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1.
J Dairy Sci ; 107(5): 3006-3019, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38101745

RESUMO

The aims of this study were to estimate genetic parameters and to identify genomic regions associated with eating time (ET) and rumination time (RUT) in Holstein dairy cows. Genetic correlations among ET, RUT, and milk yield traits were also estimated. The data were collected from 2019 to 2022 in 6 dairy herds located in the Walloon Region of Belgium. The dataset consisted of daily ET and RUT records on 284 Holstein cows, from which 41 cows had records only for the first parity (P1), 101 cows had records from both the first and second parities, and 142 cows had records only for the second parity (P2). The number of daily ET and RUT records in the P1 and P2 cows were 18,569 (on 142 cows) and 34,464 (on 243 cows), respectively. Data on 28,994 SNPs located on 29 Bos taurus autosomes (BTA) of 747 animals (435 males) were used. Random regression test-day models were used to estimate genetic parameters through the Bayesian Gibbs sampling method. The SNP solutions were estimated using a single-step genomic best linear unbiased prediction approach. The proportion of genetic variance explained by each 20-SNP sliding window (with an average size of 1.52 Mb) was calculated, and regions accounting for at least 1.0% of the total additive genetic variance were used to search for candidate genes. Mean (standard deviation; SD) averaged daily ET and RUT were 327.0 (85.66) and 559.4 (77.69) min/d for cows in P1 and 316.0 (82.24) and 574.2 (75.42) min/d for cows in P2, respectively. Mean (standard deviation; SD) heritability estimates for daily ET and RUT were 0.42 (0.09) and 0.45 (0.06) for cows in P1 and 0.45 (0.04) and 0.43 (0.02) for cows in P2, respectively. Mean (SD) daily genetic correlations between daily ET and RUT were 0.27 (0.07) for P1 and 0.34 (0.08) for P2. Genome-wide association analyses identified 6 genomic regions distributed over 5 chromosomes (BTA1, BTA4, BTA11, 2 regions of BTA14, and BTA17) associated with ET or RUT. The findings of this study increase our preliminary understanding of the genetic background of feeding behavior in dairy cows; however, larger datasets are needed to determine whether ET and RUT might have the potential to be used in selection programs.


Assuntos
Estudo de Associação Genômica Ampla , Lactação , Animais , Bovinos/genética , Feminino , Masculino , Gravidez , Teorema de Bayes , Genoma , Estudo de Associação Genômica Ampla/veterinária , Lactação/genética , Leite , Fenótipo
2.
Diabetes Obes Metab ; 25(11): 3171-3180, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37424165

RESUMO

AIMS: To determine the relationship between exposure and weight-loss trajectories for the glucagon-like peptide-1 analogue semaglutide for weight management. MATERIALS AND METHODS: Data from one 52-week, phase 2, dose-ranging trial (once-daily subcutaneous semaglutide 0.05-0.4 mg) and two 68-week phase 3 trials (once-weekly subcutaneous semaglutide 2.4 mg) for weight management in people with overweight or obesity with or without type 2 diabetes were used to develop a population pharmacokinetic (PK) model describing semaglutide exposure. An exposure-response model describing weight change was then developed using baseline demographics, glycated haemoglobin and PK data during treatment. The ability of the exposure-response model to predict 1-year weight loss based on weight data collected at baseline and after up to 28 weeks of treatment, was assessed using three independent phase 3 trials. RESULTS: Based on population PK, exposure levels over time consistently explained the weight-loss trajectories across trials and dosing regimens. The exposure-response model had high precision and limited bias for predicting body weight loss at 1 year in independent datasets, with increased precision when data from later time points were included in the prediction. CONCLUSION: An exposure-response model has been established that quantitatively describes the relationship between systemic semaglutide exposure and weight loss and predicts weight-loss trajectories for people with overweight or obesity who are receiving semaglutide doses up to 2.4 mg once weekly.


Assuntos
Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Sobrepeso/complicações , Sobrepeso/tratamento farmacológico , Redução de Peso , Peptídeos Semelhantes ao Glucagon/efeitos adversos , Obesidade/complicações , Obesidade/tratamento farmacológico , Peptídeo 1 Semelhante ao Glucagon/uso terapêutico
3.
J Clin Med ; 12(12)2023 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-37373733

RESUMO

Malabsorption is a consequence of gastric bypass (GB). GB increases the risk of kidney stone formation. This study aimed to evaluate the accuracy of a screening questionnaire for assessing the risk of lithiasis in this population. We performed a monocentric retrospective study to evaluate a screening questionnaire administered to patients who underwent gastric bypass surgery between 2014 and 2015. Patients were asked to answer a questionnaire that included 22 questions divided into four parts: medical history, episodes of renal colic before and after bypass surgery, and eating habits. A total of 143 patients were included in the study, and the mean age of the patients was 49.1 ± 10.8 years. The time between gastric bypass surgery and the completion of the questionnaire was 50.75 ± 4.95 months. The prevalence of kidney stones in the study population was 19.6%. We found that with a score of ≥6, the sensitivity and specificity were 92.9% and 76.5%, respectively. Positive and negative predictive values were 49.1% and 97.8%, respectively. The ROC curve showed an Area Under the Curve (AUC) of 0.932 ± 0.029 (p < 0.001). We developed a reliable and short questionnaire to identify patients at a high risk of kidney stones after gastric bypass. When the results of the questionnaire were equal to or greater than six, the patient was at a high risk of kidney stone formation. With a good predictive negative value, it could be used in daily practice to screen patients who have undergone gastric bypass and are at a high risk of renal lithiasis.

4.
N Engl J Med ; 384(11): 989-1002, 2021 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-33567185

RESUMO

BACKGROUND: Obesity is a global health challenge with few pharmacologic options. Whether adults with obesity can achieve weight loss with once-weekly semaglutide at a dose of 2.4 mg as an adjunct to lifestyle intervention has not been confirmed. METHODS: In this double-blind trial, we enrolled 1961 adults with a body-mass index (the weight in kilograms divided by the square of the height in meters) of 30 or greater (≥27 in persons with ≥1 weight-related coexisting condition), who did not have diabetes, and randomly assigned them, in a 2:1 ratio, to 68 weeks of treatment with once-weekly subcutaneous semaglutide (at a dose of 2.4 mg) or placebo, plus lifestyle intervention. The coprimary end points were the percentage change in body weight and weight reduction of at least 5%. The primary estimand (a precise description of the treatment effect reflecting the objective of the clinical trial) assessed effects regardless of treatment discontinuation or rescue interventions. RESULTS: The mean change in body weight from baseline to week 68 was -14.9% in the semaglutide group as compared with -2.4% with placebo, for an estimated treatment difference of -12.4 percentage points (95% confidence interval [CI], -13.4 to -11.5; P<0.001). More participants in the semaglutide group than in the placebo group achieved weight reductions of 5% or more (1047 participants [86.4%] vs. 182 [31.5%]), 10% or more (838 [69.1%] vs. 69 [12.0%]), and 15% or more (612 [50.5%] vs. 28 [4.9%]) at week 68 (P<0.001 for all three comparisons of odds). The change in body weight from baseline to week 68 was -15.3 kg in the semaglutide group as compared with -2.6 kg in the placebo group (estimated treatment difference, -12.7 kg; 95% CI, -13.7 to -11.7). Participants who received semaglutide had a greater improvement with respect to cardiometabolic risk factors and a greater increase in participant-reported physical functioning from baseline than those who received placebo. Nausea and diarrhea were the most common adverse events with semaglutide; they were typically transient and mild-to-moderate in severity and subsided with time. More participants in the semaglutide group than in the placebo group discontinued treatment owing to gastrointestinal events (59 [4.5%] vs. 5 [0.8%]). CONCLUSIONS: In participants with overweight or obesity, 2.4 mg of semaglutide once weekly plus lifestyle intervention was associated with sustained, clinically relevant reduction in body weight. (Funded by Novo Nordisk; STEP 1 ClinicalTrials.gov number, NCT03548935).


Assuntos
Fármacos Antiobesidade/administração & dosagem , Peptídeo 1 Semelhante ao Glucagon/agonistas , Peptídeos Semelhantes ao Glucagon/administração & dosagem , Obesidade/tratamento farmacológico , Adulto , Fármacos Antiobesidade/efeitos adversos , Composição Corporal/efeitos dos fármacos , Índice de Massa Corporal , Colelitíase/induzido quimicamente , Diarreia/induzido quimicamente , Método Duplo-Cego , Feminino , Peptídeos Semelhantes ao Glucagon/efeitos adversos , Estilo de Vida Saudável , Humanos , Injeções Subcutâneas , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Náusea/induzido quimicamente , Obesidade/complicações , Estado Pré-Diabético/complicações , Redução de Peso/efeitos dos fármacos
5.
ANZ J Surg ; 89(9): 1028-1034, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30974508

RESUMO

INTRODUCTION: Many infectious diseases display seasonal variation corresponding with particular conditions. In orthopaedics a growing body of evidence has identified surges in post-operative infection rates during higher temperature periods. The aim of this research was to collate and synthesize the current literature on this topic. METHODS: A systematic review and meta-analysis was performed using five databases (PubMed, Embase, CINAHL, Web of Science and Central (Cochrane)). Study quality was assessed using the Grading of Recommendations Assessment, Development and Evaluation method. Odds ratios (ORs) were calculated from monthly infection rates and a pooled OR was generated using the DerSimonian and Lairds method. A protocol for this review was registered with the National Institute for Health Research International Prospective Register of Systematic Reviews (CRD42017081871). RESULTS: Eighteen studies analysing over 19 000 cases of orthopaedic related infection met inclusion criteria. Data on 6620 cases and 9035 controls from 12 studies were included for meta-analysis. The pooled OR indicated an overall increased odds of post-operative infection for patients undergoing orthopaedic procedures during warmer periods of the year (pooled OR 1.16, 95% confidence interval 1.04-1.30). CONCLUSION: A small but significantly increased odds of post-operative infection may exist for orthopaedic patients who undergo procedures during higher temperature periods. It is hypothesized that this effect is geographically dependent and confounded by meteorological factors, local cultural variables and hospital staffing cycles.


Assuntos
Temperatura Alta/efeitos adversos , Infecções/etiologia , Procedimentos Ortopédicos/estatística & dados numéricos , Complicações Pós-Operatórias/microbiologia , Estudos de Casos e Controles , Humanos , Infecções/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Projetos de Pesquisa , Estações do Ano
6.
Acta Neuropsychiatr ; 29(5): 267-277, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27919300

RESUMO

OBJECTIVE: To evaluate the efficacy of transcranially applied pulsed electromagnetic fields (PEMF) on functional impairments and symptom severity in multiple chemical sensitivity (MCS) patients. METHODS: The study was conducted as a nationwide trial in Denmark using a randomised, parallel-group, double-blind and placebo-controlled design. Sample size was estimated at 40 participants. Eligibility criteria were age 18-75 years and fulfilment of the MCS case criteria. Participants received either PEMF or placebo PEMF (no stimulation) applied transcranially for 6 weeks. The primary outcome was the Life Impact Scale (LIS) of the Quick Environmental Exposure and Sensitivity Inventory (QEESI). Secondary outcomes were the Symptom Severity Scale (SSS) and the Chemical Intolerance Scale of QEESI. RESULTS: A total of 39 participants were randomised to PEMF or placebo treatment. No significant difference was observed on QEESI LIS between groups with a mean change score of -5.9 in the PEMF group compared with -1.5 in the placebo group (p=0.35, effect size=-0.31). However, a significant decrease was detected on QEESI SSS within and between groups with a mean change score of -11.3 in the PEMF group compared with -3.2 in the placebo group (p=0.03, effect size=-0.60). CONCLUSION: PEMF treatment of 6 weeks showed no effect on functional impairments in MCS. However, a significant decrease in symptom severity was observed.


Assuntos
Magnetoterapia , Sensibilidade Química Múltipla/terapia , Adolescente , Adulto , Idoso , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade Química Múltipla/complicações , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
7.
Asian Pac J Cancer Prev ; 15(4): 1791-6, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24641410

RESUMO

BACKGROUND: Colorectal cancer (CRC) is a leading cause of cancer death among Vietnamese Americans, yet screening remains underutilized. We investigated the effectiveness of a culturally tailored DVD intervention in promoting CRC screening among unscreened Vietnamese Americans age 50 and over. MATERIALS AND METHODS: Using a community-based participatory research approach, we conducted a trial comparing twenty-eight subjects who received a mailed DVD in Vietnamese, with twenty-eight subjects who received a mailed brochure in Vietnamese. Subjects completed telephone surveys at baseline, One-month, and one-year. The primary outcome was receipt of screening. Secondary measures were participants' knowledge, attitudes, and beliefs about CRC screening. Two focus groups explored the intervention's acceptability and effectiveness. RESULTS: At one year, CRC screening rates of 57.1% and 42.9% were observed in experimental and control group respectively (p=0.42), Subjects in both groups showed increased knowledge about CRC after one month. Focus group findings revealed that the DVD was an effective method of communicating information and would help promote screening. CONCLUSIONS: The findings suggest that culturally tailored, linguistically appropriate content is more important than the type of media used. This relatively low intensity, low cost intervention utilizing a DVD can be another useful method for outreach to the often hard-to-reach unscreened population.


Assuntos
Neoplasias Colorretais/prevenção & controle , Detecção Precoce de Câncer , Programas de Rastreamento/psicologia , Cooperação do Paciente , Gravação de Videodisco , Idoso , Asiático , Neoplasias Colorretais/diagnóstico , Pesquisa Participativa Baseada na Comunidade , Feminino , Grupos Focais , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Folhetos , Inquéritos e Questionários , Estados Unidos , Vietnã/etnologia , Populações Vulneráveis
8.
Scand J Pain ; 5(2): 104-109, 2014 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-29913674

RESUMO

Background Multiple chemical sensitivity (MCS) is a chronic, disabling condition characterized by recurrent multisystem symptoms triggered by common airborne chemicals. Evidence points towards abnormal sensory processing in the central nervous system (CNS) as a likely pathophysiological mechanism. No effective treatment has yet been reported, but clinical observations suggest that as pulsed electromagnetic fields (PEMF) is a treatment for some CNS disorders (depression and chronic pain), it may also be a treatment modality for MCS. Methods In an open case study, the effects of PEMF were assessed in three MCS patients. All cases received 30 min daily treatment 5 days a week for 8 consecutive weeks. Symptoms and functional impairments related to MCS, depressive symptoms, and capsaicin-induced secondary punctate hyperalgesia were assessed at baseline and weekly until an 18-week follow-up. Results Two of the three cases showed considerable improvement on all measures of symptoms and functional impairments related to MCS in response to PEMF therapy. One case showed no improvement and during the treatment period was unexpectedly diagnosed with depression. Conclusion Our findings indicate potential benefits of PEMF therapy in MCS. Implication The therapeutic effect of PEMF in MCS needs to be investigated by a randomized placebo-controlled trial.

9.
Trials ; 14: 256, 2013 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-23947742

RESUMO

BACKGROUND: Multiple chemical sensitivity (MCS) is a chronic condition of unknown etiology. MCS is characterized by recurrent nonspecific symptoms from multiple organ systems in response to chemical exposures in concentrations that are normally tolerated by the majority of the population. The symptoms may have severe impact on patients' lives, but an evidence-based treatment for the condition is nonexisting. The pathophysiology is unclarified, but several indicators point towards abnormal processing of sensory signals in the central nervous system. Pulsed electromagnetic fields (PEMF) offer a promising new treatment for refractory depression and can be targeted at the brain, thereby activating biochemical cell processes. METHODS/DESIGN: In a parallel, randomized, double-blind, placebo-controlled trial conducted at the Danish Research Centre for Chemical Sensitivities, the effects of PEMF in MCS patients will be assessed using the Re5 Independent System. Based on sample size estimation, 40 participants will be randomized to either PEMF therapy or placebo. The allocation sequence will be generated by computer. All involved parties (that is, participants, investigators, the research nurse, and the statistician) will be blinded to group allocation. The participants will receive PEMF therapy or placebo applied transcranially 30 minutes twice a day for 7 days a week over 6 consecutive weeks. Outcomes will be measured at baseline, once weekly during treatment, post treatment, and at 2.5-month and 4.5-month follow-up according to a predefined timetable. The primary outcome will be a measurement of the impact of MCS on everyday life. The secondary outcomes will be measurements of MCS symptoms, psychological distress (stress, anxiety or depressive symptoms), capsaicin-induced secondary punctate hyperalgesia, immunological markers in serum, and quality of life. DISCUSSION: This trial will assess the effects of PEMF therapy for MCS. Currently, there is no treatment with a documented effect on MCS, and in terms of healthcare there is very little to offer these patients. There is thus a great need for well-conducted randomized trials aimed at assessing possible treatment effects. A positive outcome will pave the way for improved healthcare and understanding of this very disabling and overlooked condition. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01834781.


Assuntos
Sensibilidade Química Múltipla/terapia , Projetos de Pesquisa , Estimulação Magnética Transcraniana , Atividades Cotidianas , Protocolos Clínicos , Efeitos Psicossociais da Doença , Dinamarca , Método Duplo-Cego , Humanos , Sensibilidade Química Múltipla/diagnóstico , Sensibilidade Química Múltipla/fisiopatologia , Sensibilidade Química Múltipla/psicologia , Qualidade de Vida , Fatores de Tempo , Resultado do Tratamento
10.
PLoS One ; 8(8): e71241, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23951117

RESUMO

OBJECTIVES: To investigate the prevalence and the severity of fragrance-related symptoms among hairdressers in Denmark compared with the Danish general population. Further, to characterize former hairdressers who are severely chemically intolerant to fragranced products in relation to sex, age and health- and work-related reasons for leaving the hairdressing profession. METHODS: The study population consisted of all hairdressers who graduated from the public vocational schools in Denmark during 1985 and 2007 (n = 7840) and a random sample of individuals from the Danish general population (n = 6000). Both populations received a postal questionnaire on symptoms from inhalation of fragranced products and the resultant behavioural consequences. All former hairdressers also answered additional questions on health- and work-related reasons for leaving the profession. RESULTS: No differences were found in the prevalence (OR = 1.0, CI = 0.89-1.14) or the severity (OR = 1.1, CI = 0.80-1.51) of symptoms from inhalation of fragranced products in hairdressers compared with the general population. Among hairdressers, however, experience of fragrance-related symptoms (OR = 1.2, CI = 1.01-1.31) and adjustments of social (OR = 1.8, CI = 1.12-2.80) and occupational conditions (OR = 2.8, CI = 1.84-4.25) were reported significantly more often by former hairdressers than current hairdressers. CONCLUSIONS: The prevalence and the severity of fragrance-related symptoms were similar in hairdressers and the general population. Former hairdressers were more affected by fragranced products than current hairdressers were. Although fragrance-related symptoms did not seem to be more frequent among hairdressers, the hairdressing profession might pose a problem for those who are chemically intolerant.


Assuntos
Doenças Profissionais/epidemiologia , Exposição Ocupacional , Adulto , Idoso , Dinamarca/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Inalação , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
11.
Int J Hyg Environ Health ; 216(2): 202-10, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22487274

RESUMO

BACKGROUND: Multiple Chemical Sensitivity (MCS) is a chronic condition characterized by recurrent, non-specific symptoms in response to chemically unrelated exposures in non-toxic concentrations. Although the pathophysiology of MCS remains unknown, central sensitization may be an important factor contributing to the clinical manifestations. PURPOSE: To use quantitative sensory testing (QST) to study central hyperexcitability and multiple aspects of central sensory processing in MCS patients without comorbid overlapping disorders and to compare the results with those among matched controls. METHODS: 15 MCS patients and 15 healthy matched controls underwent QST to assess the following aspects of pain: capsaicin-induced secondary punctate hyperalgesia, stimulus response function (SRF) to punctate mechanical stimuli before and after capsaicin injection, temporal summation to punctate stimuli post capsaicin injection, pressure pain thresholds, heat pain thresholds, tonic heat stimulation and conditioning pain modulation (CPM: formerly known as diffuse noxious inhibitory control or DNIC). RESULTS: The mean area of capsaicin-induced secondary punctate hyperalgesia was significantly larger in MCS patients than in controls at 5, 30 and 60 min post capsaicin injection (p=0.01). In addition MCS patients reported higher ratings in response to punctate mechanical stimuli assessed by SRF compared with controls (p<0.001). The CPM test induced significantly higher pain ratings in patients than in controls (p=0.002). We found no group differences in pressure pain and heat pain thresholds, temporal summation to punctate stimuli post capsaicin injection, capsaicin and tonic heat pain ratings or CPM effect. CONCLUSION: Increased capsaicin-induced secondary punctate hyperalgesia was demonstrated in MCS patients without comorbid, overlapping disorders, suggesting facilitated central sensitization in MCS.


Assuntos
Sensibilização do Sistema Nervoso Central , Hiperalgesia/complicações , Sensibilidade Química Múltipla/complicações , Adulto , Capsaicina/administração & dosagem , Temperatura Baixa , Feminino , Temperatura Alta , Humanos , Hiperalgesia/etiologia , Hiperalgesia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Sensibilidade Química Múltipla/fisiopatologia , Medição da Dor , Inquéritos e Questionários
12.
J Cardiovasc Pharmacol Ther ; 15(4): 326-37, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20938037

RESUMO

OBJECTIVES: to evaluate the existing literature on a proposed interaction between clopidogrel and proton pump inhibitors (PPIs) and discuss its implications for clinicians treating patients with this combination therapy. BACKGROUND: each year millions of patients receive antiplatelet therapy. A number of these patients are prescribed PPIs concomitantly to reduce the risk of gastrointestinal side effects associated with antiplatelet therapy. Several studies have been published recently addressing a potential adverse drug-drug interaction between clopidogrel and PPIs. METHODS: literature was evaluated through Pubmed using the terms clopidogrel, PPI, prasugrel, cytochrome P450, genetic polymorphisms, H( 2) blockers, famotidine, genetic cytochrome P450 polymorphisms, and drug interaction. Articles with these terms were considered for evaluation. In addition, reference citations from publications identified in the searches were further reviewed and analyzed. RESULTS: none of the currently published studies were specifically designed to evaluate this drug-drug interaction or address the clinical relevance of this interaction prospectively. Conflicting evidence raised concerns but the information did not conclude with certainty a cause-and-effect relationship between concomitant use of the drugs and emerging safety issues. However, the Food and Drug Administration issued a public-health warning on the possible interaction between clopidogrel and PPIs, predominantly with omeprazole, in November 2009. CONCLUSIONS: controversies exist on a potential drug-drug interaction between clopidogrel and PPIs. Although further studies are warranted, several studies indicated that there was a drug-drug interaction through this combination therapy with detrimental clinical outcomes and increased costs. Studies suggested that the use of a PPI may make clopidogrel less effective resulting in a higher risk of myocardial infarction, stroke, or death. Until additional information becomes available clinicians should consider discontinuing PPI use if no clear indication is documented. Alternative options like H(2)-receptor antagonists should be considered. Upon availability, genetic testing may provide additional valuable information.


Assuntos
Doenças Cardiovasculares/induzido quimicamente , Infarto do Miocárdio/induzido quimicamente , Inibidores da Agregação Plaquetária/efeitos adversos , Inibidores da Bomba de Prótons/efeitos adversos , Acidente Vascular Cerebral/induzido quimicamente , Ticlopidina/análogos & derivados , Hidrocarboneto de Aril Hidroxilases/genética , Hidrocarboneto de Aril Hidroxilases/metabolismo , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/mortalidade , Ensaios Clínicos como Assunto , Clopidogrel , Citocromo P-450 CYP2C19 , Sistema Enzimático do Citocromo P-450/metabolismo , Interações Medicamentosas , Quimioterapia Combinada , Humanos , Infarto do Miocárdio/tratamento farmacológico , Omeprazol/efeitos adversos , Omeprazol/uso terapêutico , Inibidores da Agregação Plaquetária/metabolismo , Inibidores da Agregação Plaquetária/uso terapêutico , Inibidores da Bomba de Prótons/uso terapêutico , Fatores de Risco , Acidente Vascular Cerebral/mortalidade , Ticlopidina/efeitos adversos , Ticlopidina/metabolismo , Ticlopidina/uso terapêutico , Resultado do Tratamento
13.
Fundam Clin Pharmacol ; 21(1): 45-53, 2007 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17227444

RESUMO

A combination of midodrine and dihydroergotamine (DHE) is frequently used clinically in patients suffering from severe orthostatic hypotension (OH). Whereas midodrine acts as a selective, peripheral alpha1-receptor agonist, DHE displays complex pharmacology and can behave as an alpha-adrenergic receptor agonist or antagonist. Surprisingly, the consequences of such a combination on blood pressure have never been investigated. The present study was performed in order to evaluate the pressor effects induced by the administration of both midodrine and DHE in old conscious dogs (n = 6) in experimental condition reproducing autonomic failure-related baroreflex dysfunction (atropine 0.1 mg/kg). For this purpose, we first studied the relative potency and intrinsic activity of each agonist and noradrenaline (NA) for the alpha1-adrenergic receptor. The orders of potency obtained in our study were 0.35, 11 and 400 microg/kg for NA, DHE and midodrine, and intrinsic activity: NA > midodrine > DHE. These results strongly suggest that DHE really acts in vivo as an alpha1-adrenoceptor partial agonist. Afterwards, the pressor effects of coadministration of midodrine (0.4 mg/kg) and DHE (15 microg/kg) were investigated: in one setting, midodrine was first administered, followed by DHE; in another, DHE was first administered, followed by midodrine. Our results show that in conscious dogs, the combination of midodrine and DHE leads to near-complete abolition of the pressor effect induced by the first administered drug. This in vivo proof of such antagonistic effects on blood pressure could explain clinical observations of worsening of OH in humans administered midodrine plus DHE. Although in vivo results obtained in conscious healthy dogs need to be experimentally and clinically confirmed in humans suffering from OH, these results strongly suggest that a midodrine-DHE combined treatment should be avoided in clinical practice.


Assuntos
Agonistas alfa-Adrenérgicos/farmacologia , Di-Hidroergotamina/farmacologia , Hipotensão Ortostática/tratamento farmacológico , Midodrina/farmacologia , Agonistas de Receptores Adrenérgicos alfa 1 , Animais , Pressão Sanguínea/efeitos dos fármacos , Di-Hidroergotamina/antagonistas & inibidores , Cães , Frequência Cardíaca/efeitos dos fármacos , Hipotensão Ortostática/fisiopatologia , Masculino , Midodrina/antagonistas & inibidores
14.
Clin Auton Res ; 13(4): 281-5, 2003 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-12955553

RESUMO

INTRODUCTION: Essential hyperhidrosis (EH) is often considered to be related to an increased activity of sympathetic nervous system (SNS). However, there is a lack of studies comparing autonomic nervous system (ANS) activity in controls and in EH patients. The aim of the present study was to simultaneously investigate in patients with severe EH, blood pressure, heart rate variability and plasma catecholamine levels in comparison with controls. METHODS: 19 EH patients and 20 controls with normal ANS function assessed by clinical testing were included. Blood pressure (BP) and heart rate (HR) were measured using a Finapres beat-to-beat monitor. BP and HR variabilities (Fast Fourier transformation) and plasma catecholamine levels (HPLC) were obtained at rest and during a 15 min 70 degrees head-up tilt test. RESULTS: At rest, a significantly higher relative energy of low frequency band (LF) of systolic BP was observed in EH in comparison with controls contrasting with the lack of difference in BP, HR, plasma catecholamine levels and in other spectral parameters. During tilt, all changes were comparable in EH and in control subjects excepting relative energy of LF of SBP which remained unchanged when compared to the resting condition in EH group. CONCLUSIONS: In EH, SNS is not over-reactive even if resting overactivity cannot be excluded.


Assuntos
Pressão Sanguínea/fisiologia , Frequência Cardíaca/fisiologia , Hiperidrose/fisiopatologia , Adolescente , Adulto , Sistema Nervoso Autônomo/fisiopatologia , Toxinas Botulínicas/farmacologia , Catecolaminas/sangue , Método Duplo-Cego , Feminino , Humanos , Iodo , Masculino , Pessoa de Meia-Idade , Postura/fisiologia , Amido
15.
Eur J Pharmacol ; 444(3): 197-202, 2002 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-12063080

RESUMO

The study investigated the effects of dopamine D1-like receptor stimulation on the autonomic nervous system. Fenoldopam (20 microg/kg) was injected i.v. in conscious sinoaortic denervated dogs, that is, surgically deprived of baroreflex pathways. In barodenervated dogs, fenoldopam (20 microg/kg) induced arterial hypotension as well as bradycardia and reduced noradrenaline plasma levels. Pentolinium (0.1 mg/kg i.v.), used to induce partial blockade of nicotinic ganglionic receptors, suppressed the fenoldopam-induced decrease in sympathetic tone, suggesting a ganglionic location for the dopamine D1-like receptor. Moreover, the inability of fenoldopam to reduce the nicotine-induced increase in sympathetic tone suggests that a postsynaptic ganglionic location can be excluded for the dopamine D1-like receptor. The results of these "in vivo" experiments strongly suggest a presynaptic location for the ganglionic dopamine D1-like receptor, stimulation of which results in a reduction of sympathetic tone.


Assuntos
Sistema Nervoso Autônomo/efeitos dos fármacos , Fenoldopam/farmacologia , Gânglios Autônomos/efeitos dos fármacos , Inibição Neural/efeitos dos fármacos , Animais , Sistema Nervoso Autônomo/fisiologia , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Cães , Gânglios Autônomos/fisiologia , Bloqueadores Ganglionares/farmacologia , Frequência Cardíaca/efeitos dos fármacos , Frequência Cardíaca/fisiologia , Masculino , Inibição Neural/fisiologia , Norepinefrina/sangue , Receptores de Dopamina D1/agonistas , Receptores de Dopamina D1/fisiologia
16.
J Hypertens ; 20(5): 957-64, 2002 May.
Artigo em Inglês | MEDLINE | ID: mdl-12011657

RESUMO

OBJECTIVE: To investigate the status of alpha2-adrenoceptors in a model of obesity-related arterial hypertension. DESIGN: A parallel study in dogs randomly assigned to a high-fat diet (HFD group, n = 6) or normal canine food (controls, n = 6) for 9 weeks. METHODS: Postsynaptic vascular alpha2-adrenoceptors were assessed through analysis of dose-pressor responses to clonidine [2.5, 5.0 and 15.0 microg/kg intravenously (i.v.)] after muscarinic, beta- and alpha1-adrenergic receptor blockade. Presynaptic and central alpha2-adrenoceptors were studied through measurement of changes in plasma concentrations of catecholamine induced by yohimbine (0.05 mg/kg i.v.). The number of platelet alpha2-adrenoceptors (expressed as fmol/mg protein) and the percentage in a state of high affinity were measured using [3H]RX821002. RESULTS: Clonidine, when administered to dogs that were under autonomic blockade, elicited a dose-dependent increase in blood pressure. The doses of clonidine required to induce a 50% maximum increase in systolic and diastolic blood pressures remained unchanged after 9 weeks of a high-fat diet (systolic: 6.0 +/- 0.3 microg/kg at baseline and 5.6 +/- 0.2 microg/kg after 9 weeks; diastolic: 4.2 +/- 0.2 microg/kg at baseline and 3.9 +/- 0.2 microg/kg after 9 weeks). After 9 weeks of the regimen, plasma concentrations of noradrenaline were significantly greater in the HFD group than in controls (337 +/- 22 pg/ml compared with 212 +/- 37 pg/ml). The increment in plasma concentrations of noradrenaline elicited by yohimbine after 9 weeks was smaller in the HFD group than in controls (93 +/- 44% compared with 181 +/- 46%; P = 0.024). In the HFD group, the number of platelet alpha2-adrenoceptors and the percentage that were in a state of high affinity were significantly lower after 9 weeks, compared with baseline (number: 239 +/- 21 fmol/mg protein at baseline and 95 +/- 7 fmol/mg protein after 9 weeks; high-affinity: 30 +/- 3% at baseline and 21 +/- 4% after 9 weeks; P < 0.05). CONCLUSIONS: These results suggest that presynaptic or central alpha2-adrenoceptor function, or both, is specifically impaired after 9 weeks of a high-fat diet. These modifications may account for the development of arterial hypertension in this model.


Assuntos
Gorduras na Dieta/administração & dosagem , Hipertensão/complicações , Hipertensão/fisiopatologia , Obesidade/complicações , Receptores Adrenérgicos alfa/fisiologia , Agonistas alfa-Adrenérgicos/farmacologia , Antagonistas Adrenérgicos alfa/farmacologia , Antagonistas Adrenérgicos beta/farmacologia , Animais , Plaquetas/metabolismo , Pressão Sanguínea/efeitos dos fármacos , Catecolaminas/sangue , Clonidina/administração & dosagem , Clonidina/farmacologia , Diástole , Cães , Relação Dose-Resposta a Droga , Frequência Cardíaca , Masculino , Prazosina/farmacologia , Receptores Adrenérgicos alfa/sangue , Sístole , Ioimbina/farmacologia
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