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1.
Emerg Med Clin North Am ; 38(4): 841-856, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32981621
2.
Medicine (Baltimore) ; 99(24): e20283, 2020 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-32541452

RESUMO

RATIONALE: There is an increasing and compelling need for early recognition of features of osmotic demyelination syndrome (ODS), and a further attempt at correcting this even where presentation is late. PATIENT CONCERNS: A 49-year-old male admitted into the emergency department with a complaint of lethargy and severe hyponatremia, with subsequent ODS supervening on initial attempts at correction. DIAGNOSIS: Rapid rise in serum sodium concentration (121 mmol/L in 8 hours from a nadir of 101 mmol/L), concomitant deterioration in patient's conscious level support the diagnosis of ODS. INTERVENTION: Concomitant administration of 5% dextrose water with desmopressin with a therapeutic objective of gradual relowering of serum sodium concentration. OUTCOMES: Significant improvement in patients' conscious level and motor function with the commencement of sodium relowering therapy. The patient was eventually discharged home. LESSONS: Regardless of the temporal profile of neurologic sequelae following ODS due to hyponatremia, its worthwhile attempting initial sodium relowering with dextrose 5% and desmopressin and then monitoring of biochemical and neurologic markers.


Assuntos
Doenças Desmielinizantes/induzido quimicamente , Doenças Desmielinizantes/terapia , Hiponatremia/complicações , Antidiuréticos/administração & dosagem , Antidiuréticos/uso terapêutico , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Desamino Arginina Vasopressina/administração & dosagem , Desamino Arginina Vasopressina/uso terapêutico , Doenças Desmielinizantes/sangue , Doenças Desmielinizantes/diagnóstico , Quimioterapia Combinada/métodos , Glucose/administração & dosagem , Glucose/uso terapêutico , Humanos , Hiponatremia/terapia , Doença Iatrogênica , Letargia/etiologia , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Concentração Osmolar , Solução Salina Hipertônica/efeitos adversos , Sódio/sangue , Edulcorantes/administração & dosagem , Edulcorantes/uso terapêutico , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
4.
Psychopharmacology (Berl) ; 237(4): 1011-1026, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31900523

RESUMO

RATIONALE: Animal models, notably with non-competitive NMDA receptor antagonist MK801, are commonly used to investigate the mechanisms of schizophrenia and to pursue its mechanism-related drug discoveries. OBJECTIVES: In the current study, we have extensively examined the protective effects of MogrosideV (MogV), a plant-derived three terpene glucoside known to exhibit anti-oxidative and anti-inflammatory activities. METHODS AND RESULTS: Here, we investigated its protective effects against neuronal damages elicited by MK-801 treatment. Our behavioral experimental results showed that MK-801-induced PPI deficits and social withdrawal were prevented by MogV treatment. Moreover, the cellular and neurochemical responses of MK-801 in medial prefrontal cortical cortex (mPFC) were also ameliorated by MogV treatment. Also, profiling metabolites assay through artificial intestinal microbiota was performed to identify bioactive components of MogV. An in vitro study of primary neuronal culture demonstrated that MogV and its metabolite 11-oxo-mogrol treatment prevented the MK-801-induced neuronal damages through the mechanisms of promoting neurite outgrowth, inhibiting cell apoptosis, and [Ca2+]i release. Additionally, 11-oxo-mogrol reversed inactivation of phosphorylation levels of AKT and mTOR induced by MK801. CONCLUSIONS: These results suggest therapeutic potential of MogV for schizophrenia.


Assuntos
Maleato de Dizocilpina/toxicidade , Microbioma Gastrointestinal/efeitos dos fármacos , Fármacos Neuroprotetores/uso terapêutico , Esquizofrenia/prevenção & controle , Edulcorantes/uso terapêutico , Triterpenos/uso terapêutico , Adulto , Animais , Antagonistas de Aminoácidos Excitatórios/toxicidade , Feminino , Microbioma Gastrointestinal/fisiologia , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Neurônios/efeitos dos fármacos , Neurônios/patologia , Fármacos Neuroprotetores/farmacologia , Córtex Pré-Frontal/efeitos dos fármacos , Córtex Pré-Frontal/patologia , Receptores de N-Metil-D-Aspartato/antagonistas & inibidores , Receptores de N-Metil-D-Aspartato/metabolismo , Esquizofrenia/induzido quimicamente , Esquizofrenia/patologia , Edulcorantes/farmacologia , Triterpenos/farmacologia , Adulto Jovem
5.
Clin Perinatol ; 46(4): 709-730, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31653304

RESUMO

Infants undergo painful procedures involving skin puncture as part of routine medical care. Pain from needle puncture procedures is suboptimally managed. Numerous nonpharmacologic interventions are available that may be used for these painful procedures, including swaddling/containment, pacifier/non-nutritive sucking, rocking/holding, breastfeeding and breastmilk, skin-to-skin care, sweet tasting solutions, music therapy, sensorial saturation, and parental presence. Adoption these interventions into routine clinical practice is feasible and should be a standard of care in quality health care for infants. This review summarizes the epidemiology of pain from common needle puncture procedures in infants, the effectiveness of nonpharmacologic interventions, implementation considerations, and unanswered questions.


Assuntos
Aleitamento Materno , Método Canguru , Musicoterapia , Chupetas , Manejo da Dor/métodos , Dor Processual/terapia , Punções , Edulcorantes/uso terapêutico , Cateterismo Venoso Central , Cateterismo Periférico , Humanos , Lactente , Recém-Nascido , Injeções Intramusculares , Injeções Subcutâneas , Pais , Flebotomia , Punção Espinal , Sacarose/uso terapêutico
6.
Phytother Res ; 33(11): 2904-2917, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31423662

RESUMO

Stevia rebaudiana Bertoni, a plant from South America and indigenous of Paraguay, has shown several biological effects and healthy properties, although it is especially used in South America and some Asiatic regions. In addition, it is a natural sweetener, almost 300 times sweeter than sucrose, being attributed to its phytoconstituents prominent antioxidant, antimicrobial, antidiabetic (antihyperglycemic, insulinotropic, and glucagonostatic), antiplatelet, anticariogenic, and antitumor effects. In this sense, this work aims to provide an extensive overview on the historical practices of stevia and its effects in human health based on its chemical composition and applications for both food and pharmaceutical industries.


Assuntos
Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Stevia , Animais , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Ensaios Clínicos como Assunto/métodos , Diterpenos de Caurano/isolamento & purificação , Diterpenos de Caurano/farmacologia , Diterpenos de Caurano/uso terapêutico , Avaliação Pré-Clínica de Medicamentos , Glucosídeos/isolamento & purificação , Glucosídeos/farmacologia , Glucosídeos/uso terapêutico , Humanos , Hipoglicemiantes/farmacologia , Hipoglicemiantes/uso terapêutico , Extratos Vegetais/química , Folhas de Planta/química , Folhas de Planta/fisiologia , Stevia/química , Stevia/fisiologia , Edulcorantes/química , Edulcorantes/farmacologia , Edulcorantes/uso terapêutico
7.
Pain ; 160(5): 1059-1069, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31008815

RESUMO

The taste of sucrose is commonly used to provide pain relief in newborn humans and is innately analgesic to neonatal rodents. In adulthood, sucrose remains a strong motivator to feed, even in potentially hazardous circumstances (ie, threat of tissue damage). However, the neurobiological mechanisms of this endogenous reward-pain interaction are unclear. We have developed a simple model of sucrose drinking-induced analgesia in Sprague-Dawley rats (6-10 weeks old) and have undertaken a behavioral and pharmacological characterization using the Hargreaves' test of hind-paw thermal sensitivity. Our results reveal an acute, potent, and robust inhibitory effect of sucrose drinking on thermal nociceptive behaviour that unlike the phenomenon in neonates is independent of endogenous opioid signalling and does not seem to operate through classical descending inhibition of the spinal cord circuitry. Experience of sucrose drinking had a conditioning effect whereby the apparent expectancy of sucrose enabled water alone (in euvolemic animals) to elicit a short-lasting placebo-like analgesia. Sweet taste alone, however, was insufficient to elicit analgesia in adult rats intraorally perfused with sucrose. Instead, the sucrose analgesia phenomenon only appeared after conditioning by oral perfusion in chronically cannulated animals. This sucrose analgesia was completely prevented by systemic dosing of the endocannabinoid CB1 receptor antagonist rimonabant. These results indicate the presence of an endogenous supraspinal analgesic circuit that is recruited by the context of rewarding drinking and is dependent on endocannabinoid signalling. We propose that this hedonic sucrose-drinking model may be useful for further investigation of the supraspinal control of pain by appetite and reward.


Assuntos
Hiperalgesia/terapia , Limiar da Dor/efeitos dos fármacos , Medula Espinal/fisiologia , Sacarose/uso terapêutico , Edulcorantes/uso terapêutico , Animais , Antagonistas de Receptores de Canabinoides/farmacologia , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Comportamento de Ingestão de Líquido/efeitos dos fármacos , Adjuvante de Freund/toxicidade , Temperatura Alta/efeitos adversos , Hiperalgesia/induzido quimicamente , Injeções Espinhais/métodos , Masculino , Naloxona/farmacologia , Antagonistas de Entorpecentes/farmacologia , Proteínas Proto-Oncogênicas c-fos/metabolismo , Ratos , Ratos Sprague-Dawley , Tempo de Reação/efeitos dos fármacos , Rimonabanto/farmacologia , Medula Espinal/efeitos dos fármacos , Privação de Água/fisiologia
8.
Int J Hyperthermia ; 36(1): 302-312, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30729822

RESUMO

Controlling the magnetic properties of a nanoparticle efficiently via its particle size to achieve optimized heat under alternating magnetic field is the central point for magnetic hyperthermia-mediated cancer therapy (MHCT). Here, we have shown the successful use of stevioside (a natural plant-based glycoside) as a promising biosurfactant to control the magnetic properties of Fe3O4 nanoparticles by controlling the particle size. The biocompatibility and cellular uptake efficiency by rat C6 glioma cells and calorimetric magnetic hyperthermia profile of the nanoparticles were further examined. Our finding suggests superior properties of stevioside-coated magnetite nanoparticles in comparison to polysorbate-80 and oleic acid coated nanomagnets as far as particle size reduction, biocompatibility, hyperthermic effect, and cellular uptake by the glioblastoma cancer cells are concerned. The stevioside-coated nanomagnets exhibiting the maximum temperature rise were further investigated as heating agents in in vitro magnetic hyperthermia experiments (405 kHz, 168 Oe), showing their efficacy to induce cell death of rat C6 glioma cells after 30 min at a target temperature T = 43 °C.


Assuntos
Diterpenos de Caurano/uso terapêutico , Glucosídeos/uso terapêutico , Hipertermia Induzida/métodos , Nanopartículas de Magnetita/química , Edulcorantes/uso terapêutico , Animais , Diterpenos de Caurano/farmacologia , Glucosídeos/farmacologia , Humanos , Ratos
9.
Int J Med Sci ; 16(1): 1-7, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30662322

RESUMO

The objective of this study was to determine the relationship between glucose dosage in parenteral nutrition and reductions in levels of body thiamine in rats. Vitamin-free infusions with differing amounts of glucose were administered to normal or thiamine-deficient rats for 5 days, after which urinary thiamine excretion and the amounts of thiamine in the blood, liver, brain, and skeletal muscles were measured. The total energy dosage was set at three levels (98, 140, and 196 kcal/kg), and the dose of amino acids was constant among all groups. Urinary thiamine excretions on Day 5 decreased with increasing glucose dosage in the infusions. In normal rats, the amount of thiamine in the blood and all organs decreased compared with the diet group; however, no significant differences were found among the infusion groups. In thiamine-deficient rats, on the other hand, the amount of thiamine in the liver and skeletal muscles did not differ significantly among infusion groups; however, the amount of thiamine in the brain and blood decreased with increasing glucose dosage. An organ-specific correlation was found between glucose dosage in infusions and reductions in levels of thiamine. To prevent thiamine deficiencies from affecting the central nervous system, greater caution must be exercised during high-caloric parenteral nutrition. However, a constant supply of thiamine seemed to be essential, irrespective of the amount of energy supplied via parenteral nutrition, to maintain a sufficient level of thiamine in the body.


Assuntos
Glucose/administração & dosagem , Edulcorantes/metabolismo , Deficiência de Tiamina , Tiamina/sangue , Tiamina/urina , Complexo Vitamínico B/sangue , Complexo Vitamínico B/urina , Aminoácidos/administração & dosagem , Animais , Encéfalo/metabolismo , Eletrólitos/administração & dosagem , Glucose/uso terapêutico , Japão , Fígado/metabolismo , Masculino , Músculo Esquelético/metabolismo , Especificidade de Órgãos , Nutrição Parenteral , Ratos , Ratos Sprague-Dawley , Edulcorantes/administração & dosagem , Edulcorantes/uso terapêutico , Tiamina/metabolismo , Deficiência de Tiamina/tratamento farmacológico , Deficiência de Tiamina/metabolismo
10.
CJEM ; 21(4): 499-504, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30460885

RESUMO

OBJECTIVE: Syncope accounts for 1% of emergency department (ED) visits, yet few experience a serious adverse event (SAE). Two-thirds of syncope patients are transported to the ED by ambulance, placing considerable burden on emergency medical services (EMS), and many of these transports may be unnecessary. We estimated the proportion of syncope patients who fell into a low-risk category based on an ED diagnosis of vasovagal syncope and the absence of EMS intervention, hospitalization, or SAE. METHODS: We conducted a multicentre prospective cohort study enrolling adult syncope patients transported to the ED by ambulance over 13 months. We collected demographics and EMS interventions, and followed patients for 30 days to identify all SAE, including death, dysrhythmia, myocardial infarction, aortic dissection, pulmonary embolism, subarachnoid hemorrhage, significant hemorrhage, and related procedural interventions. RESULTS: Of 990 (67.2%) patients transported to the ED by ambulance, 121 had EMS interventions, 137 suffered 30-day SAE, 393 (39.7%; 95%CI 36.6, 42.8) were deemed low risk, 41 patients with vasovagal syncope were lost to follow-up, and 298 patients were diagnosed with non-vasovagal syncope. During transport, 121 (12.2%; 95%CI 10.2, 14.3) patients underwent some EMS intervention, and 137 (14.6%; 95%CI 12.4, 16.9) suffered SAEs within 30 days. CONCLUSION: About 40% of patients transported to the ED by ambulance are at low risk and may not benefit from paramedic care or transport to a hospital. A robust clinical decision tool would help identify patients safe for treat-and-release, diversion to alternative care, or rapid offload into low-acuity ED areas, potentially reducing EMS workload and cost.


Assuntos
Ambulâncias , Serviço Hospitalar de Emergência , Síncope/epidemiologia , Antieméticos/uso terapêutico , Arritmias Cardíacas/epidemiologia , Canadá/epidemiologia , Estimulação Cardíaca Artificial/estatística & dados numéricos , Fármacos Cardiovasculares/uso terapêutico , Estudos de Coortes , Uso de Medicamentos/estatística & dados numéricos , Feminino , Glucose/uso terapêutico , Humanos , Hipnóticos e Sedativos/uso terapêutico , Masculino , Pessoa de Meia-Idade , Edulcorantes/uso terapêutico , Síncope/terapia
11.
BMJ Case Rep ; 12(12)2019 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-31888913

RESUMO

A 69-year-old woman with uncontrolled type 2 diabetes mellitus was admitted in the hospital for the management of urosepsis. Patient was overdosed with detemir insulin 1000 units inadvertently. Care provider was confused with volume and dose of the insulin by using insulin vial. Blood sugars were monitored closely every 30 min-1 hour for 24 hours. Patient was treated with dextrose 5% and 10% continuous infusion; and hydrocortisone 75 mg every 6 hours for 24 hours. The lowest blood sugar reached was 142 mg/dL (7.9 mmo/L). Patient did not develop hypoglycaemia. Proper safety measures and mandatory nurse education about administration of insulin were implemented to prevent future occurrences.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Pessoal de Saúde/educação , Insulina Detemir/efeitos adversos , Infecções Urinárias/complicações , Idoso , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Glicemia/análise , Glicemia/efeitos dos fármacos , Overdose de Drogas/tratamento farmacológico , Feminino , Glucose/administração & dosagem , Glucose/uso terapêutico , Hospitalização , Humanos , Hidrocortisona/administração & dosagem , Hidrocortisona/uso terapêutico , Doença Iatrogênica/epidemiologia , Doença Iatrogênica/prevenção & controle , Infusões Intravenosas , Insulina Detemir/uso terapêutico , Edulcorantes/administração & dosagem , Edulcorantes/uso terapêutico , Resultado do Tratamento
12.
Hosp Pediatr ; 8(9): 515-523, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30076160

RESUMO

OBJECTIVES: Pain in hospitalized children remains under-assessed and undertreated. With this study, we aim to describe results from a repeat single-day, hospital-wide survey of children's pain and its treatment after the initiation of a hospital-wide quality improvement initiative used to reduce or eliminate pain caused by needle procedures. METHODS: All patients and parents listed on the inpatient morning census, in emergency department and outpatient surgery registration lists, were invited to participate in a brief single-day point prevalence survey of their experience with pain and its management in the hospital setting. Results were compared with a survey conducted 2 years earlier, before implementation of a system-wide Children's Comfort Promise needle pain treatment and prevention protocol. RESULTS: A total of 194 children and their parents participated in the current survey. A higher percentage of children reported having no pain compared with the previous survey (33% vs 24%; P = .07; not significant) and fewer experienced severe pain (score ≥7 out of 10). Fewer children identified pain caused by needles as the cause of the worst pain (21% vs 30%), although it remained the highest reported cause of the most painful experience overall. The number of pain management strategies administered and offered to children with needle pain (distraction, positioning, numbing cream, and sucrose and/or breastfeeding for infants) increased. CONCLUSIONS: The implementation of a mandatory Comfort Promise protocol used to minimize or prevent pain caused by elective needle procedures was associated with a significant reduction in overall pain prevalence and improved use of evidence-based practices for needle pain management.


Assuntos
Manejo da Dor/estatística & dados numéricos , Dor Processual/epidemiologia , Punções/métodos , Analgésicos/uso terapêutico , Anestésicos Locais/uso terapêutico , Aleitamento Materno , Criança , Criança Hospitalizada , Pré-Escolar , Serviço Hospitalar de Emergência , Feminino , Hospitais Pediátricos , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Agulhas , Dor Processual/prevenção & controle , Pais , Posicionamento do Paciente , Prevalência , Sacarose/uso terapêutico , Inquéritos e Questionários , Edulcorantes/uso terapêutico , Estados Unidos/epidemiologia
13.
BMJ Open ; 8(8): e020941, 2018 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-30082349

RESUMO

INTRODUCTION: Xylitol (or 'birch sugar') is a naturally occurring sugar with antibacterial properties that has been used as a natural non-sugar sweetener in chewing gums, confectionery, toothpaste and medicines. In this preventative randomised trial, xylitol will be tested for the prevention of acute otitis media (AOM), a common and costly condition in young children. The primary outcome will be the incidence of AOM. Secondary outcomes will include upper respiratory tract infections (URTIs) and dental caries. METHODS AND ANALYSIS: This study will be a pragmatic, blinded (participant and parents, practitioners and analyst), two-armed superiority, placebo-controlled randomised trial with 1:1 allocation, stratified by clinical site. The trial will be conducted in the 11 primary care group practices participating in the TARGet Kids! research network in Canada. Eligible participants between the ages of 2-4 years will be randomly assigned to the intervention arm of regular xylitol syrup use or the control arm of regular sorbitol use for 6 months. We expect to recruit 236 participants, per treatment arm, to detect a 20% relative risk reduction in AOM episodes. AOM will be identified through chart review. The secondary outcomes of URTIs and dental caries will be identified through monthly phone calls with specified questions. ETHICS AND DISSEMINATION: Ethics approval from the Research Ethics Boards at the Hospital for Sick Children and St. Michael's Hospital has been obtained for this study and also for the TARGet Kids! research network. Results will be submitted for publication to a peer-reviewed journal and will be discussed with decision makers. TRIAL REGISTRATION NUMBER: NCT03055091; Pre-results.


Assuntos
Otite Média/prevenção & controle , Edulcorantes/uso terapêutico , Xilitol/uso terapêutico , Canadá , Pré-Escolar , Humanos , Estudos Multicêntricos como Assunto , Ensaios Clínicos Pragmáticos como Assunto
14.
CEN Case Rep ; 7(2): 292-295, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29978296

RESUMO

Spinal muscular atrophy (SMA) is a genetic neuromuscular disease characterized by progressive muscle weakness and atrophy. We report a case of a 36-year-old man with SMA type 3 who presented to our emergency department with epigastric pain and vomiting. He was found to have severe ketoacidosis on laboratory evaluation. The patient's symptoms and ketoacidosis resolved after dextrose infusion and a relatively small amount of sodium bicarbonate infusion. Given the severity of the ketosis that seemed inconsistent with moderate starvation alone, we postulate that there must have been other contributing factors besides moderate starvation that might explain the severity of acidosis in this particular patient. These factors include low muscle mass, disturbed fatty acid metabolism, hormonal imbalances and defective glucose metabolism. Ketoacidosis is an under-recognized entity in patients with neuromuscular diseases and requires a high index of suspicion for prompt diagnosis and management.


Assuntos
Cetose/diagnóstico , Cetose/etiologia , Atrofia Muscular Espinal/complicações , Adulto , Diagnóstico Diferencial , Glucose/administração & dosagem , Glucose/uso terapêutico , Humanos , Infusões Intravenosas , Cetose/sangue , Cetose/terapia , Masculino , Atrofia Muscular Espinal/classificação , Atrofia Muscular Espinal/patologia , Índice de Gravidade de Doença , Bicarbonato de Sódio/administração & dosagem , Bicarbonato de Sódio/uso terapêutico , Edulcorantes/administração & dosagem , Edulcorantes/uso terapêutico , Resultado do Tratamento
15.
Rev Bras Enferm ; 71(3): 1092-1098, 2018 May.
Artigo em Português, Inglês | MEDLINE | ID: mdl-29924160

RESUMO

OBJECTIVE: To verify the effectiveness of nursing interventions based on the Imogene King's Theory of Goal Attainment, on improving care for people with diabetes and adherence to treatment. METHOD: Quasi-experimental, longitudinal, randomized, simple study in a Primary Health Care Unit, in the city of Fortaleza, Ceará state, Brazil. The sample consisted of 60 people with diabetes, divided into intervention and control groups, whose collection occurred from February to August 2013. RESULTS: In the intervention group, a significant adherence of the patients to the goals defined in the study was found. In the control, there was improvement in some aspects of the treatment. CONCLUSION: With these results, it was possible to conclude the feasibility of using Theory of Goal Attainment in the positive aspects for adherence to diabetes treatment and improvement of quality of life.


Assuntos
Diabetes Mellitus/enfermagem , Cuidados de Enfermagem/métodos , Teoria de Enfermagem , Edulcorantes/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
16.
Medicine (Baltimore) ; 97(23): e10978, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29879053

RESUMO

RATIONALE: Perineural injection with dextrose could be a novel intervention for peripheral entrapment neuropathy. However, this intervention has not been reported for treating radial nerve palsy (RNP). Here, we present a case with RNP having outstanding improvement after 2 sessions of ultrasound-guided perineural injection with 5% dextrose (D5W). PATIENT CONCERNS: A 62-year-old woman presented with difficulty and weakness in extension of her left wrist and fingers after she slept with the arm compressed against her body. DIAGNOSES: On the basis of the findings of electrophysiological study and ultrasonography, the RNP with axonal injury was diagnosed. INTERVENTIONS: Initially, the patient received 2-months conservative treatments without any improvement. Two sessions of ultrasound-guided perineural injection with total 15cc D5W with an interval of 1 month were performed 2 months after symptom onset. OUTCOMES: A noteworthy improvement in sensory and motor functions was observed after ultrasound-guided perineural injection with D5W. LESSONS: This case shows that ultrasound-guided perineural injection with D5W may be an effective and novel intervention for RNP.


Assuntos
Glucose/uso terapêutico , Síndromes de Compressão Nervosa/tratamento farmacológico , Paralisia/tratamento farmacológico , Nervo Radial/fisiopatologia , Neuropatia Radial/fisiopatologia , Ultrassonografia de Intervenção/métodos , Feminino , Glucose/administração & dosagem , Humanos , Injeções , Pessoa de Meia-Idade , Bloqueio Nervoso/métodos , Nervo Radial/lesões , Edulcorantes/uso terapêutico , Resultado do Tratamento , Ultrassonografia/métodos
17.
Rev. bras. enferm ; 71(3): 1092-1098, May-June 2018. tab
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-958632

RESUMO

ABSTRACT Objective: To verify the effectiveness of nursing interventions based on the Imogene King's Theory of Goal Attainment, on improving care for people with diabetes and adherence to treatment. Method: Quasi-experimental, longitudinal, randomized, simple study in a Primary Health Care Unit, in the city of Fortaleza, Ceará state, Brazil. The sample consisted of 60 people with diabetes, divided into intervention and control groups, whose collection occurred from February to August 2013. Results: In the intervention group, a significant adherence of the patients to the goals defined in the study was found. In the control, there was improvement in some aspects of the treatment. Conclusion: With these results, it was possible to conclude the feasibility of using Theory of Goal Attainment in the positive aspects for adherence to diabetes treatment and improvement of quality of life.


RESUMEN Objetivo: Comprobar la efectividad de intervenciones en enfermería, justificada en la Teoría del Alcance de Metas de Imogene King, en el perfeccionamiento del cuidado a la persona con diabetes y en la adhesión al tratamiento. Método: Estudio cuasi experimental, de naturaleza longitudinal, aleatorizado simple, en una Unidad de Atención Primaria a la Salud, en el municipio de Fortaleza, Ceará, Brasil. La muestra incluyó 60 personas con diabetes, divididas en los grupos de intervención y control, cuya recolección ocurrió de febrero a agosto de 2013. Resultados: En el grupo de intervención, se encontró una adhesión significativa de los pacientes a las metas definidas en el estudio. En el control, hubo una mejora en algunos aspectos del tratamiento. Conclusión: Con estos resultados se pudo concluir la viabilidad del empleo de la Teoría del Alcance de Metas en los aspectos positivos para la adhesión al tratamiento de la diabetes y mejora de la calidad de vida.


RESUMO Objetivo: Verificar a efetividade de intervenções em enfermagem, fundamentada na Teoria do Alcance de Metas de Imogene King, na melhoria do cuidado à pessoa com diabetes e na adesão ao tratamento. Método: Estudo quase-experimental, do tipo longitudinal, randomizado simples, numa Unidade de Atenção Primária à Saúde, no município de Fortaleza, Ceará, Brasill. A amostra contou com 60 pessoas com diabetes, divididas nos grupos de intervenção e controle, cuja coleta ocorreu de fevereiro a agosto de 2013. Resultados: No grupo de intervenção, encontrou-se uma adesão significativa dos pacientes às metas definidas no estudo. No controle, houve melhora em alguns aspectos do tratamento. Conclusão: Com esses resultados pôde-se concluir a viabilidade do emprego da Teoria do Alcance de Metas nos aspectos positivos para a adesão ao tratamento do diabetes e melhoria da qualidade de vida.


Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Idoso de 80 Anos ou mais , Edulcorantes/uso terapêutico , Teoria de Enfermagem , Diabetes Mellitus/enfermagem , Cuidados de Enfermagem/métodos , Brasil , Pessoa de Meia-Idade
18.
J Pediatr ; 198: 151-155.e1, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29625731

RESUMO

OBJECTIVE: To evaluate the costs of using dextrose gel as a primary treatment for neonatal hypoglycemia in the first 48 hours after birth compared with standard care. STUDY DESIGN: We used a decision tree to model overall costs, including those specific to hypoglycemia monitoring and treatment and those related to the infant's length of stay in the postnatal ward or neonatal intensive care unit, comparing the use of dextrose gel for treatment of neonatal hypoglycemia with placebo, using data from the Sugar Babies randomized trial. Sensitivity analyses assessed the impact of dextrose gel cost, neonatal intensive care cost, cesarean delivery rate, and costs of glucose monitoring. RESULTS: In the primary analysis, treating neonatal hypoglycemia using dextrose gel had an overall cost of NZ$6863.81 and standard care (placebo) cost NZ$8178.25; a saving of NZ$1314.44 per infant treated. Sensitivity analyses showed that dextrose gel remained cost saving with wide variations in dextrose gel costs, neonatal intensive care unit costs, cesarean delivery rates, and costs of monitoring. CONCLUSIONS: Use of buccal dextrose gel reduces hospital costs for management of neonatal hypoglycemia. Because it is also noninvasive, well tolerated, safe, and associated with improved breastfeeding, buccal dextrose gel should be routinely used for initial treatment of neonatal hypoglycemia. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12608000623392.


Assuntos
Glucose/economia , Hipoglicemia/tratamento farmacológico , Edulcorantes/economia , Custos e Análise de Custo , Árvores de Decisões , Géis , Glucose/uso terapêutico , Recursos em Saúde/economia , Humanos , Hipoglicemia/economia , Recém-Nascido , Terapia Intensiva Neonatal/economia , Tempo de Internação/economia , Nova Zelândia , Edulcorantes/uso terapêutico
19.
Biomed Res Int ; 2018: 8718053, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29546070

RESUMO

The objective of the current research was to review and update evidence on the dietary effect of the consumption of tagatose in type 2 diabetes, as well as to elucidate the current approach that exists on its production and biotechnological utility in functional food for diabetics. Articles published before July 1, 2017, were included in the databases PubMed, EBSCO, Google Scholar, and Scielo, including the terms "Tagatose", "Sweeteners", "Diabetes Mellitus type 2", "Sweeteners", "D-Tag". D-Tagatose (D-tag) is an isomer of fructose which is approximately 90% sweeter than sucrose. Preliminary studies in animals and preclinical studies showed that D-tag decreased glucose levels, which generated great interest in the scientific community. Recent studies indicate that tagatose has low glycemic index, a potent hypoglycemic effect, and eventually could be associated with important benefits for the treatment of obesity. The authors concluded that D-tag is promising as a sweetener without major adverse effects observed in these clinical studies.


Assuntos
Diabetes Mellitus Tipo 2/dietoterapia , Hexoses/uso terapêutico , Obesidade/dietoterapia , Edulcorantes/uso terapêutico , Glicemia/efeitos dos fármacos , Diabetes Mellitus Tipo 2/sangue , Humanos , Hipoglicemiantes/sangue , Hipoglicemiantes/uso terapêutico , Obesidade/sangue
20.
Biomed Res Int ; 2018: 4806534, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29511682

RESUMO

Noncaloric sweeteners (NCS) are food additives used to provide sweetness without adding calories. Their consumption has become more widespread around the world in all age groups, including children. The aim of this study is to show the state of the art about the intake of noncaloric sweeteners in children, as well as their benefits and consumption risk. Scientific searchers were used (PUBMED, Scopus, and Scielo) to analyze articles that included keywords (noncaloric sweeteners/saccharin/cyclamate/acesulfame potassium/aspartame/sucralose/stevia/children) in English, Spanish, and Portuguese. Authors conclude that it is imperative that health professionals judiciously and individually evaluate the overall benefits and risks of NCS use in consumers before recommending their use. Different subgroups of the population incorporate products containing NCS in their diet with different objectives, which should be considered when recommending a diet plan for the consumer. In childhood, in earlier age groups, this type of additives should be used as a dietary alternative when other forms of prevention in obesity are not sufficient.


Assuntos
Ingestão de Energia , Aditivos Alimentares/uso terapêutico , Obesidade/dietoterapia , Edulcorantes/uso terapêutico , Aspartame/efeitos adversos , Aspartame/uso terapêutico , Criança , Ciclamatos/efeitos adversos , Ciclamatos/uso terapêutico , Aditivos Alimentares/efeitos adversos , Humanos , Obesidade/epidemiologia , Obesidade/prevenção & controle , Medição de Risco , Sacarina/efeitos adversos , Sacarina/uso terapêutico , Stevia/química , Sacarose/efeitos adversos , Sacarose/análogos & derivados , Sacarose/uso terapêutico , Edulcorantes/administração & dosagem , Tiazinas/efeitos adversos , Tiazinas/uso terapêutico
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