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3.
BMC Pulm Med ; 21(1): 187, 2021 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-34078339

RESUMO

BACKGROUND: Previous studies suggest that transient receptor potential (TRP) channels and neurogenic inflammation may be involved in idiopathic pulmonary fibrosis (IPF)-related high cough sensitivity, although the details of mechanism are largely unknown. Here, we aimed to further explore the potential mechanism involved in IPF-related high cough sensitivity to capsaicin challenge in a guinea pig model of pulmonary fibrosis induced by bleomycin. METHODS: Western blotting and real-time quantitative polymerase chain reaction (RT-qPCR) were employed to measure the expression of TRP channel subfamily A, member 1 (TRPA1) and TRP vanilloid 1 (TRPV1), which may be involved in the cough reflex pathway. Immunohistochemical analysis and RT-qPCR were used to detect the expression of neuropeptides substance P (SP), Neurokinin-1 receptor (NK1R), and calcitonin gene-related peptide (CGRP) in lung tissues. Concentrations of nerve growth factor (NGF), SP, neurokinin A (NKA), neurokinin B (NKB), and brain-derived neurotrophic factor (BDNF) in lung tissue homogenates were measured by ELISA. RESULTS: Cough sensitivity to capsaicin was significantly higher in the model group than that of the sham group. RT-qPCR and immunohistochemical analysis showed that the expression of TRPA1 and TRPV1 in the jugular ganglion and nodal ganglion, and SP, NK1R, and CGRP in lung tissue was significantly higher in the model group than the control group. In addition, expression of TRP and neurogenic factors was positively correlated with cough sensitivity of the experimental animals. CONCLUSION: Up-regulated expression of TRPA1 and TRPV1 in the cough reflex pathway and neurogenic inflammation might contribute to the IPF-related high cough sensitivity in guinea pig model.


Assuntos
Tosse/metabolismo , Fibrose Pulmonar Idiopática/fisiopatologia , Pulmão/patologia , Canal de Cátion TRPA1/metabolismo , Canais de Cátion TRPV/metabolismo , Animais , Bleomicina , Tosse/induzido quimicamente , Modelos Animais de Doenças , Progressão da Doença , Cobaias , Pulmão/metabolismo , Masculino , Inflamação Neurogênica/induzido quimicamente , Inflamação Neurogênica/metabolismo , Substância P/efeitos adversos , Substância P/metabolismo , Canal de Cátion TRPA1/genética , Canais de Cátion TRPV/genética
5.
J Med Chem ; 64(10): 6656-6669, 2021 05 27.
Artigo em Inglês | MEDLINE | ID: mdl-33998786

RESUMO

The nociceptin/orphanin FQ (N/OFQ)/N/OFQ receptor (NOP) system controls different biological functions including pain and cough reflex. Mixed NOP/opioid receptor agonists elicit similar effects to strong opioids but with reduced side effects. In this work, 31 peptides with the general sequence [Tyr/Dmt1,Xaa5]N/OFQ(1-13)-NH2 were synthesized and pharmacologically characterized for their action at human recombinant NOP/opioid receptors. The best results in terms of NOP versus mu opioid receptor potency were obtained by substituting both Tyr1 and Thr5 at the N-terminal portion of N/OFQ(1-13)-NH2 with the noncanonical amino acid Dmt. [Dmt1,5]N/OFQ(1-13)-NH2 has been identified as the most potent dual NOP/mu receptor peptide agonist so far described. Experimental data have been complemented by in silico studies to shed light on the molecular mechanisms by which the peptide binds the active form of the mu receptor. Finally, the compound exerted antitussive effects in an in vivo model of cough.


Assuntos
Peptídeos/química , Receptores Opioides mu/agonistas , Receptores Opioides/agonistas , Animais , Sítios de Ligação , Tosse/induzido quimicamente , Tosse/tratamento farmacológico , Modelos Animais de Doenças , Cobaias , Humanos , Interações Hidrofóbicas e Hidrofílicas , Masculino , Simulação de Dinâmica Molecular , Peptídeos/metabolismo , Peptídeos/uso terapêutico , Receptores Opioides/metabolismo , Receptores Opioides mu/genética , Receptores Opioides mu/metabolismo , Proteínas Recombinantes/biossíntese , Proteínas Recombinantes/química , Proteínas Recombinantes/isolamento & purificação , Relação Estrutura-Atividade
6.
Br J Pharmacol ; 178(19): 3905-3923, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33988876

RESUMO

BACKGROUND AND PURPOSE: Many pain-triggering nociceptor neurons express TRPV1 or TRPA1, cation-selective channels with large pores that enable permeation of QX-314, a cationic analogue of lidocaine. Co-application of QX-314 with TRPV1 or TRPA1 activators can silence nociceptors. In this study, we describe BW-031, a novel more potent cationic sodium channel inhibitor, and test whether its application alone can inhibit pain associated with tissue inflammation and whether this strategy can also inhibit cough. EXPERIMENTAL APPROACH: We tested the ability of BW-031 to inhibit pain in three models of tissue inflammation:- inflammation in rat paws produced by complete Freund's adjuvant or by surgical incision and a mouse ultraviolet (UV) burn model. We tested the ability of BW-031 to inhibit cough induced by inhalation of dilute citric acid in guinea pigs. KEY RESULTS: BW-031 inhibited Nav 1.7 and Nav 1.1 channels with approximately sixfold greater potency than QX-314 when introduced inside cells. BW-031 inhibited inflammatory pain in all three models tested, producing more effective and longer-lasting inhibition of pain than QX-314 in the mouse UV burn model. BW-031 was effective in reducing cough counts by 78%-90% when applied intratracheally under isoflurane anaesthesia or by aerosol inhalation in guinea pigs with airway inflammation produced by ovalbumin sensitization. CONCLUSION AND IMPLICATIONS: BW-031 is a novel cationic sodium channel inhibitor that can be applied locally as a single agent to inhibit inflammatory pain. BW-031 can also effectively inhibit cough in a guinea pig model of citric acid-induced cough, suggesting a new clinical approach to treating cough.


Assuntos
Tosse , Bloqueadores dos Canais de Sódio , Animais , Tosse/induzido quimicamente , Tosse/tratamento farmacológico , Cobaias , Camundongos , Nociceptores , Dor/tratamento farmacológico , Ratos , Bloqueadores dos Canais de Sódio/farmacologia , Bloqueadores dos Canais de Sódio/uso terapêutico , Canais de Cátion TRPV
7.
Am J Speech Lang Pathol ; 30(3): 1261-1291, 2021 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-33989029

RESUMO

Purpose The primary aim of this review was to identify environmental irritants known to trigger chronic cough through the life span and develop a comprehensive clinically useful irritant checklist. Method A scoping review was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews, checklist, and explanation. English-language, full-text resources were identified through Medline, PsycINFO, SPORTDiscus, Web of Science, and ProQuest Dissertations and Theses Global. Results A total of 1,072 sources were retrieved; of these, 109 were duplicates. Titles of abstracts of 963 articles were screened, with 295 selected for full-text review. Using the exclusion and inclusion criteria listed, 236 articles were considered eligible and 214 different triggers were identified. Triggers were identified from North America, Europe, Africa, Asia, and Australia. Occupational exposures were also delineated. Conclusions A clinically useful checklist of both frequently encountered triggers and idiosyncratic or rare triggers was developed. The clinical checklist provides a unique contribution to streamline and standardize clinical assessment of irritant-induced chronic cough. The international scope of this review extends the usefulness of the clinical checklist to clinicians on most continents.


Assuntos
Lista de Checagem , Irritantes , Ásia , Austrália , Tosse/induzido quimicamente , Tosse/diagnóstico , Humanos , Irritantes/efeitos adversos , América do Norte
8.
J Med Food ; 24(4): 348-357, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33861937

RESUMO

Chronic cough is very common in respiratory clinics, and no effective drugs are available. Schisandra chinensis (Turcz.) Baill. (S. chinensis), an important traditional Chinese medicine, has been extensively prescribed for patients with a persistent cough. Preliminary research indicated that 95% ethanol extracts (EE) of S. chinensis showed remarkable antitussive activity in guinea pigs exposed to cigarette smoke (CS). To find out the antitussive ingredients of S. chinensis, EE was divided into four fractions according to the polarity: petroleum ether extract (PEE), ethyl acetate extract (ECE), n-butyl alcohol extract, and residue extract. The antitussive, antioxidant, and anti-inflammatory effects of the four fractions were evaluated in a guinea pig model of cough hypersensitivity induced by CS exposure. Eighteen main constituents of the two effective fractions, PEE and ECE, were identified using ultra-high-pressure liquid chromatography electronic spray ion time-of-flight mass spectrometry. The cough inhibition activities of compound 1, 3, 9, 10, 17 were evaluated on citric acid induced acute cough guinea pigs. The results showed that the antitussive activity of EE was almost all contained in PEE and ECE. The 16 major peaks in PEE were identified as 15 lignans (1-12 and 14-16) and 1 triterpene (compound 13), and 3 major peaks (1, 17, and 18) in ECE were also identified as lignans. Three doses of five compounds brought about a significant decrease in number of cough efforts (P < .01), and the cough inhibition rates were between 40.9% and 85.1%. Therefore, lignans are the antitussive ingredients of S. chinensis.


Assuntos
Antitussígenos , Lignanas , Schisandra , Animais , Cromatografia Líquida de Alta Pressão , Tosse/induzido quimicamente , Tosse/tratamento farmacológico , Cobaias , Humanos , Lignanas/análise
9.
J Int Med Res ; 49(3): 300060521996143, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33730928

RESUMO

BACKGROUND: Sufentanil-induced cough (SIC) is a common complication during anesthesia induction. We explored the recommended sufentanil dose that effectively avoids cough during general anesthesia using a clinical trial to analyze the effective dose (ED)50 and ED95 of sufentanil that avoids cough, hemodynamic fluctuations, and adverse reactions. METHODS: On the basis of sufentanil dose, 136 patients (ASA class I-II) were randomly allocated into the following groups: I, 0.1 µg/kg; II, 0.3 µg/kg; III, 0.5 µg/kg; or IV, 1.0 µg/kg. The number of coughing incidents, dizziness, panic, and chest tightness within 1 minute after sufentanil injection, and the patient's heart rate (HR) and blood pressure 5 minutes after intubation were recorded and analyzed. Cough was assessed as follows: none, 0 times; mild, 1 to 2 times/minute; moderate, 3 to 4 times/minute; and severe, 5 times/minute or more. RESULTS: The ED50 and ED95 of cough incidence induced by intravenous sufentanil in patients during general anesthesia induction was 0.332 µg/kg and 1.423 µg/kg, respectively. The cough rate in group I was lower than the other groups. The incidence of dizziness, panic, chest tightness, hypertension, bradycardia, and tachycardia were not significantly different. CONCLUSIONS: The recommended sufentanil dose during general anesthesia induction is 0.1 µg/kg.


Assuntos
Tosse , Sufentanil , Anestesia Geral/efeitos adversos , Tosse/induzido quimicamente , Tosse/prevenção & controle , Frequência Cardíaca , Hemodinâmica , Humanos , Sufentanil/efeitos adversos
10.
Eur J Pharmacol ; 891: 173698, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33129789

RESUMO

Flavonol kaempferol possesses a broad spectrum of potent pharmacological activities that seem to be effective in the modulation of allergic respiratory diseases. In our study, an experimental animal model of ovalbumin (OVA)-induced allergic airway inflammation in guinea pigs was used to determine the anti-asthmatic potential of kaempferol. The parameters of specific airway resistance (sRaw) and cough reflex response were evaluated in vivo. In vitro, an assessment of tracheal smooth muscle (TSM) contractility and analyses of inflammatory cytokines (IL-4, IL-5, IL-13, GM-CSF, IFN-γ), transforming growth factor (TGF-ß1), immune cells count and ciliary beating frequency (CBF) were performed. Both single (6, 20 mg/kg b. w. p. o.) and long-term administered doses of kaempferol (20 mg/kg b. w. p. o., 21 days) suppressed sRaw provoked by histamine in conscious animals. The administration of kaempferol for 21 days attenuated histamine-induced TSM contractility in vitro and ameliorated the progression of chronic airway inflammation by decreasing the levels of IL-5, IL-13, GM-CSF, eosinophil count in bronchoalveolar lavage (BAL) fluid and TGF-ß1 protein level in lung tissue. Kaempferol also eliminated the alterations in cough reflex sensitivity invoked by OVA-sensitization, but it did not affect CBF. The results demonstrate that flavonol kaempferol can modulate allergic airway inflammation and associated asthma features (AHR, aberrant stimulation of cough reflex).


Assuntos
Antiasmáticos/farmacologia , Broncoconstrição/efeitos dos fármacos , Quempferóis/farmacologia , Pulmão/efeitos dos fármacos , Pneumonia/prevenção & controle , Hipersensibilidade Respiratória/prevenção & controle , Traqueia/efeitos dos fármacos , Resistência das Vias Respiratórias/efeitos dos fármacos , Animais , Líquido da Lavagem Broncoalveolar/química , Tosse/induzido quimicamente , Tosse/metabolismo , Tosse/fisiopatologia , Tosse/prevenção & controle , Citocinas/metabolismo , Modelos Animais de Doenças , Cobaias , Mediadores da Inflamação/metabolismo , Leucócitos/efeitos dos fármacos , Leucócitos/metabolismo , Pulmão/metabolismo , Pulmão/fisiopatologia , Masculino , Ovalbumina , Pneumonia/induzido quimicamente , Pneumonia/metabolismo , Pneumonia/fisiopatologia , Hipersensibilidade Respiratória/induzido quimicamente , Hipersensibilidade Respiratória/metabolismo , Hipersensibilidade Respiratória/fisiopatologia , Traqueia/metabolismo , Traqueia/fisiopatologia , Fator de Crescimento Transformador beta1/metabolismo
11.
J Ethnopharmacol ; 269: 113719, 2021 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-33358856

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Hanchuan Zupa Granule (HCZP), a traditional Chinese ethnodrug, has the functions of supressing a cough, resolving phlegm, warming the lungs, and relieving asthma. In clinical practice employing traditional Chinese medicine (TCM), HCZP is commonly used to treat acute colds, cough and abnormal mucous asthma caused by a cold, or "Nai-Zi-Lai" in the Uygur language. Studies have confirmed the use of HCZP to treat cough variant asthma (CVA) and other respiratory diseases. However, the pharmacological mechanisms of HCZP remain unrevealed. AIM OF THE STUDY: To investigate the anti-tussive and anti-asthmatic effects and the possible pharmacological mechanisms of HCZP in the treatment of CVA. MATERIALS AND METHODS: A guinea pig CVA animal model was established by intraperitoneal injection of ovalbumin (OVA) combined with intraperitoneal injection of aluminium hydroxide adjuvant and atomized OVA. Meanwhile, guinea pigs with CVA received oral HCZP (at dosages of 0.571, 0.285 and 0.143 g/kg bodyweight). The number of coughs induced by aerosol capsaicin was recorded, and the airway hyperresponsiveness (AHR) of CVA guinea pigs was detected with the FinePointe series RC system. H&E staining of lung tissues was performed to observe pathological changes. ELISA was used to detect inflammatory cytokines. qRT-PCR and western blotting analyses were used to detect the expression of Th1-specific transcription factor (T-bet), Th2-specific transcription factor (GATA3), and Toll-like receptor 4 (TLR4) signal transduction elements. These methods were performed to assess the protective effects and the potential mechanisms of HCZP on CVA. RESULTS: Great changes were found in the CVA guinea pig model after HCZP treatment. The number of coughs induced by capsaicin in guinea pigs decreased, the body weights of guinea pigs increased, and inflammation of the eosinophilic airway and AHR were reduced simultaneously. These results indicate that HCZP has a significant protective effect on CVA. A pharmacological study of HCZP showed that the levels of interleukin-4 (IL-4) and IL-5 and tumour necrosis factor-α (TNF-α) in serum decreased. The amount of interferon-γ (IFN-γ) increased, mRNA and protein expression of TLR4 and GATA3 weakened, and mRNA and protein expression of T-bet increased. CONCLUSIONS: HCZP ameliorated the symptoms of guinea pigs with CVA induced by OVA by regulating the Th1/Th2 imbalance and TLR4 receptors.


Assuntos
Antiasmáticos/farmacologia , Antitussígenos/farmacologia , Asma/tratamento farmacológico , Tosse/tratamento farmacológico , Medicamentos de Ervas Chinesas/farmacologia , Animais , Antiasmáticos/uso terapêutico , Antitussígenos/uso terapêutico , Asma/induzido quimicamente , Peso Corporal/efeitos dos fármacos , Capsaicina/toxicidade , Tosse/induzido quimicamente , Citocinas/sangue , Modelos Animais de Doenças , Medicamentos de Ervas Chinesas/química , Medicamentos de Ervas Chinesas/uso terapêutico , Flavonoides/química , Fator de Transcrição GATA3/genética , Fator de Transcrição GATA3/metabolismo , Ácido Glicirrízico/química , Cobaias , Pulmão/efeitos dos fármacos , Pulmão/metabolismo , Pulmão/patologia , Medicina Tradicional Chinesa , Ovalbumina/toxicidade , Hipersensibilidade Respiratória/induzido quimicamente , Hipersensibilidade Respiratória/tratamento farmacológico , Proteínas com Domínio T/genética , Proteínas com Domínio T/metabolismo , Células Th1/efeitos dos fármacos , Células Th2/efeitos dos fármacos , Receptor 4 Toll-Like/genética , Receptor 4 Toll-Like/metabolismo , Triterpenos/química
12.
Folia Med (Plovdiv) ; 62(3): 515-518, 2020 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-33009763

RESUMO

INTRODUCTION: A smokeless tobacco known as Maras powder (MP) is commonly consumed in the southern region of Turkey. To the extent of our knowledge, no previous study in literature has reported acute MP intoxication in children. AIM: Our aim was to determine the clinical effects and treatment strategies of MP poisoning in children.Materials and methods: We retrospectively reviewed the medical records of children <18 years of age with MP intoxication who were followed up in the Intensive Care Unit between January 2016 and April 2018 in our center. RESULTS: Forty-one patients (M/F= 25/16) were included in this study. The mean age was 13.2±22.4 months (age range: 7 to 30 months). The patients presented with vomiting (n=23, 56%), cough (n=17, 41.5%), loss of consciousness (n=11, 26.8%), respiratory distress (n=6, 14.6%), convulsion (n=7, 17%), cyanosis (n=1, 2.4%), and abdominal pain (n=1, 2.4%) following oral ingestion of the substance. On their physical examination all patients with convulsion were in a comatose state. Thirty-two patients (78%) had tachycardia; 15 patients (36.5%) had pharyngeal hyperemia; and three (7.3%) had hiccups. Although the female patients had a lesser rate of symptoms than male patients, the difference was not statistically significant. CONCLUSIONS: Our aim was to inform the doctors about the clinical picture that develops after taking this substance and contribute to the understanding of the treatment approach.


Assuntos
Envenenamento/epidemiologia , Tabaco sem Fumaça/envenenamento , Criança , Pré-Escolar , Tosse/induzido quimicamente , Feminino , Humanos , Lactente , Masculino , Envenenamento/complicações , Estudos Retrospectivos , Taquicardia/induzido quimicamente , Turquia , Vômito/induzido quimicamente
13.
Hypertension ; 76(6): 1828-1837, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33012200

RESUMO

Hypertensive disease in pregnancy is associated with future cardiovascular disease and, therefore, provides an opportunity to identify women who could benefit from targeted interventions aimed at reducing cardiovascular morbidity. This study focused on the highest-risk group, women with preterm preeclampsia, who have an 8-fold risk of death from future cardiovascular disease. We performed a single-center feasibility randomized controlled trial of 6 months' treatment with enalapril to improve postnatal cardiovascular function. Echocardiography and hemodynamic measurements were performed at baseline (<3 days), 6 weeks, and 6 months postdelivery on 60 women. At randomization, 88% of women had diastolic dysfunction, and 68% had concentric remodeling/hypertrophy. No difference was seen in total vascular resistance (P=0.59) or systolic function (global longitudinal strain: P=0.14) between groups at 6 months. However, women treated with enalapril had echocardiographic measurements consistent with improved diastolic function (E/E'[the ratio of early mitral inflow velocity and early mitral annular diastolic velocity]: P=0.04) and left ventricular remodeling (relative wall thickness: P=0.01; left ventricular mass index: P=0.03) at 6 months, compared with placebo. Urinary enalapril was detectable in 85% and 63% of women in the enalapril arm at 6 weeks and 6 months, respectively. All women responded positively to taking enalapril in the future. Our study confirmed acceptability and feasibility of the study protocol with a recruitment to completion rate of 2.2 women per month. Importantly, postnatal enalapril treatment was associated with improved echocardiographic measurements; these early improvements have the potential to reduce long-term cardiovascular disease risk. A definitive, multicenter randomized controlled trial is now required to confirm these findings. Registration- URL: https://www.clinicaltrials.gov; Unique identifier: NCT03466333.


Assuntos
Fenômenos Fisiológicos Cardiovasculares/efeitos dos fármacos , Enalapril/uso terapêutico , Hemodinâmica/efeitos dos fármacos , Pré-Eclâmpsia/fisiopatologia , Adulto , Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Tosse/induzido quimicamente , Método Duplo-Cego , Ecocardiografia , Enalapril/efeitos adversos , Exantema/induzido quimicamente , Estudos de Viabilidade , Feminino , Hemodinâmica/fisiologia , Humanos , Recém-Nascido , Gravidez , Resultado do Tratamento , Função Ventricular Esquerda/efeitos dos fármacos , Função Ventricular Esquerda/fisiologia
15.
BMC Anesthesiol ; 20(1): 249, 2020 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-32988369

RESUMO

BACKGROUND: During emergence from anesthesia after partial and total laryngectomy, excessive airway reflex and systemic hypertension may lead to subcutaneous emphysema, hemorrhage or pneumothorax. METHODS: American Society of Anesthesiologist physical status III and IV male adults undergoing elective laryngectomy were recruited and randomly allocated to receive either dexmedetomidine (group D) or midazolam (group M). The primary outcome was incidence and severity of cough. Pulse oximetry results (SpO2), heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were also recorded. The visual analog scale and the Ramsay sedation scale were recorded at the points of wakefulness and departure from the post-anesthesia care unit (PACU). Rescue analgesia consumption, the time of spontaneous breath recovery, duration of the PACU stay, and the incidence of adverse effects were also recorded. RESULTS: The prevalence of no coughing was significantly higher in group D than in group M at the points of wakefulness and departure. HR, SBP, and DBP were significantly lower in group D compared with group M, and SpO2 was significantly higher in group D than in group M at the moment of laryngectomy. Pain scores were lower in group D than in group M. The Ramsay score at the point of wakefulness was higher in group D than in group M. There was no difference in time to spontaneous breathing recovery, duration of the PACU stay, and incidence of adverse effects. CONCLUSIONS: Compared with midazolam, dexmedetomidine is an effective alternative to attenuate coughing and hemodynamic changes with a low incidence of adverse events during emergence from anesthesia after partial and total laryngectomy. TRIAL REGISTRATION: NCT03918889 , registered at clinicaltrials.gov, date of registration: March 28, 2019.


Assuntos
Período de Recuperação da Anestesia , Tosse/induzido quimicamente , Dexmedetomidina/efeitos adversos , Hipnóticos e Sedativos/efeitos adversos , Laringectomia/métodos , Midazolam/efeitos adversos , Complicações Pós-Operatórias/induzido quimicamente , Adulto , Idoso , Tosse/prevenção & controle , Método Duplo-Cego , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos
16.
BMC Anesthesiol ; 20(1): 235, 2020 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-32938386

RESUMO

BACKGROUND: The aim of this prospective randomized controlled study was to evaluate whether pretreatment with a small dose of dezocine could prevent remifentanil-induced cough in general anesthesia induction. TRIAL DESIGN: a prospective, randomized, controlled study. METHODS: A total of 210 patients receiving elective operative hysteroscopy from December 2018 to April 2019 were enrolled in the present study. They were randomly equally separated into dezocine group (n = 105) and control group (n = 105). Patients were intravenously pre-administrated with dezocine 0.03 mg/kg (diluted to 5 mL) or the same volume of normal saline 1 min prior to remifentanil infusion. One minute later, intravenous injection of propofol 1.5 mg/kg and cisatracurium 0.1 mg/kg were given to all patients for induction of general anesthesia. The counts of coughs occurred during the anesthesia induction period were recorded and the severity of cough was scaled. RESULTS: There were 7 cases of mild cough in dezocine group and 18 cases of mild cough, 12 cases of moderate cough and 4 cases of severe cough in control group. The incidence rate of cough was significantly lower and the severity of cough was obviously relieved in dezocine group compared to control group (6.67% vs. 32.38%, P <  0.001). The two groups were not significantly different in heart rate and mean arterial pressure before the induction, before and after the intubation, and in operating time and postoperative visual analog scale pain scores. CONCLUSION: This study recommends the efficacy and safety of a pretreatment with a small dose of dezocine in reducing remifentanil-induced cough during general anesthesia. TRIAL REGISTRATION: ChiCTR2000032035 . Date of registration: Retrospectively registered on 2020/04/18.


Assuntos
Analgésicos Opioides/uso terapêutico , Anestesia Geral , Compostos Bicíclicos Heterocíclicos com Pontes/uso terapêutico , Tosse/prevenção & controle , Remifentanil/efeitos adversos , Tetra-Hidronaftalenos/uso terapêutico , Adulto , Idoso , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/efeitos adversos , Compostos Bicíclicos Heterocíclicos com Pontes/administração & dosagem , Tosse/induzido quimicamente , Feminino , Humanos , Histeroscopia , Pessoa de Meia-Idade , Estudos Prospectivos , Remifentanil/administração & dosagem , Tetra-Hidronaftalenos/administração & dosagem , Resultado do Tratamento , Adulto Jovem
17.
J Psychiatr Res ; 130: 333-341, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32889355

RESUMO

PURPOSE: Codeine-containing cough syrup (CCS) is considered among the most popular drugs of abuse in adolescents worldwide. Accurate prediction and identification of CCS dependent (CCSD) users are crucial. This study aimed to identify a brain-connectome-based predictor of CCSD using a machine learning model based on a ten-fold cross-validation logistic regression (LR) classifier. METHODS: 40 CCSD users and 40 healthy control (HC) subjects underwent functional magnetic resonance imaging to construct weight functional networks. Partial correlation analysis was used to analyze relations between abnormal network metrics and clinical characteristics (BIS total scores, CCS abuse duration, and mean CCS dose) in CCSD. A ten-fold cross-validation LR classifier was used to classify CCSD users and HC subjects. RESULTS: The CCSD group showed significantly abnormal nodes and connections in the right posterior cingulate, right middle insula, bilateral prefrontal cortex, parietal lobe, temporal lobe, occipital lobe, and cerebellum. Furthermore, higher characteristic path length and lower clustering coefficient (Cp), global efficiency, and local efficiency (Eloc) were observed in the global topologies in CCSD. The abnormal global properties (Cp and Eloc) and node properties of the prefrontal cortex were significantly correlated with clinical characteristics (BIS-11 scores, CCS abuse duration) in CCSD. The LR classifier models demonstrated accuracy, sensitivity, specificity, precision, and AUC of 82.5%, 82.5%, 82.5%, 76.8%, and 82.5%. CONCLUSIONS: These data demonstrate that abnormal functional connectome may be closely linked to clinical characteristics in CCSD. Functional connectome-based biomarkers can be a powerful tool for personalized diagnosis of CCSD in the future.


Assuntos
Conectoma , Adolescente , Biomarcadores , Encéfalo/diagnóstico por imagem , Codeína , Tosse/induzido quimicamente , Tosse/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética
18.
Ann Palliat Med ; 9(5): 3562-3570, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32921095

RESUMO

Chronic cough is defined as a cough lasting for ≥8 weeks with a normal chest radiograph. The common causes of chronic cough are cough variant asthma (CVA), upper airway cough syndrome/postnasal drip syndrome (UACS/PNDs), eosinophilic bronchitis (EB), gastroesophageal reflux-related chronic cough (GERC) and atopic cough (AC). Drug-induced chronic cough, a rare cause of chronic cough, refers to a chronic cough caused by certain drugs. In addition to angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), there are cases reporting that some drugs such as omeprazole and leflumide that can cause cough. An important step in the diagnosis and treatment of chronic cough is to determine the history of the patient with regard to any drugs that can induce chronic cough. If the cough occurs after taking the medicine, a suspected diagnosis of drug-induced cough should be established. If the cough resolution occurs within 1 to 4 weeks after drug withdrawal, it would be considered as a side effect of the medication. we should be alert to the possibility of drug-induced chronic cough after excluding CVA, UACS, EB and other common causes of chronic cough. This article reviews the relevant drugs that may cause cough and their possible mechanisms of action.


Assuntos
Asma , Preparações Farmacêuticas , Antagonistas de Receptores de Angiotensina , Inibidores da Enzima Conversora de Angiotensina , Doença Crônica , Tosse/induzido quimicamente , Tosse/tratamento farmacológico , Humanos
19.
Med Clin (Barc) ; 155(7): 295-298, 2020 10 09.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32747012

RESUMO

INTRODUCTION AND OBJECTIVE: A recent outbreak of coronavirus disease 2019 (COVID-19) occurs in the worldwide. Angiotensin-converting enzyme 2 (ACE2) can mediate coronavirus entry into host cells. Therefore, renin-angiotensin system inhibitors (RASI) were suspected of contributing to the increase of coronavirus infection. We aimed to analyze the effects of RASI in COVID-19 patients with hypertension. PATIENTS AND METHOD: In this retrospective, single-center study, 27 COVID-19 patients with hypertension, who were admitted to the Shanghai Public Health Clinical Center from January 25, 2020 to January 31, 2020, were analyzed for clinical features, laboratory parameters, medications and the length of stay. All the patients were given antiviral and antihypertension treatment, of which 14 patients were treated with RASI and 13 patients without RASI. RESULTS: Comparing the two groups, we did not found statistically significant differences in clinical symptoms and laboratory tests. Furthermore, cough was not aggravated. CONCLUSIONS: Through the analysis of this small sample, RASI could be deemed safe and effective to control high blood pressure of COVID-19 patients. Further analysis with a larger sampling size is required to explore the underlying mechanisms.


Assuntos
Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Betacoronavirus , Infecções por Coronavirus/etiologia , Hipertensão/tratamento farmacológico , Pneumonia Viral/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , COVID-19 , Estudos de Casos e Controles , China , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Tosse/induzido quimicamente , Tosse/virologia , Feminino , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Prognóstico , Estudos Retrospectivos , SARS-CoV-2 , Índice de Gravidade de Doença
20.
J Med Food ; 23(10): 1060-1069, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32758004

RESUMO

Platycodon grandiflorum (PG) has been extensively utilized as an herb to relieve phlegm. In this study, the effects of PG root extracts on airway inflammation and cough reflex were investigated, especially using fermented PG extracts (FPE) to increase an active compound, platycodin D by fermentation. FPE significantly reduced the numbers of eosinophils and total cells in the bronchoalveolar lavage fluid (BALF) obtained from lipopolysaccharide/ovalbumin (LPS/OVA)-induced asthma mice versus those of vehicle control. Moreover, in the BALF and the serum, FPE significantly reduced the concentration of IL-17E, a proinflammatory cytokine that causes TH2 immunity, including eosinophil amplification. It was also demonstrated that FPE might relieve inflammations through histological analysis of the lung separated from each mouse. Furthermore, in cough reflex guinea pigs induced by citric acid treatment, FPE treatment significantly reduced the number of coughs versus that of vehicle control, and consequently decreased cough reflex sensitivity. In addition, the total cell number and eosinophils significantly decreased in the BALF obtained from each guinea pig versus that of vehicle control. In in vitro study, pretreatment with FPE in LPS-stimulated RAW264.7 cells significantly reduced the levels of proinflammatory cytokines such as TNF-α, IL-6, and IL-1ß, and inducible nitric oxide synthases (iNOS). Therefore, we demonstrated that FPE relieved airway inflammation and cough reflex sensitivity in vivo, and exhibited anti-inflammatory effects through suppression of iNOS and several proinflammatory cytokines. These findings suggest that FPE might have a beneficial effect on respiratory health, and may be useful as a functional food to prevent respiratory diseases.


Assuntos
Asma/tratamento farmacológico , Tosse , Inflamação , Extratos Vegetais/farmacologia , Platycodon/química , Animais , Asma/induzido quimicamente , Líquido da Lavagem Broncoalveolar , Tosse/induzido quimicamente , Tosse/tratamento farmacológico , Citocinas , Modelos Animais de Doenças , Cobaias , Inflamação/induzido quimicamente , Inflamação/tratamento farmacológico , Lipopolissacarídeos , Camundongos , Camundongos Endogâmicos BALB C , Ovalbumina , Reflexo
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