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1.
J Fr Ophtalmol ; 44(10): 1499-1504, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34774348

RESUMO

PURPOSE: To assess myopia progression in Spanish children and whether treatment with low-dose atropine eye drops delays myopia progression and axial elongation. METHODS: 339 eyes of 339 Caucasian patients with myopia, aged 5 to 11 years, were examined. Participants were randomized to a treatment arm, receiving one atropine (0.01%) eye drop/day for two, and an untreated control arm. At the baseline and 2-year follow-up visits, we recorded: spherical equivalent (SE), axial length (AL), mean keratometry (Mean-K) and anterior chamber depth (ACD). We also examined the rate of children with higher myopia progression (change in SE >1 D/2 years) and identified risk factors for progression. RESULTS: In 339 eyes of the 339 children (age=7.61; SD 1.70; range 5-11 years), the mean baseline SE was-2.15 (SD 0.62) D, and AL was 24.24 (SD 0.79) mm. After 2 years, higher increases occurred in all variables except ACD in the untreated group vs. the atropine group, respectively: SE (-0.51 (SD 0.39) D vs. -0.76 (SD 0.37) D, P<0.001), AL (0.20 (SD 0.20) mm vs. 0.37 (SD 0.27) mm, P<0.001) and Mean-K (0.01 (0.28) D vs. 0.09 (0.32) D, P=0.018). Myopia progression was reduced by 32% in the treatment group. There were more progressors >1D/2y in the control group: 62/168 (36.9%) vs. 35/171 (20.5%) (P<0.001). Atropine was identified as a protective factor against myopia progression (B=1.12; 95% CI= 0.98-1.27; P=<0.001). CONCLUSION: Spanish children showed a low rate of myopia progression. Atropine 0.01% showed a significant effect in slowing the progression of both refractive error and axial elongation.


Assuntos
Atropina , Miopia , Comprimento Axial do Olho , Criança , Pré-Escolar , Córnea , Progressão da Doença , Método Duplo-Cego , Humanos , Miopia/diagnóstico , Miopia/tratamento farmacológico , Miopia/epidemiologia , Soluções Oftálmicas , Refração Ocular
2.
Ann Palliat Med ; 10(9): 9535-9543, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34628879

RESUMO

BACKGROUND: To date, guidelines on the impact and value of atropine combined with omeprazole in the treatment of acute gastritis have not been well established or well defined. This study aimed to clarify the efficacy and safety of combined atropine and omeprazole therapy for the management of patients with acute gastritis. METHODS: Through searching the electronic database, the related literature of the combination of atropine with omeprazole in the treatment of acute gastritis were reviewed. A meta-analysis was performed after literature selection according to inclusion criteria. The treatment efficiency and the incidence of adverse reactions were used as the main outcome indicators. The odds ratios (ORs), standardized mean differences (SMDs), and 95% confidence intervals (CIs) of the two treatment regimens were analyzed. RESULTS: This study analyzed 11 articles from the literature with a total of 1,053 subjects. The combination of atropine and omeprazole significantly improved the clinical outcomes of patients with acute gastritis compared to patients treated with combined anisodamine and omeprazole (control group). The effective rate of combined atropine and omeprazole treatment was 1.21 times higher than that observed with the control group, and the incidence of adverse reactions was 0.41 times that of the control group. Atropine combined with omeprazole significantly alleviated the clinical symptoms of the patients. The total treatment time was shortened by 0.57 days, duration of abdominal pain was shortened by 2.82 days, duration of diarrhea was reduced by 1.99 days, and the duration of nausea and vomiting was shortened by 2.68 days compared to the control group. DISCUSSION: The combination of atropine with omeprazole in the treatment of acute gastritis demonstrated a high effective rate with few adverse reactions than. It was effective at alleviating the clinical symptoms associated with acute gastritis. The results of this study provide support for the clinical implementation of combined atropine and omeprazole in the treatment of patients with acute gastritis.


Assuntos
Gastrite , Omeprazol , Atropina/efeitos adversos , Gastrite/tratamento farmacológico , Humanos , Omeprazol/uso terapêutico , Resultado do Tratamento
3.
Molecules ; 26(19)2021 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-34641293

RESUMO

A fast method for the determination of tropane alkaloids, using a portable CE instrument with a capacitively coupled contactless conductivity detector (CE-C4D) was developed and validated for determination of atropine and scopolamine in seeds from Solanaceae family plants. Separation was obtained within 5 min, using an optimized background electrolyte consisting of 0.5 M acetic acid with 0.25% (w/v) ß-CD. The limit of detection and quantification was 0.5 µg/mL and 1.5 µg/mL, respectively, for both atropine and scopolamine. The developed method was validated with the following parameters-precision (CV): 1.07-2.08%, accuracy of the assay (recovery, RE): 101.0-102.7% and matrix effect (ME): 92.99-94.23%. Moreover, the optimized CE-C4D method was applied to the analysis of plant extracts and pharmaceuticals, proving its applicability and accuracy.


Assuntos
Atropina/análise , Escopolamina/análise , Solanaceae/química , Eletroforese Capilar , Limite de Detecção , Alcaloides de Solanáceas/análise
4.
Sensors (Basel) ; 21(17)2021 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-34502770

RESUMO

A supramolecular atropine sensor was developed, using cucurbit[6]uril as the recognition element. The solid-contact electrode is based on a polymeric membrane incorporating cucurbit[6]uril (CB[6]) as an ionophore, 2-nitrophenyl octyl ether as a solvent mediator, and potassium tetrakis (4-chlorophenyl) borate as an additive. In a MES-NaOH buffer at pH 6, the performance of the atropine sensor is characterized by a slope of (58.7 ± 0.6) mV/dec with a practical detection limit of (6.30 ± 1.62) × 10-7 mol/L and a lower limit of the linear range of (1.52 ± 0.64) × 10-6 mol/L. Selectivity coefficients were determined for different ions and excipients. The obtained results were bolstered by the docking and spectroscopic studies which demonstrated the interaction between atropine and CB[6]. The accuracy of the potentiometric analysis of atropine content in certified reference material was evaluated by the t-Student test. The herein proposed sensor answers the need for reliable methods providing better management of this hospital drug shelf-life while reducing its flush and remediation costs.


Assuntos
Atropina , Polímeros , Eletrodos , Humanos , Ionóforos , Potenciometria
5.
PLoS One ; 16(9): e0257480, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34520481

RESUMO

PURPOSE: The outbreak of coronavirus disease 2019 (COVID-19) has caused many children to stay indoors. Increased near work and insufficient outdoor activities are considered important risk factors for myopic progression. This study aimed to compare the changes in myopic progression before and after COVID-19 in children treated with low-concentration atropine. METHODS: The records of 103 eyes of 103 children who were treated with low-concentration atropine eye drops were retrospectively reviewed. We classified children according to the concentration of atropine eye drops and children's age. The beginning of the pre-COVID-19 period was set from January 2019 to May 2019, and the endpoint was set in March 2020. The beginning of the post-COVID-19 period was set in March 2020, and the endpoint was set from January 2021 to March 2021. We evaluated the questionnaires administered to children's parents. RESULTS: A significant myopic progression was observed in the post-COVID-19 period compared to the pre-COVID-19 period in the 0.05% and 0.025% atropine groups (P < 0.001 and P = 0.020, respectively). For children aged 5 to 7 and 8 to 10 years, the axial elongations were significantly faster in the post-COVID-19 period than in the pre-COVID-19 period (P = 0.022 and P = 0.005, respectively). However, the rates of axial elongation and myopic progression were not significantly different between pre- and post-COVID-19 in children aged 11 to 15 years (P = 0.065 and P = 0.792, respectively). The average time spent using computers and smartphones and reading time were significantly increased, and the times of physical and outdoor activity were significantly decreased in the post-COVID-19 period compared to the pre-COVID-19 period. CONCLUSIONS: The rates of myopic progression have increased substantially after the spread of COVID-19 with an increase in the home confinement of children. Therefore, it is necessary to control the environmental risk factors for myopia, even in children undergoing treatment for the inhibition of myopic progression.


Assuntos
Atropina/administração & dosagem , COVID-19/prevenção & controle , Miopia/tratamento farmacológico , Adolescente , Atropina/uso terapêutico , COVID-19/epidemiologia , Criança , Controle de Doenças Transmissíveis , Computadores , Humanos , Miopia/epidemiologia , Soluções Oftálmicas , Pandemias , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Smartphone
6.
Molecules ; 26(18)2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34576975

RESUMO

In rats with polycystic ovary syndrome (PCOS) induced by injection of estradiol valerate (EV), unilateral or bilateral section of the vagus nerve restores ovulatory function in 75% of animals, suggesting that the vagus nerve participates in the development of PCOS. Since the vagus nerve is a mixed nerve through which mainly cholinergic-type information passes, the objective of the present study was to analyze whether acetylcholine (ACh) is involved in the development of PCOS. Ten-day-old rats were injected with 2.0 mg EV, and at 60 days of age, they were microinjected on the day of diestrus in the bursa of the left or right ovary with 100 or 700 mg/kg of ovarian weight atropine, a blocker of muscarinic receptors, and sacrificed for histopathological examination after the surgery. Animals with PCOS microinjected with 100 mg of atropine showed a lack of ovulation, lower serum concentrations of progesterone and testosterone, and cysts. Histology of the ovaries of animals microinjected with 700 mg of atropine showed corpus luteum and follicles at different stages of development, which was accompanied by a lower concentration of progesterone and testosterone. These results allow us to suggest that in animals with PCOS, ACh, which passes through parasympathetic innervation, is an important component in the persistence and development of the pathophysiology.


Assuntos
Síndrome do Ovário Policístico , Progesterona , Animais , Atropina/farmacologia , Estradiol , Feminino , Ovulação/efeitos dos fármacos , Ratos
8.
J Binocul Vis Ocul Motil ; 71(3): 110-117, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34348581

RESUMO

BACKGROUND: The coronavirus (COVID-19) global pandemic has been a poignant reminder of the value of telehealth services to deliver care, especially as a means of reducing the risk of infectious disease transmission caused by close personal contact, decreasing unnecessary travel for medical consultations, and limiting the number of individuals in waiting rooms. The role of telehealth in ophthalmology has historically been limited to store-and-forwarding of images, much like what is used in radiology. PATIENTS AND METHODS: Remote evaluation using two-way audio-video communications over the initial 10-week period of clinic shutdowns. Visual acuity (VA) measurement was attempted using a printed single surrounded HOTV or Snellen chart. The VA measurement of fellow eyes was compared to the prior in person clinical visit. External and strabismus examinations were also conducted. RESULTS: Fifty-eight patients were evaluated with a mean age 12.5 years (range 5 months to 82 years). Twenty of 58 (34%) were younger than 5 years of age. Reasons for evaluation were strabismus in 26 patients (45%), refractive error in 25 (43%), and amblyopia in 10 patients (19%). Recognition visual acuity was obtained in 69% (40 of 58), including every patient older than 5 years of age. Nine children from 2 to 5 years of age (mean 3 years) were unable to perform HOTV VA testing. Of nine children unable to do complete VA testing, five had been premature and seven had developmental delay. There was a mean bias of -0.12 logMAR in favor of the prior in office test in the right eyes of 21 non-amblyopic patients. The 95% limits of agreement between the in-person visit and the subsequent telehealth video visit logMAR VA were +0.20 logMAR upper limit, -0.44 logMAR lower limit. CONCLUSIONS: Telehealth video visits provided basic ophthalmic information in patients who are physically incapable to come to the office, leading to improved triage. Vision could be tested remotely in young children, but we found substantial variability in the measurement of clinically normal eyes. Improvements in the reliability of at-home visual acuity testing are needed.


Assuntos
COVID-19/epidemiologia , Consulta Remota/métodos , SARS-CoV-2 , Estrabismo/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Atropina/administração & dosagem , Criança , Pré-Escolar , Óculos , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Antagonistas Muscarínicos/administração & dosagem , Oftalmologia/métodos , Pediatria/métodos , Consulta Remota/organização & administração , Privação Sensorial , Estrabismo/fisiopatologia , Estrabismo/terapia , Estados Unidos/epidemiologia , Testes Visuais/métodos , Acuidade Visual/fisiologia
9.
FASEB J ; 35(9): e21846, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34405458

RESUMO

Myopia (short-sightedness), usually caused by excessive elongation of the eye during development, has reached epidemic proportions worldwide. In animal systems including the chicken model, several treatments have been shown to inhibit ocular elongation and experimental myopia. Although diverse in their apparent mechanism of action, each one leads to a reduction in the rate of ocular growth. We hypothesize that a defined set of retinal molecular changes may underlie growth inhibition, irrespective of the treatment agent used. Accordingly, across five well-established but diverse methods of inhibiting myopia, significant overlap is seen in the retinal transcriptome profile (transcript levels and alternative splicing events) in chicks when analyzed by RNA-seq. Within the two major pathway networks enriched during growth inhibition, that of cell signaling and circadian entrainment, transcription factors form the largest functional grouping. Importantly, a large percentage of those genes forming the defined retinal response are downstream targets of the transcription factor EGR1 which itself shows a universal response to all five growth-inhibitory treatments. This supports EGR1's previously implicated role in ocular growth regulation. Finally, by contrasting our data with human linkage and GWAS studies on refractive error, we confirm the applicability of our study to the human condition. Together, these findings suggest that a universal set of transcriptome changes, which sit within a well-defined retinal network that cannot be bypassed, is fundamental to growth regulation, thus paving a way for designing novel targets for myopia therapies.


Assuntos
Olho/crescimento & desenvolvimento , Olho/metabolismo , Redes Reguladoras de Genes , Miopia/genética , Miopia/prevenção & controle , Transcriptoma , Processamento Alternativo/efeitos dos fármacos , Animais , Atropina/farmacologia , Galinhas , Ritmo Circadiano/efeitos dos fármacos , Proteína 1 de Resposta de Crescimento Precoce/metabolismo , Olho/efeitos dos fármacos , Regulação da Expressão Gênica/efeitos dos fármacos , Redes Reguladoras de Genes/efeitos dos fármacos , Humanos , Janus Quinases/metabolismo , Masculino , Modelos Biológicos , Ácidos Fosfínicos/farmacologia , Pirenzepina/farmacologia , Piridinas/farmacologia , Reprodutibilidade dos Testes , Retina/efeitos dos fármacos , Retina/crescimento & desenvolvimento , Retina/metabolismo , Fatores de Transcrição STAT/metabolismo , Tetra-Hidronaftalenos/farmacologia , Fatores de Tempo , Transcriptoma/efeitos dos fármacos
10.
J Exp Biol ; 224(17)2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34427663

RESUMO

When snakes digest large meals, heart rate is accelerated by withdrawal of vagal tone and an increased non-adrenergic-non-cholinergic tone that seems to stem from circulating blood-borne factors exerting positive chronotropic effects. To investigate whether this tonic elevation of heart rate impairs the ability for autonomic regulation of heart during digestion, we characterised heart rate responses to pharmacological manipulation of blood pressure in the snake Boa constrictor through serial injections of sodium nitroprusside and phenylephrine. Both fasting and digesting snakes responded with a robust tachycardia to hypotension induced by sodium nitroprusside, with digesting snakes attaining higher maximal heart rates than fasting snakes. Both fasting and digesting snakes exhibited small reductions of the cardiac chronotropic response to hypertension, induced by injection of phenylephrine. All heart rate changes were abolished by autonomic blockade with the combination of atropine and propranolol. The digesting snakes retained the capacity for compensatory heart rate responses to hypotension, despite their higher resting values, and the upward shift of the barostatic response curve enables snakes to maintain the cardiac limb of barostatic regulation for blood pressure regulation.


Assuntos
Boidae , Animais , Atropina/farmacologia , Sistema Nervoso Autônomo , Pressão Sanguínea , Frequência Cardíaca , Nitroprussiato/farmacologia , Nervo Vago
11.
Asia Pac J Ophthalmol (Phila) ; 10(5): 450-460, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34456234

RESUMO

PURPOSE: To determine the effect of atropine on pupillary diameter, accommodative amplitude as well as myopia progression. METHODS: Medical databases and Cochrane Library were systematically searched for studies from 1980 until June 2020. The primary and secondary outcomes were: a) change in pupillary diameter (PD) and accommodative amplitude (AA) and b) annualized mean change in spherical equivalent and axial length with various concentrations of atropine compared to control. RESULTS: Thirteen trials (6 RCTs, 7 observational studies) that studied 9 atropine concentrations (0.01-1.0%) were included. The relation between atropine and change in PD and AA was nonlinear; at < 0.10% atropine, the slope of the curve was steep but the change in PD (+0.7 mm; 95% CI: +0.1 to +1.4) and AA (-1.6D; 95% CI: -3.9 to +0.7) was smaller whereas at ≥0.10% atropine, the slope plateaued but change in PD (+3.2 mm, 95% CI: +2.8 to +3.5) and AA (-10.7D; 95% CI: -12.2 to -9.2) was high.Reduction in myopia progression with atropine at <0.10% and ≥0.10% as compared to controls was 0.37D (95% CI: 0.16 to 0.58) versus 0.75D (95% CI: 0.17 to 1.33) for spherical equivalent and -0.10 mm (95% CI: -0.24 to 0.05) versus -0.23 mm (95% CI: -0.34 to -0.13) for axial length. CONCLUSIONS: A nonlinear dose-response relationship exists between atropine and PD and AA. Further work is warranted to determine the concentration that provides maximal efficacy with tolerable side effects.


Assuntos
Atropina , Miopia , Progressão da Doença , Humanos , Miopia/tratamento farmacológico , Soluções Oftálmicas , Refração Ocular
12.
Methods Mol Biol ; 2320: 295-302, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34302666

RESUMO

Recent evidence has provided exciting proof of concepts for the use of pluripotent stem cell-derived cardiomyocytes (PSC-CMs) for cardiac repair; however, large animal studies, which better reflect human disease, are required for clinical application. Here, we describe how to create myocardial infarction in cynomolgus monkey followed by transplantation of PSC-CMs. This method ensures the establishment of a myocardial infarction model and enables reliable PSC-CM transplantation.


Assuntos
Modelos Animais de Doenças , Células-Tronco Pluripotentes Induzidas/citologia , Macaca fascicularis , Infarto do Miocárdio/terapia , Miócitos Cardíacos/transplante , Anestesia por Inalação/métodos , Anestesia por Inalação/veterinária , Animais , Atropina/uso terapêutico , Bradicardia/tratamento farmacológico , Bradicardia/prevenção & controle , Células Cultivadas , Complicações Intraoperatórias/tratamento farmacológico , Complicações Intraoperatórias/prevenção & controle , Ligadura
13.
Eur J Anaesthesiol ; 38(8): 856-864, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34226418

RESUMO

BACKGROUND: The lower oesophageal sphincter (LOS) barrier serves to prevent regurgitation of gastric contents. Although general anaesthesia depresses its function, its recovery process during emergence from anaesthesia has not been systematically examined. OBJECTIVE: To explore whether recovery of lower oesophageal barrier function differed between patients receiving a mixture of 1 mg atropine and 2 mg neostigmine and those receiving 2 mg kg-1 sugammadex during emergence from anaesthesia. DESIGN: An unblinded randomised controlled pilot study. SETTING: A single university hospital from January 2016 to December 2018. PATIENTS: A total of 20 non-obese adult females undergoing minor surgery. INTERVENTION: The patients were randomly assigned to a group either receiving atropine and neostigmine or sugammadex for reversal of rocuronium. MAIN OUTCOME MEASURES: Through use of the high-resolution manometry technique, the lower oesophageal barrier pressure (PBAR: primary variable) defined as a pressure difference between pressures at the LOS and the stomach was measured at five distinguishable time points during emergence from total intravenous anaesthesia. A mixed effects model for repeated measures was used to test the hypothesis. RESULTS: In all patients baseline PBAR values were positive even under muscle paralysis and general anaesthesia before administration of reversal agents, and did not differ between the groups (P = 0.299). During recovery from muscle paralysis and general anaesthesia, PBAR (mean ±â€ŠSD) significantly increased (P = 0.004) from 17.0 ±â€Š2.9 to 21.0 ±â€Š5.0 mmHg in the atropine and neostigmine group (n = 8) and from 19.1 ±â€Š9.0 to 24.5 ±â€Š12.7 mmHg in the sugammadex group (n = 11). PBAR significantly increased immediately after return of consciousness in both groups, whereas return of muscle tone, lightening of anaesthesia and tracheal extubation did not change it. CONCLUSION: Recovery of the lower oesophageal barrier function does not differ between patients receiving either atropine and neostigmine or sugammadex and is completed after recovery of consciousness from general anaesthesia. TRIAL REGISTRATION: UMIN Clinical Trials Registry: UMIN000020500: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000023594&type=summary&language=E.


Assuntos
Bloqueio Neuromuscular , Fármacos Neuromusculares não Despolarizantes , Adulto , Atropina , Inibidores da Colinesterase , Feminino , Humanos , Neostigmina , Projetos Piloto , Sugammadex
14.
Int J Pharm ; 606: 120898, 2021 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-34310952

RESUMO

Atropine sulfate (AS) auto-injectors are the only approved antidote for out-of-hospital emergency treatment of organophosphates (OP) toxicity. However, they are only available for military use and require the administration of multiple auto-injectors. Therefore, an alternative, patient-friendly and more affordable fast-disintegrating sublingual tablets (FDSTs) of AS were previously developed. In this article, the effect of modifying the microenvironment's pH and/or using penetration enhancers on AS sublingual transport pathways were evaluated in an attempt to further enhance AS sublingual permeability. Ten different AS FDST formulations with or without the incorporation of alkalizer and various penetration enhancers were manufactured and characterized. AS permeability was investigated through excised porcine sublingual membrane using Franz cells. Results showed that the incorporation of either a transcellular enhancer or alkalizer achieved a significantly higher AS permeability enhancement (twofold). Combining sodium bicarbonate (Na Bicarb) 2% as alkalizer with sodium dodecyl sulfate (SDS) 1% as a transcellular enhancer resulted in the greatest synergistic enhancement in AS sublingual permeability (up to twelvefold). In conclusion, the modified AS FDST developed in this work has the potential to improve the pharmacokinetic parameters of AS following sublingual administration for the first-aid treatment of OP toxicity in future animal bioequivalency studies.


Assuntos
Atropina , Organofosfatos , Administração Sublingual , Animais , Humanos , Concentração de Íons de Hidrogênio , Permeabilidade , Suínos , Comprimidos
15.
Toxicol Appl Pharmacol ; 427: 115650, 2021 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-34273408

RESUMO

Most research on medical countermeasures for nerve agent exposure assumes a military scenario, in which (autoinjector) treatment is envisaged to be available immediately. In a civilian setting however, treatment is delayed until arrival of first-aid responders. This may significantly affect treatment efficacy and the requirements for secondary intensive care. The aim of the current study was to develop a guinea pig model to evaluate the efficacy of delayed treatment following nerve agent exposure. We identified a trigger-to-treat based on a progressive stage of the toxidrome following VX exposure, which was associated with the subsiding of clonic movements. This paradigm resulted in treatment consistently being administered between 15 and 25 min post-exposure. Using the model, we investigated the potential for the anticholinergic scopolamine to act as a delayed treatment either as a standalone treatment, or as an adjunct to delayed treatment with Standard of Care (SOC), containing atropine, 2-PAM, and midazolam. The study provides a framework for a small animal model for evaluating the efficacy of treatment administered at a specific stage of the toxidrome, when immediate treatment is absent. As an adjunct, scopolamine treatment did not result in improved survival, but did show a beneficial effect on recovery, in terms of general posture. As a standalone treatment, scopolamine showed a significant, dose-responsive, beneficial effect on survival and recovery. These promising results warrant additional studies to investigate which observed physiological improvements are relevant for the recovery process and residual injury.


Assuntos
Substâncias para a Guerra Química/toxicidade , Antagonistas Colinérgicos/administração & dosagem , Agentes Neurotóxicos/toxicidade , Compostos Organotiofosforados/toxicidade , Escopolamina/administração & dosagem , Tempo para o Tratamento , Animais , Atropina/administração & dosagem , Relação Dose-Resposta a Droga , Avaliação Pré-Clínica de Medicamentos/métodos , Quimioterapia Combinada , Cobaias , Masculino , Midazolam/administração & dosagem , Compostos de Pralidoxima/administração & dosagem , Taxa de Sobrevida/tendências
17.
PLoS One ; 16(7): e0254061, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34264970

RESUMO

PURPOSE: Identifying axial length growth rate as an indicator of fast progression before initiating atropine 0.01% for myopia progression in children. METHOD: From baseline, axial length growth over six months was measured prospectively. Subjects were then initiated on atropine 0.01% if axial length growth was greater than 0.1mm per 6 months (fast progressors), axial length and spherical equivalent change measurements recorded every six months. The rate of change was compared to the baseline pre-treatment rate. If axial length change was below the threshold, subjects received monitoring only. RESULTS: 73 subjects were identified as fast progressors and commenced atropine 0.01%, (mean baseline refraction of OD -2.9±1.6, OS -2.9±1.8 and a mean baseline axial length OD 24.62 ± 1.00 mm, OS 24.53 ± 0.99 mm). At six months, the mean paired difference of axial length growth rate was significantly reduced by 50% of baseline (all 73 subjects, p<0.05). 53 subjects followed to 12 months, and 12 to 24 months maintained a reduced growth rate. Change in mean spherical equivalent was significantly reduced compared to pre-treatment refractive error (mean paired difference p<0.05) and at each subsequent visit. 91 children were slow progressors and remained untreated. Their axial length growth rate did not change significantly out to 24 months. Spherical equivalent changed less than -0.5D annually in this group. CONCLUSION: Identifying fast progressors before treatment initiation demonstrated a strong treatment effect with atropine 0.01% reducing their individual rate of myopia progression by 50%. Another large group of myopic children, slow progressors, continued without medical intervention. A baseline axial length growth rate is proposed as a guideline to identify fast progressors who are more likely to benefit from atropine 0.01%.


Assuntos
Atropina , Miopia Degenerativa , Criança , Progressão da Doença , Humanos , Midriáticos , Refração Ocular
18.
J AAPOS ; 25(3): 162.e1-162.e6, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34102258

RESUMO

PURPOSE: To report a consolidated management protocol for patients with spasm of near reflex (SNR), including classification of cases as mild, moderate, and severe based on treatment outcomes. METHODS: Patients with SNR treated at a single institution between August 2016 and November 2018 were included. Management of SNR included modified optical fogging, vision therapy, and pharmacological intervention (cyclopentolate eye drops and, if required, atropine eye drops). Outcome measures were visual acuity (20/25 or better) and refractive error (reduction of excessive myopia). RESULTS: Of 1,306 patients examined during the study period, 66 were diagnosed with SNR, yielding a prevalence of 5% among first-time patients visiting our binocular vision and orthoptics clinic. Of the 45 patients recruited for this study (mean age, 14 ± 5 years; 24 males), all three near-triad components were involved in 11 patients (24%), only the accommodation component in 32 (71%), and only the convergence component in 2 (4%). SNR was relieved in the first post-cyclopentolate refraction visit or with the modified optical fogging technique in 29 patients (66%; mild SNR) and with one-time usage of atropine eyedrops in 10 patients (22%; moderate SNR). In 6 patients (13%), atropine was continued long-term (severe SNR). Of 15 patients with long-term follow-up (1 year), 11 (73%) had persistent relief of SNR. CONCLUSIONS: In our study cohort, SNR with accommodation component was the most common and could be largely relaxed through a one-time use of cycloplegic eye drops and optical intervention. Only severe forms of SNR may require extended use of strong cycloplegics.


Assuntos
Acomodação Ocular , Atropina , Adolescente , Adulto , Atropina/uso terapêutico , Criança , Ciclopentolato , Humanos , Masculino , Midriáticos/uso terapêutico , Soluções Oftálmicas , Reflexo , Refração Ocular , Espasmo , Resultado do Tratamento , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: mdl-34126232

RESUMO

Irisin is a 23 kDa myokine encoded in its precursor, fibronectin type III domain containing 5 (FNDC5). The exercise-induced increase in the expression of peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC1-α) promotes FNDC5 mRNA, followed by the proteolytic cleavage of FNDC5 to release irisin from the skeletal or cardiac muscle into the blood. Irisin is abundantly expressed in skeletal and cardiac muscle and plays an important role in feeding, modulates appetite regulatory peptides, and regulates cardiovascular functions in zebrafish. In order to determine the potential mechanisms of acute irisin effects, in this research, we explored whether adrenergic or muscarinic pathways mediate the cardiovascular effects of irisin. Propranolol (100 ng/g B·W) alone modulated cardiac functions, and when injected in combination with irisin (0.1 ng/g B·W) attenuated the effects of irisin in regulating cardiovascular functions in zebrafish at 15 min post-injection. Atropine (100 ng/g B·W) modulated cardiovascular physiology in the absence of irisin, while it was ineffective in influencing irisin-induced effects on cardiovascular functions in zebrafish. At 1 h post-injection, irisin downregulated PGC-1 alpha mRNA, myostatin-a and myostatin-b mRNA expression in zebrafish heart and skeletal muscle. Propranolol alone had no effect on the expression of these mRNAs in zebrafish and did not alter the irisin-induced changes in expression. At 1 h post-injection, irisin siRNA downregulated PGC-1 alpha, troponin C and troponin T2D mRNA expression, while upregulating myostatin a and b mRNA expression in zebrafish heart and skeletal muscle. Atropine alone had no effects on mRNA expression, and was unable to alter effects on mRNA expression of siRNA. Overall, this research identified a role for the sympathetic/beta-adrenergic pathway in regulating irisin effects on cardiovascular physiology and cardiac gene expression in zebrafish.


Assuntos
Regulação da Expressão Gênica , Proteínas de Peixe-Zebra/biossíntese , Peixe-Zebra/genética , Antagonistas Adrenérgicos beta/farmacologia , Animais , Atropina/farmacologia , Fenômenos Fisiológicos Cardiovasculares , Sistema Cardiovascular/efeitos dos fármacos , Feminino , Perfilação da Expressão Gênica , Coração , Masculino , Músculo Esquelético/metabolismo , Miostatina/metabolismo , Peptídeos , Propranolol/farmacologia , RNA Mensageiro/metabolismo , Fatores de Transcrição/metabolismo
20.
Graefes Arch Clin Exp Ophthalmol ; 259(10): 3083-3092, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34142186

RESUMO

BACKGROUND: Several randomized controlled studies have demonstrated the beneficial effects of 0.01% atropine eye drops on myopia progression in children. However, treatment effects may be different in a routine clinical setting. We performed a retrospective analysis of our clinical data from children to investigate the effect of 0.01% atropine eye drops on myopia progression in a routine clinical setting. METHODS: Atropine-treated children were asked to instill one drop of 0.01% atropine in each eye every evening at 5 days a week. Myopic children who did not undergo atropine treatment served as controls. Objective refraction and ocular biometry of 80 atropine-treated and 103 untreated children at initial visit and 1 year later were retrospectively analyzed. RESULTS: Myopic refractions in the treated and untreated children at initial visit ranged from -0.625 to -15.25 D (-4.21 ± 2.90 D) and from -0.125 to -9.375 D (-2.92 ± 1.77 D), respectively. Ages at initial visit ranged from 3.2 to 15.5 years (10.1 ± 2.7 years) in the treated and from 3.4 to 15.5 years (11.2 ± 3.0 years) in untreated children. Two-factor ANOVA for age and atropine effects on axial length growth confirmed that axial length growth rates declined with age (p<0.0001) and revealed a significant inhibitory effect of atropine on axial length growth (p<0.0015). The atropine effect on axial length growth averaged to 0.08 mm (28%) inhibition per year. Effects on refraction were not statistically significant. CONCLUSION: The observed atropine effects were not very distinctive: Statistical analysis confirmed that atropine reduced axial length growth, but to an extent of minor clinical relevance. It was also shown that beneficial effects of 0.01% atropine may not be obvious in each single case, which should be communicated with parents and resident ophthalmologists.


Assuntos
Atropina , Midriáticos , Adolescente , Comprimento Axial do Olho , Biometria , Criança , Pré-Escolar , Progressão da Doença , Humanos , Soluções Oftálmicas , Refração Ocular , Estudos Retrospectivos
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