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Article in Chinese | WPRIM | ID: wpr-879808


OBJECTIVE@#To study the clinical effect and mechanism of total glucosides of paeony (TGP) in the adjuvant therapy for children with Henoch-Schönlein purpura nephritis (HSPN).@*METHODS@#Sixty-four HSPN children with moderate proteinuria were divided into a TGP treatment group (@*RESULTS@#Compared with the healthy children before treatment, the children with HSPN had higher proportion of Tfh cells and expression levels of IL-21 and IL-4 (@*CONCLUSIONS@#TGP has a marked clinical effect in the treatment of HSPN and can reduce the inflammatory response of the kidney and exert a protective effect on the kidney by inhibiting the proliferation of Tfh cells and downregulating the expression of IL-21 and IL-4 in plasma.

Child , Glucosides/therapeutic use , Humans , Nephritis , Paeonia , Prospective Studies , Purpura, Schoenlein-Henoch/drug therapy
Rev. Assoc. Med. Bras. (1992) ; 66(supl.1): s17-s24, 2020. tab, graf
Article in English | LILACS | ID: biblio-1057108


SUMMARY Type 2 diabetes mellitus is an important public health problem, with a significant impact on cardiovascular morbidity and mortality and an important risk factor for chronic kidney disease. Various hypoglycemic therapies have proved to be beneficial to clinical outcomes, while others have failed to provide an improvement in cardiovascular and renal failure, only reducing blood glucose levels. Recently, sodium-glucose cotransporter-2 (SGLT2) inhibitors, represented by the empagliflozin, dapagliflozin, and canagliflozin, have been showing satisfactory and strong results in several clinical trials, especially regarding the reduction of cardiovascular mortality, reduction of hospitalization due to heart failure, reduction of albuminuria, and long-term maintenance of the glomerular filtration rate. The benefit from SGLT2 inhibitors stems from its main mechanism of action, which occurs in the proximal tubule of the nephron, causing glycosuria, and a consequent increase in natriuresis. This leads to increased sodium intake by the juxtaglomerular apparatus, activating the tubule glomerular-feedback and, finally, reducing intraglomerular hypertension, a frequent physiopathological condition in kidney disease caused by diabetes. In addition, this class of medication presents an appropriate safety profile, and its most frequently reported complication is an increase in the incidence of genital infections. Thus, these hypoglycemic agents gained space in practical recommendations for the management of type 2 diabetes mellitus and should be part of the initial therapeutic approach to provide, in addition to glycemic control, cardiovascular outcomes, and the renoprotection in the long term.

Humans , Cardiovascular Diseases/prevention & control , Diabetes Mellitus, Type 2/drug therapy , Sodium-Glucose Transporter 2/pharmacology , Sodium-Glucose Transporter 2 Inhibitors/pharmacology , Hypoglycemic Agents/pharmacology , Kidney Diseases/prevention & control , Benzhydryl Compounds/therapeutic use , Cardiovascular Diseases/etiology , Cardiovascular Diseases/mortality , Diabetes Mellitus, Type 2/complications , Diabetic Nephropathies/etiology , Diabetic Nephropathies/metabolism , Diabetic Nephropathies/prevention & control , Sodium-Glucose Transporter 2/therapeutic use , Canagliflozin/therapeutic use , Sodium-Glucose Transporter 2 Inhibitors/therapeutic use , Glomerular Filtration Rate , Glucose/metabolism , Glucosides/therapeutic use , Hypoglycemic Agents/therapeutic use , Kidney/drug effects , Kidney/physiopathology , Kidney/metabolism , Kidney Diseases/etiology , Kidney Diseases/metabolism
Rev. Assoc. Med. Bras. (1992) ; 65(2): 246-252, Feb. 2019. tab, graf
Article in English | LILACS | ID: biblio-990338


SUMMARY Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are drugs that act by maintaining glycosuria. Recent studies have shown promising effects of these in the treatment of type 2 diabetes mellitus (DM2). However, there may be an increased risk of developing urinary tract infections (UTIs) in patients treated with these. Our study aims to analyze the association between the risk of UTI in patients treated with SGLT2i. A systematic review of the literature was carried out by randomized clinical trials, totalizing at the end of the selection 23 articles that were statistically evaluated. The incidence of UTI was generally demonstrated in articles and in different subgroups: patients on SGLT2i monotherapy or on combination therapy; according to specific comorbidities of each sample or according to the drug used. They noticed an increase in the chance of UTI in the SGLT2i groups compared to the control groups on placebo or other oral antidiabetic agents. This increased chance was found predominantly with the use of Dapagliflozin, Canagliflozin, and Tofogliflozin, regardless of the dosing. Lastly, stands out that the dimension of UTI chances for DM2 patients who use SGLT2i remains to be more strictly determined.

RESUMO Os inibidores do cotransportador de sódio-glicose do tipo 2 (SGLT2i) são medicamentos que atuam mantendo a glicosúria. Estudos recentes têm demonstrado efeitos promissores desses no tratamento de diabetes mellitus tipo 2 (DM2). No entanto, pode haver um risco aumentado de desenvolver infecções do trato urinário (UTI) em pacientes tratados com essa classe de medicação. Nosso estudo tem como objetivo analisar a associação entre o risco de desenvolver UTI em pacientes tratados com SGLT2i. Uma revisão sistemática da literatura foi realizada por ensaios clínicos randomizados, totalizando, ao final da seleção, 23 artigos que foram avaliados estatisticamente. A incidência de UTI foi demonstrada genericamente de acordo com os dados dos artigos e em diferentes subgrupos: pacientes em monoterapia com SGLT2i ou em terapia combinada, de acordo com as comorbidades específicas de cada amostra ou de acordo com a droga utilizada. Verificou-se um aumento na chance de UTI nos grupos SGLT2i em comparação com os grupos de controle em placebo ou outros agentes antidiabéticos orais. Essa chance aumentada foi encontrada predominantemente com uso de Dapagliflozina, Canagliflozina e Tofoglifozina, independentemente da dosagem. Por fim, ressaltou-se que as chances de UTI em pacientes com DM2 em uso de SGLT2i ainda precisam ser mais bem determinadas.

Humans , Urinary Tract Infections/etiology , Diabetes Mellitus, Type 2/drug therapy , Sodium-Glucose Transporter 2 Inhibitors/adverse effects , Benzhydryl Compounds/adverse effects , Benzhydryl Compounds/therapeutic use , Randomized Controlled Trials as Topic , Risk Factors , Diabetes Mellitus, Type 2/complications , Canagliflozin/adverse effects , Canagliflozin/therapeutic use , Sodium-Glucose Transporter 2 Inhibitors/therapeutic use , Glucosides/adverse effects , Glucosides/therapeutic use
Arch. endocrinol. metab. (Online) ; 62(4): 424-430, July-Aug. 2018. tab, graf
Article in English | LILACS | ID: biblio-950077


ABSTRACT Objective: This analysis compared the efficacy and safety of the sodium-glucose cotransporter-2 (SGLT2) inhibitor, dapagliflozin, and the dipeptidyl peptidase-4 (DPP4) inhibitor, saxagliptin, both added on to metformin. Materials and methods: This was a post-hoc analysis from a double-blind, randomized, 24-week clinical trial (NCT01606007) of patients with type 2 diabetes (T2D) inadequately controlled with metformin. We compared the dapagliflozin 10 mg (n = 179) and saxagliptin 5 mg (n = 176) treatment arms. Results: Dapagliflozin showed significantly greater mean reductions versus saxagliptin in HbA1c (difference versus saxagliptin [95% CI]: −0.32% [-0.54, −0.10]; p < 0.005), fasting plasma glucose (-0.98 [-1.42, −0.54] mmol/L; p < 0.0001), body weight (-2.39 [-3.08, −1.71] kg; p < 0.0001) and systolic blood pressure (SBP) (-3.89 [-6.15, −1.63] mmHg; p < 0.001). More dapagliflozintreated than saxagliptin-treated patients achieved the composite endpoint of HbA1c reduction ≥ 0.5%, weight loss ≥ 2 kg, SBP reduction ≥ 2 mmHg and no major/minor hypoglycemia (24% versus 7%). No major events of hypoglycemia were reported. More patients on dapagliflozin (6%) versus saxagliptin (0.6%) experienced genital infections. Conclusion: Dapagliflozin demonstrated greater glycemic efficacy than saxagliptin with additional benefits on weight and SBP, and the safety profile was consistent with previous studies.

Humans , Male , Female , Middle Aged , Benzhydryl Compounds/therapeutic use , Adamantane/analogs & derivatives , Diabetes Mellitus, Type 2/drug therapy , Dipeptides/therapeutic use , Dipeptidyl-Peptidase IV Inhibitors/therapeutic use , Glucosides/therapeutic use , Benzhydryl Compounds/adverse effects , Blood Glucose/drug effects , Blood Pressure/drug effects , Body Weight/drug effects , Adamantane/adverse effects , Adamantane/therapeutic use , Double-Blind Method , Diabetes Mellitus, Type 2/blood , Dipeptides/adverse effects , Sodium-Glucose Transporter 2/therapeutic use , Dipeptidyl-Peptidase IV Inhibitors/adverse effects , Hypoglycemic Agents/therapeutic use , Metformin/therapeutic use
Rev. Assoc. Med. Bras. (1992) ; 63(7): 636-641, July 2017. tab, graf
Article in English | LILACS | ID: biblio-896368


Summary Introduction: Diabetes mellitus is one of the most common chronic diseases in the world, with high morbidity and mortality rates, resulting in a greatly negative socioeconomic impact. Although there are several classes of oral antidiabetic agents, most of the patients are outside the therapeutic goal range. Objective: To review the use of SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus, focusing on their favorable and unfavorable effects, as well as on cardiovascular profile. Method: A literature search on Pubmed database was performed using the following keywords: "SGLT-2 inhibitors," "dapagliflozin," "empagliflozin," "canagliflozin." Results: SGLT-2 inhibitors are a class of oral antidiabetic drugs directed to the kidney. Their mechanism of action is to reduce blood glucose by inducing glycosuria. Extra-glycemic benefits have been described, such as weight loss, decline in blood pressure and levels of triglycerides and uric acid, and they can slow the progression of kidney disease. Genitourinary infections are the main side effects. There is a low risk of hypotension and hypoglycemia. Diabetic ketoacidosis is a serious adverse effect, although rare. Empagliflozin has already had its cardiovascular benefit demonstrated and studies with other drugs are currently being performed. Conclusion: SGLT-2 inhibitors are a new treatment option for type 2 diabetes mellitus, acting independently of insulin. They have potential benefits other than the reduction of blood glucose, but also carry a risk for adverse effects.

Resumo Introdução: O diabetes mellitus é uma das doenças crônicas mais frequentes no mundo, com altas taxas de morbimortalidade, resultando em um grande impacto negativo socioeconômico. Apesar de existirem diversas classes de antidiabéticos orais, a maioria dos pacientes acometidos está fora da meta terapêutica. Objetivo: Revisar o uso dos inibidores da SGLT-2 no tratamento do diabetes mellitus tipo 2, com enfoque nos efeitos favoráveis, desfavoráveis e no perfil cardiovascular. Método: Foi realizada uma pesquisa bibliográfica transversal com artigos científicos obtidos da base de dados Pubmed, utilizando os descritores: "SGLT-2 inhibitors", "dapagliflozin", "empagliflozin", "canagliflozin". Resultados: Os inibidores da SGLT-2 são uma classe de antidiabéticos orais com atuação no rim. O mecanismo de ação é reduzir a glicemia induzindo glicosúria. Benefícios extraglicêmicos já foram descritos, como redução de peso, pressão arterial, triglicerídeos e ácido úrico, além de retardar a progressão da doença renal. O principal efeito colateral é a infecção geniturinária, com baixo risco de hipotensão e hipoglicemia. Cetoacidose diabética é um efeito adverso grave, mas infrequente. A empagliflozina já teve seu benefício cardiovascular demonstrado, e estudos com outras drogas estão em andamento. Conclusão: Os inibidores da SGLT-2 são uma nova opção de tratamento do diabetes mellitus tipo 2, que atua de forma insulino-independente e com potenciais benefícios adicionais, além da redução da glicemia, mas também com risco de efeitos adversos.

Humans , Diabetes Mellitus, Type 2/drug therapy , Sodium-Glucose Transporter 2 Inhibitors , Hypoglycemic Agents/therapeutic use , Benzhydryl Compounds/therapeutic use , Blood Glucose/drug effects , Sodium-Glucose Transporter 2 , Canagliflozin/therapeutic use , Glucosides/therapeutic use , Hypoglycemic Agents/adverse effects , Kidney/drug effects
J. bras. pneumol ; 41(1): 16-22, Jan-Feb/2015. tab
Article in English | LILACS | ID: lil-741568


Objective: To evaluate the impact of asthma on patients in Brazil, by age group (12-17 years, 18-40 years, and ≥ 41 years). Methods: From a survey conducted in Latin America in 2011, we obtained data on 400 patients diagnosed with asthma and residing in one of four Brazilian state capitals (São Paulo, Rio de Janeiro, Curitiba, and Salvador). The data had been collected using a standardized questionnaire in face-to-face interviews. For the patients who were minors, the parents/guardians had completed the questionnaire. The questions addressed asthma control, number of hospitalizations, number of emergency room visits, and school/work absenteeism, as well as the impact of asthma on the quality of life, sleep, and leisure. We stratified the data by the selected age groups. Results: The proportions of patients who responded in the affirmative to the following questions were significantly higher in the 12- to 17-year age group than in the other two groups: "Have you had at least one episode of severe asthma that prevented you from playing/exercising in the last 12 months?" (p = 0.012); "Have you been absent from school/work in the last 12 months?" (p < 0.001); "Have you discontinued your asthma relief or control medication in the last 12 months?" (p = 0.008). In addition, 30.2% of the patients in the 12- to 17-year age group reported that normal physical exertion was very limiting (p = 0.010 vs. the other groups), whereas 14% of the patients in the ≥ 41-year age group described social activities as very limiting (p = 0.011 vs. the other groups). Conclusions: In this sample, asthma had a greater impact on the patients between 12 and 17 years of age, which might be attributable to poor treatment compliance. .

Objetivo: Avaliar o impacto da asma em pacientes segundo as faixas etárias de 12-17 anos, 18-40 anos e ≥ 41 anos no Brasil. Métodos: Os dados de 400 pacientes com asma diagnosticada por um médico e residentes de quatro capitais estaduais brasileiras (São Paulo, Rio de Janeiro, Curitiba e Salvador) foram obtidos em um inquérito realizado em países da América Latina em 2011. Os dados foram coletados por meio de um questionário padronizado em entrevista presencial com os pacientes ou com os pais/responsáveis daqueles < 18 anos. As questões abordavam controle da asma, número de hospitalizações, número de consultas de urgência, absenteísmo na escola/trabalho e impactos da asma na qualidade de vida, sono e lazer. Os dados foram estratificados pelas faixas etárias selecionadas. Resultados: Em comparação com os grupos de pacientes adultos, houve uma proporção significativamente maior no grupo 12-17 anos em relação a ter ao menos um episódio de asma grave que impediu o paciente a continuar a jogar ou a se exercitar nos últimos 12 meses (p = 0,012), absenteísmo escolar/trabalho nos últimos 12 meses (p < 0,001), e interrupção de medicação para controle ou prevenção da asma nos últimos 12 meses (p = 0,008). Além disso, 30,2% dos pacientes na faixa etária 12-17 anos relataram que esforços físicos normais eram atividades muito limitantes (p = 0,010 vs. outros grupos), enquanto 14% dos pacientes do grupo ≥ 41 anos descreveram as atividades sociais como muito limitantes (p = 0,011 vs. outros grupos). Conclusões: Nessa amostra, o impacto da asma foi maior nos pacientes com idade entre 12 e 17 anos do que nos adultos, e isso pode ser atribuído à baixa aderência ao tratamento. .

Female , Humans , Male , Middle Aged , Benzhydryl Compounds/therapeutic use , Blood Glucose/metabolism , /drug therapy , Glucosides/therapeutic use , Hypoglycemic Agents/therapeutic use , Metformin/therapeutic use , Blood Pressure , Body Weight , Clinical Trial , Cohort Studies , Dose-Response Relationship, Drug , Double-Blind Method , Drug Therapy, Combination , /blood , Follow-Up Studies , Glycated Hemoglobin A/analysis , Time Factors
Vet. Méx ; 31(3): 189-134, jul.-sept. 2000. tab
Article in Spanish | LILACS | ID: lil-304569


Con el propósito de probar el efecto parasiticida del "Tepozán" (Buddleja cordata), se extrajeron dos de sus compuestos; el primero con hexano (extracto acuoso) y el segundo con metanol (extracto metanólico), y se probaron contra Costia necatrix. Se llevaron a cabo dos tratamientos con 24 horas de diferencia entre ellos; se utilizaron cuatro dosis (100 mg/l, 50 mg/l y 10 mg/l del extracto acuoso, y 100 mg/l, 50 mg/l y 25 mg/l del extracto metanólico) disueltas en el agua del acuario (con un pez parasitado por acuario). Los resultados no mostraron efecto alguno del extracto acuoso, mientras que el extracto metanólico a dosis de 25 mg/l, 50 mg/l y 100 mg/l mata al 83.34 por ciento, 97.92 por ciento y 100 por ciento de los parásitos, respectivamente. Se hizo la extracción e identificación del compuesto activo del extracto metanólico con cromatografía en placa de sílica gel y se obtuvieron tres fracciones (F1, F2 y F3). Sólo la fracción F2 mostró efecto parasiticida contra C. necatrix cuando se probó a dosis de 50 mg/l. Esta fracción representa un glucósido fenilpropanoide llamado verbascósido.

Animals , Antiparasitic Agents , Tilapia , Glucosides/therapeutic use
Rev. venez. cir ; 53(2): 87-91, jun. 2000. graf
Article in Spanish | LILACS | ID: lil-333967


Establecer el número de controles de laboratorio en la determinación de los valores de creatinina sérica y uroanálisis realizados en pacientes que cumplen tratamiento con aminoglucósidos. Estudio retrospectivo en pacientes admitidos en el Departamento de Cirugía e ingresados al hospital a través de la Emergencia en los años comprendidos de 1991 a 1995. Departamento de Cirugía del Hospital Universitario de Coro "Dr. Alfredo Van Grieken". Estado Falcón, Venezuela. El promedio de días bajo tratamiento con aminoglucósidos fue de 9 y se realizaron exámenes de laboratorio para determinar los valores de creatinina en un promedio de 1,68 veces por cada paciente durante la administración del medicamento. El uroanálisis se hizo en el 51,94 por ciento de aquellos sometidos a tratamiento pero la densidad urinaria se determinó sólo al 3,89 por ciento de este grupo. El número de controles necesarios que debe realizarse a una persona que recibe tratamiento con aminoglucósidos bajo indicación y supervisión médica en un centro hospitalario se encontró por debajo de lo requerido. Asimismo, la medición de la densidad urinaria se hizo sólo en 15 pacientes

Humans , Male , Adolescent , Adult , Female , Middle Aged , Creatinine , Glucosides/administration & dosage , Glucosides , Glucosides/therapeutic use , General Surgery , Venezuela
Rev. biol. trop ; 44(2A): 361-7, ago. 1996. ilus, tab
Article in Spanish | LILACS | ID: lil-218366


Extracts from thirteen species of plants were evaluated by(r)in vivo(r)antimalarial test against plasmodium berghei effects. Significant activities were observed in the ethyl acetate and aqueous extracts, elaborated of Cedrela tonduzii leaves, Trichilia havanensis and Trichilia americana barks, Neurolaena lobata and liricidia sepium leaves and Duranta repens fruits. Compounds identified include flavanoids, coumarins, mellilotic acid and iridoids which some kind of biodynamic activity has previously been reported. The flavone uercetin 1 purified from C. tonduzii gave strong antimalarial activity, however, its respective glucosides (quercetin 3-glucoside 2 y robinine 7) showed little significant activity

Animals , Antimalarials/therapeutic use , Coumarins/therapeutic use , Flavonoids/therapeutic use , Glucosides/therapeutic use , Malaria/drug therapy , Plant Extracts/chemistry , Plant Extracts/pharmacology , Plasmodium berghei/drug effects , Antimalarials/pharmacology , Coumarins/pharmacology , Flavonoids/pharmacology , Malaria/parasitology , Plant Extracts , Plasmodium berghei/parasitology