Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 115
Filter
2.
Rev. méd. hondur ; 85(3/4): 103-107, jul.-dic. 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-970191

ABSTRACT

Antecedentes: La psoriasis es una enfermedad inmune crónica con manifestaciones dermatológicas y articulares. Puede presentarse a cualquier edad pero ocurre con mayor frecuencia en dos picos: 20-30 años y 50-60 años. Tiene un componente genético fuerte porque aproximadamente el 30% de los pacientes tienen un familiar de primer grado con la enfermedad, y sus hijos pueden de-sarrollar artritis psoriásica sin alteraciones cutáneas. El paciente experimenta pocos periodos de remisión espontanea.Caso clínico: Mujer de 39 años, ama de casa del casco rural de Tela, diagnosticada con psoriasis hace 7 años. Acude a consulta en buen estado general sin secuelas psicológicas, con lesión en placa localizada en codo derecho con área afectada del 4% y eritrodermia psoriásica que cubre la totalidad del abdomen en un 9% de la supericie corporal. Reiere mejoría con los productos naturales. Actualmente con sobrepeso (27 IMC) y con hipertensión sistólica aislada (140/82 mmHg) sugerente de ateroesclerosis. Discusión: Se deben tomar en cuenta los aspectos psico-sociales y metabólicos que afectan la calidad de vida de estos pacientes, para tratarlos de forma inte-gral con un grupo multidisciplinario. El médico general puede manejar la psoriasis en casos concretos como las placas localizadas ≤ 5% del BSA, en los cuales el tratamiento indicado es tópico con corticoesteroides de alta potencia como primera línea. Para todo lo demás, el paciente con psoriasis debe ser evaluado por un dermatólogo.


Subject(s)
Humans , Female , Adult , Psoriasis/diagnosis , Skin Diseases/complications , Adrenal Cortex Hormones/pharmacology , Dermatitis, Exfoliative/complications
3.
Biomédica (Bogotá) ; 37(supl.1): 104-111, abr. 2017. tab
Article in Spanish | LILACS | ID: biblio-888516

ABSTRACT

Resumen Introducción. Los glucocorticoides, ampliamente utilizados en el periodo perinatal, pueden asociarse con efectos adversos en el neurodesarrollo. Objetivo. Analizar los resultados del tratamiento con corticoides en el periodo prenatal y en el posnatal en el neurodesarrollo de una cohorte de recién nacidos de muy bajo peso. Materiales y métodos. Se hizo un estudio prospectivo de cohortes en los recién nacidos de muy bajo peso hospitalizados en la unidad de cuidados intensivos neonatales de un hospital de tercer nivel entre el 2008 y el 2013. Se comparó el neurodesarrollo entre aquellos que no recibieron tratamiento prenatal con corticoides y quienes recibieron el esquema completo (dos dosis de 12 mg de betametasona) o el incompleto (una dosis). También, se compararon los resultados en el neurodesarrollo de los recién nacidos que no recibieron tratamiento posnatal y aquellos que sí (dexametasona sistémica a partir de la primera semana de vida). Se evaluó la función motora, la neurosensorial y la cognitiva, así como los trastornos de conducta durante los dos primeros años de vida. Resultados. Se analizaron 225 recién nacidos de muy bajo peso; 83,6 % de las madres había recibido tratamiento prenatal con corticoides (esquema incompleto: 24 %; esquema completo: 59,6 %). Durante el periodo posnatal solamente el 13,3 % había recibido dexametasona sistémica. El seguimiento neurológico se llevó a cabo en 194 neonatos. En el análisis de regresión logística no se detectó que el tratamiento prenatal no el posnatal se asociara con más trastornos neurológicos, ni hubo diferencias significativas entre quienes recibieron el esquema completo y los que recibieron el incompleto durante el periodo prenatal. Conclusión. Los resultados de este estudio no pudieron demostrar que el tratamiento perinatal con corticoides se asociara con peores resultados en el neurodesarrollo en recién nacidos de muy bajo peso.


Abstract Introduction: Glucocorticoids, widely used in the perinatal period, may be associated with adverse neurodevelopmental effects. Objectives: To analyze neurodevelopmental outcomes in a cohort of very low birth weight newborns treated with antenatal and/or postnatal corticosteroids. Materials and methods: This was a prospective cohort study in which we included all very low birth weight babies admitted to the neonatal intensive care unit of a tertiary hospital between 2008 and 2013. We compared the neurodevelopment among very low birth-weight newborns who did not receive prenatal corticosteroid therapy and those who received a complete course (two doses of 12 mg betamethasone) and an incomplete course (one dose), and between those who did not receive postnatal corticosteroid therapy and those who received it (systemic dexamethasone after the first week of life). Motor, neurosensory and cognitive functions, as well as behavior disorders during the first two years of age were evaluated. Results: A total of 225 very low birth weight newborns were analyzed; 83.6% received prenatal corticosteroid therapy (24% incomplete treatment schedule and 59.6% complete schedule). Only 13.3% received systemic dexamethasone during the postnatal period. Neurological monitoring was performed in 194 infants. Logistic regression analysis did not detect an association between prenatal and postnatal corticosteroid therapy and more neurological disorders, and no significant differences were found among those who received complete and incomplete courses of prenatal corticosteroid therapy. Conclusion: These results did not demonstrate an association between perinatal corticosteroid therapy and worse neurodevelopmental outcomes in very low birth weight newborns.


Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Dexamethasone/pharmacology , Adrenal Cortex Hormones/pharmacology , Glucocorticoids/pharmacology , Infant, Premature, Diseases/drug therapy , Dexamethasone/chemistry , Prospective Studies , Adrenal Cortex Hormones/chemistry , Glucocorticoids/chemistry
4.
J. pediatr. (Rio J.) ; 91(4): 373-379, July-Aug. 2015. tab
Article in English | LILACS | ID: lil-759341

ABSTRACT

OBJECTIVES: To evaluate the association between oxidative and inflammatory stress markers with peri-intraventricular hemorrhage (PIVH) in very-low birth weight newborns.METHODS: This was a prospective study conducted in a level III neonatal unit. Basal and stimulated reactive oxygen intermediates (ROIs), reduced glutathione (GSH), and interleukin-6 (IL-6) levels were measured in umbilical cord blood. Newborns underwent serial ultrasound at the bedside, at 6, 12, 24, and 72 hours of life and at seven days for the diagnosis of PIVH, classified as grades I to IV. Two groups were assessed, those with and without PIVH; maternal and neonatal control variables were used for comparison. Univariate and multiple regression analyses were applied.RESULTS: A total of 125 newborns were assessed. PIVH incidence rate was 12.0%. In the univariate analysis, basal ROI, the use of two or more doses of corticosteroids, birth weight < 1,000 g, ventilatory support use, and SNAPPE II value ≥ 22 were significantly associated with PIVH. However, in the multivariate analysis, only antenatal steroid use was independently associated with the disease (OR 0,194; 95% CI: 0,048 to 0,773; p=0,02).CONCLUSION: ROI, GSH, and IL-6 levels were not associated with the occurrence of PIVH in very-low birth weight infants.


OBJETIVOS: Avaliar a associação entre marcadores de estresse oxidativo e inflamatório com a hemorragia peri- e intraventricular (HPIV) em recém-nascidos (RN) de muito baixo peso ao nascer.MÉTODOS: Estudo prospectivo em unidade neonatal nível III. Foi feita dosagem em sangue de cordão umbilical de intermediários reativos de oxigênio (ROI) basal e estimulado, glutationa reduzida (GR) e interleucina-6 (IL-6). Recém-nascidos foram submetidos a ultrassonografia seriada, à beira do leito, com seis, 12, 24 e 72 horas de vida e sete dias para o diagnóstico de HPIV, classificada em graus de I a IV. Foram avaliados dois grupos: com e sem HPIV e variáveis de controle maternas e neonatais foram usadas para comparação. Análise univariada e de regressão múltipla foram aplicados.RESULTADOS: Foram avaliados 125 recém-nascidos. A taxa de incidência de HPIV foi de 12%. Na análise univariada o valor basal de ROI, o uso de duas ou mais doses de corticosteroide, peso ao nascer menor do que 1.000 g, o uso de assistência respiratória e valor de SNAPPE II maior ou igual a 22 foram significativamente associados à HPIV. Porém, na análise multivariada, apenas o uso antenatal de esteroides se mostrou independentemente associado à doença (OR 1,94 IC95% 0,048-0,773 p = 0,02).CONCLUSÃO: ROI, GR e Il-6 não foram associados à ocorrência de HPIV em RN de muito baixo peso ao nascer.


Subject(s)
Female , Humans , Infant, Newborn , Male , Cerebral Ventricles , Cerebral Hemorrhage/blood , Fetal Blood , Glutathione/blood , Oxidative Stress/physiology , Reactive Oxygen Species/analysis , Adrenal Cortex Hormones/pharmacology , Biomarkers/blood , Cerebral Hemorrhage , Cerebral Ventricles , Infant, Very Low Birth Weight , Inflammation/metabolism , /blood , Oxidative Stress/drug effects , Prospective Studies , Protective Agents/pharmacology
5.
Salud(i)ciencia (Impresa) ; 20(5): 521-525, may.2014. tab
Article in Spanish | LILACS | ID: lil-790867

ABSTRACT

La rinitis alérgica (RA) es una enfermedad crónica del tracto respiratorio superior cuya prevalencia ha aumentado en las últimas décadas; en la actualidad afecta entre el 5% y el 40 % de la población general en muchos países desarrollados. Aunque no se asocia con morbilidad grave o mortalidad, en un número considerable de enfermos la RA afecta sustancialmente la calidad de vida. El tratamiento eficaz incluye el tratamiento de la RA y de las comorbilidades. Los corticoides intranasales (CIN) se utilizan para el tratamiento de la RA desde principios de la década de 1970. En la actualidad, los CIN se consideran los agentes más eficaces y la terapia de primera línea para aliviar los síntomas de la RA. Diversos estudios han demostrado que los CIN y, en especial, los preparados más nuevos, son fármacos seguros,asociados con efectos adversos graves mínimos o nulos. En este trabajo se realizó una actualización de la terapia con CIN...


Subject(s)
Humans , Administration, Intranasal , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/adverse effects , Adrenal Cortex Hormones/pharmacology , Adrenal Cortex Hormones/therapeutic use , Chronic Disease , Morbidity , Pharmacology , Rhinitis, Allergic
6.
J. appl. oral sci ; 20(1): 50-56, Jan.-Feb. 2012. ilus, graf
Article in English | LILACS | ID: lil-618153

ABSTRACT

Intracanal medication in pulpectomy therapy is used between appointments with the objective of reducing pain and inflammatory processes in pulp and periapical tissues. Propolis has been known as a natural antibiotic and has been subject of medical and dental research due to its therapeutic properties such as antibiotic, analgesic and anti-inflammatory effects. OBJECTIVE: The aim was to carry out an in vivo evaluation of the periapical tissue response to propolis paste when used as an intracanal medication in the teeth of dogs after pulpectomy. MATERIAL AND METHODS: 72 dog's incisors were selected for the experiment. After biomechanical preparation the root canal was filled with a corticosteroid-antibiotic preparation, experimental propolis paste, non-medicament (negative control) or non-pulpectomy at all (positive control). The medications were left inside the root canal for 7, 14 or 28 days. At the end of the experimental period histological sections were prepared and all laboratories processes for Harris hematoxylin and eosin staining was proceeded followed by the analysis using an optical microscope. Sections were classified according to a score representing the inflammatory events observed: the presence of polymorphonuclear neutrophils, polymorphonuclear eosinophils, lymphocytes and plasma cells, macrophages and/or giant cells, fibrous condensation and abscesses. RESULTS: There were statistically significant differences between the tissue reactions caused by the two substances being tested, after different experimental periods, with the periapical tissue that was in contact with propolis paste exhibiting fewer inflammatory reactions in comparison to corticosteroid-antibiotic preparation. CONCLUSIONS: The low tissue responses from propolis paste suggest that this material could be considered as an option for root canal medication after pulpectomy.


Subject(s)
Animals , Dogs , Adrenal Cortex Hormones/pharmacology , Anti-Bacterial Agents/pharmacology , Pulpectomy , Periapical Tissue/drug effects , Propolis/pharmacology , Root Canal Irrigants/pharmacology , Dental Pulp Cavity/drug effects , Dental Pulp/drug effects , Models, Animal , Time Factors
7.
Braz. j. oral sci ; 9(3): 337-344, July-Sept. 2010. ilus, tab
Article in English | LILACS, BBO | ID: lil-578052

ABSTRACT

Aim: To evaluate the treatment with corticosteroid/antibiotic dressing in pulpotomy with calciumhydroxide. Methods: Forty-six premolars were pulpotomized and randomly assigned into 3groups. In Group I pulpal wound was directly capped with calcium hydroxide, and Group II and Group III received corticosteroid/antibiotic dressing for 10 min or 48 h, respectively, before pulp capping. Teeth were processed for histological analysis after 7, 30 or 60 days to determine inflammatory cell response, tissue disorganization, dentin bridge formation and presence of bacteria.Attributed scores were analyzed by Kruskal-Wallis and Mann-Whitney tests (á=0.05). Results:On the 7th day, all groups exhibited dilated and congested blood vessels in the tissue adjacent to pulpal wound. The inflammatory cell response was significantly greater in Group III (p<0.05). On the 30th day, in all groups, a thin dentin matrix layer was deposited adjacent to the pulpal wound and a continuous odontoblast-like cell layer underlying the dentin matrix was observed. On the60th day, all groups presented a thick hard barrier characterized by an outer zone of dystrophic calcification and an inner zone of tubular dentin matrix underlined by a defined odontoblast-like celllayer. Conclusions: Within the limitations of present study, considering that the treatment was performed in healthy teeth, it may be concluded that the use of a corticosteroid/antibiotic dressing before remaining tissue protection with calcium hydroxide had no influence on pulp tissue healing.


Subject(s)
Humans , Child , Adolescent , Adrenal Cortex Hormones/pharmacology , Calcium Hydroxide/pharmacology , Dental Pulp Capping/methods , Dental Pulp/drug effects , In Vitro Techniques , Dental Pulp Necrosis , Dental Pulp/anatomy & histology , Dental Pulp/microbiology , Dentin, Secondary/anatomy & histology , Pulpotomy/methods , Statistics, Nonparametric , Time Factors
8.
Alerg. inmunol. clin ; 28(3/4): 57-57, 2010.
Article in Spanish | LILACS | ID: lil-616802

ABSTRACT

Los corticosteroides inhalados se usan para la prevención del asma. Los corticoides intranasales se utilizan en el tratamiento de la fiebre del heno, rinitis alérgica perenne y en otras patologías nasales.


Subject(s)
Humans , Male , Female , Allergy and Immunology , Adrenal Cortex Hormones/adverse effects , Adrenal Cortex Hormones/pharmacology , Adrenal Cortex Hormones/immunology , El Niño Phenomenon , Pharmacology
9.
Rev. chil. pediatr ; 80(4): 347-353, ago. 2009. ilus, tab
Article in Spanish | LILACS | ID: lil-556702

ABSTRACT

Introduction: Systemic corticosteroids are widely used in patients with acute bronchial obstruction (ABO). It has been recommended that such treatment last a maximum of 5 days to avoid adverse effects. Suppression of the adrenal axis under these conditions among children has not been evaluated. Objective: Assessment of the hypothalamic pituitary adrenal axis (HHS) function after use of systemic steroids in children after a 5-7 day use of corticoids, utilizing the micro ACTH test. Method: Prospective observational study conducted in the Department of Pediatrics, Hospital Clínico Universidad Católica de Chile. ACTH test used with microdosis (1 mcg/1.73 m²). A normal response was determined if cortisol post-ACTH > 20 mcg/dL. Results: 7 patients were recruited, median age was 4 years 4 months (range 4 months to 8 years). The test was perfomed within an average of 72 hours after discontinuation of prednisone. All patients had normal basal cortisol values, with an average value of 6.5 mcg/dl, range 1 to 9 mcg/dl. The ACTH test yielded a response of cortisol levels with an average value of 13.6 mcg/dL and a range of 3.7 to 20 mcg/dL. Five of the 7 patients presented an abnormal response. Conclusions: Our results suggest that the adrenal response may be reduced in children who have been treated with systemic steroids for ABO even if managed during short periods of time.


Introducción: Los corticoides sistémicos son ampliamente utilizados en pacientes con crisis bronquiales obstructivo (CBO). Se ha recomendado un máximo de 5 días para evitar efectos adversos. No ha sido evaluado si tratamientos por cursos cortos pueden suprimir el eje adrenal. Objetivo: Evaluar la función del eje hipotálamo hipófisis suprarrenal (HHS) mediante la prueba de microdosis de ACTH en pacientes con CBO que recibieron corticoides sistémicos entre 5 a 7 días. Diseño: Estudio observacional prospectivo realizado en el Servicio de Pediatría del Hospital Clínico de la Universidad Católica de Chile. Prueba de ACTH con microdosis (1 mcg/1,73 m²). Se consideró como respuesta normal una respuesta de cortisol postestímulo > 20 mcg/dL. Resultados: Fueron reclutados 7 pacientes, mediana de edad de 4 años 4 meses (rango 4 meses a 8 años). Los resultados fueron obtenidos con una mediana de 72 horas de suspendidos los corticoides (prednisona). Todos los pacientes presentaban valores de cortisol basal normal promedio de 6,5 mcg/dl (rango 1 a 9 mcg/dl). La respuesta de cortisol postestímulo fue de 13,6 mcg/dL (3,7 a 20 mcg/ dL), cinco de los 7 pacientes presentaron respuesta anormal. Conclusiones: La respuesta adrenal puede estar disminuida en pacientes que usan corticoides sistémicos por cursos cortos por CBO.


Subject(s)
Humans , Male , Female , Infant , Adrenal Cortex Hormones/administration & dosage , Adrenal Glands , Airway Obstruction/drug therapy , Adrenal Cortex Hormones/pharmacology , Dose-Response Relationship, Drug , Prospective Studies
10.
Medicina (B.Aires) ; 68(6): 455-464, nov.-dic. 2008. ilus, tab
Article in Spanish | LILACS | ID: lil-633589

ABSTRACT

Los tratamientos utilizados para desordenes inmunológicos son de origen empírico, utilizando drogas inmunosupresoras identificadas a través de la selección de un gran número de compuestos naturales y sintéticos. Las drogas inmunosupresoras son ampliamente utilizadas en tratamientos clínicos de desordenes autoinmunes, en la prevención de rechazo a transplantes así como también en desordenes de carácter no autoinmune tales como las alergias. El diseño de las terapias inmunosupresoras está basado en controlar una respuesta inmune exacerbada. La base fisiopatológica de este concepto es en modular la acción de células mononucleares, siendo el principal punto de control las células T. Estas drogas inhiben la función normal de protección del sistema inmune llevando a la aparición de complicaciones en las terapias de inmunosupresión. Las drogas inmunosupresoras tienen diferentes blancos en el proceso de inmunidad celular. Según su modo de acción pueden clasificarse en cuatro categorías: drogas antinflamatorias de la familia de los corticosteroides, inmunosupresoras específicas inhibidoras de la calcineurina, citotóxicas o antiproliferativas y anticuerpos específicos. En este trabajo describimos el mecanismo de acción molecular de agentes inmunosupresores tales como, esteroides, ciclosporina, tacrolimo, azatioprina, ciclofosfamida, sirolimus, mofetil mecofenolato, leflunomida y anticuerpos específicos, para contribuir a la comprensión de cómo utilizar y mejorar estos agentes.


A number of natural and synthetic substances are used in the treatment of immunological disorders. The immunosuppressive drugs are widely utilized in clinical treatments of autoimmune disorders, in the prevention of transplant rejection as well as in non-autoimmune diseases such as allergy. The design of immunosuppressive therapies is based on the control of the exacerbated immune response. The pathophysiologic mean of this concept is to modulate the action of mononuclear cells, being T cells the main targets. Immunosuppressive agents have different molecular targets, and an important drawback in their use is that they also inhibit the normal immune system response. Depending on their mode of action, immunosuppressive drugs can be classified in four different groups: antinflammatory drugs of the corticosteroid family, inhibitors of the calcineurin pathway, cytototoxic or antiproliferative drugs and specific antibodies. In this article, we focus on the molecular action of immunosuppressive drugs such as steroids, cyclosporine, tacrolimus, azathioprine, cyclophosphamide, sirolimus, mycophenolate mofetil, leflunomide and specific antibodies, providing data to characterize and improve the use of these agents.


Subject(s)
Animals , Humans , Adrenal Cortex Hormones/pharmacology , Autoimmune Diseases/drug therapy , Immunosuppressive Agents/pharmacology , Anti-Inflammatory Agents/pharmacology , Immune System/drug effects
11.
Col. med. estado Táchira ; 17(2): 46-48, abr.-jun. 2008. ilus
Article in Spanish | LILACS | ID: lil-531279

ABSTRACT

El síndrome de tolosa-Hunt es una oftalmoplejia dolorosa, recurrente provocada por una inflamación granulomatosa inespecífica que afecta al seno cavernoso, la hendidura esfenoidal y el apex orbitario. Se caracteriza por dolor retrocular agudo recurrente con parálisis extraocular, que generalmente afecta los nervios craneanos tercero, cuarto, quinto y sexto. Se le atribuye a una infiltración granulomatosa del apex orbitrario o en el seno cavernoso, que responde a la corticoideoterapia. Nuestro paciente consulta por enfermedad de 3 meses de evolución presenta de forma súbita cefalea de fuerte intensidad; y pulsátil acompañado de dolor de fuerte intensidad en globo ocular derecho de carácter pulsátil y progresivamente ptosis palpebral derecha. Se le instaura tratamiento con corticoides, AINES y antiglaucomatosos con poca mejoría sin recuperar amaurosis del ojo derecho. Se obtienen estudios por TAC y RNM de órbita donde se evidencia engrosamiento a nivel del seno cavernoso. Evaluado por equipo multidisciplinario de oftalmología, neurocirugía, Medicina Interna, Imagenología. Considerando que existe un predominio por el seno cavernoso. No se disponen de estudios de prevalencia o incidencia. Se ubica el síndrome de Tolosa-Hunt como la tercera causa de síndrome del seno cavernoso, superado por el trauma y los tumores.


Subject(s)
Humans , Male , Aged, 80 and over , Blepharoptosis/diagnosis , Headache/diagnosis , Adrenal Cortex Hormones/therapeutic use , Pain/diagnosis , Magnetic Resonance Spectroscopy/methods , Granuloma, Plasma Cell/pathology , Cavernous Sinus/anatomy & histology , Sphenoid Sinus/physiopathology , Tolosa-Hunt Syndrome/pathology , Cerebral Angiography/methods , Blindness/etiology , Adrenal Cortex Hormones/pharmacology , Inflammation/etiology , Cranial Nerves/anatomy & histology , Ophthalmology , Eye Diseases/pathology
13.
In. Universidade Federal do Rio de Janeiro.Instituto de Estudos em Saúde Coletiva. Investigações em sistema de saúde e controle da hanseníase. Rio de Janeiro, s.n, abr.-jun., 2008. p.377-384, tab.
Non-conventional in Portuguese | LILACS, SES-SP, HANSEN, HANSENIASE, SESSP-ILSLACERVO, SES-SP | ID: biblio-1247261

ABSTRACT

O objetivo deste trabalho foi determinar a frequência de hipertensão ocular e de catarata em portadores de hanseníase em tratamento de estado reacional dos tipos I e II, associado ou não à neurite, com corticoterapia oral. A partir daí, selecionar, orientar e encaminhar os pacientes que apresentaram complicações oculares para propedêutica e tratamento oftalmológico adequados. Foi elaborado estudo descritivo que inclui 31 portadores de hanseníase com estado reacional, em tratamento regular com corticosteróide oral, por um período de 5 a 40 meses (média de 18,7 +- 10,1 meses) sendo 14 do sexo masculino e 17 do sexo feminino, 10 leucodérmicos, 14 faiodérmicos e 7 melanodérmicos. As idades variaram entre 15 e 62 anos (média de 36,8 +- 13,0 anos). Todos foram submetidos à avaliação oftalmológica para que a frequência de hipertensão ocular e de opacidades cristalinianas subcapsulares posteriores pudessem ser determinadas. A hipertensão ocular foi observada em 22,6% dos olhos examinados, enquanto que a catarata foi diagnosticada em 19,4%. Hipertensão ocular e catarata são achados frequentes em portadores de hanseníase em tratamento de estado reacional com corticoterapia oral. O controle oftalmológico regular para o pronto diagnóstico, propedêutica e tratamento adequado dessas complicações oculares visam prevenir ou minimizar possíveis danos visuais iatrogênicos.


Subject(s)
Adrenal Cortex Hormones/pharmacology , Adrenal Cortex Hormones/therapeutic use , Leprosy/immunology , Leprosy/drug therapy , Ocular Hypertension/physiopathology , Ocular Hypertension/therapy , Ocular Hypertension/drug therapy
15.
Indian J Exp Biol ; 2007 Aug; 45(8): 676-82
Article in English | IMSEAR | ID: sea-56708

ABSTRACT

In vitro effects of gonadal hormones (testosterone, 17beta-estradiol estriol and estrone) and corticosteroid hormones (corticosterone and cortisol) were studied on arylalklyamine N-acetyltransferase (AA-NAT) activity in the pineal organ of the fish, C. gariepinus during quiescent, progressive, breeding and regressive phases of its annual breeding cycle. The pineals were collected under dim red light, maintained in organ culture for 7 hr and incubated with three concentrations (10(-6), 10(-5) and 10(-4) M) of hormones for 6 hr. The treatments with gonadal hormones and corticosteroid hormones inhibited pineal AA-NAT activity in a dose-dependent manner during all the phases of the breeding cycle. AA-NAT activity was comparatively more sensitive to the inhibitory effects of the gonadal hormones during the regressive phase and less sensitive during the quiescent phase. Further, the enzyme activity was more sensitive to the inhibitory effects of corticosteroid hormones (corticosterone and cortisol) during the breeding phase and less sensitive during the quiescent phase. These findings seem to suggest that gonadal hormones and corticosteroid hormones have direct inhibitory influence on AA-NAT activity and, hence melatonin synthesis in the photoreceptive pineal organ of C. gariepinus.


Subject(s)
Adrenal Cortex Hormones/pharmacology , Animals , Arylamine N-Acetyltransferase/antagonists & inhibitors , Breeding , Catfishes/growth & development , Estradiol/pharmacology , Estriol/pharmacology , Gonadal Steroid Hormones/pharmacology , Melatonin/metabolism , Pineal Gland/drug effects , Testosterone/pharmacology
17.
Neumol. pediátr ; 2(2): 101-104, 2007. tab
Article in Spanish | LILACS | ID: lil-489165

ABSTRACT

El asma es la enfermedad inflamatoria crónicas más frecuente en niños. Diversas guías clínicas nacionales y extranjeras recomiendan a los corticoides inhalados (CI) como el tratamiento de elección, de manera independiente de la severidad de la enfermedad. Nuevos CI han ingresado al mercado nacional, con características particulares que ameritan una revisión apropiada para su empleo. Este trabajo resume algunos aspectos farmacológicos básicos del uso de CI en niños así como su mecanismo de acción en sujetos con asma.


Subject(s)
Humans , Child , Administration, Inhalation , Asthma/drug therapy , Adrenal Cortex Hormones/pharmacology , Anti-Asthmatic Agents/pharmacology , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/adverse effects , Nebulizers and Vaporizers
18.
J. pediatr. (Rio J.) ; 82(5,supl): S213-S221, Nov. 2006. tab, graf
Article in English | LILACS | ID: lil-441741

ABSTRACT

OBJETIVO: Comparar os antagonistas de leucotrienos (ARLT) aos outros grupos de medicamentos utilizados para tratar a asma e a rinite alérgica. FONTES DOS DADOS: MEDLINE, LILACS e Biblioteca Cochrane. Palavras chaves: leucotrienos, antileucotrienos, tratamento da asma, tratamento da rinite alérgica, asma e rinite alérgica. Procurou-se agrupar os principais trabalhos e revisões sobre o assunto. SíNTESE DOS DADOS: Os ARLT são mais eficazes do que placebo e potencializam os efeitos dos corticosteróides inalados. A associação de corticosteróides inalados com agentes beta2 agonistas de longa duração (LABA) é mais eficaz do que a associação de cortiscoteróides inalados + ARLT. Embora pareça racional o uso de ARLT na crise aguda de asma e rinite alérgica, mais estudos são necessários para comprovar esse benefício. Os ARLT promovem redução no tempo de hospitalização e no número de crises de sibilância em lactentes com bronquiolite viral aguda pelo vírus respiratório sincicial e na sibilância recorrente após bronquiolite viral aguda. Os ARLT são menos eficazes que os corticosteróides intranasais no manejo da rinite alérgica. Os ARLT são eficazes na asma induzida por exercício (AIE), embora não constituam a primeira linha de tratamento. CONCLUSÃO: Estudos controlados e randomizados mostram que os corticosteróides inalados são as drogas de escolha para o tratamento da asma persistente e rinite alérgica. :Não existem evidências suficientes para recomendar o uso de ARLT como medicamento de primeira linha (monoterapia) em crianças com asma (nível I). Nas crianças que não podem usar corticosteróides inalados, os ARLT podem ser uma alternativa (nível II).


OBJECTIVE: To compare leukotriene antagonists (LTA) to other groups of drugs used in asthma and allergic rhinitis treatment. SOURCES: MEDLINE, LILACS and Cochrane Library. Keywords: leukotrienes, antileukotrienes, asthma treatment, allergic rhinitis treatment, asthma and allergic rhinitis. An attempt was made to group the main studies and reviews about this topic. SUMMARY OF THE FINDINGS: LTA are more efficient than placebo and enhance the effects of inhaled corticosteroids. The association of inhaled corticosteroids with long-acting beta2-agonists is more efficient than the association of inhaled corticosteroids + LTA. Although use of LTA in acute asthma attacks and allergic rhinitis seems reasonable, more studies are needed to confirm this benefit. LTA reduce hospitalization time and the number of wheezing attacks in infants with acute viral bronchiolitis caused by respiratory syncytial virus, as well as recurrent wheezing after acute viral bronchiolitis. LTA are less efficient than intranasal corticosteroids for allergic rhinitis management. LTA are efficient in exercise-induced asthma, although they are not the first-line treatment. CONCLUSIONS: Controlled and randomized studies show that inhaled corticosteroids are the drugs of choice to treat persistent asthma and allergic rhinitis. There is not enough evidence to recommend the use of LTA as first-line drug (monotherapy) in children with asthma (level I). For children who cannot use inhaled corticosteroids, LTA may be a good alternative (level II).


Subject(s)
Humans , Infant , Child , Adrenal Cortex Hormones/therapeutic use , Adrenergic beta-Agonists/therapeutic use , Anti-Asthmatic Agents/therapeutic use , Asthma/drug therapy , Leukotriene Antagonists/therapeutic use , Rhinitis/drug therapy , Acute Disease , Administration, Inhalation , Adrenal Cortex Hormones/pharmacology , Adrenergic beta-Agonists/pharmacology , Anti-Asthmatic Agents/pharmacology , Asthma, Exercise-Induced/drug therapy , Drug Combinations , Leukotriene Antagonists/pharmacology , Leukotrienes/classification , Leukotrienes/metabolism , Leukotrienes/pharmacology , Membrane Proteins/metabolism , Membrane Proteins/physiology , Practice Guidelines as Topic , Receptors, Leukotriene/metabolism , Receptors, Leukotriene/physiology , Respiratory System/drug effects , Treatment Outcome
19.
Neumol. pediátr ; 1(2): 73-76, 2006. tab, ilus
Article in Spanish | LILACS | ID: lil-497923

ABSTRACT

Durante muchas décadas, los corticoides inhalados han sido las drogas de elección para el manejo y control del asma crónica, tanto en niños como en adultos. Diversas guías y consensos de manejo (internacionales y nacionales) recomiendan su uso; sin embargo existe pocas revisiones publicadas en nuestro medio de sus aspectos mas básicos. En el presente artículo se revisan los mecanismos de acción y el rol del receptor para glucocorticoides intracitoplasmático, así como sus interacciones moleculares con otros receptores importantes para la expresión de genes que codifican para la síntesis de proteínas específicas pro-inflamatorias y anti-inflamatorias. Se revisan las equivalencias - en términos de dosis - y las principales diferencias entre los corticoides disponibles actualmente, para finalmente describir brevemente los efectos adversos más frecuentes descritos en niños.


Subject(s)
Humans , Child , Asthma/drug therapy , Adrenal Cortex Hormones/pharmacology , Administration, Inhalation , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/adverse effects
20.
Rev. bras. anestesiol ; 55(1): 118-134, jan.-fev. 2005. ilus, tab
Article in Portuguese, English | LILACS | ID: lil-393580

ABSTRACT

JUSTIFICATIVA E OBJETIVOS: As doenças congênitas do coração atingem 0,8 por cento dos recém-nascidos (RN) vivos, sendo que muitos necessitam de correção cirúrgica ainda no período neonatal. A cirurgia cardíaca com circulação extracorpórea (CEC), nesta faixa etária, associa-se a maior incidência de complicações, devido à imaturidade funcional da criança, à falta de equipamentos de CEC que sejam totalmente compatíveis com as dimensões do RN e às dificuldades técnicas para correção da lesão cardíaca. Este artigo tem o propósito de apresentar os aspectos relacionados à técnica anestésica, a CEC e seus efeitos em RN. CONTEUDO: Elevadas doses de fentanil ou sufentanil provêm adequada anestesia sem interferir na estabilidade cardiocirculatória. A depressão respiratória residual dos opióides não é problema neste grupo de pacientes porque a maioria necessita assistência respiratória no pós-operatório imediato. A entrada em CEC pode ser acompanhada de hipotensão arterial por manipulação do coração e/ou sangramento. O posicionamento inadequado das cânulas venosas e aórtica pode causar sérias complicações, como insuficiente fluxo encefálico ou dificuldade na drenagem venosa. São comuns a utilização de hipotermia profunda e a parada circulatória total durante a CEC. A hipotermia modifica a viscosidade do sangue que é tratada com hemodiluição e traz implicações para a correção do pH (alfa-stat versus pH stat). No desmame da CEC é freqüente ocorrer baixo débito cardíaco e ajustes em um ou em todos os seus componentes ( pré-carga, contratilidade, pós-carga e freqüência cardíaca) podem ser necessários. Além das drogas clássicas, como a adrenalina e a dopamina, pode ser necessário o emprego de outras substâncias como a aprotinina, o óxido nítrico ou os inibidores da fosfodiesterase. CONCLUSÕES: O anestesiologista tem papel preponderante no ajuste da homeostasia durante o período peri-operatório. Conhecimentos sobre o tipo de lesão cardíaca, a correção a ser realizada, a resposta do organismo a CEC podem ser úteis no manuseio destas crianças.


Subject(s)
Infant, Newborn , Humans , Anesthesia , Anticoagulants/pharmacology , Antifibrinolytic Agents/pharmacology , Cardiopulmonary Bypass , Heart Defects, Congenital/surgery , Adrenal Cortex Hormones/pharmacology , Extracorporeal Circulation , Infant, Newborn , Respiratory Mechanics
SELECTION OF CITATIONS
SEARCH DETAIL