ABSTRACT
A rinossinusite crônica (RSC) é uma síndrome caracterizada pela inflamação da mucosa nasal e dos seios paranasais por pelo menos 12 semanas, acometendo de 5% a 12% da população geral. A síndrome é associada a alta morbidade e considerada um grande problema de saúde pública devido a sua prevalência, seu custo para a sociedade e ao impacto que acarreta na qualidade de vida dos pacientes e em seu desempenho escolar ou profissional. Ademais, a RSC está associada a diversas comorbidades, como dermatite atópica, distúrbios respiratórios do sono, conjuntivite, otite média, asma e problemas emocionais. O dupilumabe é eficaz e seguro no tratamento da RSC com polipose nasal. A eficácia é progressiva no primeiro ano de tratamento, e a posologia de 300 mg a cada duas semanas é superior em relação à de cada quatro semanas. A interrupção do tratamento com 24 semanas acarreta a perda parcial de seus efeitos benéficos. O imunobiológico também é eficaz no controle da asma nos pacientes que apresentam essa doença como comorbidade. Alguns pacientes podem apesentar aumento transitório de eosinófilos sanguíneos, e 2,7% desenvolveram conjuntivite como reação adversa nos estudos SINUS-24 e SINUS-52. O dupilumabe é uma excelente opção terapêutica no tratamento concomitante de múltiplas doenças caracterizadas pela inflamação de tipo II.
Chronic rhinosinusitis (CRS) is a syndrome characterized by inflammation of the nasal mucosa and paranasal sinuses for at least 12 weeks, affecting 5% to 12% of the general population. The syndrome is associated with high morbidity and is considered a major public health problem because of its prevalence, its cost to society, and the impact it has on patients' quality of life and on their school or professional performance. Furthermore, CRS is associated with several comorbidities, such as atopic dermatitis, sleep-disordered breathing, conjunctivitis, otitis media, asthma, and emotional problems. Dupilumab is effective and safe in the treatment of CRS with nasal polyposis. Effectiveness is progressive in the first year of treatment, and a dosage of 300 mg every two weeks is more effective than that of every four weeks. Discontinuing treatment at 24 weeks results in partial loss of its beneficial effects. The biological drug is also effective in controlling asthma in patients who have this disease as a comorbidity. Some patients may experience a transient increase in blood eosinophils, and 2.7% developed conjunctivitis as an adverse reaction in the SINUS-24 and SINUS-52 studies. Dupilumab is an excellent therapeutic option in the concomitant treatment of multiple diseases characterized by type II inflammation.
Subject(s)
Humans , Rhinitis , Nasal Polyps , Antibodies, Monoclonal, Humanized , Otitis Media , Paranasal Sinuses , Patients , Quality of Life , Asthma , Sinusitis , Therapeutics , Effectiveness , Conjunctivitis , Dermatitis, Atopic , Eosinophils , Nasal MucosaABSTRACT
Hereditary angioedema is an autosomal dominant disease characterized by recurrent angioedema attacks with the involvement of multiple organs. The disease is unknown to many health professionals and is therefore underdiagnosed. Patients who are not adequately diagnosed and treated have an estimated mortality rate ranging from 25% to 40% due to asphyxiation by laryngeal angioedema. Intestinal angioedema is another important and incapacitating presentation that may be the main or only manifestation during an attack. In this article, a group of experts from the "Associação Brasileira de Alergia e Imunologia (ASBAI)" and the "Grupo de Estudos Brasileiro em Angioedema Hereditário (GEBRAEH)" has updated the Brazilian guidelines for the diagnosis and treatment of hereditary angioedema.
Subject(s)
Angioedemas, Hereditary/diagnosis , Angioedemas, Hereditary/classification , Angioedemas, Hereditary/physiopathology , Brazil , Complement C1 Inhibitor Protein/analysis , Complement C4/analysis , Diagnosis, Differential , HumansABSTRACT
Hereditary angioedema is an autosomal dominant disease characterized by recurrent angioedema attacks with the involvement of multiple organs. The disease is unknown to many health professionals and is therefore underdiagnosed. Patients who are not adequately diagnosed and treated have an estimated mortality rate ranging from 25% to 40% due to asphyxiation by laryngeal angioedema. Intestinal angioedema is another important and incapacitating presentation that may be the main or only manifestation during an attack. In this article, a group of experts from the "Associação Brasileira de Alergia e Imunologia (ASBAI)" and the "Grupo de Estudos Brasileiro em Angioedema Hereditário (GEBRAEH)" has updated the Brazilian guidelines for the diagnosis and treatment of hereditary angioedema.
Subject(s)
Humans , Angioedemas, Hereditary/diagnosis , Brazil , Complement C4/analysis , Diagnosis, Differential , Complement C1 Inhibitor Protein/analysis , Angioedemas, Hereditary/classification , Angioedemas, Hereditary/physiopathologyABSTRACT
O angioedema hereditário é uma doença autossômica dominante caracterizada por crises de edema com o envolvimento de múltiplos órgãos. A doença é desconhecida por muitos profissionais da área da saúde e, portanto, subdiagnosticada. Os pacientes que não são diagnosticados e tratados adequadamente têm uma mortalidade estimada de 25% a 40%, devido ao angioedema da laringe, resultando em asfixia. O angioedema de alças intestinais é outra manifestação importante e incapacitante, que pode ser a principal ou a única durante uma crise da doença. Neste cenário, um grupo de especialistas da Associação Brasileira de Alergia e Imunologia (ASBAI) e do Grupo de Estudos Brasileiro em Angioedema Hereditário (GEBRAEH) atualizou as diretrizes para o diagnóstico e terapia do angioedema hereditário.
Hereditary angioedema is an autosomal dominant disease characterized by edema attacks with the involvement of multiple organs. The disease is unknown to many health professionals and is therefore underdiagnosed. Patients who are not adequately diagnosed and treated have an estimated mortality rate ranging from 25% to 40%, due to laryngeal angioedema, which results in asphyxia. Angioedema affecting bowel loops is another important, incapacitating presentation that may be the main or only manifestation during a crisis. In this scenario, a group of experts affiliated with Associação Brasileira de Alergia e Imunologia (ASBAI) and Grupo de Estudos Brasileiro em Angioedema Hereditário (GEBRAEH) has updated the guidelines for the diagnosis and treatment of hereditary angioedema.
Subject(s)
Humans , Male , Female , History, 21st Century , Guidelines as Topic , Allergy and Immunology , Angioedemas, Hereditary/drug therapy , Therapeutics , Diagnosis , Hereditary Angioedema Types I and IIABSTRACT
The aim of this study was to investigate the involvement of the transient receptor potential ankyrin 1 (TRPA1) in haemorrhagic cystitis, the main side effect of cyclophosphamide-based chemotherapy. Hannover female rats received intraperitoneal (i.p.) injection of cyclophosphamide (three doses of 100 mg/kg, every other day, in a total of five days). This treatment was followed by the treatment with TRPA1 antagonist HC 030031 (50 mg/kg, p.o.). The threshold for hindpaw withdrawal or abdominal retraction to von Frey Hair and the locomotor activity were measured. The treatment with the TRPA1 antagonist HC 030031 significantly decreased mechanical hyperalgesia induced by cyclophosphamide without interfere with locomotor activity. Urodynamic parameters were performed by cystometry 24 h after a single treatment with cyclophosphamide (200 mg/kg, i.p.) in control and HC 030031 treated rats. Analyses of the urodynamic parameters showed that a single dose of cyclophosphamide was enough to significantly increase the number and amplitude of non-voiding contractions and to decrease the voided volume and voiding efficiency, without significantly altering basal, threshold or maximum pressure. The treatment with HC 030031 either before (100 mg/kg, p.o.) or after (30 mg/kg, i.v.) cyclophosphamide inhibited the non-voiding contractions but failed to counteract the loss in voiding efficiency. Our data demonstrates that nociceptive symptoms and urinary bladder overactivity caused by cyclophosphamide, in part, are dependent upon the activation of TRPA1. In this context, the antagonism of the receptor may be an alternative to minimise the urotoxic symptoms caused by this chemotherapeutic agent.
Subject(s)
Cyclophosphamide/adverse effects , Cystitis/chemically induced , Cystitis/complications , Hemorrhage/complications , Hyperalgesia/drug therapy , TRPC Cation Channels/antagonists & inhibitors , Urinary Bladder, Overactive/drug therapy , Acetanilides/pharmacology , Acetanilides/therapeutic use , Animals , Antineoplastic Agents, Alkylating/adverse effects , Cystitis/metabolism , Cystitis/physiopathology , Female , Hyperalgesia/complications , Purines/pharmacology , Purines/therapeutic use , Rats , TRPA1 Cation Channel , Urinary Bladder, Overactive/complications , Urodynamics/drug effectsABSTRACT
A mark-release-recapture technique was developed and tested for use in tracking the field movements of adult glassy-winged sharpshooters, Homalodisca coagulata (Say) (Hemiptera: Cicadellidae), in various agricultural and urban plantings. Greenhouse experiments in which adult H. coagulata were marked with one of five colored fluorescent dusts (Aurora Pink-All, Horizon Blue-A19, Blaze Orange-A15N, Saturn Yellow-A17, and Corona Magenta-A21) and released into cages with citrus seedlings showed that their mortality rates during a 30-d period were statistically similar to that of the undusted controls. Adults marked with a sixth dust color (Signal Green-A18N) suffered higher rates of mortality than did the undusted controls and thus were eliminated from further consideration. Adult H. coagulata marked with one of the five accepted colors of fluorescent dust were able to fly beyond 100 m in a field devoid of vegetation within minutes of their release, and the marking did not affect overall flight behavior significantly compared with that of the undusted controls. However, at wind speeds above 5 m/s, percentage recapture was significantly reduced, which indicates that both dusted and undusted adults were unable to orient their flight. In total, 41,124 marked and unmarked adults were released in the three field experiments in southern California (Riverside and Kern counties) during 2000 and 2001 to evaluate flight dispersal and estimate densities of H. coagulata. The mark-release-recapture and feral data obtained during the June, July, and August 2001 studies, when coupled with the Lincoln index, yielded estimates of adult H. coagulata of 1.2 and 2.2 million per ha, respectively, at a San Joaquin Valley (Kern Co.) and a southern California (Riverside Co.) citrus grove. The use of colored dusts to mark H. coagulata proved to be reliable, cost-effective, and time-efficient for mark-release-recapture studies with this insect within a citrus grove, but they are less likely to be useful for studies of adult H. coagulata movements among plantings.
