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1.
Medicine (Baltimore) ; 98(37): e17109, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517844

RESUMO

BACKGROUND: Patients suffering from chemotherapy-induced nausea and vomiting (CINV) might have negative adherence of treatment. Acupoint therapies, including acupuncture, acupressure, acupoints injection, massage, and moxibustion, are safe medical procedures with minimal side effects for CINV, but studies about overall safety and effectiveness of acupoint therapies have not been scientifically and methodically evaluated in recent years. Evaluating the overall safety and effectiveness of acupoint therapies in patients with CINV is the purpose of this review. METHODS AND ANALYSIS: Relevant randomized controlled trials (RCTSs) are being searched in the following electronic databases: PubMed, Cochrane Library, Web of Science, EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP database), Wanfang Data Knowledge Service Platform, and Chinese Biomedical Literature Database (CBM). We will also attempt to obtain the unpublished academic data by contacting the colleague, professor, or Institute of Traditional Chinese Medicine. The RCTs of the acupoint therapies for CINV patients will be searched in the databases from inception to July 2019. The primary outcomes are defined as severity, duration and frequency of nausea or vomiting, or both. The secondary outcomes are defined as any adverse events and quality of life. Performing the meta-analysis by using RevMan version 5 software. Mean difference (MD) or standardized mean difference (SMD) will express the continuous variables, while relative risk (RR) will express the categorical variables. RESULTS: The results of this review will provide a high-quality synthesis to evaluate the effectiveness and safety of acupoint therapies for CINV. CONCLUSION: This review will provide evidence to estimate whether acupoint therapies are effective interventions for CINV. DISSEMINATION: Evidence whether acupoint therapies are effective interventions for CINV will be provided by this systematic review. This knowledge will recommend better acupoint therapies and selections of acupoints which might be helpful in treating CINV. The findings of this systematic review will be disseminated via various forms of presentation and publication of the data in a journal or electronic databases. PROSPERO REGISTRATION NUMBER: CRD42019125538.


Assuntos
Terapia por Acupuntura/normas , Tratamento Farmacológico/métodos , Náusea/etiologia , Vômito/etiologia , Terapia por Acupuntura/métodos , Antineoplásicos/efeitos adversos , Humanos , Náusea/prevenção & controle , Náusea/terapia , Vômito/prevenção & controle , Vômito/terapia
2.
Cell Host Microbe ; 26(1): 22-34, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31295421

RESUMO

Despite the recognition, nearly a century ago, that the human microbiome plays a clinically relevant role in drug disposition, mechanistic insights, and translational applications are still limited. Here, we highlight the recent re-emergence of "pharmacomicrobiomics," which seeks to understand how inter-individual variations in the microbiome shape drug efficacy and side effect profiles. Multiple bacterial species, genes, and enzymes have already been implicated in the direct biotransformation of drugs, both from targeted case studies and from systematic computational and experimental analyses. Indirect mechanisms are also at play; for example, microbial interactions with the host immune system can have broad effects on immunomodulatory drugs. Finally, we discuss multiple emerging strategies for the precise manipulation of complex microbial communities to improve treatment outcomes. In the coming years, we anticipate a shift toward a more comprehensive view of precision medicine that encompasses our human and microbial genomes and their combined metabolic activities.


Assuntos
Tratamento Farmacológico/métodos , Microbiota , Medicina de Precisão/métodos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Humanos , Medicina de Precisão/tendências , Resultado do Tratamento
3.
Cell Host Microbe ; 26(1): 61-72, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31295426

RESUMO

The global challenges presented by drug-resistant bacterial infections have stimulated much activity in finding new treatments. This review summarizes the progress and setbacks of non-traditional approaches intent on circumventing bacterial drug resistance. These approaches include targeting virulence via toxin production and virulence factor secretion, impeding bacterial adhesion to host cells and biofilm formation, interrupting or inhibiting bacterial communication, and downregulating virulence. Other strategies include immune evasion, microbiome-modifying therapies, and the employment of phages as treatments or carriers. Finally, the prospects of nanoparticles, immunotherapy, antisense RNA, and drug-resistance-modulation approaches are discussed. The development of non-traditional treatments suffers similar challenges faced by developers of conventional antibiotics; however, most of these new strategies have additional and considerable hurdles before it can be shown that they are safe and efficacious for patient use. For the foreseeable future, it is likely that most of these treatments, if approved, will be used in combination with antibiotics.


Assuntos
Infecções Bacterianas/terapia , Terapia Biológica/métodos , Tratamento Farmacológico/métodos , Humanos
5.
Oncology ; 97(4): 202-205, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31288226

RESUMO

Based on the results of several phase 3 randomized trials, "maintenance therapy" (prolonged treatment after an initial response to cytotoxic chemotherapy) has assumed a critical role in the routine care of advanced epithelial ovarian cancer. While earlier data had provided support for this therapeutic concept in disease management (e.g., multiple cycles of single-agent paclitaxel following a clinical complete response to a platinum/paclitaxel regimen), more recent data has revealed both the efficacy and safety of the anti-angiogenesis agent, bevacizumab, and several PARP inhibitors when employed in this clinical setting.


Assuntos
Tratamento Farmacológico/métodos , Oncologia/tendências , Neoplasias Ovarianas/tratamento farmacológico , Bevacizumab/administração & dosagem , Feminino , Humanos , Neoplasias Ovarianas/imunologia , Paclitaxel/administração & dosagem , Platina/administração & dosagem , Inibidores de Poli(ADP-Ribose) Polimerases/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
6.
Chem Commun (Camb) ; 55(61): 9015-9018, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31290867
7.
Rev Bras Enferm ; 72(3): 640-645, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31269127

RESUMO

AIM: To demonstrate the relationship between religious/spiritual coping and hope in cancer patients undergoing chemotherapy. METHOD: This is a cross-sectional, descriptive study with a quantitative approach performed in a reference outpatient clinic in Caruaru, PE, between August and October 2017. A total of 82 cancer patients undergoing chemotherapy were included in the study, using the brief religious/spiritual coping scale (RCOPE-Brief) and the Herth Hope Scale (HHS). RESULTS: The sample presented mean positive RCOPE scores (3.03 ± 0.41) and the level of hope was considered high (42.7 points ± 3.67). Patients who had a high RCOPE score were found to have a higher mean of Herth's level of hope (44.12 points). CONCLUSION: This study becomes relevant to nursing professionals by encouraging care that takes into account the patient's spiritual dimension in order to stimulate positive mechanisms of religious coping and, consequently, raise the levels of hope.


Assuntos
Adaptação Psicológica , Esperança , Neoplasias/complicações , Espiritualidade , Adulto , Estudos Transversais , Tratamento Farmacológico/métodos , Tratamento Farmacológico/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Psicometria/instrumentação , Psicometria/métodos , Inquéritos e Questionários
8.
Medicine (Baltimore) ; 98(25): e16075, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31232946

RESUMO

RATIONALE: Gastric cancer is still one of the most common cancer in East Asia. More than 70% gastric cancer patients are diagnosed at an advanced stage in China. Moreover, about 10% cases are unresectable which usually suffer a poor prognosis with a median survival time of 5 to 12 months. In recent years, some clinical studies found that many unresectable gastric cancer cases could get opportunity for surgery after treatment that improve prognosis significantly PATIENT CONCERNS:: 64-year-old male patient was admitted with upper abdominal pain. Upper gastrointestinal endoscopy showed a large ulcerated tumor located from the cardia to the anterior wall of the upper gastric body. Histopathological examination showed it was moderately differentiated adenocarcinoma. Computed tomography (CT) scan image showed a large bulging mass with internal ulcer at the lesser curvature wall, left gastric artery and coeliac trunk were surrounded by fused lymph nodes. DIAGNOSES: Based on the histopathological examination and imaging findings, patient was diagnosed advanced gastric cancer and hardly to resect radically. INTERVENTION: Oral chemotherapy combined with trans-arterial chemotherapy and embolization (TACE) was initiated. Eight weeks after initial therapy, radical laparoscopy-assisted total gastrectomy with D2 lymph node dissection and Roux-en-Y anastomosis were performed successfully. OUTCOMES: Patient was discharged on postoperative day 11 without complications. Histological analysis of the specimen and resected 31 lymph nodes revealed no malignancy. The patient experienced a pathological complete response (pCR). LESSONS: In this case, oral chemotherapy combined with TACE which was rarely reported in the treatment of unresectable gastric cancer achieves a great therapeutic benefit. Although further clinical studies will be needed to establish, it may be a potent strategy for degrading stage and supplying a new chance for surgery.


Assuntos
Quimioembolização Terapêutica/métodos , Tratamento Farmacológico/métodos , Neoplasias Gástricas/tratamento farmacológico , Administração Oral , China , Gastrectomia/métodos , Humanos , Laparoscopia/métodos , Excisão de Linfonodo/métodos , Masculino , Pessoa de Meia-Idade , Prognóstico , Neoplasias Gástricas/cirurgia , Tomografia Computadorizada por Raios X/métodos
9.
Orv Hetil ; 160(23): 896-907, 2019 Jun.
Artigo em Húngaro | MEDLINE | ID: mdl-31155882

RESUMO

The proportion of elderly patients is getting increased in the developed countries as a consequence of which pharmacotherapy takes a more and more important place in the healthcare system. Important biological alterations are characteristic for the elderly subjects, which have effect on the pharmacokinetics and pharmacodynamics of the pharmaceuticals. Gradually decreased kidney function may demand the modification of the administration of the pharmaceuticals. Certain pharmaceuticals and drug-interactions are potentially dangerous for this population. Therefore several factors have to be taken into account in conjunction with the therapy of elderly patients including co-morbidities, cognitive function and the social state. At the same time, the risk-benefit ratio of the pharmaceuticals is the worst among elderly patients with pharmaceutical therapy including polypragmasy. Thus, it is inevitable for the development of geriatric pharmacotherapy that the physiologic alteration of elderly has to be taken into account not only in the daily practice but also during the development and formulation of a pharmaceutical. The present paper gives an overview of the most important factors influencing the pharmacotherapy of the elderly. Orv Hetil. 2019; 160(23): 896-907.


Assuntos
Interações de Medicamentos , Tratamento Farmacológico/métodos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Erros de Medicação/prevenção & controle , Polimedicação , Idoso , Comorbidade , Assistência à Saúde , Humanos , Medição de Risco
10.
Pharm. pract. (Granada, Internet) ; 17(2): 0-0, abr.-jun. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184686

RESUMO

Background: Fixed-dose drug combinations (FDCs), are combinations of two or more active drugs in a single dosage form. Despite the advantages obtained from the use of these agents, there is increasing evidence questioning the rationality of several FDCs found in pharmaceutical markets-especially those in developing countries like Nigeria. Objectives: To describe the availability of FDCs in drug retailing outlets located in Kaduna Nigeria, and to assess FDC registration status and inclusion on national and international essential medicines lists (EMLs). Rationality of selected FDCs was also assessed. Methods: A cross-sectional survey was carried out from June to September 2018 in 60 registered pharmacies and patent medicine shops selected through multi-stage sampling. A data collection form was used to obtain information on the generic names and strengths of the active ingredients of the FDCs, their country of manufacture and evidence of registration with the Nigerian drug regulatory agency. To assess rationality, a scoring rubric developed from earlier studies was used. Data collected was coded and entered into a Microsoft excel 2016 spreadsheet for analysis. Descriptive statistics (frequencies and percentages) were used to report the data collected. Results: FDCs encountered included 74 oral tablets/capsules, 52 oral liquids and 23 topical semi solids. Majority of the available FDCs were registered by Nigerian drug regulatory agency (91.5%), although only 8.5% and 6.5% in total were included on the Nigerian EML and the WHO model list respectively. Of the 99 FDCs assessed for rationality, 58 (58.6%) were found to be rational. Irrational FDCs included drugs acting on the respiratory tract (29.3%), analgesics (26.8%) and anti-infectives (22%). Conclusions: A wide variety of FDCs were available in the study area, even though not all of them were rational. There is an urgent need for policy makers within the country to develop better detailed guidelines for FDC registration


No disponible


Assuntos
Humanos , Combinação de Medicamentos , Tratamento Farmacológico/métodos , Assistência Farmacêutica/organização & administração , Adesão à Medicação/estatística & dados numéricos , Nigéria/epidemiologia , Inquéritos e Questionários/estatística & dados numéricos , Comercialização de Produtos , Dispensários de Medicamentos , Controle de Medicamentos e Entorpecentes/tendências
11.
Int J Antimicrob Agents ; 54(2): 176-183, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31108223

RESUMO

The efficacy and safety of short-course intravenous (i.v.) antimicrobial therapy for bloodstream infections is unknown. Therefore, a retrospective 8-year cohort study including 1431 hospitalised adults was conducted to compare the outcomes of patients receiving short-course (5-10 days) and long-course (11-16 days) i.v. antibiotic therapy for community-onset bacteraemia. Of 1010 patients who received short-course therapy, 726 were matched with 363 patients in the long-course group through propensity score matching at a ratio of 1:2 based on independent predictors of 30-day mortality identified in the multivariate regression model. Following appropriate matching, similarities between the two groups in the proportion of baseline characteristics (age, sex, major co-morbidities, co-morbidity severity, bacteraemia severity at onset and major bacteraemia sources) and 30-day crude mortality rate after bacteraemia onset were observed. Notably, clinical outcomes within 30 days after the end of i.v. therapy, in terms of proportions of post-treatment overall infections (2.2% vs. 6.1%; P = 0.001), infections caused by antimicrobial-resistant pathogens (ARPs) (1.7% vs. 4.4%; P = 0.007), and thereby post-treatment crude mortality (1.4% vs. 3.6%; P = 0.009), were lower in the short-course group. In conclusion, for adults with community-onset uncomplicated bacteraemia, short-course (5-10 days) i.v. antibiotic treatment did not result in an increased risk of mortality but instead decreased the odds of overall and ARP infections after the treatment course.


Assuntos
Antibacterianos/administração & dosagem , Bacteriemia/tratamento farmacológico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Tratamento Farmacológico/métodos , Administração Intravenosa , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bacteriemia/mortalidade , Infecções Comunitárias Adquiridas/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Análise de Sobrevida , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
12.
Expert Opin Pharmacother ; 20(12): 1457-1470, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31112441

RESUMO

Introduction: ADHD is characterized by a developmentally inappropriate level of inattentiveness, impulsivity and/or hyperactivity. In adults, the disorder is frequently accompanied by Emotional Dysregulation (ED), associated to a variety of related psychiatric comorbidities, complicating its recognition and treatment management. Areas covered: This paper reviews randomized active comparator-controlled or placebo-controlled trials evaluating the use of pharmacotherapy in adults with ADHD and ED, other neurodevelopmental disorders, Bipolar Disorder (BD) and Anxiety Disorders (ADs). When controlled data are unavailable, the authors have included open-label and observational studies. Expert opinion: ED in adult patients with ADHD is a very common and impairing problem that can be treated with stimulants or atomoxetine. ADHD studies in adults with other neurodevelopment disorders are scarce; stimulants seem to be the most effective and safe drugs in treating ADHD symptoms, without worsening the core features of other neurodevelopmental disorders. In patients with ADHD and comorbid BD, the treatment of BD alone may result in residual symptoms of ADHD. Patients should be treated hierarchically: BD should be treated first, while ADHD should be treated combining ADHD medications and mood stabilizers after mood stabilization. The available evidence for treating patients with ADHD and comorbid ADs in adults supports the idea of an anti-anxiety/ADHD-specific treatment association.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Tratamento Farmacológico/tendências , Drogas em Investigação/uso terapêutico , Adulto , Antimaníacos/uso terapêutico , Transtornos de Ansiedade/tratamento farmacológico , Transtornos de Ansiedade/epidemiologia , Cloridrato de Atomoxetina/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/epidemiologia , Comorbidade , Tratamento Farmacológico/métodos , Humanos , Estudos Observacionais como Assunto/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Terapias em Estudo/métodos , Terapias em Estudo/tendências
14.
Expert Opin Pharmacother ; 20(12): 1439-1448, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31095426

RESUMO

Introduction: Nosocomial pneumonia is the second most common infection in hospital settings, resulting in substantial increases in morbidity, mortality, and length of hospital stay. The rapid increase in resistance of nosocomial pathogens to many antibiotics and the high dissemination of resistance genes highlight the need for innovative approaches to combat difficult-to-treat nosocomial respiratory infections. Areas covered: This review summarizes the synthetic antimicrobials that are currently in development for the treatment of nosocomial pneumonia, focusing on antibiotics in the final phases of clinical development and on the strategies employed by novel synthetic antimicrobial peptides. Expert opinion: Several novel synthetic antimicrobials are currently in the pipeline, and it appears that new antimicrobial peptides or mimetics will soon be made available, expanding the opportunities to treat nosocomial pneumonia. However, the approval process for use in the treatment of nosocomial pneumonia is arduous. Given that significant investments by pharmaceutical companies have ended in failure to obtain the approval of regulatory agencies, novel platforms for antimicrobial discovery are needed. The identification of new and fully synthetic chemical structures with activity against nosocomial pathogens needs to be followed by preclinical studies in large animals and by pharmacokinetic and pharmacodynamic studies in specific critically ill populations to assess lung penetration.


Assuntos
Antibacterianos/uso terapêutico , Infecção Hospitalar/tratamento farmacológico , Tratamento Farmacológico/tendências , Pneumonia Associada a Assistência à Saúde/tratamento farmacológico , Técnicas de Química Sintética/métodos , Técnicas de Química Sintética/tendências , Infecção Hospitalar/epidemiologia , Descoberta de Drogas/métodos , Descoberta de Drogas/tendências , Tratamento Farmacológico/métodos , Pneumonia Associada a Assistência à Saúde/epidemiologia , Humanos , Pneumonia/tratamento farmacológico , Pneumonia/epidemiologia
15.
BMJ Case Rep ; 12(5)2019 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-31061188

RESUMO

Primary cardiac angiosarcoma, the most common primary cardiac sarcoma has an incidence ranging from 0.001% to 0.028% in autopsy reports with around 200 cases reported in literature. Since a diagnosis of cardiac angiosarcoma portends a poor prognosis, it is vital to ascertain the precise extent of the lesions for follow-up. Imaging with positron emission tomography (PET) tracer 2-deoxy-2-[18F]-fluoro-D-glucose in cardiac angiosarcoma is challenging as myocardium takes up glucose and delineation of tumour becomes difficult. Cell proliferation rate in normal cardiac muscular tissue is low whereas cardiac tumours display a higher proliferation rate. This aspect could be exploited by use of 3'-deoxy-3'[(18)F]-fluorothymidine positron emission tomography (18F-FLT PET/CT] in cardiac tumours where the cell proliferation could be measured. Herein, we imaged an index case of cardiac angiosarcoma using 18F-FLT PET/CT and report the findings.


Assuntos
Fibrilação Atrial/etiologia , Fluordesoxiglucose F18 , Átrios do Coração/patologia , Neoplasias Cardíacas/patologia , Hemangiossarcoma/patologia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Angioplastia , Fibrilação Atrial/diagnóstico por imagem , Proliferação de Células , Tratamento Farmacológico/métodos , Dispneia , Ecocardiografia , Átrios do Coração/diagnóstico por imagem , Neoplasias Cardíacas/diagnóstico por imagem , Hemangiossarcoma/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
16.
Int J Antimicrob Agents ; 54(2): 184-188, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31085297

RESUMO

The optimum duration of antimicrobial therapy would eradicate infection whilst minimising potential adverse drug effects to the patient. Australian and New Zealand infectious diseases (ID) and ICU specialists were surveyed regarding their recommended duration of antibiotic treatment for five common bacteraemic syndromes. A total of 239 clinicians responded to the survey (15.5% ICU and 84.5% ID). Overall, the most common reported durations were 7 (33.7%), 10 (25.9%) and 14 (26.0%) days, with 46% of responses recommending ≤7 days. Most respondents (>75% for each characteristic) would not modify duration based on host characteristics such as patient age or co-morbidities. ID physicians recommended longer durations than ICU physicians for all five syndromes (ID, median 10, IQR 7-14, range 1-28 days; ICU, median 7, IQR 5-10, range 2-21 days). Across all respondents, the median (IQR) duration for each syndrome was: CVC-BSI, 7 (7-10) days; bacteraemic pneumonia, 7 (7-10) days; bacteraemic UTI, 10 (7-14) days; bacteraemic IAI, 7 (7-12) days; and bacteraemic SSTI, 10 (7-14) days. Marked variation exists amongst clinicians' recommended duration of antibiotic treatment for BSI. A proportion of clinicians recommend therapy of ≤7 days at present (33.3-59.7% across scenarios). Patient characteristics are not strongly considered in the decision on therapy duration. This survey was undertaken as preparatory work for initiation of the BALANCE study, an ongoing randomised trial comparing 7 days with 14 days of therapy for BSI, providing an evidence base to inform best clinical treatment for this patient population.


Assuntos
Antibacterianos/administração & dosagem , Bacteriemia/tratamento farmacológico , Tratamento Farmacológico/métodos , Padrões de Prática Médica/estatística & dados numéricos , Austrália , Humanos , Nova Zelândia , Inquéritos e Questionários , Tempo
17.
J Colloid Interface Sci ; 548: 131-144, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-30991180

RESUMO

The construction of multifunctional theranostic nanoplatforms to integrate accurate imaging and enhanced therapy to treat tumors is highly attractive but remains a challenge. Here, we developed a molybdenum disulfide (MoS2)-based hyaluronic acid (HA)-functionalized nanoplatform capable of achieving the targeted co-delivery of the gadolinium (Gd)-based contrast agents (CAs) and the anticancer drug gefitinib (Gef) for magnetic resonance imaging (MRI) and synergetic chemo-photothermal therapy of tumors. Gd3+ ions were coupled to HA-grafted MoS2 nanosheets with diethylenetriaminepentaacetic acid (DTPA) as a linker, followed by the incorporation of Gef. The resulting MoS2-HA-DTPA-Gd/Gef exhibited enhanced relaxivity, 3.3 times greater than that of the commercial CA DTPA-Gd, which facilitated the MRI in vivo. Moreover, the nanoplatform effectively converted the absorbed near-infrared (NIR) light into heat, which not only induced the photothermal ablation of cancer cells but also triggered the release of Gef from MoS2-HA-DTPA-Gd/Gef, enabling the synergetic chemo-photothermal therapy. The results of in vitro and in vivo experiments revealed that MoS2-HA-DTPA-Gd/Gef upon NIR irradiation effectively blocked the phosphatidylinositol 3 kinase (PI3K)/protein kinase B (Akt) signaling pathway and activated apoptosis-related proteins to induce cell apoptosis and suppress cell proliferation, thus inhibiting the tumor growth in lung cancer cell-bearing mice. Taken together, this multifunctional theranostic nanoplatform has significant promise for the diagnosis and treatment of cancer.


Assuntos
Dissulfetos/química , Portadores de Fármacos/química , Ácido Hialurônico/química , Molibdênio/química , Nanopartículas/química , Neoplasias/diagnóstico por imagem , Neoplasias/terapia , Animais , Antineoplásicos/química , Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Transporte Biológico , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Terapia Combinada , Meios de Contraste/química , Liberação Controlada de Fármacos , Tratamento Farmacológico/métodos , Gadolínio/química , Gefitinibe/química , Gefitinibe/farmacologia , Humanos , Raios Infravermelhos , Imagem por Ressonância Magnética/métodos , Camundongos , Tamanho da Partícula , Fototerapia/métodos , Transdução de Sinais , Propriedades de Superfície , Nanomedicina Teranóstica
18.
Expert Opin Pharmacother ; 20(9): 1153-1160, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30958725

RESUMO

INTRODUCTION: Standard treatment for diabetic foot ulcers (DFUs) includes off-loading, debridement, moisture balance, management of infection and peripheral arterial disease (PAD) as well as adequate glycemic control. The outcomes so far are unsatisfactory. AREAS COVERED: Herein, the authors provide an outline of newer pharmacological agents for the management of DFUs and give their expert perspectives on future treatment strategies. EXPERT OPINION: Evidence-based healthcare calls for high quality evidence from large RCTs before the implementation of new guidelines for the management of DFUs. Empagliflozin and liraglutide can be recommended for glucose control in patients with DFUs and PAD, while intensive lipid lowering therapy with evolocumab when primary cholesterol goals are not met could be offered to patients with DFUs. Further clinical studies are warranted to develop a structured algorithm for the treatment of DFUs that fail to heal after four weeks of current standard of care. Sucrose octasulfate dressings, becaplermin gel, and platelet-rich plasma (PRP) could also be considered as advanced treatment options for the management of hard to heal DFUs.


Assuntos
Pé Diabético/tratamento farmacológico , Tratamento Farmacológico/métodos , Cicatrização/efeitos dos fármacos , Pé Diabético/patologia , Humanos
19.
Expert Opin Pharmacother ; 20(9): 1109-1121, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30983431

RESUMO

INTRODUCTION: Prosthetic joint infections are an increasingly important problem among patients undergoing arthroplasty procedures, and are associated with significant morbidity, reduced quality of life, substantial healthcare costs, and even mortality. Arthroplasties are performed with increasing frequency in elderly patients, who present specific problems. AREAS COVERED: Surgical therapy is clearly influenced by the clinical status of the patient, which in some case can contraindicate surgery. Antibiotic selection is also affected by comorbidities and underlying diseases, which in some cases reduce therapeutic options. The authors review this together with the changes in pharmacokinetics and pharmacodynamics in the elderly population and the prospects for future research on prevention and treatment. EXPERT OPINION: The management of PJI in the elderly makes multidisciplinary teams even more mandatory than in other patients, because the complexity of these patients. A frequent scenario is that in which surgery is contraindicated with long-term suppressive treatment as the only available option. Treating physicians must consider the presence of multiple comorbidities, interactions with other treatments and secondary effects when choosing antibiotic treatment. An in-depth knowledge of the alterations in pharmacokinetics and pharmacodynamics in elderly patients is key for a proper treatment selection.


Assuntos
Desenvolvimento de Medicamentos/métodos , Tratamento Farmacológico/métodos , Infecções Relacionadas à Prótese/tratamento farmacológico , Qualidade de Vida/psicologia , Idoso , Comorbidade , Humanos , Infecções Relacionadas à Prótese/patologia
20.
Rev Bras Enferm ; 72(2): 391-399, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31017201

RESUMO

OBJECTIVE: Construct and validate instrument content for nursing consultation in an adult chemotherapy outpatient clinic. METHOD: Methodological study composed of two stages: elaboration of the instrument and validation of content. A literary review of the dimensions of customer care was carried out in the light of Theory of Basic Human Needs Theory, culminating in two instruments: one for admission consultation and other for follow-up. The content was validated by the evaluation of listed experts based on the adapted Fehring's Validation Model. RESULTS: In the first round, two items of the admission instrument and three items of follow-up required reformulation. In the second round, there was an increase in agreement rate: 11% in the instrument of admission and 10% in follow-up. FINAL CONSIDERATION: The instrument represents a guideline for the Nursing Process and future research, but it cannot be seen as a substitute for nurses' knowledge and clinical reasoning.


Assuntos
Assistência Ambulatorial/métodos , Tratamento Farmacológico/métodos , Encaminhamento e Consulta , Assistência Ambulatorial/tendências , Tratamento Farmacológico/tendências , Humanos , Inquéritos e Questionários
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