RESUMO
Orally administered antipsychotic drugs are the first-line treatment for psychotic disorders, such as schizophrenia and bipolar disorder. Nevertheless, adverse drug reactions jeopardize clinical outcomes, resulting in patient non-compliance. The design formulation strategies for enhancing brain drug delivery has been a major challenge, mainly due to the restrictive properties of the blood-brain barrier. However, recent pharmacokinetic and pharmacodynamic in vivo assays confirmed the advantage of the intranasal route when compared to oral and intravenous administration, as it allows direct nose-to-brain drug transport via neuronal pathways, reducing systemic side effects and maximizing therapeutic outcomes. In addition, the incorporation of antipsychotic drugs into nanosystems such as polymeric nanoparticles, polymeric mixed micelles, solid lipid nanoparticles, nanostructured lipid carriers, nanoemulsions, nanoemulgels, nanosuspensions, niosomes and spanlastics, has proven to be quite promising. The developed nanosystems, having a small and homogeneous particle size (ideal for nose-to-brain delivery), high encapsulation efficiency and good stability, resulted in improved brain bioavailability and therapeutic-like effects in animal models. Hence, although it is essential to continue research in this field, the intranasal delivery of nanosystems for the treatment of schizophrenia, bipolar disorder and other related disorders has proven to be quite promising, opening a path for future therapies with higher efficacy.
RESUMO
ANTECEDENTES Y OBJETIVO: Se ha descrito que el riesgo de fractura en pacientes con diabetes mellitus (DM) esta aumentado. Nuestro objetivo fue investigar la posible asociación entre DM y fractura de cadera y los factores de riesgo asociados mediante una revisión sistemática de la literatura. MÉTODOS: Para identificar los estudios relevantes publicados desde enero de 2001 hasta agosto de 2018 se utilizaron las bases PubMed y SCOPUS. Se seleccionaron los estudios en los cuales se evidenciaba el riesgo estimado de fractura de cadera comparando grupos de pacientes diabéticos con no diabéticos. También se seleccionaron los estudios que investigaban los posibles factores de riesgo para dicha asociación. RESULTADOS: Se evaluaron un total de 27 artículos que cumplían los criterios de inclusión. Se observó una asociación entre DM y fractura de cadera en mujeres y hombres diabéticos con respecto a aquellos individuos no diabéticos. En cuanto a los factores de riesgo detectados, los más importantes fueron que la DM fuese de tipo 1, asociado probablemente a una mayor duración de la misma DM, y el ser mujer. CONCLUSIONES: Existe un riesgo aumentado de tener una fractura de cadera en los pacientes diagnosticados de DM. Esta asociación es más importante en los pacientes con DM tipo 1 y en las mujeres
BACKGROUND AND OBJECTIVES: It has been reported that the risk of fracture is increased in patients with diabetes mellitus (DM). The aim of this study was to investigate the possible relationship between DM and hip fracture, as well as any associated risk factors, by means of a systemic review of the literature. METHODS: PubMed and SCOPUS databases were used to search for relevant studies published from January 2001 to August 2018. Retrospective and prospective cohort studies were selected in which the estimated risk of hip fracture was demonstrated by comparing groups of diabetic patients with non-diabetics. A search was also made for risk factors independent from the association between DM and hip fracture. RESULTS: A total of 27 articles that fulfilled the inclusion criteria were included. A clear association was observed in diabetic patients (women and men) compared to non-diabetics patients. Among the risk factors, the most important ones were the fact that diabetes was type 1, probably associated with greater risk to a longer duration of DM, and being a female. CONCLUSIONS: There is an increased risk of hip fracture in patients diagnosed with DM. This association is more significant in diabetes type 1 and women
Assuntos
Humanos , Masculino , Feminino , Complicações do Diabetes , Fraturas do Quadril/etiologia , Diabetes Mellitus/epidemiologia , Fraturas do Quadril/epidemiologia , Fatores de Risco , Fatores SexuaisRESUMO
BACKGROUND AND OBJECTIVES: It has been reported that the risk of fracture is increased in patients with diabetes mellitus (DM). The aim of this study was to investigate the possible relationship between DM and hip fracture, as well as any associated risk factors, by means of a systemic review of the literature. METHODS: PubMed and SCOPUS databases were used to search for relevant studies published from January 2001 to August 2018. Retrospective and prospective cohort studies were selected in which the estimated risk of hip fracture was demonstrated by comparing groups of diabetic patients with non-diabetics. A search was also made for risk factors independent from the association between DM and hip fracture. RESULTS: A total of 27 articles that fulfilled the inclusion criteria were included. A clear association was observed in diabetic patients (women and men) compared to non-diabetics patients. Among the risk factors, the most important ones were the fact that diabetes was type 1, probably associated with greater risk to a longer duration of DM, and being a female. CONCLUSIONS: There is an increased risk of hip fracture in patients diagnosed with DM. This association is more significant in diabetes type 1 and women.