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1.
Tempo psicanál ; 52(2): 230-242, jul.-dez. 2020.
Article in Portuguese | LILACS-Express | LILACS, INDEXPSI | ID: biblio-1252261

ABSTRACT

Este trabalho propõe uma reflexão sobre a importância da escuta psicanalítica dos ruídos do tempo, num momento em que os acontecimentos da pandemia ainda estão em curso, logo, em que ainda estamos numa posição de obscuridade em relação à subjetividade da época. Nesse sentido, propõe pensar a "brutalidade" - significante extraído por Freud e Mbembe das pandemias de suas épocas -, que perpassa o discurso atual, numa espécie de língua pandêmica. A partir disso, introduz a relevância do presente dossiê, como contribuição provisória de uma rede internacional de psicanalistas aos desafios atuais da interface Psicanálise e Educação.


This work proposes a reflection on the importance of psychoanalytic listening to the noise of the time, at a time when the events of the pandemic are still ongoing, therefore, in which we are still in a position of obscurity in relation to the subjectivity of the time. In this sense, this work proposes to think about "brutality" - signifier extracted by Freud and Mbembe from the pandemics of their times -, that runs through the current discourse, in a kind of pandemic language. From these considerations, the paper introduces the importance of this dossier, as an interim contribution of an international network of psychoanalysts to the current challenges of Psychoanalysis and Education interface.


Este trabajo propone una reflexión sobre la importancia de la escucha psicoanalítica de los ruidos del tiempo, en un momento en que los eventos de la pandemia aún continúan, por tanto, en un momento en que todavía estamos en una posición de oscuridad en relación con la subjetividad del tiempo. En este sentido, propone pensar en la "brutalidad" - significante extraído por Freud y Mbembe de las pandemias de sus tiempos - que recorre el discurso actual, en una especie de lenguaje pandémico. A partir de estas consideraciones, introduce la relevancia del presente dossier, como contribución provisional de una red internacional de psicoanalistas a los desafíos actuales de la interfaz entre Psicoanálisis y Educación.

2.
Rev. ciênc. farm. básica apl ; 41: [12], 01/01/2020.
Article in English | LILACS | ID: biblio-1147072

ABSTRACT

Anxiety in the world population has increased significantly; the problem has encouraged studies regarding innovative alternatives for treatment. Research with Citrus aurantium L. essential oil (CEO) has revealed positive results with anxiolytic effects in both animals and humans. However, certain limitations affect its storage and preservation, its efficiency in therapy, and determination of adequate posologies. The potential use of cyclodextrins as drug carriers has been successfully explored. This study aims to assess the anxiolytic potential of a CEO/2-hydroxypropyl-ß-cyclodextrin (HP-ß-CD) inclusion complex. Preparation of the inclusion complex was performed using the Alpha 1-2 LDplus lyophilizer. To allow formation, and avoid loss of volatiles to the atmosphere, Limonene (LIM), the main compound in CEO, together with HP-ß-CD in a molar ratio of (1: 1M) was dispersed in ethanol for 36 hours using a laboratory shaker at room temperature (25°C). Non-clinical murine pharmacological tests were performed for anxiety assessment in experimental and control groups. To assess anxiety and motor impairment, the animals were evaluated using the elevated plus maze, open field, and rota-rod tests. Satisfactory results of the anxiolytic effect of the OEC complexed in HP-ß-CD were observed, with the indication of an potentiation of the effect with doses lower than 500 mg/kg and 250 mg/kg complexed, suggesting improvement in the anxiolytic properties of the OEC.


Subject(s)
Mediation Analysis
3.
Rev. bras. farmacogn ; 28(5): 602-609, Sept.-Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-977727

ABSTRACT

Abstract Annona leptopetala (R.E.Fr.) H. Rainer, Annonaceae, is used in folk medicine like antitumor and anti-inflammatory. The aim of this study was to determine chemical composition, toxicity and antitumor activity of A. leptopetala leaves volatile oil. Fresh leaves were hydrodistilled and then the volatile oil chemical composition was assessed by gas chromatography and mass spectrometry. Toxicity was assessed using haemolysis, micronucleus and acute toxicity protocols. Antitumor effects were determined in vitro and in vivo, using sulforhodamine B assay and sarcoma 180 murine tumor model, respectively. Spathulenol was the major component identified (12.56%). The volatile oil showed in vitro antitumor activity mainly in leukemia cell line (K-562), with Total growth inhibit (TGI) (concentration producing TGI) of 0.64 µg/ml. In other hand, the volatile oil <250 µg/ml did not inhibit HaCat non-tumor cell line growth. The concentration that produced 50% haemolysis was 372.8 µg/ml. The 50% lethal dose in mice was approximately 447.2 mg/kg intraperitoneally. Sarcoma 180 tumor growth inhibition rates were 59.29% and 58.77% at 100 and 150 mg/kg intraperitoneally, respectively. The volatile oil presented moderate gastrointestinal toxicity and no genotoxicity was observed at 350 mg/kg. Thus, the volatile oil shows antitumor activity with moderate toxicity.

4.
Rev. bras. farmacogn ; 28(2): 218-222, Mar.-Apr. 2018. tab, graf
Article in English | LILACS | ID: biblio-958860

ABSTRACT

ABSTRACT The irritable bowel syndrome is defined as the presence of continuing or recurrent abdominal pain and it is associated with altered bowel habit. Experimental studies with Panax ginseng C.A. Mey., Araliaceae, have demonstrated the antinociceptive action on calcium and sodium channels, as well as on primary sensory neurons. A clinical double-blind, randomized, prospective and experimental trial was conducted for sixty days, comparing the action of dry extract of P. ginseng (300 mg/day) with trimebutine (600 mg/day). Patients were assessed at four visits for abdominal pain, using the Likert scale, and adverse events. Twenty-four patients completed the study, being 87.5% female and mean age of 47.41 years. There was improvement in abdominal pain, through Likert scale values, in patients who used P. ginseng. This group started from a median basal of −5 to 2.5, 3 and 5 in the 1st, 4th and 8th weeks of treatment, respectively, with a statistically significant difference. Similar results were achieved in those patients who used trimebutine. The only adverse effect observed was the occurrence of headache in two patients (16.66%) in the group that used the herbal. The research suggests that P. ginseng was effective in the control of abdominal pain in irritable bowel syndrome patients, analogous to trimebutin, and may be used in future studies for a better evaluation of the obtained results.

5.
Rev. bras. ciênc. saúde ; 21(1): 97-102, 2017. ilus, tab
Article in Portuguese | LILACS | ID: biblio-882854

ABSTRACT

Este estudo teve como objetivo revisar a literatura cientffica sobre o use racional dos anti-inflamatOrios nao esteroides na clinica medica-odontolOgica, tendo como primeira opcao a sua escolha nos mais variados processos inflamatOrios que requeiram a sua administragao e que em contrapartida venham a proporcionar menos efeitos adversos sobre o paciente. Material e metodos: Foi consultada a rede BVS de dados tendo como o descritor os Anti-inflamatOrios nao esteroides. Resultados: A literatura relata que ao inibirem a sintese de prostaglandinas e tromboxano, os anti-inflamatOrios nao hormonais (AIN Es), sao os mais utilizados no controle das manifestagoes musculoesqueleticas, sendo amplamente utilizados na Clinica Modica e OdontolOgica para prevenir as reagoes inflamatOrias traurnaticas pOs-cirurgicas. Todavia estes medicamentos podem provocar uma serie de efeitos colaterais quando mal empregados. 0 processo doloroso que acomete as estruturas bucais, geralmente é de origem inflamatOria aguda, obrigando o paciente a buscar um cirurgiao-dentista para tratt-las adequadamente, no entanto o professional deve ter um bom conhecimento sobre as suas indicagoes, contra-indicagoes e efeitos adversos. Sao prescritos preferencialmente os inibidores seletivos da COX-2, sendo portanto os mais indicados, por apresentarem melhor eficacia anti-inflamatOria e sem os efeitos gastrintestinais indesejaveis sao chamados de coxibes, se ligam seletivamente ao local ativo da enzima COX-2 e a bloqueia com mais eflcacia que a COX-1. Conclusao: Nesta revise° pode ser aferido que os COX-2, alem de serem os mais indicados, tem tambern efeito analgesic° e anti-inflamatOrio semelhante aos demais AINE'S, estando portanto indicado como sendo de primeira escolha para o tratamento de pacientes que tem predisposicao a ulceragao e sangramento digestivo. (AU)


This study aimed to review the scientific literature on the rational use of non-steroidal anti-inflammatory drugs in the medical and dental clinics, based on the treatment of inflammatory processes with fewer adverse effects. Material and Methods: Bibliographical searches were carried out in the electronic database BVS using the descriptor "non-steroidal anti-inflammatory". Results: The literature reports that by inhibiting the synthesis of prostaglandins and thromboxane, non-steroidal anti-inflammatory drugs (NSAIDs) have been mostly used in medicine and dentistry for the control of musculoskeletal manifestations to prevent post-surgical traumatic inflammatory reactions. However, these drugs can cause a number of side effects when misused. The painful process that affects the oral structures is usually of acute inflammatory origin, forcing the patient to seek a dentist to properly treat them. Hence, the professional should have a good knowledge of the drug indications, contraindications and side effects. Selective inhibitors of COX-2 are being preferably prescribed as these have better anti-inflammatory effectiveness and no undesirable gastrointestinal effects. These drugs are called coxibs and selectively bind to the active site of the enzyme COX-2, creating a blockage which is more effective than that of COX-1. Conclusion: This review may infer that COX-2 NSADs are most commonly indicated due to their analgesic and anti-inflammatory effectiveness, which is similar to that of other NSAIDs. Thus, this class of drugs is indicated as a first choice for the treatment of patients who are predisposed to ulceration and digestive bleeding. (AU)


Subject(s)
Humans , Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Inflammation
6.
Rev. bras. oftalmol ; 75(2): 115-120, Mar.-Apr. 2016. tab, graf
Article in Portuguese | LILACS | ID: lil-779969

ABSTRACT

RESUMO Objetivo: Avaliar a irritação ocular aguda em coelhos, após a administração tópica de óleo essencial. Métodos: Para tanto, os animais foram divididos em três grupos, cada um com três coelhos, totalizando 6 olhos por grupo, e a diferença entre eles foi a concentração utilizada ( 1, 3 e 9%). Aplicou-se no saco conjuntival, de um dos olhos do animal, uma dose única de 0,1 ml do produto e o olho contralateral foi usado como controle. Analisou-se os efeitos causados pelo óleo essencial na conjuntiva, íris e córnea após 1, 24, 48, 72 horas e no final do sétimo dia após a aplicação tópica. As avaliações oftalmológicas foram feitas com o auxílio de um oftalmoscópio binocular indireto com e sem fluoresceína. As reações observadas foram graduadas segundo a escala de Draize. Foram realizados exames anatomopatológicos em todos os olhos estudados no final do experimento. Resultados: No grupo de animais submetidos à instilação ocular do óleo essencial a 1%, não se observou alterações. O tratamento com o óleo a 3% provocou alteração conjuntival no exame feito em 1 hora, o que foi reduzindo. A administração do óleo essencial a 9% induziu hiperemia conjuntival, não havendo qualquer alteração nos outros tempos de avaliação oftalmológica. Conclusão: A avaliação contribuiu para conhecer as alterações clínicas na superfície ocular. Desta forma, foi possível classificar o óleo a 1% como não irritante e nas concentrações de 3 e 9% como pouco irritante, tornando possível estudos clínicos, a fim de estabelecer o óleo como alternativa terapêutica em conjuntivites bacterianas.


ABSTRACT Objective: To evaluate acute eye irritation in rabbits following topical administration of essential oil. Methods: animals were divided into three groups, each containing three rabbits, with a total of 6 eyes per group. The difference between them was the concentration used (1, 3 and 9%). A single dose of 0.1 ml of the product was applied into the conjunctival sac of one eye of the animal, and the contralateral eye was used as control. The effects caused by the essential oil in the conjunctiva, iris and cornea were analyzed after 1, 24, 48 and 72 hours and at the end of the seventh day after topical application. Ophthalmologic evaluations were performed with the aid of a binocular indirect ophthalmoscope fluorescein and with and without the observed responses, before being graded according to the Draize scale. Pathological examinations were performed on all eyes studied at the end of the experiment. Results: in the group of animals subjected to the ocular instillation of 1% essential oil, there was no change. For treatment with 3% oil, conjunctival changes were found to be decreasing during the examination after 1 hour. Administration of the 9%essential oil induced conjunctival injection, without any change in the other ophthalmologic evaluation times. Conclusion: the evaluation contributed to meet the clinical changes in the ocular surface. Thus, it was possible to classify the oil at 1% as non-irritating and the concentration of 3% and 9 as mildly irritating, making it possible for clinical studies to establish the oil as an alternative therapy in bacterial conjunctivitis.


Subject(s)
Animals , Plant Oils/pharmacology , Oils, Volatile/pharmacology , Iris/drug effects , Conjunctiva/drug effects , Cornea/drug effects , Origanum , Ophthalmoscopy , Rabbits , Plant Oils/administration & dosage , Oils, Volatile/administration & dosage , Conjunctivitis, Bacterial , Iritis/chemically induced , Administration, Topical , Toxicity Tests/methods , Corneal Opacity/chemically induced , Fluorescein , Quantitative Structure-Activity Relationship , Hyperemia/chemically induced , Irritants/toxicity
7.
Rev. Col. Bras. Cir ; 43(1): 28-34, Jan.-Feb. 2016. tab, graf
Article in English | LILACS | ID: lil-779027

ABSTRACT

Objective: to assess post-angioplasty myointimal hyperplasia in iliac artery of rabbits treated with extract of Moringa oleifera leaves. Methods : we conducted a randomized trial in laboratory animals for five weeks of follow-up, developed in the Vivarium of Pharmaceutical Technology Laboratory of the Universidade Federal da Paraíba. We used rabbits from the New Zealand breed, subjected to a hypercholesterolemic diet and angioplasty of the external iliac artery, randomized into two groups: M200 Group (n=10) - rabbits treated with 200mg/kg/day of Moringa oleifera leaves extract orally; SF group (n=10) - rabbits treated with 0.9% saline orally. After five weeks, the animals were euthanized and the iliac arteries prepared for histology. Histological sections were analyzed by digital morphometry. Statistical analysis was performed using the Student's t test. The significance level was 0.05. Results : there was no significant difference in myointimal hyperplasia between M200 and SF groups when comparing the iliac arteries submitted to angioplasty. Conclusion : there was no difference of myointimal hyperplasia between groups treated with saline and Moringa oleifera after angioplasty.


Objetivo: determinar a diferença da média de hiperplasia miointimal pós-angioplastia na artéria ilíaca de coelhos tratados e não tratados com extrato das folhas de Moringa oleifera. Métodos: ensaio aleatório em animais de laboratório por cinco semanas de seguimento, desenvolvido no Biotério do Laboratório de Tecnologia Farmacêutica da Universidade Federal da Paraíba. Foram utilizadas coelhas da raça Nova Zelândia, submetidas à dieta hipercolesterolêmica e angioplastia da artéria ilíaca externa, randomizadas em dois grupos: Grupo M200 (n=10), coelhas tratadas com 200mg/kg/dia de extrato de folhas de Moringa oleifera, por via oral; Grupo SF (n=10), coelhas tratadas com soro fisiológico 0,9%, por via oral. Após cinco semanas, os animais foram eutanaziados e as artérias ilíacas preparadas para histologia. Os cortes histológicos foram analisados por morfometria digital. A análise estatística foi realizada com o teste t de Student. O nível de significância foi 0,05. Resultados: comparando as artérias ilíacas submetidas à angioplastia do grupo M200 com as do grupo SF, não houve diferença significativa da hiperplasia miointimal Conclusão: não houve diferença da hiperplasia miointimal nos grupos tratados com soro fisiológico e Moringa oleifera após angioplastia.


Subject(s)
Animals , Female , Postoperative Complications/etiology , Postoperative Complications/prevention & control , Plant Extracts/therapeutic use , Tunica Intima/pathology , Angioplasty/adverse effects , Moringa oleifera , Iliac Artery/pathology , Phytotherapy , Rabbits , Random Allocation , Hyperplasia/etiology , Hyperplasia/prevention & control
8.
Rev. bras. farmacogn ; 25(5): 491-498, Sept.-Oct. 2015. tab, graf
Article in English | LILACS | ID: lil-765077

ABSTRACT

ABSTRACTCissampelos sympodialis Eichler, Menispermaceae, is widely used by Indian tribes and folk medicine to treat various inflammatory disorders, including asthma. Clinical toxicological trials were made with the tea of C. sympodialis, a medicinal plant. The study took place at Lauro Wanderley Hospital/UFPB-PB, where seventeen healthy volunteers were chosen, among those six men and eleven women who orally ingested, during four weeks uninterruptedly, 150 ml of the tea, once a day. Before the first ingestion and after the last one, the participants were subjected to clinical and laboratorial tests for their overall conditions in order to analyze the toxicity of the plant. The results demonstrated that the volunteers neither experience clinical nor laboratorial alterations, as well as no significant adverse effects, apart from little change detected in their hematological tests. Nevertheless, none demonstrated any pathological conditions, just alterations of the normal human being physiology. Therefore, it is concluded that these data complement that obtained during pre-clinical studies and confirm a low toxicity of this plant.

9.
Arq. gastroenterol ; 51(3): 255-260, Jul-Sep/2014. tab, graf
Article in English | LILACS | ID: lil-723856

ABSTRACT

Objectives Panax ginseng, Camellia sinensis and bezafibrate were compared for their lipid-lowering, antioxidant and anti-inflammatory properties as potential agents to prevent nonalcoholic fatty liver disease and its progression to nonalcoholic steatohepatitis. Methods Fifty Wistar rats were randomized into five groups: G1 (feed with standard diet); G2 (feed with high-fat diet with 58% of energy from fat); G3 (high-fat diet + standardized Panax ginseng extract at 100 mg/kg/day); G4 (high-fat diet + standardized Camellia sinensis extract at 100 mg/kg/day); and G5 (high-fat diet + bezafibrate at 100 mg/kg/day), given by gavage. The animals were sacrificed eight weeks later and blood was collected for glucose, insulin, cholesterol, triglycerides, AST, ALT, alkaline phosphatase and gamma-glutamyl transferase determinations. The score system for nonalcoholic fatty liver disease was used to analyse the liver samples. Results and conclusions High-fat diet resulted in a significant increase in animal body weight, biochemical changes and enzymatic elevations. Steatosis, inflammation and hepatocellular ballooning scores were significant high in this group. The biochemical and histological variables were statistically similar in the bezafibrate group and control group. Treatment with Panax ginseng extract prevented obesity and histological features of nonalcoholic steatohepatitis (steatosis and inflammation) compared to high-fat diet. Camellia sinensis showed a less effective biochemical response, with small reduction in steatosis and inflammation but lower ballooning scores. .


Objetivos Panax ginseng, Camellia sinensis e bezafibrato foram comparados por suas propriedades hipolipemiantes, antioxidantes e anti-inflamatórias, como potenciais agentes capazes de prevenir a doença hepática gordurosa não alcoólica e sua progressão para esteato-hepatite não alcoólica. Métodos Cinqüenta ratos Wistar foram distribuídos aleatoriamente em cinco grupos: G1 (alimentados com dieta padrão); G2 (alimentados com dieta hipercalórica com 58% de energia a partir de gordura); G3 (dieta rica em gordura + extrato padronizado Panax ginseng em 100 mg / kg / dia); G4 (dieta rica em gordura + extrato de Camellia sinensis padronizado a 100 mg / kg / dia); e G5 (dieta rica em gordura + bezafibrato, a 100 mg / kg / dia), administrado via oral. Os animais foram sacrificados após oito semanas e o sangue foi coletado para determinação da glicose, insulina, colesterol, triglicérides, AST, ALT, fosfatase alcalina e gama-glutamil transferase. O sistema NAS de pontuação para doença hepática gordurosa não alcoólica foi utilizado para analisar as amostras de fígado. Resultados e conclusões A dieta hipercalórica resultou em um aumento significativo no peso corporal dos animais, associado a alterações bioquímicas e elevações enzimáticas. Os escores de esteatose, inflamação e balonização hepatocelular foram significativamente mais elevados neste grupo. As variáveis bioquímicas e histológicas foram estatisticamente semelhantes entre os grupos bezafibrato e controle. O uso do extrato do Panax ginseng esteve associado a um menor ganho de peso dos animais, em média, bem como a menores índices nos escores de esteato-hepatite (esteatose e inflamação) em comparação com o grupo apenas alimentado com dieta hipercalórica. No grupo ...


Subject(s)
Animals , Fibric Acids/administration & dosage , Non-alcoholic Fatty Liver Disease/prevention & control , Panax/chemistry , Phytotherapy/methods , Tea/chemistry , Disease Progression , Random Allocation , Rats, Wistar
10.
J. bras. patol. med. lab ; 50(2): 136-143, Mar-Apr/2014. tab, graf
Article in English | LILACS | ID: lil-712708

ABSTRACT

Introduction: The pathophysiology of nonalcoholic steatohepatitis (NAS) includes, basically, insulin resistance, inflammation and oxidative stress. Thus, a study of immunostaining for liver insulin, adiponectin, tumor necrosis factor alpha (TNF-α), and inducible nitric oxide synthase (iNOS) receptors was conducted. Objective: To expand the knowledge about the pathophysiological and molecular mechanisms underlying the experimental model of steatohepatitis in rats fed a high-fat diet. Method: Twenty Wistar rats were divided into two groups: G1 (control, fed a standard diet), and G2 (fed a high-fat diet containing 58% of energy derived from fat, 18% from protein and 24% from carbohydrate). After eight weeks the animals were sacrificed. Blood glucose, insulin, total cholesterol, high-density lipoprotein (HDL), the very low-density lipoproteins (VLDL), triglycerides, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) were determined. The liver tissue was submitted to histopathological analysis, using a NAS score. In immunohistochemistry, we studied the expression of the insulin receptor, adiponectin, TNF-α and iNOS by tissue microarray method. Results and conclusion: There was marked cytoplasmic immunostaining for TNF-α and iNOS mediators in the group on a fat diet. Regarding insulin and adiponectin molecular markers, a reduction of cytoplasmic immunoreactivity of these antigens was observed in the group on a fat diet, reflecting, respectively, the state of hepatocellular inflammation (steatohepatitis) and insulin resistance in this experimental model of fat liver disease...


Introdução: Os mecanismos fisiopatológicos da esteato-hepatite não alcoólica incluem basicamente resistência insulínica, processo inflamatório e estresse oxidativo. Desta forma, um estudo sobre o padrão de imunoexpressão hepática para receptores de insulina, adiponectina, fator de necrose tumoral alfa (TNF-α) e sintase indutível do óxido nítrico (iNOS) foi conduzido. Objetivo: Ampliar os conhecimentos sobre os mecanismos moleculares subjacentes, em modelo experimental de esteato-hepatite. Método: Vinte ratos Wistar com dois meses de idade, pesando de 250 a 300 mg foram subdivididos em dois grupos: G1 (controle normal, submetido à dieta padrão) e G2 (grupo-controle, submetido à dieta hiperlipídica contendo 58% de energia derivada de gorduras, 18% de proteínas e 24% de carboidratos). Após oito semanas, os animais foram sacrificados; o sangue, submetido à análise bioquímica; e o fígado, removido e fixado em formalina tamponada e emblocado em parafina para estudo histopatológico. Para estudo imuno-histoquímico, foi utilizada a técnica de microarranjo de tecido. As lâminas obtidas foram submetidas à incubação com os anticorpos contra adiponectina, receptor de insulina, TNF-α e iNOS. Resultados e conclusão: Observou-se marcada imunoexpressão citoplasmática para os mediadores TNF-α e iNOS no grupo submetido à dieta hiperlipídica. No que diz respeito aos marcadores moleculares insulina e adiponectina, observou-se uma redução da imunoexpressão citoplasmática desses anticorpos no grupo submetido à dieta hiperlipídica, traduzindo, respectivamente, o estado de inflamação hepatocelular (esteato-hepatite) e resistência insulínica, desenvolvidos nesse modelo experimental de doença hepática gordurosa...


Subject(s)
Animals , Rats , Adiponectin/analysis , Fatty Liver/physiopathology , Insulin Resistance , Immunohistochemistry/methods , Disease Models, Animal , Tumor Necrosis Factor-alpha/analysis , Fatty Liver/metabolism , Nitric Oxide Synthase/analysis , Rats, Wistar , Receptor, Insulin/analysis
11.
Rev. bras. ciênc. saúde ; 18(3): 261-270, 2014. ilus, tab
Article in Portuguese | LILACS | ID: lil-780238

ABSTRACT

Este estudo tem o objetivo de revisar a literaturacientífica sobre o Papilomavírus humano (HPV). Material eMétodos: Foi consultada a base BVS com o descritorPapiloma vírus. Resultados: A literatura situa o HPV comovírus da família Papovaridae, alguns deles responsáveis porverrugas vulgares, anogenitais e ainda papilomas danasofaringe. O vírus possui um genoma de DNA de cadeiadupla combinado com histonas, que formam um complexosemelhante a um cromossoma, contido num capsídeo externode proteína virótica. O Papilomavírus humano (HPV) tem sidorelacionado ao desenvolvimento de tumores malignos emalgumas regiões que ocasionalmente costumam infectar,sendo os locais de maior incidência na mulher, o períneo,vulva, vagina, colo do útero e região anal; no homem afetamprincipalmente o pênis, uretra, saco escrotal e região anal.Além dessas áreas, estudos demonstraram a presença deHPV de alto risco e sua possível associação com ofavorecimento de lesões malignas na região da cavidadebucal e orofaringe. O seu potencial carcinogênico estáprovavelmente relacionado a duas proteínas virais, E6 e E7,as quais são capazes de interagirem com outras proteínasque regulam o ciclo celular. Conclusão: Nesta revisão podeser aferido que à medida que os conhecimentos sobre opapilomavírus humano (HPV) avançam, abrem-se novasperspectivas para entender e tratar adequadamente aslesões induzidas por este vírus. Entre os mais de 100 tiposde HPV já identificados conclui-se que cerca de 24 tiposforam associados com lesões bucais, sendo o HPV 16, omais prevalente tanto em lesões orais como genitais...


Objective: This study aims to review the scientific literatureabout the human papillomavirus (HPV). Material and Methods:Searches were carried out in the virtual library in healthdatabase using the descriptor papilloma virus. Results: HPVbelongs to Papovaridae family, whose some members areresponsible for common and anogenital warts, and alsonasopharynx papilloma. This virus has a genome of doublestrandedDNA combined with histones to form a complexsimilar to a chromosome contained in a foreign viral capsidprotein. HPV has been linked to the development of malignanttumors in some regions where infection usually occurs. Thehighest incidence sites in women are: perineum, vulva, vagina,cervix and anus; in men, it affects primarily the penis, urethra,scrotum and anus. In addition to these areas, studies haveshown the presence of high-risk HPV and its possibleassociation with the onset of malignant lesions in the oralcavity and oropharynx. Such potential carcinogenicity isprobably related to two viral proteins, E6 and E7, which arecapable of interacting with other proteins that regulate thecell cycle. Conclusion: This review shows that as theknowledge about the human papillomavirus (HPV) advances,new perspectives are opened to understand and properlyhandle the lesions induced by this virus. Among the morethan 100 types of HPV identified thus far, about 24 typeswere associated with oral lesions, being HPV type 16 themost prevalent one in both oral and genital lesions...


Subject(s)
Humans , Male , Female , Neoplasms , Oropharynx , Papillomaviridae
12.
Rev. bras. ciênc. saúde ; 18(4): 279-286, 2014. tab
Article in Portuguese | LILACS | ID: lil-772165

ABSTRACT

Introdução: A Dioclea grandiflora, conhecido como Mucunã de caroço,atua sobre o Sistema Nervoso Central, doenças da próstata e pedrasnos rins. Objetivo: Realizar estudo toxicológico não clínico agudo, emratos, com base na Instrução Normativa nº4, de 18 de junho de 2014da Agência Nacional de Vigilância Sanitária (ANVISA). Material eMétodos: Foram utilizados ratos Wistar, ambos os sexos, dose 2000mg/kg, via oral, do extrato etanólico bruto de Dioclea grandifloraadministrado a um grupo tratado e um grupo controle (veículo). Apósa administração, os parâmetros de comportamento foi observado por30, 60, 90, 120, 180 e 240 minutos, consumo de ração e água,parâmetros hematológicos e bioquímicos. O número de sobreviventescontabilizados para determinar a DL50. Resultados: Houve aumentoestatisticamente significativo no consumo de água (Controle:160,4±5,85; Tratado: 201,3±8,55) e ração das fêmeas (Controle:95,98±3,02; Tratado: 113,1±2,42) e aumento estatisticamentesignificativo no consumo de água (Controle: 236,7±6,43; Tratado:267,5±8,72) e ração dos machos (Controle: 152,4±2,51; Tratado:177,64,15). Aumento estatisticamente significativo na albumina dosmachos (Controle: 3,2±0,08; Tratado: 3,6±0,08), nas fêmeas reduziuestatisticamente significativo a fosfatase alcalina (Controle:198,5±18,81; Tratado: 99,97±16,02) , proteína total (Controle:7,85±0,09; Tratado: 6,85±0,24) e globulinas (Controle: 4,28±0,14;Tratado: 3,27±0,27). Diminuiu estatisticamente significativo o númerode hemácias nas fêmeas (Controle: 10,18±0,28; Tratado: 9,62±0,18).Conclusão: De acordo com os resultados a DL50 foi superior à dosetestada, porém são necessários estudos toxicológicos de longa duraçãopara atestar a segurança de seu uso...


Introduction: Dioclea grandiflora, known as Mucunã de caroço, acts onthe central nervous system, and against prostate disease and kidneystones. Objective: To perform a nonclinical acute toxicology study inrats following the Normative Instruction #4 as of June 18th 2014 of theNational Health Surveillance Agency (ANVISA). Material and Methods:Wistar rats of both sexes were used in the study. A dose of 2000 mg/kg of Dioclea grandiflora ethanolic extract was administered orally tothe test group. A control group using only the vehicle was also included.Then behavioral parameters were monitored for 30, 60, 90, 120, 180,and 240 minutes after feed and water intake, along with hematologicaland biochemical parameters. The number of survivors was recordedto determine the LD50. Results: There was a statistically significantincrease in water (Control: 160.4 ± 5.85; Treated: 201.3 ± 8.55), andfeed intake (Control: 95.98 ± 3.02; Treated: 113.1 ± 2.42) for femalerats; and a statistically significant increase in water (Control: 236.7 ±6.43; Treated: 267.5 ± 8.72) and feed intake (Control: 152.4 ± 2.51;Treated: 177.6 ± 4.15) for males. A statistically significant increase inalbumin levels was observed for males (Control: 3.2 ± 0.08; Treated:3.6 ± 0.08), and a decrease in alkaline phosphatase (Control: 198.5 ±18.81; Treated: 99.97 ± 16.02), total protein (Control: 7.85 ± 0.09;Treated: 6.85 ± 0.24) and globulin (Control: 4.28 ± 0.14; Treated: 3.27± 0.27) was found for females. Also, in females the number of redblood cells was found to be significantly reduced (Control: 10.18 ±0.28; Treated: 9.62 ± 0.18). Conclusion: According to the results, theLD50 value found was higher than that of the tested dose. Howeverlong-term toxicology studies are needed to further prove the safetyof the extract...


Subject(s)
Animals , Rats , Central Nervous System , Toxicity Tests, Acute/analysis , Rats, Wistar
13.
Estilos clín ; 18(2): 279-296, ago. 2013.
Article in Portuguese | LILACS | ID: lil-689008

ABSTRACT

O filme I am Sam trata da deficiência mental e das representações sociais que a envolvem. Inicialmente, o artigo pretende apresentar a definição de deficiência mental em uma perspectiva universal e cotejar a diferença entre deficiência mental, debilidade e fracasso escolar na perspectiva da psicanálise, considerando a relação da criança com o saber. Usar do cinema e da filmografia disponível para interrogar diagnósticos fixos e segregadores, que excluem o sujeito e sua relação com o saber, é o objetivo deste trabalho.


The movie "I am Sam" is about mental disability and the social representations that surround it. Initially, the article presents the definition of mental retardation from a universal perspective and discusses the differences between learning disability, school failure and weakness from the perspective of psychoanalysis considering the child's relationship with knowledge. The goal of this paper is to use films and the filmography available in order to interrogate fixed and segregational diagnoses that exclude the subject and its relationship to knowledge.


La película "Yo soy Sam" viene de las representaciones mentales y sociales de discapacidad que lo rodean. Inicialmente, el artículo presenta la definición de retraso mental en una perspectiva universal y cotejar la diferencia entre la deficiencia, la debilidad y el fracaso escolar mentales desde la perspectiva del psicoanálisis considerando la relación del niño con el saber. Utilizando el cine y la filmografía disponibles para interrogar diagnósticos fijos y segregación que excluye le sujeto y su relación con el saber el objetivo de este trabajo.


Subject(s)
Humans , Disabled Persons , Learning
14.
Rev. bras. farmacogn ; 23(2): 329-334, Mar.-Apr. 2013. tab
Article in English | LILACS | ID: lil-669510

ABSTRACT

Genotoxic effects of Mimosa tenuiflora (Willd.) Poir, Fabaceae, were investigated by using both micronucleus test and bacterial reverse mutation assay in Salmonella typhimurium TA97, TA98, TA100, TA102 respectively. In respect of Ames test results show that the extract does not induce mutations in any strains of Salmonella typhimurium tested since the mutagenicity index is less than 2. In the antimutagenic effect was observed that the extract at the concentrations tested significantly decreased the mutagenicity index of all strains tested which characterized the extract as antimutagenic in these conditions. In the micronucleus test in vivo, we observed that the concentrations used did not induce an increase in the frequency of micronucleus in normochromatic erythrocytes of mice. Therefore, we concluded that the extract of M. tenuiflora is not mutagenic in the absence of exogenous metabolizing system and does not induce an increase in the frequency of the micronucleus characterized as an agent not mutagenic in these conditions. Further studies of toxicity need to be made to the use of this plant in the treatment of diseases to be stimulated.

15.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 35(1): 21-28, Mar. 2013. ilus, tab
Article in English | LILACS | ID: lil-670469

ABSTRACT

The purpose of the study was to evaluate the efficacy of an extract of Panax ginseng in patients with fibromyalgia. A randomized, double-blind, controlled clinical trial was carried out over 12 weeks to compare the effects of P. ginseng (100 mg/d) with amitriptyline (25 mg/d) and placebo in 38 patients with fibromyalgia: 13 in Group I (amitriptyline), 13 in Group II (placebo), and 12 in Group III (P. ginseng). Ratings on the Visual Analogue Scale (VAS) revealed a reduction in pain in the P. ginseng group (p < .0001), an improvement in fatigue (p < .0001) and an improvement in sleep (p < .001), with respect to baseline characteristics, but there were no differences between the three groups. With respect to anxiety, improvements occurred in the P. ginseng group compared to baseline (p < .0001); however, amitriptyline treatment resulted in significantly greater improvements (p < .05). P. ginseng reduced the number of tender points and improved patients' quality of life (using the Fibromyalgia Impact Questionnaire - FIQ); however, there were no differences between groups. The beneficial effects experienced by patients for all parameters suggest a need for further studies to be performed on the tolerability and efficacy of this phytotherapic as a complementary therapy for fibromyalgia.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Amitriptyline/therapeutic use , Analgesics, Non-Narcotic/therapeutic use , Fibromyalgia/drug therapy , Panax , Plant Extracts/therapeutic use , Double-Blind Method , Fibromyalgia/physiopathology , Pain Measurement , Quality of Life , Surveys and Questionnaires , Time Factors , Treatment Outcome
16.
Rev. CEFAC ; 14(4): 742-754, jul.-ago. 2012.
Article in Portuguese | LILACS | ID: lil-647913

ABSTRACT

O zumbido, som percebido pelo indivíduo sem que haja estímulo externo, resulta da interação dinâmica de centros do sistema nervoso central, incluindo vias auditivas e não auditivas. O resultado desta interação, especialmente sistema límbico e sistema nervoso autônomo, seria responsável pelo desencadeamento de associações emocionais negativas e reações de incômodo em pacientes com zumbido. A ansiedade, condição fisiológica inerente ao ser humano, quando exacerbada gera um transtorno de humor, comprometendo o pensamento, o comportamento e a atividade psicológica. Se um estímulo interno ou externo for interpretado como perigoso ou ameaçador, desencadeará uma reação emocional caracterizada como estado de ansiedade. Este artigo tem como objetivo realizar uma revisão da literatura sobre a relação do zumbido e da ansiedade. Em se tratando do zumbido, a forma como o som é percebido pode ser alterado pela ansiedade, aguçando assim a sensibilidade para detectar sons que parecem uma ameaça em potencial, pois para muitos o zumbido é sinônimo de enfermidade grave. A etiologia do desenvolvimento da depressão e ansiedade pode estar relacionada ao zumbido. Muitos adquirem esse sintoma por problemas físicos e, consequentemente, desenvolvem a depressão e a ansiedade. Outros com graus diferentes de angústias adquirem o zumbido devido ao comprometimento emocional. Dessa forma, existe um vínculo entre o zumbido e problemas emocionais, mas nem sempre é fácil identificar o precursor. Estudos demonstram que pacientes acometidos pelo zumbido apresentam maior tendência ao suicídio, depressão e ansiedade. Além disso, referem o efeito aditivo da ansiedade e da depressão na qualidade de vida e no zumbido dos indivíduos.


Tinnitus is a sound perceived without external stimulus, and results from the dynamic interaction of the centers in the central nervous system, including non-auditory and auditory ways. The result of this interaction, especially with the limbic system and autonomic nervous system, would be responsible for triggering negative emotional associations and distress in patients with tinnitus. Anxiety, a physiological condition inherent to human beings, when exacerbated, generates a mood disorder, affecting thinking, behavior and physiological activity. If an inner or outer stimulus is interpreted as dangerous or threatening, it may trigger an emotional reaction characterized as a state of anxiety. This work aims to review the relationship between tinnitus and anxiety. The tinnitus sound is perceived can be altered by anxiety, thereby, sharpening the sensitivity in detecting sounds that seem a potential threat, because for many people, tinnitus is synonymous with a serious illness. The etiology for the development of depression and anxiety may be related to tinnitus. Many people acquire this symptom by physical problems and hence develop depression and anxiety. Others with different degrees of distress due to tinnitus acquire emotional problems. Thus, there is a probable link between tinnitus and emotional problems, but it is not always easy to identify which one occurs first. Studies show that patients affected by tinnitus have a greater trend for suicide, depression and anxiety. They also refer to the additive cumulative effects of anxiety and depression on the quality of life of tinnitus sufferers.

17.
Rev. bras. farmacogn ; 22(3): 663-668, May-June 2012. ilus, tab
Article in English | LILACS | ID: lil-624695

ABSTRACT

This work presents the observed changes in Wistar rats under long treatment (thirteen weeks) with different oral doses of the ethanolic extract (EE) from Jatropha gossypiifolia L., Euphorbiaceae. The most significant toxic signs indicated a reduction of the activity in the central nervous system and digestive disturbances. The histopathological analysis shows hepatotoxity and pulmonary damages. The lethality was 46.6% among males under the higher experimental dose (405 mg/kg) and 13.3% both in females under the higher dose and among the animals treated with 135 mg/kg of the product. These data show the significant oral chronic toxicity of EE of J. gossypiifolia in rats.

18.
Mundo saúde (Impr.) ; 37(1): 97-104, jan.- mar. 2013. ilus
Article in Portuguese | LILACS | ID: lil-757665

ABSTRACT

Diante da competitividade crescente, a gestão de estoques é necessária para evitar os altos custos com os produtos, diminuir o capital total investido pela empresa no estoque, além de evitar a falta de produtos para os clientes. Este trabalho visa a trazer uma abordagem teórico-prática a respeito da gestão de estoque de medicamentos, tendo como exemplo uma farmácia do Serviço de Atenção à Saúde (SAS). A metodologia aplicada consistiu em três partes. A primeira foi uma pesquisa bibliográfica para a construção do modelo teórico; a segunda foi o estudo de caso na farmácia do SAS; e a terceira etapa referiu-se a propostas de melhorias para uma gestão de estoque de qualidade dos medicamentos, com o objetivo de garantir o acesso da população a medicamentos seguros e eficazes. Na farmácia estudada, não havia uma padronização dos procedimentos realizados, desencadeando a falta de critérios técnicos, que impossibilitou a realização dos cálculos necessários para o controle de estoque de qualidade, sendo necessária a realização de uma contagem dos produtos existentes, para servir de ponto de partida do trabalho. Este trabalho indicou duas propostas de gestão de estoque: as fichas de prateleiras, que são ferramentas mais simples e a um custo acessível de serem executadas, e o programa de gerenciamento de materiais. Deve existir regulamentação dos procedimentos operacionais padrões entre estudantes e funcionários e estabelecer-se a divisão de trabalho com as devidas responsabilidades.


In an increasingly competitive market, the management of medication supplies is needed to avoid the high costs of pro-ducts, reduce the total capital invested by the company, and avoid a lack of products to clients. This study aims to bring a practical-theoretical approach regarding the management of medication supplies, having as an example a pharmacy of the Health Care Service (SAS). The methodology consisted in three parts: first a literature search was done to construct the theoretical model, then we did a case study in the SAS pharmacy and in the third stage we examined proposals for improvements in order to reach a quality management of medicine supplies for offering the population access to safe and effective medicines. At the pharmacy studied, there was not procedures standardization, causing a lack of technical crite-ria, which precluded the calculations required for quality inventory control, and this made necessary to count the existing products before beginning the study. This study proposed two proposals for inventory management: the form of shelves, which are more simple tools requiring fewer expenses to be executed, and material management program. There should be rules for standard operating procedures for both students and staff and the establishment of the division of labor with appropriate responsibilities for each.


Subject(s)
Humans , Delivery of Health Care , Pharmaceutical Preparations , Strategic Stockpile
19.
Arq. gastroenterol ; 49(1): 89-96, Jan.-Mar. 2012.
Article in English | LILACS | ID: lil-622567

ABSTRACT

CONTEXT: Non-alcoholic fatty liver disease (NAFLD), hepatic manifestation of metabolic syndrome, has been considered the most common liver disease nowadays, which is also the most frequent cause of elevated transaminases and cryptogenic cirrhosis. The greatest input of fatty acids into the liver and consequent increased beta-oxidation contribute to the formation of free radicals, release of inflammatory cytokines and varying degrees of hepatocytic aggression, whose histological expression may vary from steatosis (HS) to non-alcoholic steatohepatitis (NASH). The differentiation of these forms is required by the potential risk of progression to cirrhosis and development of hepatocellular carcinoma. OBJECTIVE: To review the literature about the major risk factors for NAFLD in the context of metabolic syndrome, focusing on underlying mechanisms and prevention. METHOD: PubMed, MEDLINE and SciELO data basis analysis was performed to identify studies describing the link between risk factors for metabolic syndrome and NAFLD. A combination of descriptors was used, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, metabolic syndrome and risk factors. At the end, 96 clinical and experimental studies, cohorts, meta-analysis and systematic reviews of great impact and scientific relevance to the topic, were selected. RESULTS: The final analysis of all these data, pointed out the central obesity, type 2 diabetes, dyslipidemia and hypertension as the best risk factors related to NAFLD. However, other factors were highlighted, such as gender differences, ethnicity, genetic factors and the role of innate immunity system. How these additional factors may be involved in the installation, progression and disease prognosis is discussed. CONCLUSION: Risk factors for NAFLD in the context of metabolic syndrome expands the prospects to 1) recognize patients with metabolic syndrome at high risk for NAFLD, 2) elucidate pathways common to other co-morbidities, 3) determine risk factors associated with a worse prognosis, 4) develop therapeutic strategies with goal of reducing risk factors, 5) apply acquired knowledge in public health policies focusing on preventive strategies.


CONTEXTO: A doença hepática gordurosa não alcoólica (DHGNA) vem sendo considerada a manifestação hepática da síndrome metabólica e a hepatopatia mais frequente da atualidade, sendo também a causa mais frequente de aumento das transaminases e de cirrose criptogênica. O maior aporte de ácidos graxos ao fígado e consequente aumento da beta-oxidação concorrem para formação de radicais livres, liberação de citocinas inflamatórias e graus variáveis de agressão hepatocítica, cuja expressão histológica pode variar da esteatose hepática (EH) à esteatohepatite não-alcoólica (EHNA), cuja diferenciação se faz necessária pelo risco potencial de progressão para cirrose e desenvolvimento do carcinoma hepatocelular. OBJETIVO: Revisar a literatura sobre os principais fatores de risco para a DHGNA no contexto da síndrome metabólica, com foco nos mecanismos subjacentes e nas estratégias de prevenção. MÉTODO: Foi realizada pesquisa bibliográfica no PubMed para identificar estudos que descrevessem a associação entre os fatores de risco para síndrome metabólica e a DHGNA, utilizando-se a combinação de descritores: "Non-alcoholic fatty liver disease, Non-alcoholic steatohepatitis, metabolic syndrome and risk factors". Foram selecionados 96 estudos clínicos, experimentais, de cohort, metanálises e revisões sistemáticas de maior impacto e relevância científica para o tema. RESULTADOS: A análise das informações consolidou a obesidade central, diabetes melitus tipo 2, dislipidemia e hipertensão como os fatores de risco mais bem relacionados à DHGNA. Entretanto, outros fatores foram destacados, como diferenças entre gêneros, etnia, fatores genéticos e o papel da imunidade inata, como estes fatores adicionais que podem estar implicados na instalação, progressão e prognóstico da doença. CONCLUSÃO: O conhecimento dos fatores de risco para a DHGNA no contexto da síndrome metabólica amplia os caminhos para: 1) reconhecer pacientes com risco elevado para a doença; 2) elucidar vias comuns a outras comorbidades; 3) determinar fatores de risco relacionados a pior prognóstico; 4) desenvolver estratégias terapêuticas com o objetivo de reduzir fatores de risco; 4) aplicar os conhecimentos adquiridos nas políticas públicas de saúde com foco em estratégias preventivas.


Subject(s)
Humans , Fatty Liver/etiology , Metabolic Syndrome/complications , Disease Progression , Risk Factors
20.
Rev. bras. ciênc. saúde ; 15(4): 493-506, dez. 2011. tab
Article in Portuguese | LILACS | ID: lil-790502

ABSTRACT

Este estudo teve como objetivo uma buscabibliográfica sobre a Miastenia gravis (MG). Metodologia: Apesquisa bibliográfica foi realizada nas bases de dadoseletrônicos Pubmed, Science Direct, Scielo e Bireme dosúltimos dez anos, além de outros artigos que apresentavamextrema relevância histórica. Resultados: MG é uma doençaauto-imune caracterizada por fraqueza muscular, cujapatogenia está relacionada com a destruição da transmissãoneuromuscular por diferentes mecanismos, como diminuiçãodos receptores nicotínicos de acetilcolina, destruição dasproteínas envolvidas com a formação neuromuscular ou pelaatuação de anticorpos contra uma proteína quinase específicado músculo (MUSK). O tratamento atual da MG se baseia nautilização de inibidores da acetilcolinesterase, corticosteróides,timectomia, imunosupressores, imunoglobulinaintravenosa e plasmaferese. A identificação precoce da MGe de seus fatores precipitantes torna esta patologia maisacessível a novas modalidades de tratamento, comoanticorpos monoclonais, prolactina, tracolimus e crotamina.Conclusão: O melhor conhecimento acerca de seusmecanismos moleculares tem proporcionado o desenvolvimentode novas opções terapêuticas, necessárias paraamenizar crises severas, levando a um prognósticoadequado. Novas descobertas poderão contribuir para aqualidade de vida dos pacientes, ocasionando remissão dadoença e não apenas amenizando os seus sintomas...


This study aimed to a search the literature onmyasthenia gravis (MG). Methodology: Literature search wasconducted in the electronic databases PubMed, ScienceDirect, Scielo and Bireme, in the last ten years, and otherarticles that had extreme historical importance were alsoincluded. Results: MG is an autoimmune diseasecharacterized by muscle weakness, whose pathogenesisis related to the destruction of neuromuscular transmissionby different mechanisms, such as decreased nicotinicacetylcholine receptors, destruction of proteins involved inthe neuromuscular formation or the activity of antibodies ona specific muscle protein kinase (MUSK). The current treatmentof MG is based on the use of acetylcholinesterase inhibitors,corticosteroids, thymectomy, immunosuppressants,intravenous immunoglobulin and plasmapheresis. Earlyidentification of MG and its precipitating factors make thisdisease more accessible to new treatment modalities suchas monoclonal antibodies, prolactin, and tacrolimus crotamine.Conclusion: A better knowledge about molecular mechanismshas provided the development of new therapeutic optionsnecessary to alleviate severe crises, leading to a properprognosis. New findings may contribute to the quality of lifeof patients, resulting in remission of the disease and not justin relieving its symptoms...


Subject(s)
Humans , Male , Female , Young Adult , Aged , Acetylcholine , Combined Modality Therapy , Myasthenia Gravis , Immune System
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