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1.
Int J Nanomedicine ; 15: 125-136, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32021169

RESUMO

Background: Despite recent advancements in surgical techniques, the repair of tendon rupture remains a challenge for surgeons. The purpose of this study was to develop novel doxycycline-loaded biodegradable nanofibrous membranes and evaluate their efficacy for the repair of Achilles tendon rupture in a rat model. Materials and Methods: The drug-loaded nanofibers were prepared using the electrospinning process and drug release from the prepared membranes was investigated both in vitro and in vivo. Furthermore, the safety and efficacy of the drug-loaded nanofibrous membranes were evaluated in rats that underwent tendon surgeries. An animal behavior cage was employed to monitor the post-surgery activity of the animals. Results: The experimental results demonstrated that poly(D,L-lactide-co-glycolide) (PLGA) nanofibers released effective concentrations of doxycycline for more than 40 days post-surgery, and the systemic plasma drug concentration was low. Rats receiving implantation of doxycycline-loaded nanofibers also showed greater activities and stronger tendons post-operation. Conclusion: Nanofibers loaded with doxycycline may have great potential in the repair of Achilles tendon rupture.


Assuntos
Doxiciclina/farmacologia , Sistemas de Liberação de Medicamentos/métodos , Nanofibras/administração & dosagem , Traumatismos dos Tendões/terapia , Implantes Absorvíveis , Tendão do Calcâneo/lesões , Animais , Doxiciclina/administração & dosagem , Doxiciclina/farmacocinética , Liberação Controlada de Fármacos , Membranas Artificiais , Nanofibras/química , Nanofibras/uso terapêutico , Copolímero de Ácido Poliláctico e Ácido Poliglicólico/química , Ratos , Ratos Sprague-Dawley , Cicatrização
4.
Intern Med ; 58(21): 3179-3183, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31685787

RESUMO

Human brucellosis, one of the most common zoonoses worldwide, rarely occurs in Japan, and only a few chronic cases have been reported. We herein report the case of a 39-year-old Japanese woman with chronic human brucellosis, considered a Brucella canis infection, that persisted for 19 years. Her medical history and fever pattern suggested chronic brucellosis, and the diagnosis was made based on the results of a serum tube agglutination test (SAT). After undergoing combination therapy with streptomycin and doxycycline, she achieved symptomatic relief and showed negative SAT results. Even in non-endemic areas, chronic brucellosis is an important differential diagnosis in patients with long-term persistent fatigue or a fever.


Assuntos
Brucelose/diagnóstico , Zoonoses/diagnóstico , Administração Oral , Adulto , Animais , Antibacterianos/administração & dosagem , Brucella canis , Brucelose/tratamento farmacológico , Doença Crônica , Diagnóstico Diferencial , Doxiciclina/administração & dosagem , Quimioterapia Combinada , Fadiga/diagnóstico , Fadiga/microbiologia , Feminino , Febre/diagnóstico , Febre/microbiologia , Humanos , Injeções Intramusculares , Japão , Estreptomicina/administração & dosagem , Zoonoses/tratamento farmacológico
5.
Eklem Hastalik Cerrahisi ; 30(3): 333-7, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31650935

RESUMO

Brucellosis is a zoonosis seen all over the world and is still endemic in certain parts of the world. Brucellosis is a systemic infection which involves multiple organs and tissues. Although musculoskeletal system involvement is frequent in brucellosis, bursal involvement is seen rarely. In this article, we present a case of subacromial and subdeltoid brucellar bursitis with positive serology and aspiration culture. Patient achieved complete recovery with rifampicin and doxycycline treatment, without any evidence of relapse. A high clinical suspicion is required for the diagnosis of brucellar bursitis.


Assuntos
Brucelose/diagnóstico , Bursite/diagnóstico , Articulação do Ombro , Idoso , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Brucelose/tratamento farmacológico , Brucelose/microbiologia , Bursite/tratamento farmacológico , Bursite/microbiologia , Diagnóstico Diferencial , Doxiciclina/administração & dosagem , Doxiciclina/uso terapêutico , Quimioterapia Combinada , Humanos , Masculino , Rifampina/administração & dosagem , Rifampina/uso terapêutico
6.
AAPS PharmSciTech ; 20(8): 325, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31659563

RESUMO

Localized intra-pocket, retentive, biodegradable, prolonged release thiolated membrane can provide an improved therapeutic efficacy of doxycycline at the site of action with evading off target side effects. To this end, thiolated chitosan-hyaluronic acid composite polymeric complex next-generation of the periodontal membrane was manufactured by solvent casting method. FTIR spectroscopic analysis displayed successful immobilization of thiol groups on the manufactured thiolated periodontal membrane. Moreover, XRD, DSC, AFM and TGA of the membrane confirmed the compatibility of ingredients and modifications in surface chemistry. The thiolated periodontal film was also investigated in terms of thickness, weight uniformity, water-uptake capacity, drug content, pH, entrapment efficiency, lysozymal degradation and release patterns. Also, mucoadhesion profile was explored on gingival mucosa. The immobilized thiol groups on thiolated chitosan and thiolated hyaluronate were found to be 168 ± 11 µM/g (mean ± SD, n = 3) and 189 ± 8 µM/g (mean ± SD, n = 3) respectively. Swelling capacity of the thiolated periodontal membrane was significantly ∼2-fold higher (p < 0.05) as compared to unmodified membrane. The obtained thiolated membrane depicted 3 -old higher mucoadhesive features as compared to the un-modified membrane. In vitro release kinetics indicated approximately more than 80% prolonged release within 7 days. Mechanical strength of the Thiolated bandage was also significantly ∼2-fold higher (p < 0.05) as compared to unmodified membrane. Ex-vivo retention study revealed enhanced retention of thiolated membrane as compared to unmodified membrane. In-vitro antimicrobial studies demonstrated that thiolated membrane could efficiently kill Porphyromonas gingivalis cells as compared to the native membrane. Moreover, ex-vivo biodegradation results indicated that 90% of the thiolated membrane was biodegradable in 28 days. Based on these findings, thiolated next-generation of the periodontal membrane seems to be promising for periodontitis therapy.


Assuntos
Antibacterianos/administração & dosagem , Doxiciclina/administração & dosagem , Sistemas de Liberação de Medicamentos/métodos , Bolsa Periodontal/tratamento farmacológico , Compostos de Sulfidrila/administração & dosagem , Adulto , Animais , Antibacterianos/metabolismo , Doxiciclina/química , Doxiciclina/metabolismo , Composição de Medicamentos , Avaliação Pré-Clínica de Medicamentos/métodos , Cabras , Humanos , Bolsa Periodontal/metabolismo , Compostos de Sulfidrila/química , Compostos de Sulfidrila/metabolismo , Adulto Jovem
7.
Dermatol Surg ; 45(11): 1401-1405, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31658188

RESUMO

BACKGROUND: Current treatment options for rosacea include topical agents, oral therapies, phototherapy using lasers, or intense pulsed light (IPL). Combination therapy for rosacea often yields better results than monotherapy. The safety of laser/light treatments in combination with systemic doxycycline has been questioned because of the theoretical risk of photosensitivity. OBJECTIVE: The purpose of this study was to assess the incidence of phototoxicity or photosensitivity in rosacea patients receiving concomitant laser or light treatments and systemic doxycycline. METHODS: Treatment records of 36 patients receiving laser/light treatments while also being treated with standard dose or anti-inflammatory dose of doxycycline were retrospectively reviewed. RESULTS: No adverse reactions related to doxycycline combined with laser/light therapy were reported. Specifically, no photosensitivity or sensitivity to wavelengths in the pulsed dye laser (PDL), or IPL range was observed in this cohort. All patients achieved some degree of clearance. CONCLUSION: The results of this retrospective study demonstrate that doxycycline used in conjunction with laser or nonlaser light therapy is a valid combination therapy for improving signs and symptoms of rosacea. No photosensitivity reactions were observed to commonly used IPL or PDL devices.


Assuntos
Antibacterianos/efeitos adversos , Doxiciclina/efeitos adversos , Terapia de Luz Pulsada Intensa/efeitos adversos , Terapia com Luz de Baixa Intensidade/efeitos adversos , Rosácea/terapia , Administração Cutânea , Adolescente , Adulto , Idoso , Antibacterianos/administração & dosagem , Terapia Combinada/efeitos adversos , Terapia Combinada/métodos , Preparações de Ação Retardada/administração & dosagem , Preparações de Ação Retardada/efeitos adversos , Doxiciclina/administração & dosagem , Feminino , Humanos , Terapia de Luz Pulsada Intensa/instrumentação , Terapia de Luz Pulsada Intensa/métodos , Lasers de Corante/efeitos adversos , Terapia com Luz de Baixa Intensidade/métodos , Masculino , Pessoa de Meia-Idade , Transtornos de Fotossensibilidade/diagnóstico , Transtornos de Fotossensibilidade/etiologia , Estudos Retrospectivos , Pele/efeitos dos fármacos , Pele/efeitos da radiação , Resultado do Tratamento , Adulto Jovem
8.
BMC Oral Health ; 19(1): 209, 2019 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488125

RESUMO

BACKGROUND: To compare the effectiveness of systemic doxycycline as an adjunct to scaling and root planing (SRP) with SRP alone in improving periodontal clinical attachment level and glycemic control in diabetic patients with periodontitis. METHODS: Two independent reviewers (KY and SJ) screened two electronic databases, PubMed and Scopus, for randomized clinical trials on the use of systemic doxycycline as an adjunct to scaling and root planing in improving periodontal status and glycemic control in diabetic patients with periodontitis using predetermined selection criteria within a 3-month period. The reviewers independently did data screening, data selection, data extraction and risk of bias. Quality of studies involved was analysed using the revised Cochrane Risk of Bias 2.0. Weighted standard mean differences (SMD) and 95% confidence intervals were calculated using a random effects meta-analysis model. Publication bias was evaluated using funnel plot. Quality of evidence was evaluated by Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: Electronic searches provided 1358 records and six studies were selected. The meta-analyses indicated that there was no statistically significant difference in the improvement of periodontal status with the use of systemic doxycycline as an adjunct for scaling and root planing (SRP). SMD of clinical attachment levels (- 0.22 [- 0.52, 0.08]) and HbA1c levels (- 0.13 [- 0.41, 0.15]) were calculated. Overall risk of bias is high in 2 out of 6 studies involved. CONCLUSION: Systemic doxycycline when used in addition to scaling and root planing yields no significant improvement of clinical attachment levels for periodontal status and reduction of HbA1c levels in treatment of diabetic patients with periodontitis when comparing the test group to the control group.


Assuntos
Antibacterianos/uso terapêutico , Raspagem Dentária/métodos , Doxiciclina/uso terapêutico , Periodontite/tratamento farmacológico , Aplainamento Radicular/métodos , Antibacterianos/administração & dosagem , Complicações do Diabetes , Diabetes Mellitus , Doxiciclina/administração & dosagem , Hemoglobina A Glicada , Humanos , Perda da Inserção Periodontal/tratamento farmacológico , Perda da Inserção Periodontal/terapia , Periodontite/terapia
9.
J Drugs Dermatol ; 18(9): 924-927, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31524349

RESUMO

Acne is primarily an inflammatory disease. Anti-inflammatory dose doxycycline (40mg: 30mg immediate release and 10mg delayed release beads) is approved for the treatment of rosacea but with demonstrated efficacy for acne. Fixed combination adapalene 0.3% and benzoyl peroxide 2.5% gel is a once-daily formulation approved for the topical management of acne vulgaris. It has both anti-inflammatory and anti-comedogenic properties. Options for management of severe acne are somewhat limited; many patients are not candidates for or refuse treatment with isotretinoin. Systemic antibiotics may be indicated; acne treatment guidelines emphasize antibiotic stewardship in light of increasing concerns about antibiotic resistance and call for the judicious use of conventional systemic antibiotics. This single-center, open label pilot study involving 20 subjects with severe acne assessed the effects of combination treatment using anti-inflammatory dose doxycycline plus adapalene 0.3% and benzoyl peroxide 2.5% gel on IGA scores as well as inflammatory lesion, non-inflammatory lesion, and nodule counts. By week 12, 95% of subjects had at least a 2-grade improvement in IGA scores. Reductions in inflammatory and non-inflammatory lesion counts were statistically significant beginning at week 4 and continuing through week 12. By week 4, the percentage of patients with 0 nodules was 70%, compared to baseline of 20%. Further improvements were seen through week 12. Treatment was well-tolerated with no serious treatment-related adverse events. Combination treatment with anti-inflammatory dose doxycycline plus combination adapalene 0.3% and benzoyl peroxide 2.5% gel is safe and effective for management of severe acne. J Drugs Dermatol. 2019;18(9):924-927.


Assuntos
Acne Vulgar/tratamento farmacológico , Combinação Adapaleno e Peróxido de Benzoil/administração & dosagem , Anti-Inflamatórios/administração & dosagem , Fármacos Dermatológicos/administração & dosagem , Doxiciclina/administração & dosagem , Combinação Adapaleno e Peróxido de Benzoil/efeitos adversos , Administração Cutânea , Administração Oral , Adolescente , Adulto , Criança , Fármacos Dermatológicos/efeitos adversos , Relação Dose-Resposta a Droga , Doxiciclina/efeitos adversos , Quimioterapia Combinada/efeitos adversos , Quimioterapia Combinada/métodos , Feminino , Géis , Humanos , Masculino , Projetos Piloto , Resultado do Tratamento , Adulto Jovem
10.
BMC Oral Health ; 19(1): 176, 2019 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-31387569

RESUMO

BACKGROUND: Glycemic control is vital in the care of type 2 diabetes mellitus (T2DM) and is significantly associated with the incidence of clinical complications. This Bayesian network analysis was conducted with an aim of evaluating the efficacy of scaling and root planning (SRP) and SRP + adjuvant treatments in improving glycemic control in chronic periodontitis (CP) and T2DM patients, and to guide clinical practice. METHODS: We searched the Pubmed, Embase, Cochrane Library and Web of Science databases up to 4 May 2018 for randomized controlled trials (RCTs). This was at least three months of the duration of study that involved patients with periodontitis and T2DM without other systemic diseases given SRP. Patients in the control group did not receive treatment or SRP combination with adjuvant therapy. Outcomes were given as HbA1c% and levels fasting plasma glucose (FPG). Random-effects meta-analysis and Bayesian network meta-analysis were conducted to pool RCT data. Cochrane's risk of bias tool was used to assess the risk of bias. RESULTS: Fourteen RCTs were included. Most were unclear or with high risk of bias. Compared to patients who did not receive treatment, patients who received periodontal treatments showed improved HbA1c% level, including SRP (the mean difference (MD) -0.399 95% CrI 0.088 to 0.79), SRP + antibiotic (MD 0.62, 95% CrI 0.18 to 1.11), SRP + photodynamic therapy (aPDT) + doxycycline (Doxy) (MD 1.082 95% CrI 0.13 to 2.077) and SRP + laser (MD 0.66 95% CrI 0.1037, 1.33). Among the different treatments, SRP + aPDT + Doxy ranked best. Regarding fasting plasma glucose (FPG), SRP did not show advantage over no treatment (MD 4.91 95% CI - 1.95 to 11.78) and SRP with adjuvant treatments were not better than SRP alone (MD -0.28 95% CI -8.66, 8.11). CONCLUSION: The results of this meta-analysis seem to support that periodontal treatment with aPDT + Doxy possesses the best efficacy in lowering HbA1c% of non-smoking CP without severe T2DM complications. However, longer-term well-executed, multi-center trails are required to corroborate the results.


Assuntos
Antibacterianos/uso terapêutico , Periodontite Crônica/terapia , Raspagem Dentária/métodos , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/terapia , Fotoquimioterapia , Aplainamento Radicular/métodos , Antibacterianos/administração & dosagem , Teorema de Bayes , Glicemia , Periodontite Crônica/sangue , Terapia Combinada , Doxiciclina/administração & dosagem , Doxiciclina/uso terapêutico , Feminino , Humanos , Masculino , Metanálise em Rede , Bolsa Periodontal/sangue , Bolsa Periodontal/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
11.
PLoS One ; 14(8): e0220905, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31408484

RESUMO

BACKGROUND: Scrub typhus, an important cause of unexplained fever, is grossly neglected and often misdiagnosed in low and middle income countries like Nepal. The main aim of this study was to report on the clinical profile and complications of scrub typhus and its outcome in Nepalese children. METHODS: A prospective observational study was carried out in children aged 1-16 years, admitted to a tertiary care hospital of central Nepal in between July 2016- Aug 2017. Scrub typhus was diagnosed with IgM ELISA. RESULTS: All cases of scrub typhus (n = 76) presented with fever and commonly had other symptoms such as headache (75%), myalgia (68.4%), vomiting (64.5%), nausea (59.2%), abdominal pain (57.9%), cough (35.5%), shortness of breath (22.4%), altered sensorium (14.5%), rashes (13.2%) and seizures (11.8%). Important clinical signs noticed were lymphadenopathy (60.5%), hepatomegaly (47.4%), edema (26.3%), jaundice (26.3%), and splenomegaly (15.8%). About 12% (n = 9) had necrotic eschar. Similarly, thrombocytopenia, raised liver enzymes and raised creatinine values were seen in 36.9%, 34.2% and 65.8% respectively. The most common complications were myocarditis (72.4%), hypoalbuminemia (71.1%), severe thrombocytopenia (22.4%), renal impairment (65.8%), hyponatremia (48.7%) and hepatitis (34.2%). Over two-thirds (69.70%) of the cases were treated with doxycycline followed by combination with azithromycin in the remaining 18.4%. Overall, mortality rate in this group was 3.9%. CONCLUSIONS: Scrub typhus should be considered as a differential in any community acquired acute undifferentiated febrile illness regardless of the presence of an eschar. Myocarditis and acute kidney injury are important complications which when addressed early can prevent mortality. Use of doxycycline showed a favorable outcome.


Assuntos
Tifo por Ácaros/parasitologia , Adolescente , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Azitromicina/administração & dosagem , Azitromicina/uso terapêutico , Criança , Pré-Escolar , Doxiciclina/administração & dosagem , Doxiciclina/uso terapêutico , Quimioterapia Combinada , Feminino , Humanos , Lactente , Masculino , Nepal/epidemiologia , Estudos Prospectivos , Tifo por Ácaros/complicações , Tifo por Ácaros/tratamento farmacológico , Centros de Atenção Terciária , Resultado do Tratamento
12.
Zhonghua Nei Ke Za Zhi ; 58(8): 596-598, 2019 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-31365982

RESUMO

To explore how to diagnose and treat brucellosis accurately and timely in patients with fever of unkown origin in non-pastoral areas. The epidemiological history, clinical symptoms, complete blood counts, procalcitonin and treatment efficacy of 7 patients with brucellosis were analyzed retrospectively. Some characteristic manifestations should be differentiated from tuberculosis. The clinical symptoms were relieved after combination of doxycycline, rifampicin, levofloxacin and amikacin for 6 weeks, only one patient with bone destruction needed orthopedic surgery. The overall response rate was 6/7. No relapse occurred during half year follow-up.


Assuntos
Amicacina/uso terapêutico , Antibacterianos/uso terapêutico , Brucelose/diagnóstico , Brucelose/tratamento farmacológico , Doxiciclina/uso terapêutico , Levofloxacino/uso terapêutico , Rifampina/uso terapêutico , Doença Aguda , Amicacina/administração & dosagem , Antibacterianos/administração & dosagem , Doxiciclina/administração & dosagem , Quimioterapia Combinada , Humanos , Levofloxacino/administração & dosagem , Pró-Calcitonina , Estudos Retrospectivos , Rifampina/administração & dosagem , Resultado do Tratamento
14.
Cutan Ocul Toxicol ; 38(4): 390-394, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31311337

RESUMO

Purpose: To evaluate the safety of subconjunctival injection of doxycycline in rabbit eyes. Methods: Eight white New Zealand rabbits were selected. Different concentrations of 250 micrograms (µg), 500 µg, 1000 µg, and 2000 µg in 0.1 ml were prepared for subconjunctival injection. Each concentration was injected into the two eyes of each rabbit. For each dose, dextrose was injected in one contralateral eye and the other fellow eye remained non-injected. All rabbits underwent ocular examination in the 1st, 3rd, and 30th day after injection. The rabbits were sacrificed 30 days after injections and the histopathological examination was performed. Results: No obvious change was detected in all four groups from the 1st day to the 3rd day after injection in terms of tearing, hyperaemia, and chemosis. There was no visible sign of inflammation or necrosis, and also no histological change in both clinical and histopathological examinations. Conclusion: Subconjunctival injection of doxycycline with different dosages of 250 to 2000 ug in 0.1cc in rabbit eyes was safe and no clinical or histological changes were observed after one month.


Assuntos
Antibacterianos/administração & dosagem , Doxiciclina/administração & dosagem , Olho/efeitos dos fármacos , Animais , Olho/anatomia & histologia , Injeções Intraoculares , Masculino , Coelhos
16.
Clin Dermatol ; 37(3): 182-191, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31178101

RESUMO

Despite advances in the control, diagnosis, and treatment of syphilis, its recognition is ill- understood or often not considered by dermatologists and other physicians who either have little specialized training in the minutiae of sexually transmitted infections (STIs) or whose dermatologic practice is only occasionally consulted by individuals from communities where STIs are prevalent. Our aim is to highlight contemporary ideas and findings on syphilis so that not only is an accurate diagnosis of syphilis made and recognized treatment given, but also necessary measures, such as counseling to exclude other STIs and to prevent reinfection, partner notification, and public health epidemiology as for any other infectious disease, are not forgotten. For syphilis, like human immunodeficiency virus (HIV) infection, not only is the biomedical aspect important, but also are the social and psychologic components.


Assuntos
Sífilis , Alopecia/etiologia , Diagnóstico Diferencial , Doxiciclina/administração & dosagem , Feminino , Infecções por HIV , Humanos , Infusões Intravenosas , Injeções Intramusculares , Masculino , Membrana Mucosa/patologia , Neurossífilis , Penicilina G Benzatina/administração & dosagem , Gravidez , Prevenção Secundária , Pele/patologia , Sífilis/diagnóstico , Sífilis/tratamento farmacológico , Sífilis/patologia , Sífilis/transmissão , Sorodiagnóstico da Sífilis/métodos , Tetraciclina/administração & dosagem
17.
Clin Dermatol ; 37(3): 192-199, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31178102

RESUMO

Tuberculosis (TB) is still prevalent in many developing countries and can pose a new potential threat to global health due to international migration. As an uncommon form of extrapulmonary TB, cutaneous TB is complicated in its clinical manifestation, pathogenesis, and classification. Cutaneous TB can be divided into two major categories, true cutaneous TB and tuberculid, depending on the source of infection, the route of transmission, the amount of bacteria, and the immune state of the host. Clinical manifestations may include patches and plaques (lupus vulgaris, TB verrucosa cutis), macules and papules (acute miliary TB, papulonecrotid tuberculid, lichen scrofulosorum), nodules, and abscesses (erythema induratum of Bazin, tuberculous gumma), erosions, and ulcers (tuberculous chancre, orificial TB, scrofuloderma), mimicking diverse skin diseases. Uncommon localizations such as external genitalia, unusual presentations such as nodular granulomatous phlebitis, and coexistence with other morbidities such as Behçet disease and acne inversa or hidradenitis suppurativa deserve special attention. Treatment of both true and tuberculid cutaneous TB follows the same drug regimens of the World Health Organization's recommendation for treatment of new cases of pulmonary TB. Erythema induratum of Bazin may need longer treatment duration and adjuvants such as dapsone, potassium iodide, doxycycline, and corticosteroids to tackle inflammation. Misdiagnosis and undertreatment in daily practice are likely, and contemplation of this classic great imitator in dermatology is warranted.


Assuntos
Tuberculose Cutânea/diagnóstico , Tuberculose Cutânea/tratamento farmacológico , Adolescente , Corticosteroides/administração & dosagem , Adulto , Antituberculosos/uso terapêutico , Criança , Dapsona/administração & dosagem , Diagnóstico Diferencial , Erros de Diagnóstico , Doxiciclina/administração & dosagem , Quimioterapia Combinada , Feminino , Infecções por HIV , Humanos , Masculino , Mycobacterium tuberculosis/isolamento & purificação , Iodeto de Potássio/administração & dosagem , Pele/microbiologia , Pele/patologia , Tuberculose Cutânea/microbiologia , Tuberculose Cutânea/patologia , Adulto Jovem
18.
Food Chem Toxicol ; 131: 110592, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31220539

RESUMO

This study aimed to determine the plasma and tissue residue depletion kinetics of doxycycline (DC) in grass carp (Ctenopharyngodon idella) after daily oral administrations at 20 mg/kg for 3 days, and to calculate the corresponding withdrawal times. Following drug administrations, samples of plasma, liver, kidney, gill and muscle + skin were collected at predetermined time points (0.25, 0.5, 1, 3, 5, 7, 14, 21, 28, 35, 42, 49 and 56 days) and analyzed for concentrations of DC using a LC-MS/MS method. The results showed that liver had the highest concentrations and the slowest depletion compared to other tissues, with detectable DC up to 49 days (58.9 ± 12.8 µg/kg). The WT 1.4 software and "reschem" package were used to calculate withdrawal times, and the results were similar. The results suggest a withdrawal time of 41 days for Europe and China and 50 days for Japan is needed for DC in grass carp after 3 daily oral administrations at 20 mg/kg. Overall, this study improves our understanding of the tissue residue depletion kinetics of DC in fish, and the results may help regulatory agencies to determine proper withdrawal periods based on different regulatory standards in different countries to ensure safety of aquatic food products.


Assuntos
Antibacterianos/farmacocinética , Carpas/metabolismo , Doxiciclina/farmacocinética , Administração Oral , Animais , Antibacterianos/administração & dosagem , Antibacterianos/sangue , China , Cromatografia Líquida , Doxiciclina/administração & dosagem , Doxiciclina/sangue , Europa (Continente) , Feminino , Japão , Limite de Detecção , Masculino , Software , Espectrometria de Massas em Tandem
19.
BMJ Case Rep ; 12(5)2019 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-31154348

RESUMO

Methotrexate (MTX) was originally formulated as one of the first antitumour drugs due to its ability to alter folate metabolism, which renders it to be an antiproliferative agent. Classically, the higher dosage is administered via parenteral route, in a cyclical fashion, to achieve antitumour effects. Patients on high doses of MTX are prone to develop rare complications of myelosuppression and pancytopenia, in a dose-dependent fashion, secondary to altered folate metabolism. 1 Herein, we present a unique case of rheumatoid arthritis presented with pancytopenia due to low-dose MTX and doxycycline drug interaction. We also report the successful management of pancytopenia and oral ulcers with combination therapy of leucovorin and granulocyte colony-stimulating factor.


Assuntos
Antirreumáticos/uso terapêutico , Artrite Reumatoide/diagnóstico , Doxiciclina/uso terapêutico , Metotrexato/uso terapêutico , Pancitopenia/diagnóstico , Antirreumáticos/administração & dosagem , Antirreumáticos/efeitos adversos , Artrite Reumatoide/tratamento farmacológico , Diagnóstico Diferencial , Doxiciclina/administração & dosagem , Doxiciclina/efeitos adversos , Quimioterapia Combinada , Humanos , Masculino , Metotrexato/administração & dosagem , Metotrexato/efeitos adversos , Pessoa de Meia-Idade , Pancitopenia/induzido quimicamente
20.
Medicine (Baltimore) ; 98(24): e15881, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31192920

RESUMO

INTRODUCTION: Because of its infrequent and the lack of clinical data and image finding, the management of acute infections with the hepatosplenic brucella abscesses is challenging. METHODS: There were 10 serologically diagnosed cases with this brucella infection. All patients had fever, 50% patients had upper abdominal pain. Ninety percent patients lived in an urban environment. The localization of lesions included: 30% hepatosplenic, 30% liver, and 40% spleen. RESULTS: Abdominal computed tomography (CT) scans and magnetic resonance imaging (MRI) demonstrated hepatosplenomegaly, with multiple small abscess lesions of various sizes in the acute stage of brucellosis, with the largest diameter of 1.5 cm in the liver. After contrast-enhanced CT and MRI findings, the arterial phase in which the enhancing area of lesions was thick, revealed multifocal hypodense or hypointense lesions of various sizes. These lesions manifested distinct boundary, which was intensified obviously in portal venous phase. CONCLUSION: Our results indicate that early CT or MRI dynamic contrast enhancement of suspected cases could improve rapid diagnosis. However, diagnostic criteria remain problematic and diagnosis is mostly based on a combination of clinical suspicion, serologic markers, and radiologic findings.


Assuntos
Brucelose/diagnóstico por imagem , Abscesso Hepático/diagnóstico por imagem , Imagem Multimodal/métodos , Esplenomegalia/diagnóstico por imagem , Adolescente , Idoso , Brucelose/tratamento farmacológico , China/etnologia , Doxiciclina/administração & dosagem , Doxiciclina/uso terapêutico , Feminino , Humanos , Abscesso Hepático/tratamento farmacológico , Abscesso Hepático/microbiologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Rifampina/administração & dosagem , Rifampina/uso terapêutico , Esplenomegalia/tratamento farmacológico , Esplenomegalia/microbiologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
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