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1.
Medicine (Baltimore) ; 99(5): e18968, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32000424

RESUMO

BACKGROUND: Lung cancer is one of the most common cancers worldwide, and approximately half of the patients with lung cancer receiving chemotherapy suffer from cancer-related fatigue (CRF). Herbal medicines (HMs) have been used in Oriental countries for centuries as tonics. Various beneficial effects of HM on fatigue and cancer have been reported. However, the effectiveness and safety of HM for CRF in lung cancer patients have not been synthesized. The purpose of this systematic review is to evaluate the effectiveness and safety of HM for CRF in patients with lung cancer, regardless of their cancer type or stage. METHODS AND ANALYSIS: A comprehensive search will be conducted in 12 electronic medical databases including 5 English-language databases (Medline via PubMed, EMBASE via Elsevier, the Cochrane Central Register of Controlled Trials [CENTRAL], the Allied and Complementary Medicine Database [AMED] via EBSCO, and the Cumulative Index to Nursing and Allied Health Literature [CINAHL] via EBSCO), 4 Korean-language databases (Oriental Medicine Advanced Searching Integrated System [OASIS], Koreanstudies Information Service System [KISS], Research Information Service System [RISS], and Korea Citation Index [KCI]), 2 Chinese-language databases (China National Knowledge Infrastructure [CNKI] and Wanfang Data), and 1 Japanese-language database (CiNii). Only randomized controlled trials (RCTs) and quasi-RCTs on HM for CRF will be allowed. The severity of fatigue assessed using a validated tool will be considered as theprimary outcome. The secondary outcomes will include the patients' quality of life, activities of daily life, incidence of adverse events, and total effective rate. Two independent researchers will perform the study selection, data extraction, and quality assessment. RevMan version 5.3 will be used for data synthesis. The methodological quality of the included RCTs will be assessed using the Cochrane Collaboration's risk of bias tool. In the meta-analysis, for dichotomous data and continuous data, risk ratio and mean difference, respectively, will be estimated with their 95% confidence intervals. According to the heterogeneity, either a fixed-effects or a random-effects model will be used. ETHICS AND DISSEMINATION: Ethical approval is not required because individual patient data are not included. The findings of this systematic review will be disseminated through a peer-reviewed publication or conference presentation. PROSPERO REGISTRATION NUMBER: CRD42019141660.


Assuntos
Sobreviventes de Câncer , Medicamentos de Ervas Chinesas/uso terapêutico , Fadiga/tratamento farmacológico , Fadiga/etiologia , Medicina Herbária/métodos , Neoplasias Pulmonares/complicações , Medicina Tradicional do Leste Asiático/métodos , Revisão Sistemática como Assunto , Humanos , Projetos de Pesquisa
2.
Chem Biodivers ; 17(2): e1900512, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31900973

RESUMO

Velvet antler (VA) is crucial and precious nourishment in China and some countries in Southeast Asia and has excellent anti-fatigue effect. The incidence of fatigue syndrome has increased gradually. VA can be a potential source of anti-fatigue products. Therefore, we investigated the anti-fatigue activity of different sections (upper, middle, and basal section) of VA from different species (red deer and sika deer) via loading swimming test in mice. Furthermore, nucleosides are one kind of active components in VA which could considerably reduce fatigue in mice. In order to explore whether the nucleosides are correlated with anti-fatigue effect, the contents of eight nucleosides (uracil, cytidine, hypoxanthine, xanthine, thymine, inosine, guanosine, and adenosine) were determined simultaneously using high-performance liquid chromatography. The results indicated that the swimming time in mice was increased from basal to upper section, which was consistent with the change trend of the total contents of eight nucleosides of VA. Therefore, we speculated that the contents of nucleosides in VA may affect its anti-fatigue effect. Furthermore, the contents of nucleosides were also used as a reference for evaluating the quality of different parts of VA obtained from red and sika deer.


Assuntos
Chifres de Veado/metabolismo , Fadiga/tratamento farmacológico , Nucleosídeos/uso terapêutico , Animais , Peso Corporal/efeitos dos fármacos , Cromatografia Líquida de Alta Pressão , Cervos , Masculino , Camundongos , Nucleosídeos/análise , Nucleosídeos/farmacologia , Condicionamento Físico Animal
3.
Int J Radiat Oncol Biol Phys ; 106(1): 100-107, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31627177

RESUMO

PURPOSE: In patients with non-small cell lung cancer (NSCLC), concurrent chemoradiation therapy (CRT) exacerbates a cluster of difficult-to-manage symptoms, especially cancer-related fatigue. Minocycline is a readily available, low-cost antibiotic with antiinflammatory properties. We conducted a phase 2 randomized, double-blinded, placebo-controlled trial to investigate the effect of minocycline in reducing CRT-symptom burden in NSCLC. METHODS AND MATERIALS: Patients with NSCLC scheduled to receive CRT provided consent and were randomized to receive either minocycline (100 mg twice daily) or a matching placebo during 6 to 7 weeks of CRT. Patient-reported fatigue and other symptoms were assessed on MD Anderson Symptom Inventory weekly from the start of CRT for 12 weeks. The primary outcome was 12-week (±2 days) area under the curve for symptom burden, which was compared between treatment groups. RESULTS: Forty of 49 enrolled patients (80%) were evaluable (19 on minocycline and 21 on placebo). There were no grade 3 + adverse events related to the study medication. Fatigue was significantly reduced in the minocycline group compared with placebo group during the 12-week trial period (area under the curve = 31.2 ± 14.2 vs 45.0 ± 20.9, P = .011), with a large effect size (Cohen's d = 0.77). Pain (Cohen's d = 0.54) and shortness of breath (Cohen's d = 0.55) were also significantly reduced in the minocycline group (all P < .05). CONCLUSIONS: Minocycline during CRT for NSCLC was feasible, had a low toxicity profile, and yielded a clinically and statistically significant positive signal in reducing symptom burden related to NSCLC and CRT. This study is a proof of concept so a larger trial in CRT patients is warranted.


Assuntos
Antibacterianos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Quimiorradioterapia/efeitos adversos , Fadiga/tratamento farmacológico , Neoplasias Pulmonares/radioterapia , Minociclina/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Carcinoma Pulmonar de Células não Pequenas/complicações , Método Duplo-Cego , Dispneia/tratamento farmacológico , Fadiga/etiologia , Feminino , Humanos , Neoplasias Pulmonares/complicações , Masculino , Pessoa de Meia-Idade , Estudo de Prova de Conceito , Estudos Prospectivos , Qualidade de Vida
4.
Zhongguo Ying Yong Sheng Li Xue Za Zhi ; 35(4): 366-370, 2019 Jul 28.
Artigo em Chinês | MEDLINE | ID: mdl-31701725

RESUMO

OBJECTIVE: To investigate the effects of Acorus tatarinowii Schott and its active component 5- hydroxymethyl furfural (HMF) on learning and memory and ERK/CREB signal in hippocampus of rats with exercise-induced fatigue. METHODS: SD rats were randomly divided into normal group (A), exercise group (B), exercise + HMF low, middle and high dose treatment group (C, D, E), exercise + acorus tatarinowii Schott low, middle and high dose treatment group (F, G, H), with ten rats in each group. The rats in group C, D and E were treated with HMF at the doses of 0.10, 1.00 and 3.00 mg. kg-1 by ig. The rats in group F, G and H were treated with the extracts of Acorus tatarinowii Schott at the doses of 0.12, 1.20 and 4.80 g. kg-1 by ig. Learning and memory of rats were tested by the method of water maze experiment, and the expression levels of p-ERK1/2 and p-CREB protein in hippocampus of rats were tested by the method of Western blot in the end of the experiment. RESULTS: The escape latencies of E and H groups were lower than those of groups B, C, D, F and G; and the numbers of plateau crossing were more than those of groups B, C, D, F and G and the expression levels of p-ERK1/2, p-CREB protein were higher than those of groups B, C, D, F and G , respectively(P < 0.01). There was no significant difference in the above indexes among groups A, E and H(P>0.05) except that the expression levels of p-ERK2 protein in group E were lower than those in group A and H (P<0.05). CONCLUSION: Acorus tatarinowii and its active component- HMF can improve the learning and memory of rats with exercise-induced fatigue, and the mechanism is related to the up-regulation of ERK / CREB signal in hippocampus of rats with exercise-induced fatigue.


Assuntos
Acorus/química , Fadiga/tratamento farmacológico , Furaldeído/análogos & derivados , Condicionamento Físico Animal , Animais , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/metabolismo , Furaldeído/farmacologia , Hipocampo/metabolismo , Sistema de Sinalização das MAP Quinases , Aprendizagem em Labirinto/efeitos dos fármacos , Memória/efeitos dos fármacos , Compostos Fitoquímicos/farmacologia , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley
5.
Medicine (Baltimore) ; 98(44): e17717, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689808

RESUMO

BACKGROUND: Cancer-related fatigue (CRF) is a major symptom experienced by lung cancer patients receiving chemotherapy and radiation therapy. Since CRF has a multidimensional influence on cancer patients, they may experience physical weakening, a decline in cognitive function, and depression from emotional consequences. Kyung-Ok-Ko is used for improving fatigue or weak physical constitution. It is known to be effective in immune activation, reducing fatigue, and enhancing cognitive function. Although Kyung-Ok-Ko is clinically used for the treatment of CRF, its efficacy and safety against CRF in lung cancer patients are yet to be studied. Therefore, we aimed to investigate the efficacy and safety of Kyung-Ok-Ko. METHODS: This is a randomized, placebo-controlled, patients-assessor blind, parallel-group, single-center clinical trial. Lung cancer patients with CRF, after termination of chemo or radiation therapies, are randomized in a 1:1 ratio to receive either Kyung-Ok-Ko or placebo for 6 weeks. The primary outcome is Brief Fatigue Inventory (BFI). The secondary outcomes include Visual Analog Fatigue Scale (VAFS), Functional Assessment of Cancer Therapy (FACIT) Fatigue scale, Hospital Anxiety Depression Scale (HADS), Montreal Cognitive Assessment Korean version (MoCA-K), and Korean pattern identification questionnaire. Adverse events are evaluated by Common Terminology Criteria for Adverse Events (CTCAE). All outcomes and adverse events are assessed at the baseline, mid-treatment, post-treatment, and at 1-month follow-up. DISCUSSION: This study investigates whether Kyung-Ok-Ko can alleviate CRF in lung cancer patients. The results of this study will provide clinical evidence for the application of Kyung-Ok-Ko in the treatment of CRF in lung cancer patients. TRIAL REGISTRATION: Korean Clinical Trial Registry (http://cris.nih.go.kr; registration number: KCT000666).Trial status: Currently, participant recruitment is ongoing.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Fadiga/tratamento farmacológico , Neoplasias Pulmonares/complicações , Adulto , Fadiga/etiologia , Feminino , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego , Resultado do Tratamento , Adulto Jovem
6.
Medicine (Baltimore) ; 98(37): e17116, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517848

RESUMO

BACKGROUND: Buyang Huanwu Tang (BHT) is a well-known herbal complex used for stroke treatment and has been used mainly during post-stroke rehabilitation in East Asia. In this review, we aim to evaluate the efficacy and safety of BHT as a treatment for post-stroke fatigue (PSF). METHODS: Eight databases will be searched for relevant studies from inception to the present date. We will include randomized controlled trials (RCTs), which assess the effect and safety of BHT for the treatment of PSF. The methodological qualities, including the risk of bias (RoB), will be evaluated using the Cochrane RoB assessment tool. After screening the studies, a meta-analysis of the RCTs will be done. RESULTS: This study will provide high-quality synthesis of current evidence of BHT for PSF. CONCLUSION: The conclusion of our systematic review will provide evidence to judge whether BHT is an effective intervention for patients with PSF. ETHICS AND DISSEMINATION: Ethical approval is not required, as this study is based on the review of published research. This review will be published in a peer-reviewed journal and disseminated both electronically and in print. TRIAL REGISTRATION NUMBER: PROSPERO CRD42019130178.


Assuntos
Medicamentos de Ervas Chinesas/normas , Fadiga/tratamento farmacológico , Acidente Vascular Cerebral/complicações , Medicamentos de Ervas Chinesas/uso terapêutico , Fadiga/etiologia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos
7.
Complement Ther Med ; 46: 29-35, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31519284

RESUMO

OBJECTIVES: Fatigue is a common problem in modern-day life. The aim of this study was to evaluate the effect of Delphinium denudatum (Jadwar) on fatigue. METHODS: This study was a randomized double-blind placebo-controlled clinical trial between healthy normal university students. In each group, participants were given one capsule of either WEACURE® (containing 500 mg of Jadwar root powder) or placebo for 15 consecutive days. Multidimensional Fatigue Inventory (MFI) questionnaire was used before and after the intervention to evaluate different aspects of fatigue. RESULTS: A total number of 64 participants completed the study. Data analysis showed decrease in the scores of all five domains of fatigue in Jadwar group (13.31 ±â€¯3.05-7.75 ±â€¯2.66, 12.31 ±â€¯3.55-7.63 ±â€¯2.62, 12.22 ±â€¯4.26-6.97 ±â€¯2.06, 11.56 ±â€¯4.21 to 7.28 ±â€¯2.37, 12.91 ±â€¯3.09-7.34 ±â€¯2.13 in general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue domains, respectively) which was statistically significant (P value<0.0001). This situation was significantly superior to the placebo group. Prescribed dosage of WEACURE® capsule was well tolerated. CONCLUSION: As a complementary tonic agent, Jadwar have a potential to reduce fatigue in normal population. However, objective evaluation of its anti-fatigue effect should be further evaluated.


Assuntos
Delphinium/química , Fadiga/tratamento farmacológico , Preparações de Plantas/uso terapêutico , Adulto , Método Duplo-Cego , Feminino , Humanos , Masculino , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
9.
Neurology ; 93(8): e733-e746, 2019 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-31331968

RESUMO

OBJECTIVE: To test a possible benefit of dalfampridine on information processing speed (IPS), a key function for cognitive impairment (CogIm) in multiple sclerosis (MS). METHODS: In this randomized, double-blind, placebo-controlled trial, we included patients with a score on the Symbol Digit Modalities Test (SDMT) under the 10th percentile of the reference value. Patients were randomized in a 2:1 ratio to receive dalfampridine 10 mg or placebo twice daily for 12 weeks. They underwent a comprehensive neuropsychological evaluation at screening (T0), at the end of treatment (T1), and after a 4-week follow-up (T2). The primary endpoint was improvement in SDMT. RESULTS: Out of 208 patients screened, 120 were randomized to receive either dalfampridine (n = 80) or placebo (n = 40). At T1, the dalfampridine group presented an increase of SDMT scores vs placebo group (mean change 9.9 [95% confidence interval (CI) 8.5-11.4] vs 5.2 [95% CI 2.8-7.6], p = 0.0018; d = 0.60 for raw score; and 0.8 [95% CI 0.6-1] vs 0.3 [95% CI 0.0-0.5], p = 0.0013; d = 0.61 for z scores; by linear mixed model with robust standard error). The improvement was not sustained at T2. A beneficial effect of dalfampridine was observed in the Paced Auditory Serial Addition Test and in cognitive fatigue. CONCLUSION: Dalfampridine could be considered as an effective treatment option for IPS impairment in MS. TRIAL REGISTRATION: 2013-002558-64 EU Clinical Trials Register. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that for patients with MS with low scores on the SDMT, dalfampridine improves IPS.


Assuntos
4-Aminopiridina/uso terapêutico , Transtornos Cognitivos/tratamento farmacológico , Esclerose Múltipla/tratamento farmacológico , Adolescente , Adulto , Idoso , Transtornos Cognitivos/complicações , Método Duplo-Cego , Fadiga/complicações , Fadiga/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Testes Neuropsicológicos/estatística & dados numéricos , Bloqueadores dos Canais de Potássio/uso terapêutico , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
10.
J Med Food ; 22(9): 944-951, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31339799

RESUMO

We developed low temperature-aged garlic (LTAG) to remove its unique and spicy flavor and evaluated the anti-fatigue properties of LTAG against exercise-induced fatigue in mice. In the results, the treadmill running time to exhaustion in the mice fed LTAG was prolonged compared with the control. There was significant difference in blood parameters of glucose, lactate, lactate dehydrogenase (LDH), and free fatty acid (FFA) concentration between the LTAG-fed mice and the control. In addition, LTAG effectively increased the content of glycogen and creatine kinase and the activity of antioxidant enzymes in the muscle. The mechanism underlying the anti-fatigue activity of LTAG is hypothesized to involve increase in postexercise tissue glycogen accumulation to improve the aerobic and anaerobic exercise capacity. LTAG may have an ergogenic effect on endurance exercise while decreasing the levels of FFA, LDH, and lactate, which are associated with the anti-fatigue effect. Thus, LTAG has potential as a pharmacological anti-fatigue agent.


Assuntos
Fadiga/tratamento farmacológico , Alho/química , Resistência Física/efeitos dos fármacos , Extratos Vegetais/administração & dosagem , Animais , Temperatura Baixa , Creatina Quinase/metabolismo , Suplementos Nutricionais/análise , Exercício , Fadiga/sangue , Fadiga/fisiopatologia , Ácidos Graxos não Esterificados/sangue , Glicogênio/metabolismo , Humanos , L-Lactato Desidrogenase/sangue , Ácido Láctico/sangue , Masculino , Camundongos , Camundongos Endogâmicos ICR , Músculo Esquelético/metabolismo
11.
Pak J Pharm Sci ; 32(3): 1011-1018, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31278714

RESUMO

Irpex lacteus is a white rot basidiomycete proposed for a wide spectrum of biotechnological applications. However, few studies examined its effects on exercise performance and physical fatigue. The present study evaluated the potential beneficial effects of I. lacteus extract (ILE) on physical fatigue in mice. Anti-fatigue activities of ILE were evaluated in Kunming mice using the forced swim test, rotating rod and forced running test. Serum and liver biochemical parameters were determined by an autoanalyzer and commercially available kits. Seven-day ILE administration at doses of 0.04, 0.2 and 1.0g/kg failed to influence mouse horizontal and vertical movement indicating its safety on the central nervous system. Compared with normal mice, ILE significantly increased persistent period during rotating rod and swimming tests, and reduced shock times in forced running test. Additionally, ILE resulted in 23.4% and 64.5% increments on adrenocorticotropic hormone and cortisol levels in serum. Compared with normal mice, and 209.0% increment on adenosine triphosphate level in liver (up to 2.5 mmol/gHb) were noted in ILE-treated mice. Moreover, ILE increased the level of super oxide dismutase and reduced the level of malondialdehyde in the liver suggesting its antioxidant activity. Data obtained from western bolt suggests that ILE-improved endurance capacity is mainly acquired through activating 5'-AMP-activated protein kinase (AMPK). ILE enhanced the endurance capacity of mouse by an elevation of antioxidant at least partially associated with AMPK pathway. Our data highlight the potential of I. lacteus as an antioxidant in the treatment of fatigue-related diseases.


Assuntos
Fadiga/tratamento farmacológico , Polissacarídeos Fúngicos/farmacologia , Polyporales/química , Proteínas Quinases Ativadas por AMP/metabolismo , Trifosfato de Adenosina/metabolismo , Hormônio Adrenocorticotrópico/metabolismo , Animais , Comportamento Animal/efeitos dos fármacos , Corticosterona/metabolismo , Modelos Animais de Doenças , Avaliação Pré-Clínica de Medicamentos , Fadiga/metabolismo , Feminino , Polissacarídeos Fúngicos/química , Fígado/efeitos dos fármacos , Fígado/metabolismo , Masculino , Malondialdeído/metabolismo , Camundongos , Resistência Física/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-akt/metabolismo , Teste de Desempenho do Rota-Rod , Superóxido Dismutase/metabolismo , Natação
12.
Food Chem Toxicol ; 131: 110541, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31150785

RESUMO

Studies on the development of non-dairy probiotic foods and beverages are emerging. The optimal Lactobacillus and carbon resources were screened to improve the viability of probiotics in blueberry pomace. During fermentation, the total titratable acid and the viable counts were measured and peaked at 24 h, 15.75 mM and 11.59 Log CFU mL-1 respectively. Lactic acid content increased from 2.361 mg mL-1 to 6.334 mg mL-1, while citric acid content was decreased significantly. Additionally, the antioxidant activity was improved, which may be attributed to the increase of total phenols and flavonoids up to 4629.21 µg GAE mL-1 and 404.99 µg RE mL-1. Simulated gastrointestinal digestion in vitro showed that the total polyphenols were decreased slightly, while anthocyanins were increased. We also studied the cholesterol-lowing capability of fermented BPL and found that the cholesterol-clearance rate could reach 67.17%. Moreover, through mice weight-loaded swimming experiments, we observed that the physical strength of mice fed a fermented juice for one month was significantly better than that of the control group (p < 0.05). Therefore, this study provides a high value application of blueberry pomace and the fermented blueberry pomace with probiotics as a new type of probiotic food can furnish potentially value to human health.


Assuntos
Antioxidantes/farmacologia , Fermentação , Lactobacillus plantarum/metabolismo , Lactobacillus rhamnosus/metabolismo , Extratos Vegetais/metabolismo , Probióticos/farmacologia , Animais , Antocianinas/análise , Anticolesterolemiantes/farmacologia , Antioxidantes/metabolismo , Mirtilos Azuis (Planta)/química , Colesterol/metabolismo , Fadiga/tratamento farmacológico , Flavonoides/análise , Frutas/química , Glucose/metabolismo , Masculino , Camundongos Endogâmicos C57BL , Fenóis/análise , Extratos Vegetais/química , Probióticos/metabolismo
13.
BMJ ; 365: l2006, 2019 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-31088853

RESUMO

CLINICAL QUESTION: What are the benefits and harms of thyroid hormones for adults with subclinical hypothyroidism (SCH)? This guideline was triggered by a recent systematic review of randomised controlled trials, which could alter practice. CURRENT PRACTICE: Current guidelines tend to recommend thyroid hormones for adults with thyroid stimulating hormone (TSH) levels >10 mIU/L and for people with lower TSH values who are young, symptomatic, or have specific indications for prescribing. RECOMMENDATION: The guideline panel issues a strong recommendation against thyroid hormones in adults with SCH (elevated TSH levels and normal free T4 (thyroxine) levels). It does not apply to women who are trying to become pregnant or patients with TSH >20 mIU/L. It may not apply to patients with severe symptoms or young adults (such as those ≤30 years old). HOW THIS GUIDELINE WAS CREATED: A guideline panel including patients, clinicians, and methodologists produced this recommendation in adherence with standards for trustworthy guidelines using the GRADE approach. THE EVIDENCE: The systematic review included 21 trials with 2192 participants. For adults with SCH, thyroid hormones consistently demonstrate no clinically relevant benefits for quality of life or thyroid related symptoms, including depressive symptoms, fatigue, and body mass index (moderate to high quality evidence). Thyroid hormones may have little or no effect on cardiovascular events or mortality (low quality evidence), but harms were measured in only one trial with few events at two years' follow-up. UNDERSTANDING THE RECOMMENDATION: The panel concluded that almost all adults with SCH would not benefit from treatment with thyroid hormones. Other factors in the strong recommendation include the burden of lifelong management and uncertainty on potential harms. Instead, clinicians should monitor the progression or resolution of the thyroid dysfunction in these adults. Recommendations are made actionable for clinicians and their patients through visual overviews. These provide the relative and absolute benefits and harms of thyroid hormones in multilayered evidence summaries and decision aids available in MAGIC (https://app.magicapp.org/) to support shared decisions and adaptation of this guideline.


Assuntos
Hipotireoidismo/tratamento farmacológico , Hormônios Tireóideos/uso terapêutico , Adulto , Idoso , Índice de Massa Corporal , Tomada de Decisões , Técnicas de Apoio para a Decisão , Depressão/tratamento farmacológico , Depressão/etiologia , Fadiga/tratamento farmacológico , Fadiga/etiologia , Feminino , Humanos , Hipotireoidismo/sangue , Hipotireoidismo/complicações , Hipotireoidismo/diagnóstico , Qualidade de Vida , Hormônios Tireóideos/efeitos adversos , Tireotropina/sangue , Tiroxina/sangue , Incerteza
14.
Biomed Pharmacother ; 116: 109003, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31125823

RESUMO

Trimetazidine (TMZ) has been shown to optimize myocardial energy metabolism and is a common anti-ischemic agent. Our trial (ChiCTR-TRC-13003298) aimed to explore whether TMZ has any preventive effect on high-altitude fatigue (HAF), cardiac function and cardiorespiratory fitness upon acute high-altitude exposure and how it works on HAF. Thirty-nine healthy young subjects were enrolled in a randomized double-blinded placebo-controlled trial and were randomized to take oral TMZ (n = 20) or placebo (n = 19), 20 mg tid, 14 days prior to departure until the end of study. The 2018 Lake Louise Score questionnaire, echocardiography, assessments of physical working capacity, circulating markers of myocardial energy metabolism and fatigue were performed both before departure and arrival at highland. At follow-up, TMZ significantly reduced the incidence of HAF (p = 0.038), reversed cardiorespiratory fitness impairment, decreased left ventricular end-systolic volume (LVESV, p = 0.032) and enhanced left ventricular ejection fraction (LVEF, p = 0.015) at highland. Relative to the placebo group, the TMZ group had significantly lower LDH (p = 0.025) and lactate levels before (p < 0.001) and after (p = 0.012) physical exercise after acute high-altitude exposure. Additionally, improved left ventricular systolic function might have contributed to ameliorating HAF during TMZ treatment (LVEF, OR = 0.859, 95% CI = 0.741-0.996, p = 0.044). In conclusion, our results demonstrated that TMZ could prevent HAF, cardiorespiratory fitness impairment and improves left ventricular systolic function during acute high-altitude exposure. This trial provides new insights into the effect of TMZ and novel evidence against HAF and cardiorespiratory fitness impairment at highland.


Assuntos
Altitude , Aptidão Cardiorrespiratória/fisiologia , Fadiga/tratamento farmacológico , Fadiga/fisiopatologia , Trimetazidina/uso terapêutico , Adolescente , Doença da Altitude/sangue , Doença da Altitude/tratamento farmacológico , Doença da Altitude/epidemiologia , Doença da Altitude/fisiopatologia , Método Duplo-Cego , Metabolismo Energético/efeitos dos fármacos , Fadiga/sangue , Testes de Função Cardíaca , Humanos , Incidência , L-Lactato Desidrogenase/sangue , Lactatos/sangue , Miocárdio/metabolismo , Placebos , Análise de Regressão , Sístole/efeitos dos fármacos , Trimetazidina/farmacologia , Função Ventricular Esquerda/efeitos dos fármacos , Adulto Jovem
15.
Ter Arkh ; 91(2): 134-142, 2019 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-31094184

RESUMO

AIM: To systematize the published data on the treatment of hepatogenic fatigue with аdеmethionine. MATERIALS AND METHODS: Search was performed using databases PubMed, EMBASE, Embase®, Medline®, eLIBRARY.ru, published in 1952-2018. RESULTS: 16 articles were found on the use of аdеmethionine in liver diseases and the assessment of the dynamics of the symptom of fatigue, including 1 double-blind, randomized, placebo-controlled study, 3 open randomized studies; most of the works were multicenter open observation programs. The studies included 3238 patients (of which 2820 were included in the final data analysis) and a wide range of liver diseases: alcoholic liver disease, nonalcoholic fatty liver disease, primary biliary cholangitis, primary sclerosing cholangitis, cirrhosis of different causes, viral hepatitis, drug-induced liver injury. Different doses, routes of administration of аdеmethionine and the duration of the course were used. CONCLUSION: Ademethionine, regardless of the route of administration, is effective in the treatment of fatigue due to different liver disease in the short and long term. The dose-dependent effect of the drug and the possibility of maintaining post-effect after end of the treatment course should be assumed, but this requires further study in randomized clinical trials.


Assuntos
Fadiga/tratamento farmacológico , Hepatopatias/complicações , S-Adenosilmetionina/uso terapêutico , Fadiga/etiologia , Humanos , Resultado do Tratamento
16.
J Med Food ; 22(4): 355-364, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30990752

RESUMO

Our study aimed to investigate the effects of the polysaccharide-rich extract of Phragmites rhizoma (PEP) against water immersion restraint (WIR) stress and forced swimming-induced fatigue. Exposure to WIR stress significantly increased the ulcer index, bleeding score, the weight of the adrenal gland, blood glucose concentrations, total cholesterol, cortisol, and creatine kinase (CK). The weight of the spleen decreased significantly. In addition, myeloperoxidase (MPO) and thiobarbituric acid-reactive substance (TBARS) were significantly upregulated by WIR stress. The antioxidative factors such as glutathione (GSH) and superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) in the stomach were decreased by WIR stress. Alterations induced by WIR stress were effectively reversed by pretreatment with PEP. The swimming endurance capacity of mice was significantly prolonged by the oral administration of PEP. Swimming-induced fatigue significantly reduced the body weight; however, the injection of PEP inhibited the decrease of body weight. The PEP-treated group had significantly lower CK levels in plasma, an indicator of muscle damage. These results indicated that PEP has anti-stress and anti-fatigue effects, which are mediated by suppressing the hyperactivation of the hypothalamus-pituitary-adrenal axis, and antagonism of the oxidative damages induced by WIR stress and prolonged swimming times.


Assuntos
Fadiga/tratamento farmacológico , Extratos Vegetais/administração & dosagem , Poaceae/química , Polissacarídeos/administração & dosagem , Animais , Catalase/metabolismo , Modelos Animais de Doenças , Fadiga/metabolismo , Fadiga/fisiopatologia , Glutationa/metabolismo , Glutationa Peroxidase/metabolismo , Humanos , Masculino , Camundongos , Camundongos Endogâmicos ICR , Peroxidase/metabolismo , Extratos Vegetais/química , Polissacarídeos/química , Rizoma/química , Estresse Fisiológico/efeitos dos fármacos , Superóxido Dismutase/metabolismo , Natação
17.
Fertil Steril ; 112(2): 298-304.e3, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30992150

RESUMO

OBJECTIVE: To evaluate the efficacy of elagolix, an oral GnRH antagonist, for the reduction of fatigue in women with moderate or severe endometriosis-associated pain. DESIGN: Randomized, double-blind, multicenter, placebo-controlled phase III trial. SETTING: Clinics. PATIENT(S): A total of 860 women treated with elagolix or placebo. INTERVENTION(S): Women received either elagolix at 150 mg daily (QD) orally, elagolix at 200 mg twice daily (BID) orally, or placebo. MAIN OUTCOME MEASURE(S): Change from baseline to month 1, 3, and 6 visits, in Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Short Form 6a questionnaire T-scores. RESULTS(S): At baseline, 54%-74% of women with moderate to severe pain associated with endometriosis reported having fatigue-related issues "quite a bit" or "very much," depending on the question asked. Fatigue extent was reduced to 29%-43% and 14%-29% for women treated with elagolix at 150 mg QD and 200 mg BID, respectively, at 6 months, compared with 35%-50% with placebo. The resultant decrease in fatigue T-scores was significant after elagolix treatment compared with placebo at 6 months, with changes of -2.21 and -5.90 with elagolix at 150 mg QD and 200 mg BID, respectively. Significant reduction in fatigue scores were observed among patients reporting clinically meaningful response "reduction" in dysmenorrhea, nonmenstrual pelvic pain, and dyspareunia (-7.31, -6.62, and -4.31, respectively) compared with nonresponders. CONCLUSION(S): In women with moderate to severe endometriosis related pain, elagolix significantly reduces fatigue levels.


Assuntos
Endometriose/tratamento farmacológico , Fadiga/tratamento farmacológico , Hidrocarbonetos Fluorados/uso terapêutico , Dor Pélvica/tratamento farmacológico , Pirimidinas/uso terapêutico , Doenças Uterinas/tratamento farmacológico , Adolescente , Adulto , Método Duplo-Cego , Endometriose/complicações , Fadiga/etiologia , Feminino , Hormônio Liberador de Gonadotropina/antagonistas & inibidores , Antagonistas de Hormônios/uso terapêutico , Humanos , Pessoa de Meia-Idade , Medição da Dor , Dor Pélvica/etiologia , Dor Pélvica/patologia , Placebos , Índice de Gravidade de Doença , Resultado do Tratamento , Doenças Uterinas/complicações , Adulto Jovem
18.
Molecules ; 24(6)2019 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-30934545

RESUMO

Sonchus arvensis L. is a nutritious vegetable and herbal medicine that is consumed worldwide. The aim of this study was to evaluate the anti-fatigue effects and underlying effects of aqueous extract of Sonchus arvensis L. (SA). Male C57BL/6 mice from four groups designated vehicle, exercise, exercise with low dose (250 mg/kg) or high dose of SA (500 mg/kg), were trained by swimming exercise and orally administrated with SA every other day for 28 days. The anti-fatigue activity was determined by exhaustive swimming test, as well as the muscle structure, levels of blood hemoglobin, and metabolites including lactate and urea nitrogen. SA alleviated mice fatigue behaviors by eliminating metabolites, while improving muscle structure and hemoglobin levels. Moreover, SA enhanced glycogen synthesis of liver but not muscle via increasing GCK and PEPCK gene expressions. Importantly, SA improved antioxidant enzymes expression and activities in both liver and muscle, which was possibly related to its primary components polysaccharides and the antioxidant components including chlorogenic acid, luteolin, and chicoric acid. Taken together, the anti-fatigue effects of SA could be partly explained by its antioxidant activity and mediating effects on glycogen synthesis and metabolites elimination. Therefore, SA could be a potential nutraceutical for improving exercise performance and alleviating physical fatigue.


Assuntos
Fadiga/metabolismo , Extratos Vegetais/farmacologia , Sonchus/química , Animais , Biomarcadores , Fadiga/tratamento farmacológico , Regulação Enzimológica da Expressão Gênica/efeitos dos fármacos , Glicogênio/metabolismo , Histocitoquímica , Fígado/efeitos dos fármacos , Fígado/metabolismo , Imagem por Ressonância Magnética , Masculino , Camundongos , Atividade Motora/efeitos dos fármacos , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Consumo de Oxigênio/efeitos dos fármacos , Condicionamento Físico Animal , Extratos Vegetais/química
19.
Complement Ther Med ; 43: 181-187, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30935528

RESUMO

AIMS: A number of studies have examined the beneficial effects of Coenzyme Q10 (CoQ10) on fatigue in different population, but the findings have been inconclusive. Herein, we systematically reviewed available interventional studies to elucidate the overall effects of CoQ10 supplementation on fatigue among adolescent and adult population. METHODS: PubMed, Cochrane's library, Science direct, Scopus, Google scholar and ISI web of science databases were searched for all available literature until April 2018 for studies assessing the effects of CoQ10 supplementation on fatigue. The Cochrane bias assessment tool were used to assess the quality of studies. RESULTS: A total of 16 studies out of 1316 met our inclusion criteria and included in our systematic review. Among included studies 10 of them showed significant beneficial effects (p < 0.05) of CoQ10 supplementation on fatigue status among healthy, fibromyalgia, statin-related fatigue, multiple sclerosis and end-stage heart failure subjects. CoQ10 supplementation could alleviate fatigue, but differences between studies population should be taken into account. CONCLUSION: It seems CoQ10 has better therapeutic effects in statin-related fatigue and fibromyalgia patients compared with the other disease related fatigue. Finally, in order to draw a firm link between CoQ10 and fatigue, more clinical trials with adequate sample size and with sufficient follow-up periods are needed.


Assuntos
Fadiga/tratamento farmacológico , Ubiquinona/análogos & derivados , Suplementos Nutricionais , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Terapia Nutricional/métodos , Ubiquinona/uso terapêutico
20.
Complement Ther Med ; 43: 44-48, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30935553

RESUMO

BACKGROUND AND PURPOSE: Fatigue is one of the most prevalent adverse events reported by cancer patients. The aim of this study was to investigate the association between traditional Chinese medicine body constitution (TCMBC) and moderate-to-severe cancer-related fatigue in cancer patients. MATERIALS AND METHODS: A cross-sectional study was conducted on cancer patients recruited from a regional hospital in southern Taiwan. The association between TCMBC, measured using the Constitution in Chinese Medicine Questionnaire (CCMQ) and moderate-to-severe cancer-related fatigue (based on the Taiwanese version of the Brief Fatigue Inventory score ≥ 4) was evaluated using multiple logistic regression analysis. RESULTS: Of the 170 participants, 37 (21.8%) had moderate-to-severe fatigue. Yang-deficiency (adjusted odds ratio [aOR] = 3.55, 95% confidence interval [CI] = 1.50-8.40) and Qi-deficiency (aOR = 2.84, 95% CI = 1.18-6.82) TCMBC were significantly associated with moderate-to-severe cancer-related fatigue. CONCLUSION: TCMBC could be used as a clinical tool to identify cancer patients prone to experience moderate-to-severe cancer-related fatigue, and to provide Chinese medicine practitioners a basis for selecting an appropriate treatment approach based on TCMBC.


Assuntos
Constituição Corporal/fisiologia , Fadiga/tratamento farmacológico , Fadiga/etiologia , Neoplasias/complicações , Estudos Transversais , Feminino , Humanos , Masculino , Medicina Tradicional Chinesa , Pessoa de Meia-Idade , Terapias Mente-Corpo/métodos , Prevalência , Qi , Taiwan , Deficiência da Energia Yang/tratamento farmacológico
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