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1.
Vaccine ; 40(52): 7505-7509, 2022 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-36357286

RESUMO

PURPOSE: Shoulder injury directly related to vaccination (SIRVA) occurs when a vaccine is administered too high in the shoulder. The primary aim of this study was to accurately detail the occurrence, symptoms, diagnosis, management and long-term outcomes of SIRVA cases in Victoria, Australia. PRINCIPAL RESULTS: The study identified 102 SIRVA cases from 2007 to 2020 from the Surveillance of Adverse Events Following Vaccination in the Community (SAEFVIC) database. The majority [73/85; (86 %)] of cases resolved completely with a median time to resolution of 8 weeks and no statistically significant difference in recovery by immunisation provider type or baseline imaging. MAJOR CONCLUSIONS: This large case series includes long-term clinical progress in SIRVA, allowing accurate evaluation and analysis. Further evaluation is required to establish if other risk factors contribute to SIRVA, which may help with targeted, tailored education for providers on correct vaccine administration technique, including in large and rapid vaccine rollouts.


Assuntos
Lesões do Ombro , Vacinação , Humanos , Lesões do Ombro/epidemiologia , Vacinação/efeitos adversos , Vitória/epidemiologia
2.
BMJ Open ; 11(7): e044806, 2021 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-34253659

RESUMO

OBJECTIVES: In Australia, therapeutic interchange of angiotensin-converting enzyme (ACE) inhibitors could generate savings for patients and the Pharmaceutical Benefits Scheme (PBS). The PBS subsidises nine drugs in the ACE inhibitor class. These drugs are therapeutically equivalent, but the price varies between each drug. Patients are key players in successful therapeutic interchange programmes, but little is known about their views. This study aims to explore patient views of therapeutic interchange of ACE inhibitors in Australian primary care. DESIGN: Qualitative exploratory research study using semi-structured interviews, asking participants about therapeutic interchange and their attitude towards hypothetically switching ACE inhibitors. Data were analysed thematically. SETTING: Australian primary care. PARTICIPANTS: Fourteen adults in Australia currently taking an ACE inhibitor, recruited via general practices and pharmacies, social media and professional networks. FINDINGS: Five key themes were identified: participants' limited understanding of medication; the expectation that a new drug would be 'the same'; the view that choice, convenience and fear of change outweigh the cost; altruism; and trust in health professionals, particularly participants' own general practitioner (GP). CONCLUSIONS: Patients' limited understanding of medication changes poses a barrier to therapeutic interchange. Clinicians should explore patients' understanding and expectations of therapeutic interchange. Counselling from trusted health professionals, particularly GPs, could ameliorate concerns. Policymakers implementing therapeutic interchange programmes should ensure a trusted GP directs medication changes.


Assuntos
Inibidores da Enzima Conversora de Angiotensina , Clínicos Gerais , Adulto , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Atitude do Pessoal de Saúde , Austrália , Humanos , Atenção Primária à Saúde , Pesquisa Qualitativa
3.
Vet Clin North Am Food Anim Pract ; 25(1): 209-20, viii, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19174290

RESUMO

This article reviews the current knowledge on the pathophysiology of abomasal ulcer formation and abomasal tympany in calves. The development of ulcers and bloat has been attributed to many factors, including coarse feed, environmental stress, vitamin and mineral deficiencies, and bacterial infections. This article discusses various factors thought to play a role in the development of these abomasal conditions in calves.


Assuntos
Abomaso/patologia , Fenômenos Fisiológicos da Nutrição Animal/fisiologia , Doenças dos Bovinos/patologia , Úlcera Gástrica/veterinária , Abomaso/microbiologia , Ração Animal , Animais , Animais Recém-Nascidos , Bovinos , Doenças dos Bovinos/microbiologia , Feminino , Masculino , Úlcera Gástrica/microbiologia , Úlcera Gástrica/patologia
4.
Am J Vet Res ; 69(6): 824-31, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18518665

RESUMO

OBJECTIVES: To compare abomasal emptying rates in calves after suckling milk replacer or 3 common orally administered electrolyte solution components. ANIMALS: 5 male calves < 35 days of age. PROCEDURES: Calves with a cannula fitted in the abomasal body were fed 2 L of milk replacer with or without parenteral administration of atropine (0.01 mg/kg, i.v., then 0.02 mg/ kg, s.c., q 30 min) or isotonic (150 mM) solutions of sodium acetate, NaHCO(3), or NaCl in a randomized crossover design. Abomasal emptying rates were determined via scintigraphy, acetaminophen absorption, ultrasonography, and change in abomasal luminal pH. RESULTS: Scintigraphic half-emptying time, time of maximal plasma acetaminophen concentration, ultrasonographic half-emptying time, and pH return time indicated similar abomasal emptying rates following suckling of isotonic sodium acetate, NaHCO(3), and NaCl solutions, whereas the emptying rate of milk replacer was significantly slower. Mean maximal abomasal luminal pH was highest following suckling of NaHCO(3) (pH(max)=7.85) and lowest following suckling of NaCl (pH(max)=4.52); sodium acetate (pH(max)=6.59) and milk replacer (pH(max)=5.84) yielded intermediate pH values. CONCLUSIONS AND CLINICAL RELEVANCE: Isotonic solutions of sodium acetate, NaHCO(3), and NaCl were rapidly emptied from the abomasum but varied markedly in their ability to alkalinize the abomasum. Sodium bicarbonate-containing orally administered electrolyte solution might increase the frequency of infection or severity of clinical disease in diarrheic calves treated for dehydration by causing prolonged abomasal alkalinization.


Assuntos
Bovinos/fisiologia , Esvaziamento Gástrico/efeitos dos fármacos , Soluções para Reidratação/farmacologia , Acetato de Sódio/farmacologia , Bicarbonato de Sódio/farmacologia , Cloreto de Sódio/farmacologia , Abomaso/diagnóstico por imagem , Abomaso/metabolismo , Acetaminofen/farmacologia , Animais , Animais Lactentes , Estudos Cross-Over , Concentração de Íons de Hidrogênio , Masculino , Cintilografia/veterinária , Distribuição Aleatória , Ultrassonografia
6.
Br J Pharmacol ; 174(13): 1895-1907, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28319650

RESUMO

Multiple sclerosis (MS) is a chronic inflammatory disease of the CNS, and one of the most common causes of disability in young adults. Over the last decade, new disease-modifying therapies have emerged, including monoclonal antibodies (mAbs) that provide highly targeted therapies with greater efficacy than platform therapies. In particular, monoclonal antibodies directed against CD20-positive B cells have shown remarkable results in recent clinical trials and renewed interest in the mechanism of B cell-depleting therapies to ameliorate relapse activity and progression in MS. Here, we review the mechanisms of action and clinical evidence of approved and emerging mAbs, with a focus on B cell-targeted therapies.


Assuntos
Anticorpos Monoclonais/farmacologia , Linfócitos B/efeitos dos fármacos , Esclerose Múltipla/tratamento farmacológico , Linfócitos B/imunologia , Humanos
7.
Am J Vet Res ; 67(8): 1377-84, 2006 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16881850

RESUMO

OBJECTIVE: To determine and compare the abomasal emptying rates in calves suckling milk replacer or an isotonic or hypertonic solution of NaHCO(3) or glucose. ANIMALS: 5 male Holstein-Friesian calves that were < 30 days of age. PROCEDURES: Calves were fed 2 L of milk replacer or isotonic (300 mOsm/L) or hypertonic (600 mOsm/L) solutions of NaHCO(3) or glucose containing acetaminophen (50 mg/kg). Venous blood samples and transabdominal ultrasonographic abomasal dimensions were obtained periodically after feeding, and abomasal luminal pH was continuously monitored by placement of a luminal pH electrode through an abomasal cannula. Abomasal emptying rate was assessed by the time to maximal plasma acetaminophen concentration, ultrasonographic determination of the half-time of abomasal emptying, and the time for luminal pH to return to within 1 pH unit of the preprandial value. RESULTS: Hypertonic NaHCO(3) solution was emptied slower than an isotonic NaHCO(3) solution, isotonic glucose solution was emptied slower than an isotonic NaHCO(3) solution, and hypertonic glucose solution emptied slower than an isotonic glucose solution. CONCLUSIONS AND CLINICAL RELEVANCE: An electrolyte solution for oral administration with a high osmolarity and glucose concentration may lead to a slower resuscitation of dehydrated diarrheic calves because such solutions decrease the abomasal emptying rate and therefore the rate of solution delivery to the small intestine. Whether slowing of the abomasal emptying rate in dehydrated diarrheic calves suckling an oral electrolyte solution is clinically important remains to be determined.


Assuntos
Abomaso/efeitos dos fármacos , Bovinos/fisiologia , Esvaziamento Gástrico/efeitos dos fármacos , Glucose/farmacologia , Soluções Hipertônicas/farmacologia , Soluções Isotônicas/farmacologia , Bicarbonato de Sódio/farmacologia , Abomaso/fisiologia , Acetaminofen/metabolismo , Analgésicos não Narcóticos/metabolismo , Animais , Animais Lactentes , Glucose/metabolismo , Masculino , Fatores de Tempo
8.
Am J Vet Res ; 66(3): 364-74, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15822577

RESUMO

OBJECTIVE: To develop nuclear scintigraphic and acetaminophen absorption methods for measuring abomasal emptying rate in suckling calves. ANIMALS: 9 male Holstein-Friesian calves < 30 days old. PROCEDURE: Calves were fed 2 L of milk replacer, fresh cow's milk, or an isoosmotic (150mM) solution of NaCl, NaHCO3, or sodium acetate containing technetium TC 99m-diethylenetriamine-pentaacetic acid (370 MBq) and acetaminophen (50 mg/kg). Right lateral scintigraphic images and venous blood samples were obtained periodically after feeding. Two power exponential equations were fitted to the scintigraphic data, and 3 pharmacokinetic models were fitted to the acetaminophen concentration-time data. RESULTS: Data from 32 feedings were analyzed, with half emptying time for scintigraphic evaluation ranging from 29 to 202 minutes. Siegel's modified power exponential equation provided a better description of the scintigraphic data than did Elashoff's power exponential equation. The first derivative of Siegel's modified power exponential formula provided the best pharmacokinetic model for the acetaminophen absorption data. Time to maximal acetaminophen concentration (Tmax) provided the most accurate index of abomasal emptying rate from the acetaminophen concentration-time data. CONCLUSIONS AND CLINICAL RELEVANCE: Abomasal emptying rate is best determined in healthy suckling calves by use of Siegel's modified power exponential equation to model the scintigraphic data. Pharmacokinetic calculation of Tmax from the acetaminophen absorption curve provides an alternative method for determining abomasal emptying rate in healthy suckling calves that is accurate, inexpensive, practical, and safe. However, it is unclear whether diarrhea would alter the acetaminophen absorption curve in calves.


Assuntos
Abomaso/fisiologia , Acetaminofen/farmacocinética , Animais Lactentes/fisiologia , Bovinos/fisiologia , Esvaziamento Gástrico/fisiologia , Cintilografia/veterinária , Abomaso/diagnóstico por imagem , Acetaminofen/sangue , Animais , Processamento de Imagem Assistida por Computador , Absorção Intestinal/fisiologia , Masculino , Modelos Biológicos , Cintilografia/métodos , Pentetato de Tecnécio Tc 99m/administração & dosagem , Fatores de Tempo
9.
Am J Vet Res ; 66(3): 537-44, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15822600

RESUMO

OBJECTIVE: To develop and validate an ultrasonographic method for measuring abomasal volume, location, and emptying rate in suckling calves. ANIMALS: 9 male Holstein calves < 40 days of age. PROCEDURE: Before and after calves were fed different volumes of milk replacer or 2 L of oral electrolyte solutions, ultrasonographic measurements of abomasal dimensions (width, length, and height) were obtained by applying a 3.5-MHz sector probe to the ventral aspect of the abdomen in the transverse and sagittal planes. Abomasal volume was calculated from the ultrasonographic measurements by modeling the abomasum as an ellipsoid and by use of a power exponential equation to calculate the half-time of abomasal emptying (t1/2). RESULTS: Preprandial abomasal volume was 20 to 137 mL. All 3 abomasal dimensions increased during feeding and after suckling, and the abomasum was symmetrically located about the midline of the ventral aspect of the abdomen. Strong linear relationships were identified between ultrasonographic and suckled volumes, between ultrasonographic and scintigraphic heights, and between ultrasonographic and scintigraphic lengths. Ultrasonographic t1/2 was linearly related to scintigraphic t1/2; the latter is regarded as the gold standard measure of gastric emptying rate. CONCLUSIONS AND CLINICAL RELEVANCE: Ultrasonographic evaluation of the abomasum appears to provide a practical, rapid, noninvasive, and accurate method for determination of abomasal volume, location, and emptying rate in suckling calves.


Assuntos
Abomaso/diagnóstico por imagem , Bovinos/anatomia & histologia , Bovinos/fisiologia , Esvaziamento Gástrico/fisiologia , Animais , Modelos Teóricos , Tamanho do Órgão , Cintilografia/veterinária , Análise de Regressão , Ultrassonografia
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