso , Anorexia , Anti-Inflamatórios/uso terapêutico , Diagnóstico Diferencial , Fadiga , Feminino , Humanos , Hidrocortisona/uso terapêutico , Hiponatremia/tratamento farmacológico , Rabdomiólise/tratamento farmacológico , Cloreto de Sódio/uso terapêutico
5.
Zhonghua Zhong Liu Za Zhi ; 41(10): 771-774, 2019 Oct 23.
Artigo em Chinês | MEDLINE | ID: mdl-31648500

RESUMO

Objective: To compare the efficiency of saline irrigation, antibiotics irrigation and high-concentration antibiotics perfusion with tube drainage in the treatment of infectious effusion. Methods: Clinical and sonographic features of abdominal and pelvic infectious effusion of 64 patients with malignant tumor collected from September 2013 to September 2017 were retrospectively analyzed. The changes of effusion size and temperature, catheterization time were evaluated in saline irrigation group and antibiotics irrigation group. The catheterization time was compared between antibiotics irrigation group and high-concentration antibiotics perfusion group. Results: The effective rates of the saline irrigation group and the antibiotics irrigation group were 68.6% and 86.8%, respectively, and the times of catheterization were 11.9±8.4 days and 7.8±4.8 days, respectively, with significantly statistical difference (both P<0.05). However, the effective rates of the antibiotics irrigation group and the high concentration antibiotic perfusion group were 86.8% and 100.0%, respectively (P=0.067), while the times of catheterization were 7.8±4.8 days and 3.6±3.1 days, respectively (P<0.001). Conclusion: The antibiotic irrigation with tube drainage, especially the high concentration perfusion is more effective than saline in the treatment of abdominal and pelvic infection effusion.


Assuntos
Antibacterianos/uso terapêutico , Infecções Bacterianas/terapia , Drenagem , Infecção Pélvica/terapia , Cloreto de Sódio/uso terapêutico , Irrigação Terapêutica , Infecções Bacterianas/complicações , Humanos , Infecção Pélvica/microbiologia , Complicações Pós-Operatórias/terapia , Período Pós-Operatório , Estudos Retrospectivos , Resultado do Tratamento
6.
Med Sci Monit ; 25: 8120-8130, 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31662580

RESUMO

BACKGROUND Our previous study found a novel fluid combination with better resuscitation effects under hypotensive condition at the early stage of uncontrolled hemorrhagic shock (UHS). However, the optimal recovery concentration of hypertonic saline in this fluid combination remains unknown. This experiment aimed to explore the optimal concentration. MATERIAL AND METHODS New Zealand white rabbits (n=40) were randomly divided into 5 groups, including a sham-operated group (SO), a shock non-treated group (SNT), a normal saline group (NS), and hypertonic saline groups (4.5% and 7.5%). We established an UHS model and administered various fluid combinations (dose-related sodium chloride solution+crystal-colloidal solution) to the groups followed by monitoring indexes of hemodynamic and renal function, measuring infusion volume and blood loss, and analyzing pathological morphology by hematoxylin and eosin staining. RESULTS The hypertonic saline groups showed more stable hemodynamic indexes, reduced blood loss, fewer required infusions, and milder decreases in renal function than those of control groups (SNT and NS groups), and exhibited fewer pathological changes in the heart, lung, kidney, and liver. All indexes in the 4.5% and 7.5% groups were better than those of the NS group, and the hemodynamic indexes in the 7.5% group were more stable than those of the 4.5% group (P<0.05), with reduced blood loss and infusion volume and a milder decrease in renal function. CONCLUSIONS The novel fluid combination with 7.5% hypertonic saline group had a better recovery effect at the early stage of UHS before hemostasis compared to that of the 4.5% hypertonic saline group. This result may provide guidance for clinical fluid resuscitation.


Assuntos
Solução Salina Hipertônica/uso terapêutico , Choque Hemorrágico/tratamento farmacológico , Cloreto de Sódio/uso terapêutico , Animais , Pressão Sanguínea , Hidratação/métodos , Hemodinâmica , Hipotensão , Masculino , Modelos Animais , Coelhos , Ressuscitação
7.
Niger J Clin Pract ; 22(10): 1328-1334, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31607720

RESUMO

Objective: The aim of the this study was to evaluate the effect of honey on the healing of tooth extraction wounds in children 4‒9 years of age. Subjects and Methods: In the present randomized clinical trial, 51 patients, 4‒9 years of age were selected randomly. All the subjects required extraction of one deciduous molar tooth. The subjects were randomly assigned to two groups. In group 1, after extraction of the tooth, the dentist used a cotton swab applicator to place a layer of honey on a piece of gauze moistened with normal saline solution (NSS) and placed it on the socket. In group 2, honey was not used; rather, NSS was applied. On days 3 and 7 after tooth extraction, the wound sizes were measured. Results: In both groups, the wound sizes decreased significantly on the third day compared with baseline and on the seventh day compared with the third day (P < 0.05). On the third and seventh days after tooth extraction, wound sizes in the honey group were significantly lower than those in the NSS group (P < 0.05). Conclusion: Honey resulted in a decrease in wound sizes and faster healing after extraction of teeth in children. Therefore, use of honey can be recommended after minor surgeries in the oral cavity.


Assuntos
Apiterapia/métodos , Mel , Extração Dentária , Alvéolo Dental , Cicatrização/efeitos dos fármacos , Administração Tópica , Bandagens , Criança , Pré-Escolar , Assistência Odontológica , Feminino , Humanos , Masculino , Cloreto de Sódio/uso terapêutico , Alvéolo Dental/efeitos dos fármacos , Alvéolo Dental/patologia , Resultado do Tratamento
8.
Adv Mater ; 31(46): e1904058, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31553099

RESUMO

Many inorganic nanoparticles are prepared and their behaviors in living systems are investigated. Yet, common electrolytes such as NaCl are left out of this campaign. The underlying assumption is that electrolyte nanoparticles will quickly dissolve in water and behave similarly as their constituent salts. Herein, this preconception is challenged. The study shows that NaCl nanoparticles (SCNPs) but not salts are highly toxic to cancer cells. This is because SCNPs enter cells through endocytosis, bypassing cell regulations on ion transport. When dissolved inside cancer cells, SCNPs cause a surge of osmolarity and rapid cell lysis. Interestingly, normal cells are much more resistant to the treatment due to their relatively low sodium levels. Unlike conventional chemotherapeutics, SCNPs cause immunogenic cell death or ICD. In vivo studies show that SCNPs not only kill cancer cells, but also boost an anticancer immunity. The discovery opens up a new perspective on nanoparticle-based therapeutics.


Assuntos
Nanopartículas , Neoplasias/diagnóstico , Neoplasias/tratamento farmacológico , Cloreto de Sódio/química , Cloreto de Sódio/uso terapêutico , Nanomedicina Teranóstica/métodos , Linhagem Celular Tumoral , Endocitose , Humanos , Neoplasias/imunologia , Neoplasias/patologia , Cloreto de Sódio/metabolismo
9.
Pediatr Dermatol ; 36(4): 561-563, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31120144

RESUMO

BACKGROUND: Umbilical granuloma is an overgrowth of granulation tissue following the separation of umbilical cord. Treatment options for this common entity are limited and have side effects such as chemical burns. In this study, we present a novel modification of the salt application method to treat infants with umbilical granuloma. METHODS: Seventeen infants were recruited in our study after institutional ethics committee approval and consent from the parents. The area of application was cleaned, and common table salt was carefully applied over the lesion. The granuloma was then occluded with surgical adhesive tape for 24 hours. Cases were followed up the next day to remove the occlusive tape and for assessment of improvement. RESULTS: All seventeen cases responded well to this approach with complete resolution of lesions at 24 hours. Small clotlike shrunken tissue was found at the site of granuloma, which was easily scraped off during gentle cleansing. No major complication or recurrence was noted in 3 months of follow-up. CONCLUSION: Complete resolution of umbilical granuloma can be achieved with a single, clinic-based application of salt under occlusion for 24 hours. Salt causes shrinkage of granuloma inside occluded hyperosmolar chamber by desiccant effect. The salient features of this method include ease of application, low cost of treatment, accurate one-time physician-controlled application, and complete and rapid resolution without complication.


Assuntos
Granuloma/tratamento farmacológico , Cloreto de Sódio/uso terapêutico , Umbigo/patologia , Administração Tópica , Feminino , Granuloma/diagnóstico , Humanos , Recém-Nascido , Masculino , Amostragem , Dermatopatias/diagnóstico , Dermatopatias/tratamento farmacológico , Resultado do Tratamento
10.
BMJ Case Rep ; 12(1)2019 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-30700462

RESUMO

We report a case of a 10-day-old male infant who presented to the emergency department with severe electrolyte imbalance and life-threatening arrhythmia. The parents reported a 3-day history of poor feeding and lethargy. On examination, he was bradycardic (heart rate of 65 beats/min) with signs of dehydration. His ECG showed broad complex bradycardia. Blood gas showed metabolic acidosis with hyponatraemia and hyperkalaemia. A probable diagnosis of congenital adrenal hyperplasia (CAH) with salt-wasting crisis was made and treatment was commenced. He was given saline bolus, nebulised salbutamol, calcium gluconate and hydrocortisone. Following the above interventions, his heart rate rose to 150 beats/min with a regular sinus rhythm within a period of 40 min. The diagnosis of CAH secondary to 21-hydroxylase deficiency with mutation in CYP21A2 was confirmed by genetic studies. He was discharged home with hydrocortisone, fludrocortisone and sodium chloride.


Assuntos
Hiperplasia Suprarrenal Congênita/complicações , Arritmias Cardíacas/complicações , Desequilíbrio Hidroeletrolítico/complicações , Hiperplasia Suprarrenal Congênita/diagnóstico , Hiperplasia Suprarrenal Congênita/terapia , Anti-Inflamatórios/uso terapêutico , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/terapia , Diagnóstico Diferencial , Fludrocortisona/uso terapêutico , Humanos , Hidrocortisona/uso terapêutico , Recém-Nascido , Masculino , Cloreto de Sódio/uso terapêutico , Desequilíbrio Hidroeletrolítico/diagnóstico , Desequilíbrio Hidroeletrolítico/terapia
11.
Cell Rep ; 26(7): 1869-1879.e3, 2019 02 12.
Artigo em Inglês | MEDLINE | ID: mdl-30759396

RESUMO

High-salt diets inhibit the suppressive function of thymus-derived natural regulatory T cells (tTreg). Transforming growth factor ß (TGF-ß)-induced ex vivo regulatory T cells (iTreg) comprise another Treg subset that exhibits similarities and differences with tTreg. Here, we demonstrate that iTregs are completely stable and fully functional under high salt conditions. High salt does not influence the development, differentiation, and functional activities of iTreg but affects Foxp3 stability and function of tTreg in vitro and in vivo. In addition, high salt does not significantly change the transcription profiles of the iTreg signature or pro-inflammatory genes. Therefore, we conclude that iTreg, unlike tTreg, are stable and functional in the presence of high salt. Our findings provide additional evidence that iTreg may have different biological features from tTreg and suggest a greater potential for clinical utility in patients with autoimmune diseases, in which the complicated role of environmental factors, including diet, must be considered.


Assuntos
Fatores de Transcrição Forkhead/genética , Cloreto de Sódio/uso terapêutico , Linfócitos T Reguladores/imunologia , Fator de Crescimento Transformador beta/metabolismo , Diferenciação Celular , Fatores de Transcrição Forkhead/metabolismo , Humanos
12.
Cancer Biol Ther ; 20(1): 52-64, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30183476

RESUMO

Small cell lung cancer (SCLC) is a malignant neuroendocrine tumor with very high mortality. Effective new therapy for advanced SCLC patients is urgently needed. By screening a FDA-approved drug library, we identified a cardiac glycoside (CG), namely digoxin (an inhibitor of cellular Na+/K+ ATPase pump), which was highly effective in inhibiting SCLC cell growth. Intriguing findings showed that NaCl supplement markedly enhanced the anti-tumor activities of digoxin in both in vitro and in vivo models of SCLC. Subsequent analysis revealed that this novel combination of digoxin/NaCl caused an up-regulation of intracellular Na+ and Ca2+ levels with an induction of higher resting membrane potential of SCLC cells. We also found that this combination lead to morphological shrinking of SCLC cells, together with high levels of cytochrome C release. Lastly, our data revealed that NaCl supplement was able to induce the expression of ATP1A1 (a Na+/K+ ATPase subunit), in which contributes directly to the increased sensitivity of SCLC cells to digoxin. Thus, this is the first demonstration that NaCl is a potent supplement necessitating superior anti-cancer effects of digoxin for SCLC. Further, our study suggests that digoxin treatment could need to be combined with NaCl supplement in future clinical trial of SCLC, particularly where low Na+ is often present in SCLC patients.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Digoxina/farmacologia , Neoplasias Pulmonares/tratamento farmacológico , Carcinoma de Pequenas Células do Pulmão/tratamento farmacológico , Cloreto de Sódio/farmacologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Linhagem Celular Tumoral , Digoxina/uso terapêutico , Ensaios de Seleção de Medicamentos Antitumorais , Sinergismo Farmacológico , Ensaios de Triagem em Larga Escala , Humanos , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/patologia , Potenciais da Membrana/efeitos dos fármacos , Carcinoma de Pequenas Células do Pulmão/sangue , Carcinoma de Pequenas Células do Pulmão/patologia , Sódio/sangue , Cloreto de Sódio/uso terapêutico , ATPase Trocadora de Sódio-Potássio/antagonistas & inibidores
13.
Muscle Nerve ; 59(3): 303-308, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30458059

RESUMO

INTRODUCTION: RNS60 is a novel immune-modulatory agent that has shown neuroprotective effects in amytrophic lateral sclerosis (ALS) preclinical models. RNS60 is administered by weekly intravenous infusion and daily nebulization. The objective of this pilot open-label trial was to test the feasibility, safety, and tolerability of long-term RNS60 administration in ALS patients. METHODS: The planned treatment duration was 23 weeks and the primary outcomes were safety and tolerability. Secondary outcomes included PBR28 positron emission tomography (PET) imaging and plasma biomarkers of inflammation. RESULTS: Sixteen participants with ALS received RNS60 and 13 (81%) completed 23 weeks of RNS60 treatment. There were no serious adverse events and no participants withdrew from the trial due to drug-related adverse events. There were no significant changes in the biomarkers. DISCUSSION: Long-term RNS60 administration was safe and well-tolerated. A large, multicenter, phase II trial of RNS60 is currently enrolling participants to test the effects of RNS60 on ALS biomarkers and disease progression. Muscle Nerve 59:303-308, 2019.


Assuntos
Esclerose Amiotrófica Lateral/tratamento farmacológico , Anti-Inflamatórios não Esteroides/uso terapêutico , Administração por Inalação , Adulto , Idoso , Esclerose Amiotrófica Lateral/diagnóstico por imagem , Esclerose Amiotrófica Lateral/fisiopatologia , Anti-Inflamatórios não Esteroides/administração & dosagem , Biomarcadores/análise , Encéfalo/diagnóstico por imagem , Feminino , Voluntários Saudáveis , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Força Muscular , Neuroimagem , Projetos Piloto , Tomografia por Emissão de Pósitrons , Cloreto de Sódio/efeitos adversos , Cloreto de Sódio/uso terapêutico , Resultado do Tratamento , Adulto Jovem
15.
Pediatr Clin North Am ; 66(1): 209-226, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30454744

RESUMO

The syndrome of inappropriate antidiuresis (SIAD) is a common cause of hyponatremia in hospitalized children. SIAD refers to euvolemic hyponatremia due to nonphysiologic stimuli for arginine vasopressin production in the absence of renal or endocrine dysfunction. SIAD can be broadly classified as a result of tumors, pulmonary or central nervous system disorders, medications, or other causes such as infection, inflammation, and the postoperative state. The presence of hypouricemia with an elevated fractional excretion of urate can aid in the diagnosis. Treatment options include fluid restriction, intravenous saline solutions, oral sodium supplements, loop diuretics, oral urea, and vasopressin receptor antagonists (vaptans).


Assuntos
Síndrome de Secreção Inadequada de HAD/diagnóstico , Síndrome de Secreção Inadequada de HAD/tratamento farmacológico , Antagonistas dos Receptores de Hormônios Antidiuréticos/uso terapêutico , Criança , Diagnóstico Diferencial , Hospitalização , Humanos , Fatores de Risco , Cloreto de Sódio/uso terapêutico , Ureia/uso terapêutico
16.
J Prev Med Hyg ; 60(4): E271-E285, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31967084

RESUMO

The burden of diarrheal diseases is very high, accounting for 1.7 to 5 billion cases per year worldwide. Typhoid fever (TF) and cholera are potentially life-threatening infectious diseases, and are mainly transmitted through the consumption of food, drink or water that have been contaminated by the feces or urine of subjects excreting the pathogen. TF is mainly caused by Salmonella typhi, whereas cholera is caused by intestinal infection by the toxin-producing bacterium Vibrio cholerae. These diseases typically affect low- and middle-income countries where housing is overcrowded and water and sanitation are poor, or where conflicts or natural disasters have led to the collapse of the water, sanitation and healthcare systems. Mortality is higher in children under 5 years of age. Regarding their geographical distribution, TF has a high incidence in sub-Saharan Africa, India and south-east Asia, while cholera has a high incidence in a few African countries, particularly in the Horn of Africa and the Arabian Peninsula. In the fight against these diseases, preventive measures are fundamental. With modern air travel, transmissible diseases can spread across continents and oceans in a few days, constituting a threat to global public health. Nowadays, people travel for many reasons, such as tourism and business. Several surveys have shown that a high proportion of travelers lack adequate information on safety issues, such as timely vaccination and prophylactic medications. The main objective of this overview is to provide information to help European travelers to stay healthy while abroad, and thus also to reduce the potential importation of these diseases and their consequent implications for public health and society. The preventive measures to be implemented in the case of travel to countries where these diseases are still endemic are well known: the adoption of safe practices and vaccinations. It is important to stress that an effective preventive strategy should be based both on vaccinations and on hygiene travel guidelines. Furthermore, the emergence of multidrug-resistant strains is becoming a serious problem in the clinical treatment of these diseases. For this reason, vaccination is the main solution.


Assuntos
Cólera/epidemiologia , Doença Relacionada a Viagens , Febre Tifoide/epidemiologia , Antibacterianos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica , Azitromicina/uso terapêutico , Bicarbonatos/uso terapêutico , Cefalosporinas/uso terapêutico , Cólera/prevenção & controle , Cólera/terapia , Vacinas contra Cólera/uso terapêutico , Ciprofloxacino/uso terapêutico , Água Potável/microbiologia , Farmacorresistência Bacteriana , Doenças Endêmicas , Epidemias , Europa (Continente) , Carga Global da Doença , Glucose/uso terapêutico , Humanos , Idarubicina , Cloreto de Potássio/uso terapêutico , Prednisona , Lactato de Ringer/uso terapêutico , Saneamento , Cloreto de Sódio/uso terapêutico , Viagem , Medicina de Viagem , Febre Tifoide/prevenção & controle , Febre Tifoide/terapia , Vacinas Tíficas-Paratíficas/uso terapêutico , Vidarabina/análogos & derivados
18.
Medicine (Baltimore) ; 97(46): e13178, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30431592

RESUMO

RATIONALE: Hyponatremia following duloxetine treatment has been reported in patients with major depressive disorder, fibromyalgia, diabetic neuropathy, or sciatic pain. The manifestations of duloxetine-induced hyponatremia are varying in different individuals. The overall prognosis for this type of hyponatremia is favorable if properly managed. PATIENT CONCERNS AND DIAGNOSES: Herein, we reported rapid-onset hyponatremia and delirium in an older patient after 2 doses of duloxetine, which was used to control his postherpetic neuralgia. Laboratory examinations revealed a rapid decline in serum sodium level and indicated the possibility of syndrome of inappropriate antidiuretic hormone (SIADH). INTERVENTIONS: Discontinuation of duloxetine, restriction of water intake, and intravenous supplement of normal saline were adopted to manage the hyponatremia. OUTCOMES: Serum concentration of sodium gradually normalized following aforementioned strategies. LESSONS: Special attention to the electrolyte abnormality is recommended in old patients undergoing duloxetine treatment.


Assuntos
Analgésicos/efeitos adversos , Delírio/induzido quimicamente , Cloridrato de Duloxetina/efeitos adversos , Hiponatremia/induzido quimicamente , Neuralgia Pós-Herpética/tratamento farmacológico , Idoso , Humanos , Síndrome de Secreção Inadequada de HAD/induzido quimicamente , Masculino , Sódio/sangue , Cloreto de Sódio/uso terapêutico
19.
BMJ Open ; 8(10): e026770, 2018 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-30385451

RESUMO

INTRODUCTION: Patients with severe dry eye disease (DED) often have limited treatment options with standard non-surgical management focused on the use of artificial tears for lubrication and anti-inflammatory drugs. However, artificial tears do not address the extraordinary complexity of human tears. Crudely, human tears with its vast constituents is essentially filtered blood. Blood and several blood-derived products including autologous serum, have been studied as tear substitutes. This study proposes to test the use of whole, fresh, autologous blood obtained from a finger prick for treatment of severe DED. METHODS AND ANALYSIS: The research team at the two participating sites will approach patients with severe DED for this study. Recruitment will take place over 12 months and we expect to recruit 60 patients in total. The primary outcome of this feasibility study is to estimate the proportion of eligible patients approached who consent to and comply with study procedures including treatment regimen and completion of required questionnaires. The secondary outcome measures, although not powered for in this feasibility, include corneal inflammation (assessed by the Oxford corneal staining guide), patient pain and symptoms scores (assessed by the Ocular Surface Disease Index Score), and objective signs of DED as indicated by visual acuity (assessed by Schirmer's test, tear break-up time, lower and/or upper tear meniscus height measurement). Other secondary outcomes include patients' quality of life (assessed using the validated EQ-5D-5L Questionnaire), cost to the National Health Service (NHS) and patient (assessed via use of NHS services and privately purchased over-the-counter treatment related to DED) and safety measure of pressure within the eye (assessed by the Intraocular Pressure (IOP) Score). ETHICS AND DISSEMINATION: This protocol and any subsequent amendments, along with any accompanying material provided to the participant in addition to any advertising material used in this trial have been approved by the East of England - Cambridgeshire and Hertfordshire Research Ethics Committee (REC reference: 17/EE/0508). Written approval from the committee was obtained and subsequently submitted to the respective Trust's Research and Development (R&D) office with final NHS R&D approval obtained. Data obtained from this study will be published in a suitable peer-review journal and will also presented at international ophthalmic conferences including the American Academy of Ophthalmology, the Royal College of Ophthalmology Annual Congress, the Association for Research and Vision and Ophthalmology, and the European Society of Cataract and Refractive Surgery. Information will be provided to patient groups and charities such as the Sjogren's Society and the Royal National Institute of Blind People. This will also be shared with the study participants as well as with relevant patient groups and charities. TRIAL REGISTRATION NUMBER: NCT03395431; Pre-results.


Assuntos
Síndromes do Olho Seco/terapia , Lubrificantes Oftálmicos/uso terapêutico , Soro , Inglaterra , Estudos de Viabilidade , Humanos , Estudos Multicêntricos como Assunto , Soluções Oftálmicas/uso terapêutico , Modelos de Riscos Proporcionais , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Índice de Gravidade de Doença , Método Simples-Cego , Cloreto de Sódio/uso terapêutico , Acuidade Visual
20.
Dis Aquat Organ ; 131(2): 157-166, 2018 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-30460921

RESUMO

The aim of the present study was to evaluate the effect of a long-term sodium chloride bath on rainbow trout Oncorhynchus mykiss naturally infected by Tetracapsuloides bryosalmonae. A total of 106 infected fish were divided into 2 groups. One group was left untreated and the other was treated with sodium chloride in increasing doses up a concentration of 0.8%. After 14 d, treatment was stopped and for a further 7 d the fish response to the sodium chloride bath was observed. Cumulative mortality was significantly lower in the treated group (19.2%) compared to the untreated group (31.5%) after 21 d. This corresponded to the lower but non-significant parasite intensity in kidney and spleen in the treated group after 14 d of treatment. However, lower prevalence of parasites in both tissues was recorded in the untreated group after 21 d of treatment, but a significant difference was observed only in spleen tissue. Furthermore, significant increases in leukocytes, hemoglobin, haematocrit, ferric reducing ability of plasma, and ceruloplasmin, and significant decreases in alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase activities were noticed in the treated group compared to the untreated group. In contrast, significant decreases in lysozyme concentration in the mucus and phagocyte oxidative burst in the blood were observed in the treated group. Histopathological examination revealed proliferative and reparative changes in parenchymatous tissues in the treated group. The 14- and 21-d salt bath used in rainbow trout with proliferative kidney disease was associated with a reduction in mortality and enhanced the reparative phase in the treated group.


Assuntos
Doenças dos Peixes/tratamento farmacológico , Nefropatias/veterinária , Myxozoa/classificação , Oncorhynchus mykiss , Doenças Parasitárias em Animais/tratamento farmacológico , Cloreto de Sódio/uso terapêutico , Animais , Doenças dos Peixes/parasitologia , Nefropatias/tratamento farmacológico , Nefropatias/parasitologia , Myxozoa/efeitos dos fármacos , Doenças Parasitárias em Animais/parasitologia
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