RESUMO
AIM: The aim of this study was to evaluate the efficacy of solifenacin on symptom bother using the Overactive Bladder Questionnaire (OAB-q). METHODS: In VIBRANT, a double-blind, US-based trial, patients with OAB for > or = 3 months received flexibly dosed solifenacin or placebo for 12 weeks. At baseline and 4-week intervals, patients completed the OAB-q [symptom bother and health-related quality of life (HRQL) scales] and 3-day bladder diaries; other patient-reported outcome measures were also assessed at baseline and week 12. The primary efficacy end-point was the change from baseline to end of treatment (EOT) on the OAB-q Symptom Bother scale. Adverse events (AEs) were monitored. RESULTS: At EOT, solifenacin (n = 377) vs. placebo (n = 374) significantly improved mean symptom bother (-29.9 vs. -20.4, p < 0.0001), HRQL total (25.3 vs. 16.7, p < 0.0001) and all HRQL domain scores (Ps < 0.0001). Solifenacin vs. placebo significantly improved daily episodes of urgency, incontinence and frequency but not nocturia. Significant separation from placebo was evident as early as week 4. Overall, significantly more solifenacin vs. placebo patients reported treatment benefit (84% vs. 63%), satisfaction (80% vs. 59%) and willingness to continue (79% vs. 60%; Ps< 0.0001). Treatment-related AEs in solifenacin vs. placebo patients were dry mouth (13% vs. 2%), constipation (8% vs. 2%) and dry eye (2% vs. 0.3%). CONCLUSIONS: As early as week 4 and through EOT, flexibly dosed solifenacin significantly improved OAB symptom bother and HRQL as well as the symptoms of urgency, frequency and incontinence compared with placebo. Significantly more solifenacin patients reported treatment benefit and satisfaction at week 12 compared with placebo.
Assuntos
Antagonistas Muscarínicos/administração & dosagem , Quinuclidinas/administração & dosagem , Tetra-Hidroisoquinolinas/administração & dosagem , Bexiga Urinária Hiperativa/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antagonistas Muscarínicos/efeitos adversos , Qualidade de Vida , Quinuclidinas/efeitos adversos , Succinato de Solifenacina , Tetra-Hidroisoquinolinas/efeitos adversos , Resultado do Tratamento , Adulto JovemRESUMO
We hypothesized that specific activation of a single retinoic acid receptor-alpha (RARalpha), without direct and concurrent activation of RARbeta and gamma, will inhibit mammary tumor oncogenesis in murine models relevant to human cancer. A total of 50 uniparous mouse mammary tumor virus (MMTV)-neu and 50 nuliparous MMTV-wnt1 transgenic mice were treated with RARalpha agonist (retinobenzoic acid, Am580) that was added to the diet for 40 (neu) and 35 weeks (wnt1), respectively. Among the shared antitumor effects was the inhibition of epithelial hyperplasia, a significant increase (P<0.05) in tumor-free survival and a reduction in tumor incidence and in the growth of established tumors. In both models, the mechanisms responsible for these effects involved inhibition of proliferation and survival pathways, and induction of apoptosis. The treatment was more effective in the MMTV-wnt1 model in which Am580 also induced differentiation, in both in vivo and three-dimensional (3D) cultures. In these tumors Am580 inhibited the wnt pathway, measured by loss of nuclear beta-catenin, suggesting partial oncogene dependence of therapy. Am580 treatment increased RARbeta and lowered the level of RARgamma, an isotype whose expression we linked with tumor proliferation. The anticancer effect of RARalpha, together with the newly discovered pro-proliferative role of RARgamma, suggests that specific activation of RARalpha and inhibition of RARgamma might be effective in breast cancer therapy.
Assuntos
Benzoatos/farmacologia , Neoplasias Mamárias Experimentais/patologia , Vírus do Tumor Mamário do Camundongo/genética , Vírus do Tumor Mamário do Camundongo/fisiologia , Receptor ErbB-2/genética , Receptores do Ácido Retinoico/agonistas , Tetra-Hidronaftalenos/farmacologia , Proteína Wnt1/genética , Animais , Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Benzoatos/uso terapêutico , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Transformação Celular Viral/genética , Feminino , Humanos , Neoplasias Mamárias Experimentais/tratamento farmacológico , Neoplasias Mamárias Experimentais/virologia , Camundongos , Camundongos Transgênicos , Oncogenes/genética , Receptor alfa de Ácido Retinoico , Tetra-Hidronaftalenos/uso terapêuticoRESUMO
The English-speaking Caribbean has the highest per capita burden of chronic non-communicable diseases (CNCDs) in the region of the Americas. Building on a long history of cooperation in health among the Caribbean Community (CARICOM) and past successes in eliminating/reducing communicable diseases through collective action, non-communicable diseases (NCDs) have now been targeted. CARICOM convened a "first-in-the-world" summit of Heads of Government to address NCDs, which generated the Port-of-Spain NCD Summit Declaration, "Uniting to Stop The Epidemic of Chronic Non-communicable Diseases". This 15-point declaration calls on all of government, civil society and the private sector to jointly tackle the common risk factors for the major chronic diseases, and improve the care of such diseases. Implementation of this declaration has been mixed, being most successful where there were regional supports, and in countries with populations > 250 000 reflecting country capacity. CARICOM has elevated this approach to the global level through successful advocacy for a United Nations High Level Meeting on NCDs to be convened in September 2011. Jamaica will be one of two co-facilitators of this meeting, a reflection of the role of CARICOM countries in advancing the NCD agenda at the global level. CARICOM Heads of Government should attend this meeting, showcase the implementation of the NCD Summit Declaration in the Caribbean, commit to enhancing systems and resources, endorse and implement the commitments made and identify and support leadership for sustained action and accountability for these initiatives.
El Caribe anglófono tiene la carga per cápita más alta de enfermedades no comunicables crónicas (ENCs) en la región de las Américas. Como continuación de una larga historia de cooperación en materias de salud en la Comunidad caribeña (CARICOM) y éxitos pasados en la eliminación/reducción de las enfermedades comunicativas a través de acciones colectivas, las ENCs se han colocado ahora en el centro de la atención. CARICOM convocó a la primera cumbre mundial de Jefes de Gobierno para abordar el problema de las ENCs, y en la cual se produjo la declaración de la Cumbre de Puerto Príncipe sobre ENC: "Unidos para detener la epidemia de las enfermedades no comunicables crónicas". Esta declaración de 15 puntos, hace un llamado a todos los gobiernos, la sociedad civil y el sector privado, a abordar el problema de los factores de riesgo comunes de las principales enfermedades crónicas. La implementación de esta declaración de lucha contra las ENCs ha tomado diversas formas, y ha tenido mayor éxito allí donde ha habido apoyo regional, y en los países con poblaciones > 250 000 reflejo de la capacidad del país. CARICOM ha elevado este enfoque a nivel global abogando exitosamente por una Reunión de Alto Nivel de las Naciones Unidas sobre ENCs a celebrarse en septiembre de 2011. Jamaica ocupará una de las dos presidencias de esta reunión, lo cual refleja el papel de los países del CARICOM en el progreso de la agenda de ENC a nivel global. Los Jefes de Gobierno de CARICOM deben asistir a esta reunión, mostrar la implementación de la Declaración de la Cumbre sobre ENC, comprometerse a mejorar los sistemas y recursos, refrendar e implementar los compromisos hechos, e identificar y apoyar el liderazgo a fin de lograr una acción sostenida y responsabilidad ante estas iniciativas.
Assuntos
Humanos , Doença Crônica/epidemiologia , Congressos como Assunto , Saúde Global , Doença Crônica/prevenção & controle , Congressos como Assunto/organização & administração , Promoção da Saúde , Fatores de Risco , Índias Ocidentais/epidemiologiaRESUMO
OBJECTIVE: To determine the prevalence of risk factors for chronic non-communicable diseases (CNCDs) among staff of The University of the West Indies (UWI), Cave Hill campus, in Barbados. METHODS: A self-administered questionnaire comprising validated questions from the WHO STEPS NCD Risk Factor Survey, the Jamaica Healthy Lifestyle (JHL) Survey and the Behaviour Risk Factor (BRF) Survey, was conducted during the Staff Health Day in May 2010, and at four locations on campus during July 2010. Standardized measurements of weight, height and blood pressure were taken. Data were analysed using EXCEL and STATA and results were compared to the Barbados 2007 STEPS NCD survey. RESULTS: The target population was all staff at the Cave Hill campus of UWI. The coverage rate was 25.2% (269/1068); 63.8% of males and 75% of females were either overweight or obese. Ninety-seven per cent ate less than the recommended 5 fruits and vegetables per day. Low levels of physical activity were reported in 51.9% of males and 62.2% of females. Thirty-two per cent of males and 13% of females were binge drinkers. All participants had at least one of the risk factors (current daily smoker, < 5 fruits and vegetables/day, physical inactivity, overweight/obese and raised blood pressure) whilst 48% of males and 57.2% of females demonstrated three or more risk factors. These results are similar to those found in the Barbados STEPS NCD risk factor survey of 2007. CONCLUSION: The results confirm a similar high prevalence of NCD risk factors among Cave Hill UWI staff as among the Barbadian population. The study reveals opportunities to inform policy on strategies to positively impact the risk factors.
OBJETIVO: Determinar la prevalencia de los factores de riesgo de ENCs entre el personal de la Universidad de West Indies (UWI), en el campus de Cave Hill, Barbados. MÉTODOS: El Día de la Salud del Personal en mayo de 2010, y en cuatro localidades del campus durante julio de 2010, se aplicó un cuestionario auto-administrado formado por varias preguntas validadas de las encuestas conocidas como WHO STEPS NCD Risk Factor Survey, JHL Survey y BRF Survey. Se hicieron mediciones estandarizadas del peso, la altura, y la presión arterial. Los datos fueron analizados usando EXCEL y STATA, y los resultados fueron comparados como los de la encuesta de Barbados 2007 STEPS NCD. RESULTADOS: La población objeto del estudio estuvo formada por todo el personal en el campus de Cave Hill de la Universidad de West Indies (UWI). La tasa de cobertura fue 25.2% (269/1068); el 63.8% de los varones y el 75% de hembras tenían sobrepeso o eran obesos. Noventa y siete por ciento consumía menos de las 5 frutas y vegetales recomendados por día. Se reportaron bajos niveles de actividad física en 51.9% de los varones y 62.2% de las hembras. Treinta y dos por ciento de los varones y 13% de las hembras eran bebedores consumados. Todos los participantes tenían al menos uno de los factores de riesgo (fumador consuetudinario, < 5 frutas y vegetales/día, inactividad física, sobrepeso/obeso, y alta presión arterial) en tanto que el 48% de los varones y el 57.2% de las hembras mostraron tres o más factores de riesgo. Estos resultados son similares a los hallados en la encuesta Barbados STEPS NCD Risk Factor Survey del 2007. CONCLUSIÓN: Los resultados confirman una alta prevalencia de factores de riesgo de ENC entre el personal de Cave Hill de UWI similar a la existente entre la población barbadense en general. El estudio revela oportunidades de informar las políticas sobre estrategias de modo que puedan lograr un impacto positivo sobre los factores de riesgo.