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1.
Folia Biol (Praha) ; 66(3): 104-110, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33069189

RESUMO

Cancer development is a highly complicated process in which tumour growth depends on the development of its vascularization system. To support their own growth, tumour cells significantly modify their microenvironment. One of such modifications inflicted by tumours is stimulation of endothelial cell migration and proliferation. There is accumulating evidence that extracellular vesicles (EVs) secreted by tumour cells (tumour-derived EVs, TEVs) may be regarded as "messengers" with the potential for affecting the biological activities of target cells. Interaction of TEVs with different cell types occurs in an auto- and paracrine manner and may lead to changes in the function of the latter, e.g., promoting motility, proliferation, etc. This study analysed the proangiogenic activity of EVs derived from human pancreatic adenocarcinoma cell line (HPC-4, TEVHPC) in vitro and their effect in vivo on Matrigel matrix vascularization in severe combined immunodeficient (SCID) mice. TEVHPC enhanced proliferation of HPC-4 cells and induced their motility. Moreover, TEVHPC stimulated human umbilical vein endothelial cell (HUVEC) proliferation and migration in vitro. Additionally, TEVHPC influenced secretion of proangiogenic factors (IL-8, VEGF) by HUVEC cells and supported Matrigel matrix haemoglobinization in vivo. These data show that TEVs may support tumour propagation in an autocrine manner and may support vascularization of the tumour. The presented data are in line with the theory that tumour cells themselves are able to modulate the microenvironment via TEVs to maximize their growth potential.


Assuntos
Carcinoma Ductal Pancreático/patologia , Vesículas Extracelulares/patologia , Neoplasias Pancreáticas/patologia , Animais , Comunicação Autócrina , Divisão Celular , Linhagem Celular Tumoral , Quimiotaxia , Colágeno , Combinação de Medicamentos , Células Endoteliais da Veia Umbilical Humana , Humanos , Interleucina-8/genética , Interleucina-8/metabolismo , Laminina , Camundongos , Camundongos SCID , Transplante de Neoplasias , Neovascularização Patológica/etiologia , Proteoglicanas , RNA Mensageiro/biossíntese , Microambiente Tumoral , Fator A de Crescimento do Endotélio Vascular/genética , Fator A de Crescimento do Endotélio Vascular/metabolismo
2.
Vestn Oftalmol ; 136(5): 96-102, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33056969

RESUMO

PURPOSE: To study the hypotensive effectiveness and safety of Bimoptic Plus (bimatoprost 0.03% + timolol 0.5%) in patients with developed primary open-angle glaucoma (POAG). MATERIAL AND METHODS: The study included 30 patients aged 57 to 72 years (45 eyes). The 1st group included 15 patients (24 eyes) who were first diagnosed with developed glaucoma with moderately elevated and high intraocular pressure (IOP) and prescribed the drug as starting therapy. Patients of the 2nd group (15 patients, 21 eyes) were prescribed Bimoptic Plus with insufficient effectiveness of monotherapy with prostaglandin analogues. The follow-up period was 6 months. RESULTS: The study was completed by 26 patients (41 eyes). Three patients (10%) has stopped using Bimoptic Plus due to side effects, one (3.3%) - due to insufficient hypotensive effect. In the 1st group, the maximum IOP decrease was recorded at the 1st month of the study and amounted to 8.34±1.47 mm Hg (32.2%) compared to baseline, while after 2 weeks, 3 and 6 months it decreased to 8.1±1.52 mm Hg (31.3%), 7.93±1.35 mm Hg (30.6%) and 7.9±1.42 mm Hg (30.5%), respectively. In patients of the 2nd group, additional IOP decrease after 2 weeks, 1, 3, and 6 months from the start of therapy was 4.68±1.24 mm Hg (20.5%), 4.94±1.18 mm Hg (21.7%), 4.55±1.23 mm Hg (20%), 4.5±1.26 mm Hg (19.7%), respectively. CONCLUSION: Bimoptic Plus effectively reduces the IOP level and has the least amount adverse reactions. It can be recommended for wide use in the treatment of patients with POAG.


Assuntos
Cloprostenol , Glaucoma de Ângulo Aberto , Idoso , Anti-Hipertensivos/efeitos adversos , Combinação de Medicamentos , Glaucoma de Ângulo Aberto/diagnóstico , Glaucoma de Ângulo Aberto/tratamento farmacológico , Humanos , Pressão Intraocular , Pessoa de Meia-Idade
3.
BMC Infect Dis ; 20(1): 723, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008327

RESUMO

BACKGROUND: The global pandemic of coronavirus disease 2019 (COVID-19) infection is ongoing and associated with high mortality. The aim of this study was to investigate the efficacy and safety of subcutaneous injection of interferon alpha-2b (IFN alpha-2b) combined with lopinavir/ritonavir (LPV/r) in the treatment of COVID-19 infection, compared with that of using LPV/r alone. METHODS: Patients diagnosed with laboratory-confirmed COVID-19 infection in Wuhan Red Cross hospital during the period from January 23, 2020 to March 19, 2020 were included. The length of stay, the time to viral clearance and adverse reactions during hospitalization were compared between patients using oral LPV/r and combined therapy of LPV/r and subcutaneous injection of IFN alpha-2b. RESULTS: A total of 22 patients were treated with LPV/r alone and 19 with combined therapy with subcutaneous injection of IFN alpha-2b. The average length of hospitalization in the combination group was shorter than that of LPV/r group (16 ± 9.7 vs 23 ± 10.5 days; P = 0.028). Moreover, the days of hospitalization in early intervention group decreased from 25 ± 8.5 days to 10 ± 2.9 days compared with delayed intervention group (P = 0.001). Combined therapy with IFN alpha-2b also significantly reduced the duration of detectable virus in the upper respiratory tract. No patient in each group was transferred to intensive care unit (ICU) or died during the treatment. There was no significant difference in the adverse effect composition between two groups. CONCLUSIONS: Subcutaneous injection of IFN alpha-2b combined with LPV/r shortened the length of hospitalization and accelerated viral clearance in COVID-19 patients, which deserves further investigation in clinical practice.


Assuntos
Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Interferon alfa-2/uso terapêutico , Pneumonia Viral/tratamento farmacológico , Idoso , Combinação de Medicamentos , Feminino , Humanos , Injeções Subcutâneas , Interferon alfa-2/administração & dosagem , Lopinavir/uso terapêutico , Masculino , Pessoa de Meia-Idade , Pandemias , Ritonavir/uso terapêutico
4.
J Contemp Dent Pract ; 21(7): 760-764, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33020359

RESUMO

AIM: One of the most vital characteristics of an ideal root filling material is the capability to inhibit the growth of the microorganisms. Mineral trioxide aggregate (MTA) is one of the most used root repair materials, with approved antibacterial effect. A newly introduced root repair material is nano-fast cement (NFC) which should be investigated. The antibacterial and antifungal activities of NFC were evaluated in the present study. MATERIALS AND METHODS: Enterococcus faecalis (PTCC 1394), Escherichia coli (ATTC 15224), and Candida albicans (PTCC 5027) were employed for the antimicrobial assessment. The following were the steps used to conduct the agar diffusion test (ADT): six agar plates were used. 0.5 McFarland concentration of each strain was cultured on two plates by a sterile cotton-tipped swab. Three holes with 5mm diameter were created on each plate. Freshly mixed cement was placed in the holes of the related plate. After two hours, the plates were incubated at 37°C for 24 hours. Then, the diameter of the growth inhibition zones were measured, and the mean values were used for the analysis. Direct contact test (DCT) was done by using the following steps: Freshly mixed materials were placed in the 96-well microtiter plate. 10 µL of each bacterial suspension was added to the tested cement. After one-hour incubation at 37°C, 245 µL of BHI broth was added to each well, and the plate was vortexed for 2 minutes. About 15 µL of this bacterial suspension was added to a new well which contained 215 µL of fresh medium. The kinetics of the bacterial outgrowth were measured by the microplate spectrophotometer hourly for 12 hours. RESULTS: No significant differences were observed between the diameters of the growth inhibition zones of MTA and NFC groups in ADT. In DCT, the MTA inhibits E. coli more effectively than NFC (p value < 0.001). Both cements had the same inhibitory effect on E. faecalis and C. albicans. CONCLUSION: The MTA and NFC are almost equally effective against the tested microorganisms. CLINICAL SIGNIFICANCE: The antibacterial characteristic of any dental material is an important matter. As well, the antibacterial efficacy of the NFC should be evaluated.


Assuntos
Antifúngicos/farmacologia , Escherichia coli , Compostos de Alumínio , Antibacterianos/farmacologia , Compostos de Cálcio , Combinação de Medicamentos , Óxidos , Materiais Restauradores do Canal Radicular , Silicatos
5.
PLoS Med ; 17(9): e1003225, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32926731

RESUMO

BACKGROUND: Early studies of narcolepsy after AS03-adjuvanted pandemic A/H1N12009 vaccine (Pandemrix) could not define the duration of elevated risk post-vaccination nor the risk in children aged under 5 years who may not present until much older. METHODS/FINDINGS: Clinical information and sleep test results, extracted from hospital notes at 3 large pediatric sleep centers in England between September 2017 and June 2018 for narcolepsy cases aged 4-19 years with symptom onset since January 2009, were reviewed by an expert panel to confirm the diagnosis. Vaccination histories were independently obtained from general practitioners (GPs). The odds of vaccination in narcolepsy cases compared with the age-matched English population was calculated after adjustment for clinical conditions that were indications for vaccination. GP questionnaires were returned for 242 of the 244 children with confirmed narcolepsy. Of these 5 were under 5 years, 118 were 5-11 years, and 119 were 12-19 years old at diagnosis; 39 were vaccinated with Pandemrix before onset. The odds ratio (OR) for onset at any time after vaccination was 1.94 (95% confidence interval [CI] 1.30-2.89), The elevated risk period was restricted to onsets within 12 months of vaccination (OR 6.65 [3.44-12.85]) and was highest within the first 6 months. After one year, ORs were not significantly different from 1 up to 8 years after vaccination. The ORs were similar in under five-year-olds and older ages. The estimated attributable risk was 1 in 34,500 doses. Our study is limited by including cases from only 3 sleep centers, who may differ from cases diagnosed in nonparticipating centers, and by imprecision in defining the centers' catchment population. The potential for biased recall of onset shortly after vaccination in cases aware of the association cannot be excluded. CONCLUSIONS: In this study, we found that vaccine-attributable cases have onset of narcolepsy within 12 months of Pandemrix vaccination. The attributable risk is higher than previously estimated in England because of identification of vaccine-attributable cases with late diagnoses. Absence of a compensatory drop in risk 1-8 years after vaccination suggests that Pandemrix does not trigger onsets in those in whom narcolepsy would have occurred later.


Assuntos
Narcolepsia/etiologia , Polissorbatos/efeitos adversos , Esqualeno/efeitos adversos , Vacinação/efeitos adversos , alfa-Tocoferol/efeitos adversos , Adolescente , Criança , Pré-Escolar , Combinação de Medicamentos , Inglaterra/epidemiologia , Feminino , Humanos , Vírus da Influenza A Subtipo H1N1/imunologia , Vacinas contra Influenza/efeitos adversos , Vacinas contra Influenza/uso terapêutico , Influenza Humana/epidemiologia , Masculino , Narcolepsia/epidemiologia , Narcolepsia/imunologia , Razão de Chances , Pandemias , Fatores de Risco , Inquéritos e Questionários
6.
J Assoc Physicians India ; 68(10): 39-43, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32978924

RESUMO

Background: Hypertension is the biggest contributor to global burden of disease and mortality. Increasing compliance with antihypertensive treatment and achieving a wide BP control in the population represents a major challenge for clinical practice. The benefits of single pill combination versus free-equivalent combination has been demonstrated in several meta-analyses and is now strongly supported by the latest 2018 ESC/ESH guidelines. The RAAS blocker with CCB and thiazide like diuretic is proposed as the optimal combination in patients inadequately controlled by two drugs. Objective: To assess the blood pressure control rate, safety, tolerability and quality of life with triple-drug SPC in patients with grade II/ III hypertension. Methods: Hypertensive patients uncontrolled (BP ≥ 140/90 mmHg) on two-drug therapy were recruited in an open-label, phase III clinical trial conducted in outpatient setting in India with 6 months treatment period. No other antihypertensive medication except the study medication was received by the patients. Results: Out of 218 evaluable patients the observed average blood pressure reduction achieved from baseline to end of study at 6 months was Systolic Blood Pressure (SBP) 28.5 mm Hg / Diastolic Blood Pressure (DBP) 13.8 mm Hg. The quality of life (QoL) questionnaire demonstrated improvement in QoL for all patients. Conclusion: This study showed the clinical efficacy, safety and acceptability of the perindopril/indapamide/amlodipine SPC in patients with grade 2/3 hypertension inadequately controlled with two-drug therapy. The clinical effectiveness was observed in more than 96 % patients. The benefit of single-pill combination (SPC) therapy in hypertension control was reconfirmed in this study.


Assuntos
Hipertensão/tratamento farmacológico , Indapamida , Anlodipino/farmacologia , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Combinação de Medicamentos , Humanos , Índia , Perindopril/efeitos adversos , Qualidade de Vida , Resultado do Tratamento
7.
Medicine (Baltimore) ; 99(37): e22178, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925788

RESUMO

INTRODUCTION: Postmenopausal osteoporosis (PMOP), which is a common and frequently occurring age-related metabolic bone disease in perimenopausal women, severely affects patients living quality. Modern medicine therapies for PMOP have several problems such as side reactions, low compliance, and high costs. Thus, nonpharmacological modality is urgently needed. Although acupoint thread embedding treatment is widely used in clinical practice, there is no persuasive evidence of its effect on increasing bone mass for PMOP. This experiment aims to investigate the efficacy and safety of acupoint thread embedding on PMOP and elucidate the correlations among brain neural activation, bone mineral density (BMD), and clinical outcomes with magnetic resonance evidence, thus to explore its neural mechanism. METHODS: This parallel designed, exploratory randomized, controlled, assessor-statistician-blinded, positive medicine clinical trial will include 70 participants with PMOP recruited from 2 traditional Chinese Medicine hospitals. These participants will be randomly allocated to a treatment group (Group Embedding) and a control group (Group Medication) in a 1:1 ratio. Participants in the treatment group will receive acupoint thread embedding treatment once 2 weeks in the following predefined acupoints: Shenshu (BL23), Sanyinjiao (SP6), Guanyuan (RN4), Ganshu (BL18), Dazhu (BL11), Xuanzhong (GB39), Zusanli (ST36), and Pishu (BL20). Meanwhile, the participants in the control group will take 0.3 mg Climen tablet orally, 1 tablet/day; every month has a schedule of the 21-day-continuous-taking-medicine period, and 7-day tablet-free period. There is a study period of 3 months and a follow-up period of 1 month for each group. The primary outcomes will be the following therapeutic indexed: Short-Form of McGill Pain Questionnaire (SF-MPQ), Osteoporosis Symptom Score during the observation period and follow-up period. The secondary outcomes will be Osteoporosis Quality of Life Scale (OQOLS), 16-item Assessment of Health-Related Quality of Life in Osteoporosis. In addition, functional magnetic resonance imaging (fMRI) scans and bone density test will be done before and after the observation period to show cranial neuroimaging changes. All the outcomes will be evaluated before and after treatment. The safety of interventions will be assessed at every visit. DISCUSSION: We present study design and rationale to explore the effectiveness and neural mechanism of acupoint thread embedding for PMOP through these outcomes. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR-INR-17011491.


Assuntos
Pontos de Acupuntura , Terapia por Acupuntura/métodos , Categute , Osteoporose Pós-Menopausa/terapia , Idoso , Biomarcadores , Densidade Óssea , Acetato de Ciproterona/uso terapêutico , Combinação de Medicamentos , Estradiol/análogos & derivados , Estradiol/uso terapêutico , Feminino , Humanos , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/tratamento farmacológico , Qualidade de Vida , Método Simples-Cego
8.
BMJ Case Rep ; 13(9)2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-32933911

RESUMO

A 50-year-old woman presented with history of intermittent angina for 2 days and signs of extensive anterior wall myocardial infarction. An urgent coronary angiogram showed a large proximally occluded left anterior descending (LAD) artery with no distal vessel opacification. After one attempt of thrombus aspiration, there was no improvement in Thrombolysis in Myocardial Infarction (TIMI) flow. The aspiration catheter was then parked in the distal vessel beyond the thrombotic lesion and 2 mg of intravenous nicorandil drug mixed with 10 mL of 50% dilute iodinated contrast media was infused slowly. A comparison was made to proximal vessel angiogram and the angioplasty procedure was then completed with a right size stent, restoring TIMI 3 flow in the LAD. This method minimises clot manipulations by avoiding repeated balloon predilatations or thrombus aspiration attempts and thus prevents the occurrence of no-reflow in lesions with large thrombus burden.


Assuntos
Angioplastia , Meios de Contraste/administração & dosagem , Oclusão Coronária/terapia , Nicorandil/administração & dosagem , Trombose/terapia , Vasos Coronários , Combinação de Medicamentos , Feminino , Humanos , Pessoa de Meia-Idade
9.
Complement Ther Med ; 52: 102473, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32951723

RESUMO

OBJECTIVE: Presentation of a case illustrating the benefits of traditional Chinese medicine (TCM) for treatment of Coronavirus disease 2019 (COVID-19) in critically ill patients. CLINICAL FEATURES AND OUTCOME: A 58-year-old woman presented with cough, fever, dizziness, chest tightness, polypnea and poor appetite. She was admitted to Guizhou Provincial People's hospital, and diagnosed with critically ill type of COVID-19 in February 2020. According to the patient's symptoms and signs, the TCM syndrome differentiation was qi deficiency, dampness-stasis and toxin accumulation. Then she received the combined therapy of a modified Chinese herbal formula and Western medicine. During a twelve-day period of treatment, her respiratory distress and appetite quickly improved. Abnormal laboratory indicators were resumed in time and lung lesions in CT scan largely absorbed. No side effects associated with this Chinese herbal formula were found. Before discharge, two consecutive nasopharyngeal swabs were shown to be negative for severe acute respiratory coronavirus 2 (SARS-CoV-2). CONCLUSIONS: Our case report suggests that collaborative treatments with traditional Chinese medicine prove beneficial in the management of COVID-19 in critically ill patients. In order to give optimal care for this COVID-19 crisis for the whole world, Chinese medicine practitioners and Western medical doctors should work together in frontline.


Assuntos
Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Antivirais/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Medicina Tradicional Chinesa , Pneumonia Viral/tratamento farmacológico , Betacoronavirus , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Estado Terminal , Combinação de Medicamentos , Feminino , Humanos , Indóis/uso terapêutico , Lopinavir/uso terapêutico , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Moxifloxacina/uso terapêutico , Ventilação não Invasiva , Oxigenoterapia , Pandemias , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Qi , Ritonavir/uso terapêutico
10.
J Gastrointestin Liver Dis ; 29(3): 473-475, 2020 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-32919428
12.
Drug Des Devel Ther ; 14: 3803-3813, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32982184

RESUMO

Objective: This study aimed to evaluate the pharmacological mechanisms of antiviral drugs against the novel coronavirus disease (COVID-19) and the study designs in clinical trials registered with the International Clinical Trials Registry Platform (ICTRP). Methods: Clinical trials involving antiviral drugs for treating COVID-19 were retrieved from the ICTRP database. For each trial, the study design, number of participants, primary endpoints, source register, antiviral mechanism, and results were evaluated. Results: On June 10, 2020, 145 eligible clinical trials were retrieved from the ICTRP, of which 99 (68.3%) were randomized trials, 109 (75.2%) were parallel assignment trials, 38 (26.2%) were double or single blinded, 130 (89.7%) involved two groups, and 75 (51.6%) included more than 100 participants; and clinical improvement or recovery and virus-negative conversion were the two most common endpoints, accounting for 40.7% and 18.6%, respectively. The drugs were divided according to the antiviral mechanism into HIV reverse transcriptase inhibitors, RNA-dependent RNA polymerase inhibitors, HIV protease inhibitors (PIs), hepatitis C virus NS3 PIs, and anti-influenza drugs. Conclusion: The design characteristics of clinical trials of antiviral drugs for treating COVID-19 as well as the mechanism of action and antiviral efficacy of the drugs were evaluated in this study. The results of these trials could constitute a reference for future clinical trials to be executed on COVID-19 treatment and prevention.


Assuntos
Antivirais/uso terapêutico , Ensaios Clínicos como Assunto , Infecções por Coronavirus/tratamento farmacológico , Pneumonia Viral/tratamento farmacológico , Sistema de Registros , Antivirais/farmacologia , Betacoronavirus/efeitos dos fármacos , Coleta de Dados , Interpretação Estatística de Dados , Gerenciamento de Dados , Combinação de Medicamentos , Humanos , Pandemias , Projetos de Pesquisa
13.
J Pharmacol Sci ; 144(3): 95-101, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32921396

RESUMO

Patients living with HIV in malarial endemic regions may experience clinically significant drug interaction between antiretroviral and antimalarial drugs. Effects of nevirapine (NVP), efavirenz (EFV) and lopinavir/ritonavir (LPVr) on lumefantrine (LM) therapeutic concentrations and toxicity were evaluated. In a four-arm parallel study design, the blood samples of 40 participants, treated with artemether/lumefantrine (AL), were analysed. Lumefantrine Cmax was increased by 32% (p = 0.012) and 325% (p < 0.0001) in the NVP and LPVr arms respectively but decreased by 62% (p < 0.0001) in the EFV-arm. AUC of LM was, respectively, increased by 50% (p = 0.27) and 328% (p < 0.0001) in the NVP and LPVr arms but decreased in the EFV-arm by 30% (p = 0.019). Median day 7 LM concentration was less than 280 ng/mL in EFV-arm (239 ng/mL) but higher in control (290 ng/mL), NVP (369 ng/mL, p = 0.004) and LPVr (1331 ng/mL, p < 0.0001) arms. There were no clinically relevant toxicities nor adverse events in both control and test arms. Artemether/lumefantrine is safe and effective for treatment of malaria in PLWHA taking NVP and LPVr based ART regimen but not EFV-based regimen.


Assuntos
Antirretrovirais/efeitos adversos , Antimaláricos/efeitos adversos , Combinação Arteméter e Lumefantrina/efeitos adversos , Benzoxazinas/efeitos adversos , Interações Medicamentosas , Infecções por HIV/tratamento farmacológico , Malária/tratamento farmacológico , Nevirapina/efeitos adversos , Adulto , Antirretrovirais/administração & dosagem , Antirretrovirais/sangue , Antimaláricos/administração & dosagem , Antimaláricos/sangue , Combinação Arteméter e Lumefantrina/administração & dosagem , Combinação Arteméter e Lumefantrina/sangue , Benzoxazinas/administração & dosagem , Benzoxazinas/sangue , Combinação de Medicamentos , Quimioterapia Combinada , Feminino , Infecções por HIV/complicações , Humanos , Lopinavir , Malária/complicações , Masculino , Pessoa de Meia-Idade , Nevirapina/administração & dosagem , Nevirapina/sangue , Nigéria , Ritonavir , Resultado do Tratamento , Adulto Jovem
14.
Eur J Paediatr Dent ; 21(3): 238-242, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32893659

RESUMO

BACKGROUND: Molar Incisor Malformation (MIM) or Molar Root Incisor malformation (MRIM) is a recently discovered root malformation with constricted pulp and abnormally located furcation presented in permanent first molars and sometimes incisors. CASE REPORT: Two cases that feature MIM are presented with the description of the characteristic tooth form, clinical/radiographic examination, medical history, the supposed aetiology, treatment procedure and results at the 2-year follow-up. Conservative endodontic treatment was performed in both cases, furcation perforation and canal perforation were filled with MTA (Mineral Trioxide Aggregate), and a good prognosis was observed after 2 years of follow-up. Furthermore, recommended treatment options are discussed to provide a more appropriate treatment for the patients. CONCLUSION: Patients with MIM need to be treated at the right time to avoid severe infection and other problems. Early diagnosis with appropriate treatment is more likely to lead to a more favourable prognosis.


Assuntos
Incisivo , Materiais Restauradores do Canal Radicular , Compostos de Alumínio , Compostos de Cálcio , Polpa Dentária , Cavidade Pulpar , Combinação de Medicamentos , Humanos , Dente Molar , Óxidos , Silicatos , Raiz Dentária
15.
Medicine (Baltimore) ; 99(35): e21810, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871902

RESUMO

RATIONALE: The clinical manifestations of the SARS-CoV-2 infection are mainly respiratory but the virus can cause a variety of symptoms. Dermatological findings are less well-characterized. Data is scarce on their timing, type and correlation with the immune response. PATIENT CONCERNS: We present the case of SARS-CoV-2 infection in a previously healthy woman who presented with respiratory symptoms and developed anosmia, diarrhea, and an erythematous maculo-papular rash on day 15 from symptom onset. DIAGNOSIS: The nasopharyngeal swab tested by real time PCR for COVID-19 was positive. We interpreted this as a viral exanthema likely caused by an immune response to SARS-CoV-2 nucleotides. INTERVENTIONS: She was treated with Hydroxychloroquine, Azithromycin and Lopinavir/Ritonavir, and the rash with topical corticosteroids. OUTCOMES: All symptoms resolved except for anosmia which persisted for 6 weeks. At the 4- and 6-weeks follow-up the IgG titers for SARS-CoV-2 were high. LESSONS: We must consider that SARS-CoV-2 has a multi-organ tropism. In our case, the SARS-CoV-2 infection had lung, nasopharyngeal, neurological, digestive, and skin manifestations. Identifying the different manifestations is useful for understanding the extent of SARS-CoV-2 infection. We not only present a rare manifestation but also suggest that cutaneous manifestations may correlate with immunity.


Assuntos
Azitromicina/administração & dosagem , Betacoronavirus , Infecções por Coronavirus , Exantema , Glucocorticoides/administração & dosagem , Hidroxicloroquina/administração & dosagem , Lopinavir/administração & dosagem , Pandemias , Pneumonia Viral , Ritonavir/administração & dosagem , Administração Tópica , Adulto , Antivirais/administração & dosagem , Betacoronavirus/imunologia , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Combinação de Medicamentos , Exantema/diagnóstico , Exantema/tratamento farmacológico , Exantema/etiologia , Exantema/imunologia , Feminino , Humanos , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Avaliação de Sintomas/métodos , Resultado do Tratamento
16.
Khirurgiia (Mosk) ; (8): 69-74, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32869618

RESUMO

OBJECTIVE: To substantiate the advisability of using cytoflavin to correct postoperative cognitive dysfunction (POCD) in patients undergoing video laparoscopic cholecystectomy (VLCE) under conditions of inhalation anesthesia with sevoflurane. MATERIAL AND METHODS: The data of two representative groups of patients (n=60) who underwent video-laparoscopic cholecystectomy under the conditions of inhalation anesthesia with sevoflurane were analyzed. At the stages of the perioperative period, in order to monitor the state of higher mental functions, neuropsychological testing was performed: anxiety and depression scales (HADS), the Montreal scale of cognitive dysfunction (MoCA), and frontal dysfunction batteries (FAB). Patients of the first group (n=19) were not corrected for POKD. For the correction of cognitive impairment, patients of the second group (n=41) were treated with Cytoflavin according to the 20 ml regimen per 250 ml of 0.9% sodium chloride solution intravenously once before the operation, then within 4 days of the postoperative period. RESULTS: Neuropsychological testing in group I patients revealed the development of moderate POCD. The inclusion of Cytoflavin in the treatment regimen in the II group of patients contributed to an improvement in the state of HMF, accompanied by a decrease in the level of anxiety and depression. CONCLUSION: The inclusion of Cytoflavin in treatment regimens helps prevent the development of POKD and is accompanied by an improvement in the state of higher mental functions, which is manifested by a decrease in the level of anxiety and depression, favorably affecting the emotional background of patients.


Assuntos
Anestésicos Inalatórios/efeitos adversos , Colecistectomia Laparoscópica , Transtornos Cognitivos/terapia , Mononucleotídeo de Flavina/administração & dosagem , Inosina Difosfato/administração & dosagem , Fármacos Neuroprotetores/administração & dosagem , Niacinamida/administração & dosagem , Sevoflurano/efeitos adversos , Succinatos/administração & dosagem , Anestesia por Inalação/efeitos adversos , Anestesia por Inalação/métodos , Colecistectomia Laparoscópica/efeitos adversos , Colecistectomia Laparoscópica/métodos , Transtornos Cognitivos/induzido quimicamente , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Combinação de Medicamentos , Humanos , Cirurgia Vídeoassistida
17.
Zhongguo Zhong Yao Za Zhi ; 45(15): 3505-3510, 2020 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-32893537

RESUMO

To explore the real world clinical application characteristics and the drug combination regularity of Ciwujia Injection, 12 554 cases of patients with Ciwujia Injection were extracted from the information systems of 24 class Ⅲ grade A hospitals in China, and a standardized analysis was carried out. Most of the patients were middle-aged and old-aged, and the main departments were cardiovascular department(22.50%) and neurology department(17.92%). Before 2008, 93.77% of the patients were single overdose users, which reduced to only 2.07% after 2011. The course of treatment was mostly between 8-14 days(32.98%). The top three di-seases diagnosed by Western medicine were hypertension(11.78%), cerebral infarction(9.47%), and coronary heart disease(8.15%), and the most common traditional Chinese medicine syndrome was the deficiency of liver and kidney(18.59%). The most commonly used Western medicine was Acetylsalicylic Acid(51.07%), and the most commonly used traditional Chinese medicine was Danshen Injection(9.67%). The most commonly used Western medicine in combined application was calcium channel blocker(46.88%), and the most commonly used traditional Chinese medicine in combined application was stasis removing agent(93.21%). And the drug combination with the highest support was Isosorbide Mononitrate + Acetylsalicylic Acide, with a high recovery rate after discharge(96.81%). The results showed that Ciwujia Injection had certain regularity. It considered underlying concurrent diseases, anticoagulation and blood circulation, with a wide range of effects in strengthening the body and regulating the mind. The results could expand the understanding of Ciwujia Injection and provide a more detailed real world basis and reference for optimizing therapeutic regimen in clinic.


Assuntos
Medicamentos de Ervas Chinesas , Eleutherococcus , Idoso , Aspirina , China , Combinação de Medicamentos , Humanos , Medicina Tradicional Chinesa , Pessoa de Meia-Idade
18.
N Engl J Med ; 383(10): 919-930, 2020 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-32877582

RESUMO

BACKGROUND: Sodium phenylbutyrate and taurursodiol have been found to reduce neuronal death in experimental models. The efficacy and safety of a combination of the two compounds in persons with amyotrophic lateral sclerosis (ALS) are not known. METHODS: In this multicenter, randomized, double-blind trial, we enrolled participants with definite ALS who had had an onset of symptoms within the previous 18 months. Participants were randomly assigned in a 2:1 ratio to receive sodium phenylbutyrate-taurursodiol (3 g of sodium phenylbutyrate and 1 g of taurursodiol, administered once a day for 3 weeks and then twice a day) or placebo. The primary outcome was the rate of decline in the total score on the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R; range, 0 to 48, with higher scores indicating better function) through 24 weeks. Secondary outcomes were the rates of decline in isometric muscle strength, plasma phosphorylated axonal neurofilament H subunit levels, and the slow vital capacity; the time to death, tracheostomy, or permanent ventilation; and the time to death, tracheostomy, permanent ventilation, or hospitalization. RESULTS: A total of 177 persons with ALS were screened for eligibility, and 137 were randomly assigned to receive sodium phenylbutyrate-taurursodiol (89 participants) or placebo (48 participants). In a modified intention-to-treat analysis, the mean rate of change in the ALSFRS-R score was -1.24 points per month with the active drug and -1.66 points per month with placebo (difference, 0.42 points per month; 95% confidence interval, 0.03 to 0.81; P = 0.03). Secondary outcomes did not differ significantly between the two groups. Adverse events with the active drug were mainly gastrointestinal. CONCLUSIONS: Sodium phenylbutyrate-taurursodiol resulted in slower functional decline than placebo as measured by the ALSFRS-R score over a period of 24 weeks. Secondary outcomes were not significantly different between the two groups. Longer and larger trials are necessary to evaluate the efficacy and safety of sodium phenylbutyrate-taurursodiol in persons with ALS. (Funded by Amylyx Pharmaceuticals and others; CENTAUR ClinicalTrials.gov number, NCT03127514.).


Assuntos
Esclerose Amiotrófica Lateral/tratamento farmacológico , Fenilbutiratos/uso terapêutico , Ácido Tauroquenodesoxicólico/uso terapêutico , Idoso , Progressão da Doença , Método Duplo-Cego , Combinação de Medicamentos , Feminino , Humanos , Análise de Intenção de Tratamento , Masculino , Pessoa de Meia-Idade , Fenilbutiratos/efeitos adversos , Índice de Gravidade de Doença , Ácido Tauroquenodesoxicólico/administração & dosagem , Resultado do Tratamento
19.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(8): 928-932, 2020 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-32912404

RESUMO

OBJECTIVE: To describe the characteristics of liver damage in severe coronavirus disease 2019 (COVID-19) patients in Sichuan area and the effect of antiviral drugs on liver function. METHODS: The clinical data of severe COVID-19 patients admitted to Chengdu Public Health Clinical Medical Center from January 21 to February 24, 2020 were retrospectively collected, including demographic data, clinical manifestations and liver function changes within 1 week after admission to intensive care unit (ICU). The changes of liver function during the course of disease in severe COVID-19 patients were analyzed and summarized, and group analysis was performed. RESULTS: A total of 30 COVID-19 patients with complete clinical data were enrolled. The incidence of severe COVID-19 in elderly men was higher (60.0%), with median age of 61 (47, 79) years old, and those aged 80 or above accounted for 23.3%. The severe COVID-19 patients mainly presented with respiratory symptoms such as fever (96.7%), cough (80.0%) and dyspnea (66.7%). The alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil) and prothrombin time (PT) of 30 patients were increased to various degrees within 1 week after ICU admission, and albumin (ALB) was decreased. (1) The patients were divided into two groups according to whether to take lopinavir/ritonavir (kaletra). It was shown that the incidence of liver dysfunction in patients taking kaletra was significantly higher than those who did not take kaletra (7-day abnormal rate of ALT was 54% vs. 33%, the abnormal rate of AST was 38% vs. 33%, the abnormal rate of TBil was 8% vs. 0%), but there were no statistical differences (all P > 0.05). (2) The patients were divided into normal dose group (500 mg, twice a day, n = 19) and reduced dose group (250 mg, twice a day, n = 5) according to the dosage of kaletra. It was shown that patients taking low-dose kaletra had a smaller effect on liver function within 1 week after ICU admission than those receiving normal dosage, and ALB, TBil in the reduced dose group were significantly lower than those in the normal dose group on the 2nd day after ICU admission [ALB (g/L): 33.3±2.0 vs. 37.5±4.0, TBil (µmol/L): 6.3±3.3 vs. 11.3±4.8, both P < 0.05]. CONCLUSIONS: Severe COVID-19 patients in Sichuan area suffered obvious liver damage in the early course of the disease and have a slower recovery. It is important to pay attention to avoid using drugs that can aggravate liver damage while treating the disease. If there is no alternative drug, liver protection treatment should be considered appropriately.


Assuntos
Infecções por Coronavirus/complicações , Infecções por Coronavirus/tratamento farmacológico , Hepatopatias/virologia , Pneumonia Viral/complicações , Pneumonia Viral/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Antivirais/uso terapêutico , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Combinação de Medicamentos , Humanos , Hepatopatias/fisiopatologia , Lopinavir/uso terapêutico , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Estudos Retrospectivos , Ritonavir/uso terapêutico , Índice de Gravidade de Doença , Resultado do Tratamento
20.
Eur J Cancer ; 138: 109-112, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32871524
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