Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 100
Filter
1.
Braz. J. Pharm. Sci. (Online) ; 56: e18094, 2020. tab, graf
Article in English | LILACS | ID: biblio-1285510

ABSTRACT

Ursodeoxycholic acid (UDCA), a secondary bile acid (BA), has been used as a drug to treat various liver diseases. UDCA is synthesised from cholic or chenodeoxycholic acid (CA/CDCA), two primary BAs frequently used as the starting materials. Nowadays, swine, cattle, and poultry bile are the main sources of those BAs. However, other commercial animals could be promising sources as well. We identified two livestock, two poultries, and eight fishes that are commercially cultivated in Indonesia. Four free BAs including CA, CDCA, deoxycholic acid (DCA), and lithocholic acid (LA) were identified for their occurrences using thin-layer chromatography and high-performance liquid chromatography. CA was detected in cow, duck, red tilapia, gourami, the common carp, and grouper, whereas CDCA was only detected in two poultries and the common carp. The occurrence of DCA was common and abundant in most tested animals. In contrast, the presence of LA was found to be very low in all samples. The biliary bile of tilapia has been found to contain a high abundance of free CA (43% of the total bile). A simple extraction was able to purify CA from biliary bile of tilapia. This is a new promising and competitive source of CA.


Subject(s)
Animals , Male , Female , Bile/drug effects , Chromatography, High Pressure Liquid/methods , Chromatography, Thin Layer/methods , Indonesia/ethnology , Animals , Ursodeoxycholic Acid , Ursodeoxycholic Acid/antagonists & inhibitors , Bile Acids and Salts/therapeutic use , Chenodeoxycholic Acid , Tilapia/classification , Cholic Acid/agonists , Deoxycholic Acid , Lithocholic Acid
2.
Rev. Soc. Bras. Med. Trop ; 53: e20180463, 2020. tab, graf
Article in English | LILACS | ID: biblio-1057304

ABSTRACT

Abstract INTRODUCTION: The therapeutic efficacy of daily amphotericin B infusion is related to its maximum concentration in blood; however, trough levels may be useful in intermittent regimens of this antifungal drug. METHODS : High performance liquid chromatography (HPLC) was used to determine the minimum concentration (Cmin) of amphotericin B in the serum of patients receiving deoxycholate (D-Amph) or liposomal amphotericin B (L-AmB) for the treatment of cryptococcal meningitis (n=28), histoplasmosis (n=8), paracoccidioidomycosis (n=1), and leishmaniasis (n=1). RESULTS: Daily use of D-Amph 30 to 50 mg or L-AmB 50 mg resulted in a similar Cmin, but a significant increase ocurred with L-AmB 100 mg/day. The geometric mean Cmin tended to decrease with a reduction in the dose and frequency of intermittent L-AmB infusions: 357 ng/mL (100 mg 4 to 5 times/week) > 263 ng/mL (50 mg 4 to 5 times/week) > 227 ng/mL (50 mg 1 to 3 times/week). The impact on Cmin was variable in patients whose dose or therapeutic scheme was changed, especially when administered the intermittent infusion of amphotericin B. The mean Cmin for each L-AmB schedule of intermittent therapy was equal or higher than the minimum inhibitory concentration of amphotericin B against Cryptococcus isolates from 10/12 patients. The Cmin of amphotericin B in patients with cryptococcal meningitis was comparable between those that survived or died. CONCLUSIONS: By evaluating the Cmin of amphotericin B, we demonstrated the therapeutic potential of its intermittent use including in the consolidation phase of neurocryptococcosis treatment, despite the great variability in serum levels among patients.


Subject(s)
Humans , Amphotericin B/blood , Deoxycholic Acid/blood , Antifungal Agents/blood , Paracoccidioidomycosis/drug therapy , Leishmaniasis/drug therapy , Amphotericin B/administration & dosage , Amphotericin B/pharmacokinetics , Chromatography, High Pressure Liquid , Meningitis, Cryptococcal/drug therapy , Deoxycholic Acid/administration & dosage , Deoxycholic Acid/pharmacokinetics , Histoplasmosis/drug therapy , Antifungal Agents/administration & dosage , Antifungal Agents/pharmacokinetics
3.
An. bras. dermatol ; 94(6): 754-756, Nov.-Dec. 2019. graf
Article in English | LILACS | ID: biblio-1054889

ABSTRACT

Abstract A 28-year-old white female patient presented with multiple erythematous-to-violaceous, painful, suppurative nodules on the buttocks and thighs that appeared after two weeks of mesotherapy with deoxycholate, caffeine, sunflower liposomes, and sinetrol for localized fat. She was treated for atypical mycobacteriosis, but with no satisfactory response after antibiotic therapy. Bacterial, mycobacterial, and fungal culture were all negative. Histopathologic examination of the biopsy showed noninfectious suppurative panniculitis. It resolved after treatment with methotrexate, prednisone, and hydroxychloroquine. This report highlights the rarity of this complication, the importance of its early recognition, and differentiation with atypical fast growing mycobacterioses.


Subject(s)
Humans , Female , Adult , Panniculitis, Nodular Nonsuppurative/chemically induced , Panniculitis, Nodular Nonsuppurative/pathology , Deoxycholic Acid/adverse effects , Mesotherapy/adverse effects , Biopsy , Panniculitis, Nodular Nonsuppurative/drug therapy , Treatment Outcome , Dermis/pathology
4.
Article in English | WPRIM | ID: wpr-739226

ABSTRACT

OBJECTIVES: The purpose of this study is to shorten the decellularization time of trachea by using combination of physical, chemical, and enzymatic techniques. METHODS: Approximately 3.5-cm-long tracheal segments from 42 New Zealand rabbits (3.5±0.5 kg) were separated into seven groups according to decellularization protocols. After decellularization, cellular regions, matrix and strength and endurance of the scaffold were followed up. RESULTS: DNA content in all groups was measured under 50 ng/mg and there was no significant difference for the glycosaminoglycan content between group 3 (lyophilization+deoxycholic acid+de-oxyribonuclease method) and control group (P=0.46). None of the decellularized groups was different than the normal trachea in tensile stress values (P>0.05). Glucose consumption and lactic acid levels measured from supernatants of all decellularized groups were close to group with cells only (76 mg/dL and 53 mg/L). CONCLUSION: Using combination methods may reduce exposure to chemicals, prevent the excessive influence of the matrix, and shorten the decellularization time.


Subject(s)
Deoxycholic Acid , DNA , Freeze Drying , Glucose , Lactic Acid , Rabbits , Tissue Engineering , Trachea
5.
Rev. méd. Chile ; 146(12): 1481-1485, dic. 2018. graf
Article in Spanish | LILACS | ID: biblio-991360

ABSTRACT

We report a 45-year-old male with AIDS who had a Cryptococcus neoformans central nervous system infection. He was treated with amphotericin B deoxycholate subsequently changed to voriconazole due to systemic toxicity of the former. Plasma levels of voriconazole were insufficient with a standard dose (0.7 μg/mL), therefore, the dose was increased thereafter to reach appropriate levels (4.5 μg/mL). Anti-retroviral therapy was started five weeks after voriconazole initiation with non-interacting drugs and he was discharged after a favorable evolution. He was re-admitted three months later due to seizures; a brain magnetic resonance showed new sub-cortical nodules. After excluding alternative causes and demonstrating fungal eradication, an immune reconstitution inflammatory syndrome (IRIS) event was suspected and treated with a short course of steroids. His evolution was satisfactory.


Subject(s)
Humans , Male , Middle Aged , Amphotericin B/adverse effects , Meningitis, Cryptococcal/drug therapy , AIDS-Related Opportunistic Infections/drug therapy , Deoxycholic Acid/adverse effects , Immune Reconstitution Inflammatory Syndrome/chemically induced , Voriconazole/administration & dosage , Antifungal Agents/adverse effects , Amphotericin B/administration & dosage , Meningitis, Cryptococcal/diagnostic imaging , AIDS-Related Opportunistic Infections/diagnostic imaging , Deoxycholic Acid/administration & dosage , Drug Combinations , Antifungal Agents/administration & dosage
6.
Rev. chil. infectol ; 35(4): 448-452, ago. 2018. graf
Article in Spanish | LILACS | ID: biblio-978057

ABSTRACT

Resumen Presentamos el caso clínico de un paciente con una leucemia linfoblástica aguda (LLA) que desarrolló una fusariosis diseminada por Fusarium verticillioides durante un episodio prolongado de neutropenia febril post quimioterapia. Fue exitosamente tratado cuando se usó terapia combinada de voriconazol más anfotericina B deoxicolato.


We report a case of a patient with acute lymphoblastic leukemia (ALL), who developed a disseminated infection by Fusarium verticillioides during chemotherapy-induced neutropenia. He was successfully treated only after combination therapy with voriconazole plus amphotericin B deoxycolate was used, but not when these compounds were used in an isolated form.


Subject(s)
Humans , Male , Adolescent , Amphotericin B/therapeutic use , Deoxycholic Acid/therapeutic use , Fusariosis/drug therapy , Voriconazole/therapeutic use , Antifungal Agents/therapeutic use , Neutropenia/drug therapy , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/complications , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/microbiology , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Drug Combinations , Drug Therapy, Combination , Fusariosis/etiology , Fusariosis/pathology , Neutropenia/etiology , Neutropenia/pathology
7.
Rev. chil. infectol ; 35(4): 420-423, ago. 2018.
Article in Spanish | LILACS | ID: biblio-978053

ABSTRACT

Resumen Introducción: La criptococcosis es una infección micótica oportunista grave, Cryptococcus neoformans es la principal especie de importancia médica, pudiendo manifestarse como meningitis, neumonía o criptococcemia. Objetivo: Caracterizar a los pacientes con infección por Cryptococcus sp. entre el 01/01/13 y 30/06/16, en el HCVB. Materiales y Métodos: Se identificaron los cultivos con desarrollo de Cryptococcus sp., y a partir de éstos se obtuvo los registros de los pacientes, los que fueron analizados por dos revisores independientes. Resultados: Se recopiló la información de 13 pacientes, que presentaron 15 casos de infección por C. neoformans. De los 13 pacientes, 11 (84,6%) eran de sexo masculino, con una mediana de edad de 35 años. 11 pacientes (84,6%) padecían infección por VIH, uno (7,7%) tenía el antecedente de leucemia linfática crónica, y uno (7,7%) de etilismo crónico. De los 15 casos, nueve (60%) presentaron infección meníngea; cinco (33,3%) presentaron criptococcemia sin compromiso del LCR; y uno (6,6%) presentó infección pulmonar. De los 13 pacientes, ocho (53,3%) se encontraban fallecidos al año de seguimiento. Conclusiones: La infección por Cryptococcus sp. es una patología que debe ser sospechada en pacientes con inmunodeficiencia de predominio celular. La infección meníngea fue la forma más frecuente de presentación. Persiste presentando una elevada mortalidad.


Background: Cryptococcosis is a severe opportunistic mycotic infection, caused mainly by Cryptococcus neoformans. It can present as meningitis, pneumonia or cryptococcemia. Aim: To characterize patients with Cryptococcus infection between January 1°, 2013 and June 30, 2016, in Hospital Carlos van Buren, Valparaíso, Chile. Methods: We identified retrospectively those cultures with Cryptococcus sp. growth, and then obtained their clinical files which were analyzed by two independent reviewers. Results: We were able to obtain data from 13 of 15 patients who presented with Cryptococcus neoformans infection. Out of all, 11 (84.6%) were males, with a median age of 35 years old. 11 (84,6%) were HIV positive, 1 (7,7%) had chronic lymphocytic leukemia, and 1 (7,7%) refered alcohol abuse. Out of the 15 episodes, 9 (60%) had meningeal infection; 5 (33.3%) were cryptococcemia without meningeal involvement and 1 (6.6%) presented as a pulmonary infection. Eight patients were deceased at one year follow up. Conclusions: Cryptococcus sp. infection must be suspected in patients with cellular immunodeficiencies. Meningeal involvement is the most frequent form of clinical presentation. It still has a high mortality rate.


Subject(s)
Humans , Male , Female , Adult , Cryptococcosis/diagnosis , CD4-Positive T-Lymphocytes , Fluconazole/therapeutic use , Chile , Retrospective Studies , Cryptococcosis/drug therapy , Cryptococcus neoformans/isolation & purification , Deoxycholic Acid/therapeutic use
8.
Rev. Nac. (Itauguá) ; 10(1): 17-35, 20180600.
Article in Spanish | LILACS, BDNPAR | ID: biblio-914219

ABSTRACT

Introducción En las últimas décadas, el agente de elección para el tratamiento de la mayoría de las micosis sistémicas ha sido la anfotericina B que, a pesar de los efectos tóxicos, sigue teniendo un papel importante en el tratamiento de las infecciones micóticas. Objetivo Determinar los efectos adversos asociados al empleo de anfotericina B en neonatos del Servicio de Neonatología del Hospital Nacional de Itauguá, en el periodo 2013 - 2015. Materiales y métodos Estudio de serie de casos, retrospectivo, de recién nacidos con tratamiento con anfotericina B. Resultados: Entre 28 recién nacidos tratados con anfotericina B, hubo mayor prevalencia en el sexo masculino. Con respecto a la edad más de la mitad de los recién nacidos fueron pre-término en el grupo estudiado. Hubo predominio de bajo peso al nacer (32,14%). Los factores de riesgo arrojaron que 53,5% no contaba con antecedentes de sepsis. La edad media de inicio de anfotericina fue 19±9 días, más de la mitad de los neonatos utilizó dosis progresiva de 0,5 mg/kp/día a 1 mg/kp/día, en 24 hs.El 96,4% recibió infusión de anfotericina B de 4 horas, 1 caso requirió 6 horas. Entre los efectos secundarios, 35,7% de los pacientes presentó anemia, el disturbio hidroelectrolítico más frecuente fue la hipokalemia, entre los signos se destacaron la taquicardia e hipotensión. Conclusiones Los efectos secundarios más llamativos encontrados durante el tratamiento con anfotericina B fueron la anemia, alteraciones de Sodio y Potasio


Introduction In recent decades, the agent of choice for the treatment of most systemic mycoses has been amphotericin B which, despite the toxic effects, continues to play an important role in the treatment of fungal infections. Objective To determine the adverse effects associated with the use of amphotericin B in neonates of the Neonatology Service of the National Hospital of Itauguá, in the period 2013 - 2015. Materials and methods: retrospective case series study of newborns treated with amphotericin B. Results Among 28 newborns treated with amphotericin B, there was a higher prevalence in males. With regard to age, more than half of the newborns were pre-term in the group studied. There was a predominance of low birth weight (32.14%). The risk factors showed that 53.5% did not have a history of sepsis. The mean age of onset of amphotericin was 19 ± 9 days, more than half of the infants used progressive dose from 0.5 mg / kp / day to 1 mg / kp / day, in 24 hours. 96.4% received infusion of amphotericin B for 4 hours, 1 case required 6 hours. Among the side effects, 35.7% of the patients presented anemia, the most frequent water and electrolyte disturbance was hypokalemia, among the signs were tachycardia and hypotension. Conclusions The most striking side effects found during treatment with amphotericin B were anemia, Sodium and Potassium alterations.


Subject(s)
Humans , Male , Female , Infant, Newborn , Amphotericin B/adverse effects , Deoxycholic Acid/adverse effects , Mycoses/drug therapy , Antifungal Agents/adverse effects , Infant, Low Birth Weight , Infant, Premature , Amphotericin B/administration & dosage , Retrospective Studies , Deoxycholic Acid/administration & dosage , Antifungal Agents/administration & dosage
9.
Rev. Soc. Bras. Med. Trop ; 50(5): 712-714, Sept.-Oct. 2017. tab, graf
Article in English | LILACS | ID: biblio-897020

ABSTRACT

Abstract Basidiobolomycosis is an unusual fungal skin infection that rarely involves the gastrointestinal tract. This study reported a 5-year-old boy with gastrointestinal basidiobolomycosis that had been misdiagnosed as gastrointestinal lymphoma. He was treated by surgical resection and a combination of posaconazole and amphotericin B deoxycholate with an acceptable response and no recurrence.


Subject(s)
Humans , Male , Child, Preschool , Colonic Diseases/microbiology , Zygomycosis/pathology , Zygomycosis/drug therapy , Zygomycosis/diagnostic imaging , Gastrointestinal Neoplasms/diagnosis , Liver Diseases/microbiology , Lymphoma/diagnosis , Triazoles/therapeutic use , Tomography, X-Ray Computed , Amphotericin B/therapeutic use , Treatment Outcome , Colonic Diseases/pathology , Colonic Diseases/diagnostic imaging , Deoxycholic Acid/therapeutic use , Diagnosis, Differential , Drug Combinations , Gastrointestinal Neoplasms/pathology , Liver Diseases/pathology , Liver Diseases/diagnostic imaging , Lymphoma/pathology , Antifungal Agents/therapeutic use
10.
Rev. Soc. Bras. Med. Trop ; 50(4): 478-482, July-Aug. 2017. tab
Article in English | LILACS | ID: biblio-896990

ABSTRACT

Abstract INTRODUCTION: The drugs available for visceral leishmaniasis (VL) treatment in Brazil have specific characteristics in terms of operability, effectiveness, toxicity, and cost. The aim of this study was to estimate the direct costs of therapies recommended by the Ministry of Health (MH) for VL treatment in Brazil. METHODS: The analytical perspective used was that adopted by the Brazilian Public Health System. Three drugs and four regimens were included: 1) N-methyl glucamine antimoniate intramuscularly at 20mg per kg per day for 30 days; 2) N-methyl glucamine antimoniate intravenously at 20mg per kg per day for 30 days; 3) amphotericin B deoxycholate at 1mg per kg per day for 21 days; and 4) liposomal amphotericin B at 3mg per kg per day for a 7 days treatment. RESULTS: The estimated direct costs of treatment for an adult patient using N-methylglucamine antimoniate administered via the intramuscular and intravenous routes were USD 418.52 and USD 669.40, respectively. The estimated cost of treatment with amphotericin B deoxycholate was USD 1,522.70. Finally, the estimated costs of treatment with liposomal amphotericin B were USD 659.79, and USD 11,559.15 using the price adopted by the WHO and the Drug Regulation Board, respectively. CONCLUSIONS: This analysis indicates the economic feasibility of replacing N-methyl glucamine antimoniate with liposomal amphotericin B, which allows a shorter treatment period with less toxicity compared with other treatments, provided that the purchase value used by the WHO and transferred to the MH is maintained.


Subject(s)
Humans , Health Care Costs/statistics & numerical data , Leishmaniasis, Visceral/drug therapy , Antiprotozoal Agents/economics , Organometallic Compounds/economics , Organometallic Compounds/therapeutic use , Brazil , Amphotericin B/economics , Amphotericin B/therapeutic use , Clinical Protocols , Deoxycholic Acid/economics , Deoxycholic Acid/therapeutic use , Drug Combinations , Meglumine Antimoniate , Leishmaniasis, Visceral/economics , Meglumine/economics , Meglumine/therapeutic use , Antiprotozoal Agents/therapeutic use
11.
Lima; s.n; feb. 2017. tab, ilus.
Non-conventional in Spanish | LILACS, BRISA | ID: biblio-848084

ABSTRACT

INTRODUCCIÓN: Antecedentes: El presente dictamen expone la evaluación de tecnología de la eficacia y seguridad de las formulaciones lipídicas de amfotericina B para el tratamiento de primera líena de pacientes con diagnóstico de mucormicosis. Aspectos Generales: La mucormicosis es una infección causada por hongos del orden Mucorales (clase Zigomycetes). Esta micosis afecta preferentemente a pacientes inmunocomprometidos o con diabetes mellitus, y se manifiesta por una variedad de síndromes, siendo los más comunes las infecciones de tipo rino-orbital-cerebral y pulmonar. Además, se recnonocen cinco formas clínicas adicionales de la infección: gastrointestinal, cutánea, renal, diseminada y con complicación del sistema central nervioso. Tecnología Sanitaria de Interés: El grupo de las formulaciones lipídicas abarca dos formulaciones disponibles, las cuales fueron desarrolladas para maximizar la utilidad terapéutica de la terapia estándar con amfotericina B y a su vez reducir la frecuencia de eventos adversos. Los compuestos considerados son: Amfotericina B Complejo Lipídico (ABCL/Marca Registrada Abelcet; Enzon Pharmaceuticals); Amfotericina B Liposomal (L-AMB/Marca Registrada AmBisome; Gilead). METODOLOGÍA: Estrategia de Búsqueda: Se realizó una búsqueda de la literatura con respecto a la eficacia y seguridad de la amfotericina B liposomal o la amfotericina B complejo lipídico para el tratamiento de mucormicosis. Esta búsqueda se realizó utilizando los meta-fuscadores: Translating Research into Practice (TRIPDATABASE), National Library of Medicine (Pubmed-Medline) y Health Systems Evidence. RESULTADOS: Sinopsis de la Evidencia: Se llevó a cabo una búsqueda de evidencia científica con respecto a la eficacia y seguridad de amfotericina B liposomal o amfotericina B complejo lipídico para el tratamiento de mucormicosis. CONCLUSIONES: En la presente evaluación de tecnología sanitaria no se encontraron estudios primarios de tipo ensayos clínicos que muestren diferencias entre las formulaicones lipídicas de amfotericina B y amfotericina B desoxicolato en cuanto a la eficacia y seguridad en pacientes con mucormicosis. El Instituto de Evaluación de Tecnologías Sanitarias e Investigación-IETSI, no aprueba el uso de las formulaciones lipídicas de la amfotericina B como primera línea de tratamiento de la mucormicosis.


Subject(s)
Humans , Amphotericin B/therapeutic use , Mucormycosis/therapy , Amphotericin B , Deoxycholic Acid , Lipids , Technology Assessment, Biomedical , Treatment Outcome
12.
Rev. Soc. Bras. Med. Trop ; 50(1): 67-74, Jan.-Feb. 2017. tab, graf
Article in English | LILACS | ID: biblio-842815

ABSTRACT

ABSTRACT INTRODUCTION Despite their high toxicity, antimonials and amphotericin B deoxycholate are commonly used for treating visceral leishmaniasis (VL). Few studies showing conflictive data about their efficacy and adverse events in pediatric population are available. This study aimed to evaluate efficacy and safety of amphotericin B deoxycholate vs. that of N-methylglucamine antimoniate in treating pediatric VL in Brazil. METHODS This was a randomized, open-label, 2-arm and controlled pilot clinical trial. Treatment naïve children and adolescents with VL without signs of severe illness were treated with N-methylglucamine antimoniate (20mg/kg/day for 20 days) or amphotericin B deoxycholate (1 mg/kg/day for 14 days). All patients were diagnosed with positive direct examination and/or positive PCR for Leishmania spp. performed in bone marrow samples. The primary efficacy end-point was VL cure determined after 180 days of completion of treatment. The analysis was performed using intention-to-treat (ITT) and per protocol (PP) analyses. RESULTS In total, 101 volunteers were assessed. Efficacy was similar for both groups. The antimonial (n=51) and amphotericin B groups (n=50) had a cure rate of 94.1% and 100%, and 94% and 97.9% according to ITT and PP analyses, respectively. All patients reported adverse events (AE). Serious AE incidence was similar in both groups. Five individuals were excluded from the study because of severe adverse events. CONCLUSIONS N-methylglucamine antimoniate and amphotericin B deoxycholate have similar efficacy and adverse events rate in pediatric patients with VL.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Organometallic Compounds/therapeutic use , Amphotericin B/therapeutic use , Deoxycholic Acid/therapeutic use , Leishmaniasis, Visceral/drug therapy , Meglumine/therapeutic use , Antiprotozoal Agents/therapeutic use , Organometallic Compounds/adverse effects , Pilot Projects , Amphotericin B/adverse effects , Treatment Outcome , Deoxycholic Acid/adverse effects , Drug Combinations , Meglumine Antimoniate , Meglumine/adverse effects , Antiprotozoal Agents/adverse effects
13.
Fisioter. Bras ; 18(3): f:349-I:355, 2017000.
Article in Portuguese | LILACS | ID: biblio-905901

ABSTRACT

Desde a primeira publicação a respeito, em 2001, a aplicação de injeções lipolíticas para gordura localizada tornou-se um procedimento amplamente utilizado na clínica. Consiste de múltiplas injeções subcutâneas de compostos lipolíticos, que podem ter diversos mecanismos de ação. O fármaco mais utilizado atualmente, o desoxicolato de sódio, foi descoberto por acaso, em uma associação com fosfatidilcolina em que sua única função era de veículo da fórmula. Conforme estudos foram sendo realizados, concluiu-se que a ação no tecido era devido ao desoxicolato, um sal biliar que emulsiona os lipídios da membrana celular, resultando em lise do adipócito e consequente necrose do tecido adiposo. Seus principais efeitos adversos, muito frequentemente relatados, incluem dor intensa, edema e formação de nódulos fibrosos nos pontos aplicados. Em decorrência de falhas na aplicação, alguns efeitos adversos mais graves podem ocorrer, como injúria do nervo facial e infecções persistentes. Apesar destes, a utilização de desoxicolato de sódio na camada subcutânea apresenta resultados muito positivos, como publicado em diversos ensaios clínicos, inclusive com relação à satisfação do paciente perante o desfecho final, sendo, portanto, uma boa escolha de técnica para contorno corporal e diminuição de depósitos de gordura localizados. (AU)


Since the first paper, in 2001, injection lipolysis for localized fat deposits became a widely used procedure in the clinics. It consists basically of multiple subcutaneous injections of lipolytic compounds, with many different mechanisms of action. The most used drug nowadays is sodium deoxycholate, initially thought to be only the solubilizing vehicle in the phosphatidilcholine formula. As studies were performed, it was concluded that the changes seen in the tissue was due to sodium deoxycholate, a biliary salt which emulsifies membrane lipids, resulting in adipocyte lysis and consequent adipose tissue necrosis. Its main adverse events include pain, oedema and fibrous nodules. Due to poor technique, more serious adverse events may happen, such as nerve injury or persistent infection by mycobacterium. In spite of these, the use of sodium deoxycholate presents great results, as published in many clinical trials, including patient's satisfaction at the end of the treatment, which is of much value in the aesthetics field. Therefore, mesotherapy using sodium deoxycholate is a good choice for body contouring and localized fat deposits. (AU)


Subject(s)
Humans , Female , Fats , Injections , Deoxycholic Acid , Phosphatidylcholines , Sodium
14.
Infection and Chemotherapy ; : 293-296, 2017.
Article in English | WPRIM | ID: wpr-102693

ABSTRACT

Protothecosis is an uncommon human infection caused by achlorophyllic algae of the genus Prototheca, especially P. wickerhamii. The skin is the most frequently involved organ and cases of protothecal tenosynovitis are very rare. A 71-year-old woman without prior medical history except hypertension presented with painful swelling of her right hand that did not improve despite receiving antibiotic treatment. She underwent tenosynovectomy and drainage. Histopathologic examination revealed necrotizing granulomatous inflammation and numerous spherical or morula-like organisms with a spoked wheel appearance. P. wickerhamii was identified from tissue culture. The lesion did not improve with empirical fluconazole therapy. Conventional amphotericin B was administered according to antifungal susceptibility tests and the lesion completely resolved. Protothecosis should be considered in the differential diagnosis for chronic tenosynovitis that does not respond to conventional antibacterial treatment; tissue biopsy with culture is required for diagnosis.


Subject(s)
Aged , Amphotericin B , Biopsy , Deoxycholic Acid , Diagnosis , Diagnosis, Differential , Drainage , Female , Fluconazole , Hand , Humans , Hypertension , Inflammation , Prototheca , Skin , Tenosynovitis
15.
Article in English | WPRIM | ID: wpr-14787

ABSTRACT

BACKGROUND/AIMS: Bile acid is an important luminal factor that affects gastrointestinal motility and secretion. We investigated the effect of bile acid on secretion in the proximal and distal rat colon and coordination of bowel movements in the guinea pig colon. METHODS: The short-circuit current from the mucosal strip of the proximal and distal rat colon was compared under control conditions after induction of secretion with deoxycholic acid (DCA) as well as after inhibition of secretion with indomethacin, 1,2-bis (o-aminophenoxy) ethane-N,N,N′,N′-tetra-acetic acid (an intracellular calcium chelator; BAPTA), and tetrodotoxin (TTX) using an Ussing chamber. Colonic pressure patterns were also evaluated in the extracted guinea pig colon during resting, DCA stimulation, and inhibition by TTX using a newly developed pressure-sensing artificial stool. RESULTS: The secretory response in the distal colon was proportionate to the concentration of DCA. Also, indomethacin, BAPTA, and TTX inhibited chloride secretion in response to DCA significantly (P < 0.05). However, these changes were not detected in the proximal colon. When we evaluated motility, we found that DCA induced an increase in luminal pressure at the proximal, middle, and distal sensors of an artificial stool simultaneously during the non-peristaltic period (P < 0.05). In contrast, during peristalsis, DCA induced an increase in luminal pressure at the proximal sensor and a decrease in pressure at the middle and distal sensors of the artificial stool (P < 0.05). CONCLUSIONS: DCA induced a clear segmental difference in electrogenic secretion. Also, DCA induced a more powerful peristaltic contraction only during the peristaltic period.


Subject(s)
Animals , Bile , Calcium , Colon , Deoxycholic Acid , Gastrointestinal Motility , Guinea Pigs , Guinea , Indomethacin , Intestine, Large , Peristalsis , Phenobarbital , Rats , Tetrodotoxin
16.
Article in Chinese | WPRIM | ID: wpr-815086

ABSTRACT

To compare clinical features, diagnosis and therapeutic effect between pulmonary histoplasmosis and progressive disseminated histoplasmosis.
 Methods: A retrospective analysis for 12 cases of hospitalized patients with histoplasmosis, who was admitted in Xiangya Hospital, Central South University during the time from February 2009 to October 2015, was carried out. Four cases of pulmonary histoplasmosis and 8 cases of progressive disseminated histoplasmosis were included. The differences of clinical features, imaging tests, means for diagnosis and prognosis were analyzed between the two types of histoplasmosis.
 Results: The clinical manifestations of pulmonary histoplasmosis were mild, such as dry cough. However, the main clinical symptoms of progressive disseminated histoplasmosis were severe, including recurrence of high fever, superficial lymph node enlargement over the whole body, hepatosplenomegaly, accompanied by cough, abdominal pain, joint pain, skin changes, etc.Laboratory examination showed pancytopenia, abnormal liver function and abnormal coagulation function. One pulmonary case received the operation of left lower lung lobectomy, 3 cases of pulmonary histoplasmosis and 6 cases of progressive disseminated histoplasmosis patients were given deoxycholate amphotericin B, itraconazole, voriconazole or fluconazole for antifungal therapy. One disseminated case discharged from the hospital without treatment after diagnosis of histoplasmosis, and 1 disseminated case combined with severe pneumonia and active tuberculosis died ultimately.
 Conclusion: As a rare fungal infection, histoplasmosis is easily to be misdiagnosed. The diagnostic criteria depends on etiology through bone marrow smear and tissues biopsy. Liposomeal amphotericin B, deoxycholate amphotericin B and itraconazole are recommended to treat infection for histoplasma capsulatum.


Subject(s)
Abdominal Pain , Amphotericin B , Therapeutic Uses , Antifungal Agents , Therapeutic Uses , Biopsy , Cough , Epidemiology , Death , Deoxycholic Acid , Therapeutic Uses , Diagnostic Errors , Drug Combinations , Fever , Hepatomegaly , Histoplasma , Histoplasmosis , Diagnosis , Mortality , Therapeutics , Humans , Invasive Fungal Infections , Diagnosis , Therapeutics , Itraconazole , Therapeutic Uses , Lung , Microbiology , General Surgery , Lung Diseases, Fungal , Diagnosis , General Surgery , Therapeutics , Pneumonia , Mortality , Recurrence , Retrospective Studies , Splenomegaly , Treatment Outcome , Tuberculosis , Mortality
18.
Acta cir. bras ; 30(9): 624-631, Sep. 2015. tab, ilus
Article in English | LILACS | ID: lil-761497

ABSTRACT

ABSTRACTPURPOSE:To assess whether deoxycholic acid (DOC) and lithocholic acid (LCA) administered in a period of six months in a concentration of 0.25% may have a carcinogenic role in mice colon.METHODS:The study used C57BL6 female mice divided into four groups. The control group received a balanced diet and the others received diets supplemented with 0.25% DOC, 0.25% LCA and 0.125% DOC+0.125% LCA, respectively. After euthanasia, the lesions found in the resected gastrointestinal tracts were stained with hematoxylin-eosin and examined microscopically.RESULTS:No gastrointestinal tract changes were observed in the control group, while hyperplastic Peyer's patches in the small intestine, flat adenomas with mild dysplasia and chronic colitis at the level of the colon were found in all three test groups. The colonic lesions prevailed in the proximal colon. The highest number of flat adenoma lesions (8), hyperplasia of Peyer's patches (25) and chronic colitis (2) were found in mice fed with diet and LCA.CONCLUSION: Precancerous or cancerous pathological lesions could not be identified. Instead, adenomatous colonic injuries occurred in a shorter period of time (six months), compared to the reported data.


Subject(s)
Animals , Female , Bile Acids and Salts/toxicity , Carcinogens/toxicity , Cholagogues and Choleretics/toxicity , Colon/drug effects , Deoxycholic Acid/toxicity , Lithocholic Acid/toxicity , Adenoma/chemically induced , Carcinogenicity Tests , Colitis/chemically induced , Colon/pathology , Colonic Neoplasms/chemically induced , Disease Models, Animal , Feces/chemistry , Peyer's Patches/drug effects , Time Factors
19.
Article in Chinese | WPRIM | ID: wpr-284830

ABSTRACT

To investigate the absorption kinetics of Cu B-SDC/PLC-MMs in rat different intestinal segments and compared with the absorption of Cu B suspension. The in vitro everted gut sacs model was established to study the absorption characteristics of Cu B-SDC/ PLC-MMs in rat duodenum, jejunum, ileum and colon, and the content of cucurbitacin B was detected by HPLC method, and the effects of concentrations on intestinal absorption were evaluated as well. The results showed that the absorption of Cu B-SDC/PLC-MMs was linearity at different intestine segment and different concentrations (R2 > 0.9), which was consistent with zero order rate process. The Ka of different intestine segments showed a concentration-dependent increasing along with the raised concentration of Cu B-SDC/ PLC-MMs, indicating that it was likely to be a mechanism of passive absorption. The best absorption site of Cu B-SDC/PLC-MMs was ileum, and its absorptions in different intestinal segments were superior to cucurbitacin B suspension. SDC/PLC-MMs could significantly enhance the intestinal absorption of cucurbitacin B, and the study of intestinal absorption kinetics of Cu B-SDC/PLC-MMs had gave a support to its further reasonable solidfication.


Subject(s)
Animals , Deoxycholic Acid , Female , Intestinal Absorption , Kinetics , Male , Micelles , Nanoparticles , Phospholipids , Rats , Rats, Wistar , Triterpenes , Pharmacokinetics
20.
Article in English | WPRIM | ID: wpr-812307

ABSTRACT

AIM@#To improve the absorption of thymopeptides (TH) by preparing sodium deoxycholate/phospholipid-mixed nanomicelles (SDC/PL-MMs).@*METHODS@#TH-SDC/PL-MMs were prepared by a film dispersion method, and then evaluated using photon correlation spectroscopy (PCS), zeta potential measurement, as well as their physical stability after storage for several days. Furthermore, in situ intestinal single-pass perfusion experiments and pharmacodynamics in immunodeficient mice were performed to make a comparison with TH powders and the control drug in absorption properties.@*RESULTS@#A narrow size distribution of nanomicelles, with a mean particle size of (149 ± 8.32) nm and a zeta potential of (-31.05 ± 2.52) mV, was obtained. The in situ intestine perfusion experiments demonstrated a significant advantage in absorption characteristics for TH compared to the other formulations, and oral administration of TH-SDC/PL-MMs potentiated an equivalent effect with i.h. TH in pharmacodynamic studies in immunodeficient mice.@*CONCLUSIONS@#TH-SDC/PL-MMs prepared by a film dispersion method are able to improve the absorption of TH. SDC/PL-MMs might be a good approach for the more effective delivery of drugs like TH.


Subject(s)
Animals , Chemistry, Pharmaceutical , Deoxycholic Acid , Chemistry , Drug Carriers , Chemistry , Drug Stability , Mice , Micelles , Particle Size , Peptides , Chemistry , Pharmacokinetics , Phospholipids , Chemistry , Rats , Rats, Wistar , Thymus Gland , Chemistry
SELECTION OF CITATIONS
SEARCH DETAIL