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3.
Clin Nurse Spec ; 34(2): 45-47, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32068631

RESUMO

Recently, there seems to be more creative advertising regarding bismuth subsalicylate (BSS) for lots of gastrointestinal issues. I have found during medication reconciliation that some patients overuse and believe use of BSS products is without risks. From an advertising perspective, there seem to be many happy persons consuming BSS with no mention of restrictions or safety recommendations. What are the risks associated with its use? How effective is BSS? What about drug interactions?


Assuntos
Bismuto/uso terapêutico , Compostos Organometálicos/uso terapêutico , Salicilatos/uso terapêutico , Bismuto/efeitos adversos , Medicina de Família e Comunidade , Humanos , Enfermeiras Clínicas , Compostos Organometálicos/efeitos adversos , Salicilatos/efeitos adversos
5.
Artigo em Inglês | MEDLINE | ID: mdl-31084597

RESUMO

BACKGROUND: Travelers' diarrhea is the most common travel-related malady. It affects millions of international travelers to developing countries annually and can significantly disrupt travel plans. OBJECTIVE: To provide an update on the evaluation, diagnosis, treatment, and prevention of traveler's diarrhea. METHODS: A PubMed search was completed in Clinical Queries using the key term "traveler's diarrhea". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. The search was restricted to English literature. Patents were searched using the key term "traveler's diarrhea" from www.freepatentsonline.com. RESULTS: Between 10% and 40% of travelers develop diarrhea. The attack rate is highest for travelers from a developed country who visit a developing country. Children are at particular risk. Travelers' diarrhea is usually acquired through ingestion of food and water contaminated by feces. Most cases are due to a bacterial pathogen, commonly, Escherichia coli, and occur within the first few days after arrival in a foreign country. Dehydration is the most common complication. Pretravel education on hygiene and on the safe selection of food items is important in minimizing episodes. For mild travelers' diarrhea, the use of antibiotic is not recommended. The use of bismuth subsalicylate or loperamide may be considered. For moderate travelers' diarrhea, antibiotics such as fluoroquinolones, azithromycin, and rifaximin may be used. Loperamide may be considered as monotherapy or adjunctive therapy. For severe travelers' diarrhea, antibiotics such as azithromycin, fluoroquinolones, and rifaximin should be used. Azithromycin can be used even for the treatment of dysentery whereas fluoroquinolones and rifaximin cannot be used for such purpose. Recent patents related to the management of travelers' diarrhea are discussed. CONCLUSION: Although travelers' diarrhea is usually self-limited, many travelers prefer expedient relief of diarrhea, especially when they are traveling for extended periods by air or ground. Judicious use of an antimotility agent and antimicrobial therapy reduces the duration and severity of diarrhea.


Assuntos
Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Bismuto/uso terapêutico , Disenteria/tratamento farmacológico , Infecções por Escherichia coli/tratamento farmacológico , Escherichia coli/fisiologia , Loperamida/uso terapêutico , Compostos Organometálicos/uso terapêutico , Salicilatos/uso terapêutico , Desidratação , Países em Desenvolvimento , Fluoroquinolonas/uso terapêutico , Contaminação de Alimentos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Educação de Pacientes como Assunto
7.
J Cell Physiol ; 234(7): 11792-11804, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30515822

RESUMO

Osteoporosis is a form of osteolytic disease caused by an imbalance in bone homeostasis, with reductions in osteoblast bone formation, and augmented osteoclast formation and resorption resulting in reduced bone mass. Cajaninstilbene acid (CSA) is a natural compound derived from pigeon pea leaves. CSA possesses beneficial properties as an anti-inflammatory, antibacterial, antihepatitis, and anticancer agent; however, its potential to modulate bone homeostasis and osteoporosis has not been studied. We observed that CSA has the ability to suppress RANKL-mediated osteoclastogenesis, osteoclast marker gene expression, and bone resorption in a dose-dependent manner. Mechanistically, it was revealed that CSA attenuates RANKL-activated NF-κB and nuclear factor of activated T-cell pathways and inhibited phosphorylation of key signaling mediators c-Fos, V-ATPase-d2, and ERK. Moreover, in osteoclasts, CSA blocked RANKL-induced ROS activity as well as calcium oscillations. We further evaluated the therapeutic effect of CSA in a preclinical mouse model and showed that in vivo treatment of ovariectomized C57BL/6 mice with CSA protects the mice from osteoporotic bone loss. Thus, this study demonstrates that osteolytic bone diseases can potentially be treated by CSA.


Assuntos
Osteoclastos/patologia , Osteoporose/tratamento farmacológico , Osteoporose/patologia , Ligante RANK/metabolismo , Salicilatos/uso terapêutico , Transdução de Sinais , Estilbenos/uso terapêutico , Animais , Reabsorção Óssea/tratamento farmacológico , Reabsorção Óssea/genética , Reabsorção Óssea/patologia , Cálcio/metabolismo , Regulação da Expressão Gênica/efeitos dos fármacos , Camundongos Endogâmicos C57BL , NF-kappa B/metabolismo , Fatores de Transcrição NFATC/metabolismo , Osteoblastos/efeitos dos fármacos , Osteoblastos/metabolismo , Osteoblastos/patologia , Osteoclastos/efeitos dos fármacos , Osteogênese/efeitos dos fármacos , Osteoporose/genética , Ovariectomia , Espécies Reativas de Oxigênio/metabolismo , Salicilatos/química , Salicilatos/farmacologia , Transdução de Sinais/efeitos dos fármacos , Estilbenos/química , Estilbenos/farmacologia
8.
J Am Acad Dermatol ; 81(2): 313-324, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30550830

RESUMO

Chemical peeling, or chemexfoliation, has been used for centuries to improve signs of ultraviolet light-induced sun damage. Over the last 30 years, the science behind chemical peeling has evolved, increasing our understanding of the role of peeling ingredients and treatment indications. The depth of peels is directly related to improved results and to the number of complications that can occur. Key principles for superficial and medium depth peeling are discussed, as well as appropriate indications for these treatments.


Assuntos
Cáusticos/uso terapêutico , Abrasão Química/métodos , Ceratolíticos/uso terapêutico , Dermatopatias/terapia , Abrasão Química/efeitos adversos , Combinação de Medicamentos , Etanol/uso terapêutico , Glicolatos/uso terapêutico , Humanos , Ácido Láctico/uso terapêutico , Fenol/uso terapêutico , Resorcinóis/uso terapêutico , Salicilatos/uso terapêutico , Ácido Salicílico/uso terapêutico , Tretinoína/uso terapêutico , Ácido Tricloroacético/uso terapêutico
9.
Clin Ther ; 40(12): 2021-2030.e1, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30447891

RESUMO

PURPOSE: Flushing and gastrointestinal (GI) events are commonly associated with the use of delayed-release dimethyl fumarate (DMF) treatment for relapsing multiple sclerosis. METHODS: PREVENT (A Multicenter, Double-Blind, Placebo-Controlled Study of Pepto-Bismol [Bismuth Subsalicylate] on Gastrointestinal Tolerability in Healthy Volunteers Receiving Oral TECFIDERA [Dimethyl Fumarate] Delayed-Release Capsules Twice Daily) is a double-blind, placebo-controlled, 8-week study that evaluated the effect of bismuth subsalicylate on DMF-related GI events. Bismuth subsalicylate 524 mg or placebo were administered 30 min before DMF (weeks 1-4). DMF was dosed twice-daily (BID) at 120 mg (week 1) and 240 mg (weeks 2-8). Using an e-diary device, participants recorded GI and flushing events on the Modified Overall Gastrointestinal Symptom Scale once daily for the preceding 24 h. The primary end point was time to first GI-related event. Secondary end points included frequency and severity of GI-related events. FINDINGS: A total of 175 participants were enrolled (placebo, n = 87; bismuth subsalicylate, n = 88), and 17 discontinued treatment (placebo, n = 8; bismuth subsalicylate n = 9). A total of 146 participants reported ≥1 GI event: placebo, n = 72 (82.8%); and bismuth subsalicylate, n = 74 (84.1%). There was no statistical difference in risk of a GI event between the groups (P = 0.8292). Mean (SD) time from DMF initiation to first GI event was similar: placebo, 5.4 (8.73) days; and bismuth subsalicylate, 5.6 (10.87) days. Incidence of flatulence (38.6% vs 50.6%) and diarrhea (36.4% vs 48.2%) during weeks 1-4 was numerically lower in the bismuth subsalicylate group compared with the placebo group. Mean worst severity scores for flatulence (1.1 vs 1.8; P = 0.0219) and diarrhea (1.0 vs 1.6; P = 0.0500) were lower with bismuth subsalicylate than with placebo. IMPLICATIONS: Although coadministration of bismuth subsalicylate did not affect the occurrence of DMF-related GI events overall, it reduced the severity and incidence of flatulence and diarrhea. ClinicalTrials.gov identifier: NCT01915901.


Assuntos
Antidiarreicos/uso terapêutico , Bismuto/uso terapêutico , Diarreia/tratamento farmacológico , Fumarato de Dimetilo/efeitos adversos , Imunossupressores/efeitos adversos , Compostos Organometálicos/uso terapêutico , Salicilatos/uso terapêutico , Adolescente , Adulto , Preparações de Ação Retardada/uso terapêutico , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Flatulência/tratamento farmacológico , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Adulto Jovem
10.
J Cosmet Dermatol ; 17(5): 802-810, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30203434

RESUMO

BACKGROUND: Successful management of acne involves choosing proper medication. Chemical peeling is a well-known option in treatment of acne vulgaris. OBJECTIVE: To evaluate and compare the clinical efficacy and safety of combination chemical peels vs single peel in treatment of mild-to-moderate acne. METHODS: The study included 45 patients with mild-to-moderate acne divided into three equal groups. Group A underwent combination sequential peels with modified Jessner's solution (MJ) followed by trichloro acetic acid (TCA20%) on the right (Rt) side of the face vs TCA 30% on the left (Lt) side. Group B was treated by combination peels of salicylic (20%) mandelic (10%) (SM) mixture on the Rt half vs salicylic acid 30% on the Lt half. Group C underwent combination sequential peeling of MJ and TCA on the Rt side vs SM combination peels on the Lt side. All patients received six sessions with 2-week intervals and followed up for 3 months after the last session. Side effects were reported. RESULTS: Both sides of the face showed significant improvement of acne lesions but improvement was significantly higher and earlier in sides treated by combination peels. Side effects were minimal. CONCLUSION: In conclusion, combination peels achieved a higher and earlier therapeutic response with a reasonable cost that is maintained for a relatively long periods than single peel. Combination sequential peels gave the best results.


Assuntos
Acne Vulgar/diagnóstico , Acne Vulgar/tratamento farmacológico , Abrasão Química/métodos , Ceratolíticos/uso terapêutico , Adulto , Análise de Variância , Combinação de Medicamentos , Quimioterapia Combinada , Etanol/uso terapêutico , Feminino , Glicolatos/uso terapêutico , Humanos , Ácido Láctico/uso terapêutico , Masculino , Análise Multivariada , Prognóstico , Resorcinóis/uso terapêutico , Salicilatos/uso terapêutico , Ácido Salicílico/uso terapêutico , Índice de Gravidade de Doença , Resultado do Tratamento , Ácido Tricloroacético/uso terapêutico , Adulto Jovem
11.
Trials ; 19(1): 375, 2018 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-30005644

RESUMO

BACKGROUND: The potential of neuroprotective agents should be revisited in the era of endovascular thrombectomy (EVT) for acute large-artery occlusion because their preclinical effects have been optimized for ischemia and reperfusion injury. Neu2000, a derivative of sulfasalazine, is a multi-target neuroprotectant. It selectively blocks N-methyl-D-aspartate receptors and scavenges for free radicals. This trial aimed to determine whether neuroprotectant administration before EVT is safe and leads to a more favorable outcome. METHODS: This trial is a phase-II, multicenter, three-arm, randomized, double-blinded, placebo-controlled, blinded-endpoint drug trial that enrolled participants aged ≥ 19 years undergoing an EVT attempt less than 8 h from symptom onset, with baseline National Institutes of Health Stroke Scale (NIHSS) score ≥ 8, Alberta Stroke Program Early CT score ≥ 6, evidence of large-artery occlusion, and at least moderate collaterals on computed tomography angiography. EVT-attempted patients are randomized into control, low-dose (2.75 g), and high-dose (5.25 g) Neu2000KWL over 5 days. Seventy participants per group are enrolled for 90% power, assuming that the treatment group has a 28.4% higher proportion of participants with functional independence than the placebo group. The primary outcome, based on intention-to-treat criteria is the improvement of modified Rankin Scale (mRS) scores at 3 months using a dichotomized model. Safety outcomes include symptomatic intracranial hemorrhage within 5 days. Secondary outcomes are distributional change of mRS, mean differences in NIHSS score, proportion of NIHSS score 0-2, and Barthel Index > 90 at 1 and 4 weeks, and 3 months. DISCUSSION: The trial results may provide information on new therapeutic options as multi-target neuroprotection might mitigate reperfusion injury in patients with acute ischemic stroke before EVT. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT02831088 . Registered on 13 July 2016.


Assuntos
Isquemia Encefálica/terapia , Procedimentos Endovasculares , Fluorbenzenos/uso terapêutico , Fármacos Neuroprotetores/uso terapêutico , Salicilatos/uso terapêutico , Acidente Vascular Cerebral/terapia , Trombectomia/métodos , meta-Aminobenzoatos/uso terapêutico , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/fisiopatologia , Ensaios Clínicos Fase II como Assunto , Avaliação da Deficiência , Método Duplo-Cego , Procedimentos Endovasculares/efeitos adversos , Fluorbenzenos/efeitos adversos , Humanos , Estudos Multicêntricos como Assunto , Fármacos Neuroprotetores/efeitos adversos , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Recuperação de Função Fisiológica , República da Coreia , Salicilatos/efeitos adversos , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Trombectomia/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , meta-Aminobenzoatos/efeitos adversos
12.
Cochrane Database Syst Rev ; 7: CD012171, 2018 07 25.
Artigo em Inglês | MEDLINE | ID: mdl-30043448

RESUMO

BACKGROUND: Ear wax (cerumen) is a normal bodily secretion that can become a problem when it obstructs the ear canal. Symptoms attributed to wax (such as deafness and pain) are among the commonest reasons for patients to present to primary care with ear trouble.Wax is part of the ear's self-cleaning mechanism and is usually naturally expelled from the ear canal without causing problems. When this mechanism fails, wax is retained in the canal and may become impacted; interventions to encourage its removal may then be needed. Application of ear drops is one of these methods. Liquids used to remove and soften wax are of several kinds: oil-based compounds (e.g. olive or almond oil); water-based compounds (e.g. sodium bicarbonate or water itself); a combination of the above or non-water, non-oil-based solutions, such as carbamide peroxide (a hydrogen peroxide-urea compound) and glycerol. OBJECTIVES: To assess the effects of ear drops (or sprays) to remove or aid the removal of ear wax in adults and children. SEARCH METHODS: We searched the Cochrane ENT Trials Register; Cochrane Register of Studies; PubMed; Ovid Embase; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the most recent search was 23 March 2018. SELECTION CRITERIA: Randomised controlled trials (RCTs) in which a 'cerumenolytic' was compared with no treatment, water or saline, an alternative liquid treatment (oil or almond oil) or another 'cerumenolytic' in adults or children with obstructing or impacted ear wax. DATA COLLECTION AND ANALYSIS: We used the standard methodological procedures expected by Cochrane. The primary outcomes were 1) the proportion of patients (or ears) with complete clearance of ear wax and 2) adverse effects (discomfort, irritation or pain). Secondary outcomes were: extent of wax clearance; proportion of people (or ears) with relief of symptoms due to wax; proportion of people (or ears) requiring further intervention to remove wax; success of mechanical removal of residual wax following treatment; any other adverse effects recorded and cost. We used GRADE to assess the quality of the evidence for each outcome; this is indicated in italics. MAIN RESULTS: We included 10 studies, with 623 participants (900 ears). Interventions included: oil-based treatments (triethanolamine polypeptide, almond oil, benzocaine, chlorobutanol), water-based treatments (docusate sodium, carbamide peroxide, phenazone, choline salicylate, urea peroxide, potassium carbonate), other active comparators (e.g. saline or water alone) and no treatment. Nine of the studies were more than 15 years old.The overall risk of bias across the 10 included studies was low or unclear. PRIMARY OUTCOME: proportion of patients (or ears) with complete clearance of ear waxSix studies (360 participants; 491 ears) contributed quantitative data and were included in our meta-analyses.Active treatment versus no treatmentOnly one study addressed this comparison. The proportion of ears with complete clearance of ear wax was higher in the active treatment group (22%) compared with the no treatment group (5%) after five days of treatment (risk ratio (RR) 4.09, 95% confidence interval (CI) 1.00 to 16.80); one study; 117 ears; NNTB = 8) (low-quality evidence).Active treatment versus water or salineWe found no evidence of a difference in the proportion of patients (or ears) with complete clearance of ear wax when the active treatment group was compared to the water or saline group (RR 1.47, 95% CI 0.79 to 2.75; three studies; 213 participants; 257 ears) (low-quality evidence). Two studies applied drops for five days, but one study only applied the drops for 15 minutes. When we excluded this study in a sensitivity analysis it did not change the result.Water or saline versus no treatmentThis comparison was only addressed in the single study cited above (active versus no treatment) and there was no evidence of a difference in the proportion of ears with complete wax clearance when comparing water or saline with no treatment after five days of treatment (RR 4.00, 95% CI 0.91 to 17.62; one study; 76 ears) (low-quality evidence).Active treatment A versus active treatment BSeveral single studies evaluated 'head-to-head' comparisons between two active treatments. We found no evidence to show that one was superior to any other.Subgroup analysis of oil-based active treatments versus non-oil based active treatmentsWe found no evidence of a difference in this outcome when oil-based treatments were compared with non-oil-based active treatments. PRIMARY OUTCOME: adverse effects: discomfort, irritation or painOnly seven studies planned to measure and did report this outcome. Only two (141 participants;176 ears) provided useable data. There was no evidence of a significant difference in the number of adverse effects between the types of ear drops in these two studies. We summarised the remaining five studies narratively. All events were mild and reported in fewer than 30 participants across the seven studies (low-quality evidence).Secondary outcomesThree studies reported 'other' adverse effects (how many studies planned to report these is unclear). The available information was limited and included occasional reports of dizziness, unpleasant smell, tinnitus and hearing loss. No significant differences between groups were reported. There were no emergencies or serious adverse effects reported in any of the 10 studies.There was very limited or no information available on our remaining secondary outcomes. AUTHORS' CONCLUSIONS: Although a number of studies aimed to evaluate whether or not one type of cerumenolytic is more effective than another, there is no high-quality evidence to allow a firm conclusion to be drawn and the answer remains uncertain.A single study suggests that applying ear drops for five days may result in a greater likelihood of complete wax clearance than no treatment at all. However, we cannot conclude whether one type of active treatment is more effective than another and there was no evidence of a difference in efficacy between oil-based and water-based active treatments.There is no evidence to show that using saline or water alone is better or worse than commercially produced cerumenolytics. Equally, there is also no evidence to show that using saline or water alone is better than no treatment.


Assuntos
Cerume , Meato Acústico Externo , Higiene , Tensoativos/uso terapêutico , Adulto , Antipirina/uso terapêutico , Benzocaína/uso terapêutico , Peróxido de Carbamida , Carbonatos/uso terapêutico , Criança , Clorobutanol/uso terapêutico , Colina/análogos & derivados , Colina/uso terapêutico , Ácido Dioctil Sulfossuccínico/uso terapêutico , Combinação de Medicamentos , Etanolaminas/uso terapêutico , Humanos , Peróxidos/uso terapêutico , Soluções Farmacêuticas/uso terapêutico , Óleos Vegetais/uso terapêutico , Potássio/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Salicilatos/uso terapêutico , Cloreto de Sódio/uso terapêutico , Ureia/análogos & derivados , Ureia/uso terapêutico , Água
14.
J Ayub Med Coll Abbottabad ; 30(1): 35-39, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29504326

RESUMO

BACKGROUND: Despite a plethora of studies done comparing different obturation techniques using gutta-percha, there is no consensus as to which obturation technique results in a 'better' sealing of root canal space. Aims of the study are to compare mean apical micro leakage in root canals of extracted teeth obturated with cold laterally compacted gutta-percha and thermoplasticised injectable gutta-percha using calcium hydroxide based sealer. METHODS: It was an in-vitro experimental study carried out using extracted teeth. After access cavity preparation and canal preparation in 70 teeth, they were randomly divided into 2 groups and filled with two different obturation techniques using Sealapex sealer. Teeth were placed in 2.0% methylene blue solution, sectioned longitudinally, observed under microscope and images were captured using microscope attached camera. Amount of dye penetration was measured in millimetre from apex to most coronal part of dye penetration. Data was analysed using SPSS 20.0. Mean and standard deviation of continuous variables was computed. Independent Sample t- test was applied to compare micro leakage values in the two study groups. Level of significance was kept at 0.05. RESULTS: According to the measurements, obturation with Obtura-II and Sealapex was leakier than the other group, with a mean dye penetration of 1.91±1.15 mm. There was a statistically significant difference in dye penetration among the two groups.. CONCLUSIONS: Cold lateral compaction plus Sealapex was the best combination for obturation as it exhibited least microleakage. Obtura IISealapex combination should be used with caution as it showed maximum microleakage. For obturation of single rooted teeth, we recommend cold lateral condensation with Sealapex sealer as it showed better sealability. Obtura-II and Sealapex should be used with caution in single rooted teeth as this group showed the maximum leakage..


Assuntos
Hidróxido de Cálcio/uso terapêutico , Infiltração Dentária , Guta-Percha/uso terapêutico , Materiais Restauradores do Canal Radicular/uso terapêutico , Obturação do Canal Radicular/métodos , Salicilatos/uso terapêutico , Cavidade Pulpar , Humanos , Preparo de Canal Radicular
15.
Toxicol Appl Pharmacol ; 345: 1-9, 2018 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-29524504

RESUMO

BACKGROUND AND PURPOSE: Protein modification by small ubiquitin-like modifier (SUMO) plays a critical role in the pathogenesis of heart diseases. The present study was designed to determine whether ginkgolic acid (GA) as a SUMO-1 inhibitor exerts an inhibitory effect on cardiac fibrosis induced by myocardial infarction (MI). EXPERIMENTAL APPROACH: GA was delivered by osmotic pumps in MI mice. Masson staining, electron microscopy (EM) and echocardiography were used to assess cardiac fibrosis, ultrastructure and function. Expression of SUMO-1, PML, TGF-ß1 and Pin1 was measured with Western blot or Real-time PCR. Collagen content, cell viability and myofibroblast transformation were measured in neonatal mouse cardiac fibroblasts (NMCFs). Promyelocytic leukemia (PML) protein was over-expressed by plasmid transfection. KEY RESULTS: GA improved cardiac fibrosis and dysfunction, and decreased SUMO-1 expression in MI mice. GA (>20 µM) inhibited NMCF viability in a dose-dependent manner. Nontoxic GA (10 µM) restrained angiotensin II (Ang II)-induced myofibroblast transformation and collagen production. GA also inhibited expression of TGF-ß1 mRNA and protein in vitro and in vivo. GA suppressed PML SUMOylation and PML nuclear body (PML-NB) organization, and disrupted expression and recruitment of Pin1 (a positive regulator of TGF-ß1 mRNA), whereas over-expression of PML reversed that. CONCLUSIONS AND IMPLICATIONS: Inhibition of SUMO-1 by GA alleviated MI-induced heart dysfunction and fibrosis, and the SUMOylated PML/Pin1/TGF-ß1 pathway is crucial for GA-inhibited cardiac fibrosis.


Assuntos
Infarto do Miocárdio/tratamento farmacológico , Proteína SUMO-1/antagonistas & inibidores , Salicilatos/uso terapêutico , Animais , Animais Recém-Nascidos , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/fisiologia , Relação Dose-Resposta a Droga , Fibrose/tratamento farmacológico , Fibrose/metabolismo , Fibrose/patologia , Masculino , Camundongos , Infarto do Miocárdio/metabolismo , Infarto do Miocárdio/patologia , Proteína SUMO-1/metabolismo , Salicilatos/farmacologia , Volume Sistólico/efeitos dos fármacos , Volume Sistólico/fisiologia
16.
Hum Pathol ; 78: 1-7, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29452215

RESUMO

Although the presence of intraepithelial lymphocytosis with surface epithelial damage is a unifying feature of lymphocytic colitis, there are nonclassical features that create morphologic heterogeneity between cases. Limited data on the significance of these secondary histologic features are available. Cases of lymphocytic colitis diagnosed between 2002 and 2013 were identified using the Research Patient Data Registry of a tertiary referral center. Diagnostic biopsy slides were reviewed and evaluated for histologic features of lymphocytic colitis. Clinical data including type of therapy and response to treatment were collected. χ2 Test (or Fisher exact test) and logistic regression analysis were used where appropriate. Thirty-two cases of lymphocytic colitis with complete clinical data and slides available for review were identified. The mean age was 56.4 years, and the female-to-male ratio was 3:2. Eleven patients improved with minimal intervention (group 1), 14 patients responded to steroid therapy (group 2), and 7 patients responded to mesalamine, bismuth subsalicylate, and/or cholestyramine therapy (group 3). Histologic differences in the characteristics of the subepithelial collagen table (P = .018), the severity of lamina propria inflammation (P = .042), and the presence of eosinophil clusters (P = .016) were seen between groups 2 and 3. Patients in group 1 were more likely to have mild crypt architectural distortion in their biopsies than patients in groups 2 and 3. Lymphocytic colitis is a heterogeneous disease, and the evaluation of histologic factors may help identify various subtypes and predict therapy response.


Assuntos
Antidiarreicos/uso terapêutico , Colite Linfocítica/terapia , Mesalamina/uso terapêutico , Esteroides/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Bismuto/uso terapêutico , Colágeno/efeitos dos fármacos , Colágeno/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Compostos Organometálicos/uso terapêutico , Salicilatos/uso terapêutico , Resultado do Tratamento
17.
Br J Sports Med ; 52(10): 642-650, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29436380

RESUMO

OBJECTIVES: To compare the efficacy and safety of topical non-steroidal anti-inflammatory drugs (NSAIDs), including salicylate, for the treatment of osteoarthritis (OA). METHODS: PubMed, Embase, Cochrane Library and Web of Science were searched from 1966 to January 2017. Randomised controlled trials (RCTs) comparing topical NSAIDs with placebo or each other in patients with OA and observational studies comparing topical NSAIDs with no treatment or each other irrespective of disease were included. Two investigators identified studies and independently extracted data. Bayesian network and conventional meta-analyses were conducted. The primary outcomes were pain relief for RCTs and risk of adverse effects (AEs) for observational studies. RESULTS: 43 studies, comprising 36 RCTs (7 900 patients with OA) and seven observational studies (218 074 participants), were included. Overall, topical NSAIDs were superior to placebo for relieving pain (standardised mean difference (SMD)=-0.30, 95% CI -0.40 to -0.20) and improving function (SMD=-0.35, 95% CI -0.45 to -0.24) in OA. Of all topical NSAIDs, diclofenac patches were most effective for OA pain (SMD=-0.81, 95% CI -1.12 to -0.52) and piroxicam was most effective for functional improvement (SMD=-1.04, 95% CI -1.60 to -0.48) compared with placebo. Although salicylate gel was associated with higher withdrawal rates due to AEs, the remaining topical NSAIDs were not associated with any increased local or systemic AEs. CONCLUSIONS: Topical NSAIDs were effective and safe for OA. Diclofenac patches may be the most effective topical NSAID for pain relief. No serious gastrointestinal and renal AEs were observed in trials or the general population. However, confirmation of the cardiovascular safety of topical NSAIDs still warrants further observational study.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Osteoartrite/tratamento farmacológico , Dor/tratamento farmacológico , Administração Cutânea , Anti-Inflamatórios não Esteroides/efeitos adversos , Teorema de Bayes , Humanos , Metanálise em Rede , Ensaios Clínicos Controlados Aleatórios como Assunto , Salicilatos/efeitos adversos , Salicilatos/uso terapêutico , Adesivo Transdérmico
18.
Korean J Gastroenterol ; 72(5): 237-244, 2018 Nov 25.
Artigo em Coreano | MEDLINE | ID: mdl-30642139

RESUMO

While the prevalence of Helicobacter pylori (H. pylori) infection is decreasing in Korea, the incidence of gastric cancer remains high, emphasizing the importance of H. pylori eradication. A new treatment strategy is needed as the eradication rate with standard triple therapy, which is currently the standard first-line regimen for H. pylori infection, has decreased below the optimum level. The major cause of eradication failure is increased antibiotic resistance. Sequential, concurrent, and hybrid therapies that include clarithromycin produce higher eradication rates than conventional standard triple therapy. However, the effectiveness of these treatments is limited in regions where the resistance rate to various antibiotics is high. Bismuth quadruple therapy is another alternative therapy, but again the eradication rate is not sufficiently high. Tailored therapy based on individual characteristics, including antibiotic susceptibility, may be ideal, but there are several limitations for clinical application and further research is needed. New potassium-competitive acid blocker-based therapies could emerge as effective alternatives in the near future. A consensus is needed to establish a strategy for applying new eradication therapies in Korea.


Assuntos
Antibacterianos/uso terapêutico , Infecções por Helicobacter/tratamento farmacológico , Amoxicilina/uso terapêutico , Esquema de Medicação , Farmacorresistência Bacteriana , Humanos , Metronidazol/uso terapêutico , Medicina de Precisão , Inibidores da Bomba de Prótons/uso terapêutico , Salicilatos/uso terapêutico
19.
Turk J Pediatr ; 60(4): 433-435, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30859770

RESUMO

Orgun A, Karagöl C, Pamuk U, Gürsu HA, Çetin I. A rare cause of facial nerve palsy in a young infant: Kawasaki disease. Turk J Pediatr 2018; 60: 433-435. Kawasaki disease (KD) is a vasculitis in which the most common complication is development of coronary aneurysms. Neurological complications rarely occur in KD patients such as facial nerve palsy (FNP). FNP associated with KD may indicate increased risk of coronary artery aneurysm. Infants with facial nerve paralysis and unexplained-prolonged febrile period should be evaluated with echocardiography. Here in, we present a 4-month-old female with FNP and unexplained fever who was diagnosed KD due to echocardiographic findings.


Assuntos
Paralisia Facial/etiologia , Síndrome de Linfonodos Mucocutâneos/diagnóstico , Anti-Inflamatórios não Esteroides/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Aneurisma Coronário/diagnóstico por imagem , Aneurisma Coronário/etiologia , Ecocardiografia/métodos , Enalapril/uso terapêutico , Feminino , Febre/etiologia , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Lactente , Síndrome de Linfonodos Mucocutâneos/complicações , Síndrome de Linfonodos Mucocutâneos/tratamento farmacológico , Salicilatos/uso terapêutico
20.
Eur J Cancer Prev ; 27(5): 502-506, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-28379883

RESUMO

To investigate the relative risk of cancer development in rheumatoid arthritis (RA) patients in Greece after taking into consideration treatment modalities. The present analysis used data on the medical history of 26 331 participants in the Greek arm of the European Prospective Investigation into Cancer and Nutrition that were collected at enrollment and thereafter during active follow-up. A history of RA and of drug treatment for the disease, as reported at baseline examination, was linked to cases of cancer reported during follow-up. A total of 91 (9.9%) patients with RA developed a cancer compared with 1542 (6.1%) patients without RA. The overall hazard ratios of all cancers increased 25% [95% confidence interval (CI): 1-54] among participants with prevalent RA, and almost all the site-specific incident cancer sites considered had rate ratios above unity. In terms of the contribution of RA medication, the hazard ratios of patients treated with salicylates was close to unity (1.07, 95% CI: 0.69-1.65), whereas those who were not treated with salicylates had a 31% (95% CI: 3-67) increased risk for cancer incidence compared with those without RA at baseline. RA patients have excess cancer risk because of either underlying complex disease pathways or treatment agents targeting immune function. Administration of salicylates appears to reduce the risk of developing malignancies.


Assuntos
Artrite Reumatoide/epidemiologia , Inibidores de Ciclo-Oxigenase/uso terapêutico , Neoplasias/epidemiologia , Salicilatos/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Artrite Reumatoide/tratamento farmacológico , Carcinogênese/efeitos dos fármacos , Inibidores de Ciclo-Oxigenase/farmacologia , Feminino , Seguimentos , Grécia/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias/prevenção & controle , Prevalência , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Salicilatos/farmacologia , Adulto Jovem
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