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3.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(11): 1043-1050, 2020 Nov 25.
Artigo em Chinês | MEDLINE | ID: mdl-33212552

RESUMO

Objective: Surgical site infection (SSI) is the most common infectious complication after emergency abdominal surgery (EAS). To a large extent, most SSI can be prevented, but there are few relevant studies in China. This study mainly investigated the current situation of SSI occurrence after EAS in China, and further explored risk factors for SSI occurrence. Methods: Multi-center cross-sectional study was conducted. Clinical data of patients undergoing EAS in 33 hospitals across China between May 1, 2019 and June 7, 2019 were prospectively collected, including perioperative data and microbial culture results from infected incisions. The primary outcome was the incidence of SSI after EAS, while the secondary outcomes were postoperative hospital stay, ICU occupancy rate, length of ICU stay, hospitalization cost, and mortality within postoperative 30 days. Univariate and multivariate logistic regression models were used to analyze the risk factors of SSI after EAS. Results: A total of 660 EAS patients aged (47.9±18.3) years were enrolled in this study, including 56.5% of males (373/660). Forty-nine (7.4%) patients developed postoperative SSI. The main pathogen of SSI was Escherichia coli [culture positive rate was 32.7% (16/49)]. As compared to patients without SSI, those with SSI were more likely to be older (median 56 years vs. 46 years, U=19 973.5, P<0.001), male [71.4% (35/49) vs. 56.1% (343/611), χ(2)=4.334, P=0.037] and diabetes [14.3% (7/49) vs. 5.1% (31/611), χ(2)=5.498, P=0.015]; with-lower preoperative hemoglobin (median: 122.0 g/L vs. 143.5 g/L, U=11 471.5, P=0.006) and albumin (median: 35.5 g/L vs. 40.8 g/L, U=9452.0, P<0.001), with higher blood glucose (median: 6.9 mmol/L vs. 6.0 mmol/L, U=17 754.5, P<0.001); with intestinal obstruction [32.7% (16/49) vs. 9.2% (56/611), χ(2)=25.749, P<0.001], with ASA score 3-4 [42.9% (21/49) vs. 13.9% (85/611), χ(2)=25.563, P<0.001] and with high surgical risk [49.0% (24/49) vs. 7.0% (43/611), χ(2)=105.301, P<0.001]. The main operative procedure resulting in SSI was laparotomy [81.6%(40/49) vs. 35.7%(218/611), χ(2)=40.232, P<0.001]. Patients with SSI experienced significantly longer operation time (median: 150 minutes vs. 75 minutes, U=25 183.5, P<0.001). In terms of clinical outcome, higher ICU occupancy rate [51.0% (25/49) vs. 19.5% (119/611), χ(2)=26.461, P<0.001], more hospitalization costs (median: 44 000 yuan vs. 15 000 yuan, U=24 660.0, P<0.001), longer postoperative hospital stay (median: 10 days vs. 5 days, U=23 100.0, P<0.001) and longer ICU occupancy time (median: 0 days vs. 0 days, U=19 541.5, P<0.001) were found in the SSI group. Multivariate logistic regression analysis showed that the elderly (OR=3.253, 95% CI: 1.178-8.985, P=0.023), colorectal surgery (OR=9.156, 95% CI: 3.655-22.937, P<0.001) and longer operation time (OR=15.912, 95% CI:6.858-36.916, P<0.001) were independent risk factors of SSI, while the laparoscopic surgery (OR=0.288, 95% CI: 0.119-0.694, P=0.006) was an independent protective factor for SSI. Conclusions: For patients undergoing EAS, attention should be paid to middle-aged and elderly patients and those of colorectal surgery. Laparoscopic surgery should be adopted when feasible and the operation time should be minimized, so as to reduce the incidence of SSI and to reduce the burden on patients and medical institutions.


Assuntos
Abdome , Laparotomia/efeitos adversos , Infecção da Ferida Cirúrgica , Abdome/cirurgia , Adulto , Idoso , China/epidemiologia , Estudos Transversais , Emergências , Feminino , Humanos , Laparotomia/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Infecção da Ferida Cirúrgica/epidemiologia
4.
Eur Rev Med Pharmacol Sci ; 24(6): 2785-2794, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32271395

RESUMO

OBJECTIVE: The aim of this study was to investigate the protective effect of magnesium sulfate (MgSO4) on the cranial nerves of preeclampsia (PE) rats through the nuclear factor-κB (NF-κB)/intercellular adhesion molecule-1 (ICAM-1) pathway. MATERIALS AND METHODS: A total of 30 pregnant rats were randomly divided into three groups, including control group, model group, and treatment group, with 10 rats in each group. Systolic blood pressure was measured at 13 d, 15 d, and 19 d. The apoptosis level in brain tissues was detected via Western blotting and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay. Protein expression of genes was detected using immunohistochemical staining. Moreover, the messenger ribonucleic acid (mRNA) expressions of NF-κB and ICAM-1 in brain tissues were determined through Reverse Transcription-Polymerase Chain Reaction (RT-PCR). RESULTS: Systolic blood pressure exhibited significant differences among the three groups at 15 d and 19 d of gestational age (p<0.05). At 15 d of gestational age, systolic blood pressure was significantly higher in model group than that of control group (p<0.05). However, it was slightly lower in treatment group than model group (p<0.05). At 19 d of gestational age, systolic blood pressure was significantly higher in model group than control group (p<0.05). However, it decreased remarkably in treatment group when compared with model group (p<0.05). In treatment group, systolic blood pressure at 19 d was significantly lower than that at 15 d (p<0.05). Subsequent Western blotting revealed that the protein expression of B-cell lymphoma-2 (Bcl-2) in brain tissues decreased evidently, whereas the expression of Bcl-2 associated X protein (Bax) increased significantly in model group compared with control group, showing statistically significant differences (p<0.01). The protein expression of Bcl-2 in brain tissues increased significantly, while the expression of Bax declined remarkably in treatment group compared with model group (p<0.01). The number of apoptotic cells in model group and treatment group increased significantly compared with that in control group, with the largest in model group (p<0.05). However, it remarkably declined in treatment group compared with model group (p<0.05). These results suggested that MgSO4 treatment could significantly reduce neuronal apoptosis in PE rats. According to the results of immunohistochemistry, the protein expressions of NF-κB and ICAM-1 in brain tissues were significantly higher in model group and treatment group than those in control group (p<0.05). However, they were significantly lower in treatment group than model group (p<0.05). RT-PCR results manifested that the mRNA expressions of NF-κB and ICAM-1 in brain tissues exhibited evident differences among the three groups (p<0.05). Model group and treatment group showed significantly up-regulated mRNA expressions of NF-κB and ICAM-1 in brain tissues compared with control group (p<0.05). The highest mRNA expression was observed in model group. However, treatment group exhibited remarkably decreased mRNA expressions of NF-κB and ICAM-1 in brain tissues compared with model group (p<0.05). CONCLUSIONS: MgSO4 exerts a protective effect on cranial nerves of PE rats by inhibiting the NF-κB/ICAM-1 signaling pathway.


Assuntos
Nervos Cranianos/efeitos dos fármacos , Molécula 1 de Adesão Intercelular/metabolismo , NF-kappa B/metabolismo , Animais , Pressão Sanguínea/efeitos dos fármacos , Nervos Cranianos/metabolismo , Modelos Animais de Doenças , Feminino , Sulfato de Magnésio/farmacologia , Pré-Eclâmpsia , Gravidez , Substâncias Protetoras , RNA Mensageiro/metabolismo , Ratos , Ratos Sprague-Dawley
5.
Br J Pharmacol ; 170(2): 328-40, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23763311

RESUMO

BACKGROUND AND PURPOSE: Genistein is an isoflavone phytoestrogen found in a number of plants such as soybeans and there is accumulating evidence that it has beneficial effects on the regulation of glucose homeostasis. In this study we evaluated the effect of genistein on glucose homeostasis and its underlying mechanisms in normal and insulin-resistant conditions. EXPERIMENTAL APPROACH: To induce insulin resistance, mice or differentiated 3T3-L1 adipocytes were treated with macrophage-derived conditioned medium. A glucose tolerance test was used to investigate the effect of genistein. Insulin signalling activation, glucose transporter-4 (GLUT4) translocation and AMP-activated PK (AMPK) activation were detected by Western blot analysis or elisa. KEY RESULTS: Genistein impaired glucose tolerance and attenuated insulin sensitivity in normal mice by inhibiting the insulin-induced phosphorylation of insulin receptor substrate-1 (IRS1) at tyrosine residues, leading to inhibition of insulin-mediated GLUT4 translocation in adipocytes. Mac-CM, an inflammatory stimulus induced glucose intolerance accompanied by impaired insulin sensitivity; genistein reversed these changes by restoring the disturbed IRS1 function, leading to an improvement in GLUT4 translocation. In addition, genistein increased AMPK activity under both normal and inflammatory conditions; this was shown to contribute to the anti-inflammatory effect of genistein, which leads to an improvement in insulin signalling and the amelioration of insulin resistance. CONCLUSION AND IMPLICATIONS: Genistein showed opposite effects on insulin sensitivity under normal and inflammatory conditions in adipose tissue and this action was derived from its negative or positive regulation of IRS1 function. Its up-regulation of AMPK activity contributes to the inhibition of inflammation implicated in insulin resistance.


Assuntos
Tecido Adiposo/efeitos dos fármacos , Genisteína/farmacologia , Glucose/metabolismo , Insulina/metabolismo , Células 3T3-L1 , Proteínas Quinases Ativadas por AMP/efeitos dos fármacos , Proteínas Quinases Ativadas por AMP/metabolismo , Adipócitos/efeitos dos fármacos , Adipócitos/metabolismo , Tecido Adiposo/metabolismo , Tecido Adiposo/patologia , Animais , Anti-Inflamatórios/farmacologia , Teste de Tolerância a Glucose , Transportador de Glucose Tipo 4/efeitos dos fármacos , Transportador de Glucose Tipo 4/metabolismo , Homeostase/efeitos dos fármacos , Inflamação/tratamento farmacológico , Inflamação/fisiopatologia , Resistência à Insulina , Masculino , Camundongos , Camundongos Endogâmicos ICR , Fosforilação/efeitos dos fármacos , Fitoestrógenos/farmacologia , Regulação para Cima/efeitos dos fármacos
6.
Nutr Metab Cardiovasc Dis ; 23(10): 973-9, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23010609

RESUMO

BACKGROUND AND AIMS: Low high-density lipoprotein cholesterol (HDL-c) is a risk factor for cardiovascular disease. Brachial-ankle pulse wave velocity (baPWV) is an indicator of arterial stiffness, which is recognized as a predictor of cardiovascular disease. The aim of this study was to investigate the association between HDL-c and baPWV among middle-aged and elderly Chinese. METHODS: A total number of 1133 Chinese (430 men, 703 women) aged from 50 to 90 years old were recruited from Shanghai downtown district. The baPWV and major cardiovascular risk factors of the participants were measured. RESULTS: Serum HDL-c was negatively correlated with baPWV (r = -0.143, P < 0.001) after adjustment for age and gender. Multivariate linear regression analysis demonstrated that age (P < 0.001), systolic blood pressure (P < 0.001), HDL-c (P < 0.001), smoking (P = 0.001), BMI (P = 0.002), fasting plasma glucose (P = 0.004), and white blood cell (P = 0.005) were independently associated with baPWV. After multiple adjustments, participants in the highest quartile of HDL-c had an odds ratio of 0.442 (95% CI 0.268-0.729) for developing high arterial stiffness compared with participants in the lowest quartile. The association remained significant after further adjustment for major cardiovascular risk factors. CONCLUSION: HDL-c has an independent protective effect on arterial stiffness in middle-aged and elderly Chinese. Early detection of HDL-c level is important in high risk populations with arterial stiffness. Increasing HDL-c level may be an attractive therapeutic target for the prevention of arterial function and subsequent disease.


Assuntos
Envelhecimento , Vasos Sanguíneos/fisiopatologia , Doenças Cardiovasculares/fisiopatologia , HDL-Colesterol/sangue , Rigidez Vascular , Idoso , Idoso de 80 Anos ou mais , Índice Tornozelo-Braço , Povo Asiático , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , China/epidemiologia , Estudos de Coortes , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso , Fatores de Risco , Saúde da População Urbana
7.
Rheumatology (Oxford) ; 41(9): 1008-16, 2002 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12209034

RESUMO

OBJECTIVE: To compare the efficacy of the COX-2 specific inhibitor valdecoxib with the conventional NSAID naproxen and placebo in treating rheumatoid arthritis (RA). METHODS: This multi-centre, randomized, double-blind, placebo-controlled trial compared the efficacy and safety of valdecoxib 10 mg (n=209), 20 mg (n=212) or 40 mg once daily (q.d.) (n=221) with naproxen 500 mg b.i.d. (n=226) or placebo (n=222), in treating the signs and symptoms of RA. Efficacy was assessed by the number of patients responding to treatment according to the American College of Rheumatology-Responder Index (ACR-20). RESULTS: ACR-20 response was recorded for all randomized patients who received a single dose of study medication (above). Valdecoxib, at all administered doses, produced significant improvements in the ACR-20 Responder Index at weeks 2, 6 and 12 compared with placebo (P

Assuntos
Artrite Reumatoide/tratamento farmacológico , Inibidores de Ciclo-Oxigenase/uso terapêutico , Isoxazóis/uso terapêutico , Naproxeno/uso terapêutico , Sulfonamidas/uso terapêutico , Administração Oral , Artrite Reumatoide/fisiopatologia , Avaliação da Deficiência , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Nível de Saúde , Humanos , Isoxazóis/administração & dosagem , Articulações/efeitos dos fármacos , Articulações/fisiopatologia , Masculino , Pessoa de Meia-Idade , Naproxeno/administração & dosagem , Medição da Dor/efeitos dos fármacos , Autoexame , Índice de Gravidade de Doença , Sulfonamidas/administração & dosagem , Resultado do Tratamento
8.
Am J Gastroenterol ; 96(4): 1019-27, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11316141

RESUMO

OBJECTIVE: Nonsteroidal anti-inflammatory drugs (NSAIDs) block prostaglandin production by inhibiting cyclooxygenase (COX); they are believed to cause gastroduodenal damage by inhibiting the COX-1 isoform and to have analgesic and anti-inflammatory effects by inhibiting the COX-2 isoform. As compared to conventional NSAIDs, celecoxib, a COX-2 specific inhibitor, has been shown in previous single posttreatment endoscopy studies to be associated with lower gastroduodenal ulcer rates. In response to concerns that such studies may under-represent ulceration rates, the present serial endoscopy study was designed to compare cumulative gastroduodenal ulcer rates associated with the use of celecoxib to those of naproxen, a conventional NSAID. METHODS: In this double-blind, parallel-group, multicenter study, 537 patients with osteoarthritis (OA) or rheumatoid arthritis (RA) were randomized to treatment with celecoxib 200 mg b.i.d. (n = 270) or naproxen 500 mg b.i.d. (n = 267) for 12 wk. Gastroduodenal damage was determined from esophagogastroduodenoscopy after 4, 8, and 12 wk of therapy. Arthritis efficacy was evaluated with Patient's and Physician's Global Assessments. RESULTS: Gastroduodenal ulcer rates after celecoxib and naproxen treatment were 4% versus 19% in the 0-4 wk interval (p < 0.001), 2% versus 14% in the 4-8 wk interval (p < 0.001), and 2% versus 10% in the 8-12 wk interval (p < 0.001), respectively. After 12 wk of treatment, the cumulative incidence of gastroduodenal ulcers was 9% with celecoxib and 41% with naproxen. In the celecoxib group, gastroduodenal ulcers were significantly associated with Helicobacter pylori status (p < 0.05), concurrent aspirin usage (p = 0.001), and a history of ulcer (p = 0.010), but not with disease type (OA/RA), age, gender, other relevant medical histories, or concurrent corticosteroid or disease-modifying antirheumatic drugs usage (p > 0.05). Celecoxib produced a significantly lower incidence rate of both gastric (p < 0.001) and duodenal (p < 0.030) ulcers. The two agents produced similar improvements in Patient's and Physician's Global Assessments of arthritis efficacy. The incidence of adverse events and withdrawal rates did not differ significantly between treatments. CONCLUSIONS: As compared to naproxen (500 mg b.i.d.), use of celecoxib (200 mg b.i.d.), a COX-2 specific agent, at the recommended RA dose and twice the most frequently prescribed OA dose, was associated with lower rates of gastric, duodenal, and gastroduodenal ulcers but had comparable efficacy, in patients with OA and RA.


Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Artrite/tratamento farmacológico , Inibidores de Ciclo-Oxigenase/efeitos adversos , Naproxeno/efeitos adversos , Úlcera Péptica/epidemiologia , Sulfonamidas/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Celecoxib , Método Duplo-Cego , Endoscopia Gastrointestinal , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Pirazóis , Fatores de Risco
9.
JAMA ; 284(10): 1247-55, 2000 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-10979111

RESUMO

CONTEXT: Conventional nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with a spectrum of toxic effects, notably gastrointestinal (GI) effects, because of inhibition of cyclooxygenase (COX)-1. Whether COX-2-specific inhibitors are associated with fewer clinical GI toxic effects is unknown. OBJECTIVE: To determine whether celecoxib, a COX-2-specific inhibitor, is associated with a lower incidence of significant upper GI toxic effects and other adverse effects compared with conventional NSAIDs. DESIGN: The Celecoxib Long-term Arthritis Safety Study (CLASS), a double-blind, randomized controlled trial conducted from September 1998 to March 2000. SETTING: Three hundred eighty-six clinical sites in the United States and Canada. PARTICIPANTS: A total of 8059 patients (>/=18 years old) with osteoarthritis (OA) or rheumatoid arthritis (RA) were enrolled in the study, and 7968 received at least 1 dose of study drug. A total of 4573 patients (57%) received treatment for 6 months. INTERVENTIONS: Patients were randomly assigned to receive celecoxib, 400 mg twice per day (2 and 4 times the maximum RA and OA dosages, respectively; n = 3987); ibuprofen, 800 mg 3 times per day (n = 1985); or diclofenac, 75 mg twice per day (n = 1996). Aspirin use for cardiovascular prophylaxis (

Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Inibidores de Ciclo-Oxigenase/efeitos adversos , Gastroenteropatias/induzido quimicamente , Isoenzimas/antagonistas & inibidores , Isoenzimas/farmacologia , Prostaglandina-Endoperóxido Sintases/farmacologia , Sulfonamidas/efeitos adversos , Idoso , Análise de Variância , Artrite Reumatoide/tratamento farmacológico , Aspirina/efeitos adversos , Celecoxib , Ciclo-Oxigenase 1 , Ciclo-Oxigenase 2 , Inibidores de Ciclo-Oxigenase 2 , Diclofenaco/efeitos adversos , Método Duplo-Cego , Feminino , Humanos , Ibuprofeno/efeitos adversos , Masculino , Proteínas de Membrana , Pessoa de Meia-Idade , Osteoartrite/tratamento farmacológico , Úlcera Péptica/induzido quimicamente , Modelos de Riscos Proporcionais , Estudos Prospectivos , Pirazóis
10.
Arthritis Care Res ; 13(2): 112-21, 2000 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-14635284

RESUMO

OBJECTIVE: To study the functional status and health-related quality of life (HRQOL) of patients with rheumatoid arthritis (RA) after treatment with celecoxib, compared with placebo and naproxen. METHODS: This was a prospective, randomized, double-blind, parallel group trial conducted at 79 sites in the United States and Canada over a 12-week treatment period. Patients were randomly assigned to 5 groups: placebo, 100 mg twice a day of celecoxib, 200 mg twice a day of celecoxib, 400 mg twice a day of celecoxib, and 500 mg twice a day of naproxen. The Health Assessment Questionnaire (HAQ) disability index was used to measure functional status. The Medical Outcomes Study Short Form 36 (SF-36) was used to measure general HRQOL. RESULTS: Enrollees were 1,149 patients with diagnosed and active RA. At the end of the treatment period, patients in the 4 active treatment groups had significant improvement in both functional status and overall HRQOL in comparison with the placebo group. Patients in the twice-daily 100 mg celecoxib group significantly differed from placebo at weeks 2 and 6 on HAQ scores and at week 12 on 5 domains and both summary scores of the SF-36. Patients treated with twice-daily 200 mg celecoxib had significantly better functional status than placebo at all times of testing with the HAQ, and also had significantly better function than those treated with naproxen after 2 and 12 weeks of treatment. Patients in the twice-daily 200 mg and 400 mg celecoxib groups showed similar improvement in HRQOL as determined by the 8 domain scores and 2 summary scores of the SF-36. CONCLUSION: Celecoxib was better than placebo and comparable with naproxen in improving functional status and overall HRQOL among RA patients.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/psicologia , Inibidores de Ciclo-Oxigenase/uso terapêutico , Qualidade de Vida , Sulfonamidas/uso terapêutico , Atividades Cotidianas , Adulto , Idoso , Idoso de 80 Anos ou mais , Canadá , Celecoxib , Método Duplo-Cego , Esquema de Medicação , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Naproxeno/uso terapêutico , Estudos Prospectivos , Pirazóis , Inquéritos e Questionários , Resultado do Tratamento , Estados Unidos
11.
JAMA ; 282(20): 1921-8, 1999 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-10580457

RESUMO

CONTEXT: In vitro studies have shown that celecoxib inhibits cyclooxygenase 2 (COX-2) but not COX-1, suggesting that this drug may have anti-inflammatory and analgesic activity without adverse upper gastrointestinal (GI) tract effects that result from COX-1 inhibition. OBJECTIVE: To test whether celecoxib has efficacy as an anti-inflammatory and analgesic with reduced GI tract mucosal damage compared with conventional nonsteroidal anti-inflammatory drugs in patients with rheumatoid arthritis. DESIGN: Randomized, multicenter, placebo-controlled, double-blind trial lasting 12 weeks, with follow-up at weeks 2, 6, and 12, from September 1996 thorugh February 1998. SETTING: Seventy-nine clinical sites in the United States and Canada. PATIENTS: A total of 1149 patients aged 18 years or older with symptomatic rheumatoid arthritis who met inclusion criteria were randomized; 688 (60%) of these completed the study. INTERVENTIONS: Patients were randomized to receive celecoxib, 100 mg, 200 mg, or 400 mg twice per day (n = 240, 235, and 218, respectively); naproxen, 500 mg twice per day (n = 225); or placebo (n = 231). MAIN OUTCOME MEASURES: Improvement in signs and symptoms of rheumatoid arthritis as assessed using standard measures of efficacy and GI tract safety as assessed by upper GI tract endoscopy before and after treatment, compared among treatment groups. RESULTS: All dosages of celecoxib and naproxen significantly improved the signs and symptoms of arthritis compared with placebo. Maximal anti-inflammatory and analgesic activity was evident within 2 weeks of initiating treatment and was sustained throughout the 12 weeks. The incidence of endoscopically determined gastroduodenal ulcers in placebo-treated patients was 4 (4%) of 99, and the incidences across all dosages of celecoxib were not significantly different (P>.40): 9 (6%) of 148 with 100 mg twice per day, 6 (4%) of 145 with 200 mg twice per day, and 8 (6%) of 130 with 400 mg twice per day. In contrast, the incidence with naproxen was 36 (26%) of 137, significantly greater than either placebo or celecoxib (P<.001). The overall incidences of GI tract adverse effects were 19% for placebo; 28%, 25%, and 26% for celecoxib 100 mg, 200 mg, and 400 mg twice per day, respectively; and 31 % for naproxen. CONCLUSION: In this study, all dosages of celecoxib were efficacious in the treatment of rheumatoid arthritis and did not affect COX-1 activity in the GI tract mucosa as evidenced by less frequent incidence of endoscopic ulcers compared with naproxen.


Assuntos
Analgésicos não Narcóticos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Inibidores de Ciclo-Oxigenase/uso terapêutico , Úlcera Péptica/induzido quimicamente , Sulfonamidas/uso terapêutico , Adulto , Idoso , Analgésicos não Narcóticos/efeitos adversos , Análise de Variância , Anti-Inflamatórios não Esteroides/efeitos adversos , Celecoxib , Ciclo-Oxigenase 1 , Ciclo-Oxigenase 2 , Inibidores de Ciclo-Oxigenase 2 , Inibidores de Ciclo-Oxigenase/efeitos adversos , Método Duplo-Cego , Duodeno , Endoscopia Gastrointestinal , Feminino , Mucosa Gástrica/efeitos dos fármacos , Humanos , Mucosa Intestinal/efeitos dos fármacos , Isoenzimas , Masculino , Proteínas de Membrana , Pessoa de Meia-Idade , Naproxeno/efeitos adversos , Naproxeno/uso terapêutico , Úlcera Péptica/diagnóstico , Estudos Prospectivos , Prostaglandina-Endoperóxido Sintases , Pirazóis , Sulfonamidas/efeitos adversos
12.
Pharmacotherapy ; 19(11): 1269-78, 1999 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-10555933

RESUMO

STUDY OBJECTIVE: To evaluate the functional status of patients with signs and symptoms of osteoarthritis of the knee after treatment with celecoxib compared with placebo and naproxen. DESIGN: Prospective, randomized, double-blind, parallel-group, 12-week trial. SETTING: Multicenter study conducted at 71 sites in the United States and Canada. PATIENTS: One thousand four patients with active osteoarthritis of the knee in a flare state. INTERVENTIONS: Patients were assigned randomly to one of five treatment groups: placebo; celecoxib 50 mg twice/day, 100 mg twice/day, and 200 mg twice/day; and naproxen 500 mg twice/day. MEASUREMENTS AND MAIN RESULTS: The Western Ontario and McMaster Universities Osteoarthritis Index was used to measure functional status. At the end of the treatment period, patients in the four active treatment groups had significantly better functional status than those receiving placebo. Patients treated with celecoxib 100 mg twice/day had significantly better improvements in pain scores than those treated with placebo and naproxen. CONCLUSION: Celecoxib was better than placebo and comparable with naproxen in improving aspects of functional status in patients with osteoarthritis.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Osteoartrite/tratamento farmacológico , Qualidade de Vida , Sulfonamidas/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Celecoxib , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/fisiopatologia , Osteoartrite/psicologia , Estudos Prospectivos , Pirazóis , Sulfonamidas/efeitos adversos
13.
Mayo Clin Proc ; 74(11): 1095-105, 1999 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-10560596

RESUMO

OBJECTIVE: To compare the efficacy and safety of celecoxib, a cyclooxygenase-2 (COX-2) inhibitor, with those of naproxen, a nonsteroidal anti-inflammatory drug (NSAID), and placebo in the treatment of osteoarthritis of the knee. METHODS: In this multicenter, randomized, double-blind, placebo-controlled trial, 1003 patients with symptomatic osteoarthritis of the knee were randomly assigned to receive celecoxib at doses of 50, 100, or 200 mg twice a day; naproxen, 500 mg twice a day; or placebo for 12 weeks. Patients were evaluated with standard measures of efficacy 2 to 7 days after discontinuing previous NSAID or analgesic therapy and after 2, 6, and 12 weeks of treatment with the study drug. RESULTS: Celecoxib treatment led to significant improvement in the signs and symptoms of osteoarthritis as determined by all efficacy measures. Significant pain relief occurred within 2 days of the initiation of treatment, and maximum anti-inflammatory and analgesic activity, evident within 2 weeks, was sustained throughout the 12-week study. All celecoxib doses were efficacious compared with placebo, although the 50-mg twice-daily dosage regimen was minimally effective. The higher doses of celecoxib (100 and 200 mg twice a day) were similarly efficacious, and the magnitude of improvement observed with these dosing regimens was comparable to that seen with naproxen at a dose of 500 mg twice a day. All doses of celecoxib and naproxen were well tolerated. CONCLUSION: COX-2 inhibition with celecoxib is an effective approach for the treatment of osteoarthritis, as seen by clinical improvement in signs and symptoms comparable to treatment with naproxen.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Inibidores de Ciclo-Oxigenase/uso terapêutico , Isoenzimas/efeitos dos fármacos , Osteoartrite/tratamento farmacológico , Prostaglandina-Endoperóxido Sintases/efeitos dos fármacos , Sulfonamidas/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios não Esteroides/administração & dosagem , Anti-Inflamatórios não Esteroides/efeitos adversos , Celecoxib , Ciclo-Oxigenase 2 , Inibidores de Ciclo-Oxigenase 2 , Inibidores de Ciclo-Oxigenase/administração & dosagem , Inibidores de Ciclo-Oxigenase/efeitos adversos , Método Duplo-Cego , Esquema de Medicação , Humanos , Incidência , Proteínas de Membrana , Pessoa de Meia-Idade , Naproxeno/uso terapêutico , Pirazóis , Sulfonamidas/administração & dosagem , Sulfonamidas/efeitos adversos , Resultado do Tratamento
14.
Brain Res Dev Brain Res ; 107(1): 49-55, 1998 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-9602055

RESUMO

To investigate the effect of a delay in ovulation on postnatal growth and development in resultant rat offspring, a 1-day ovulatory delay was induced by sodium pentobarbital, animals mated, and the offspring monitored. There were no differences between control and 1-day delayed offspring in the number of live or dead births, number of males or females, nor in the ratio of sexes. Delayed pups had a slightly lower birth weight, but then recovered to weigh more than controls by day 12. In the first two weeks post-parturition, delayed pups displayed an earlier ability to reorient themselves in a negative geotaxis test, but no differences by the righting reflex and reflex suspension tests. At postnatal day (pnd) 28, delayed pups exhibited decreased activity in a continuous corridor test, but no alterations in gait. At this time, the brains of delayed animals revealed thickening of cortical layers V plus VI. There were significant correlations between various developmental endpoints (body weight, negative geotaxis, continuous corridor activity, and gait) and the cortical layer thicknesses. The results indicate that ovulatory delay produces changes in brain cortical thickness, with correlative changes in growth and behavior. Although the mechanisms by which ovulatory delay alters postnatal development and brain structure are unknown, ovulatory delay may alter the uterine environment during early pregnancy.


Assuntos
Animais Recém-Nascidos/crescimento & desenvolvimento , Animais Recém-Nascidos/psicologia , Comportamento Animal/fisiologia , Encéfalo/anatomia & histologia , Ovulação/fisiologia , Animais , Animais Recém-Nascidos/anatomia & histologia , Encéfalo/crescimento & desenvolvimento , Córtex Cerebral/anatomia & histologia , Feminino , Marcha/fisiologia , Masculino , Ratos , Ratos Sprague-Dawley , Análise de Regressão , Fatores de Tempo , Aumento de Peso/fisiologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-7846106

RESUMO

The effects of exogenous prostaglandin E2 (PGE2) and endogenous prostanoids on cholinergic neurotransmission were determined by measurement of acetylcholine (ACh) release from canine and equine airway tissues. Trachealis strips and bronchial segments were suspended in 2 ml tissue baths. ACh release was induced by electrical field stimulation (EFS), and its content in tissue bath liquid was measured by high pressure liquid chromatography (HPLC) with electrochemical detection. In canine airways, exogenous PGE2 (10(-9) to 10(-7) M) inhibited ACh release concentration-dependently, whereas inhibition of endogenous prostanoid production by indomethacin (3 x 10(-6) M) augmented ACh release. By contrast, in equine airways, exogenous PGE2 had no effect on ACh release in bronchi but at 10(-7) M augmented ACh release in the trachea. Cyclooxygenase inhibition by either indomethacin or meclofenamate (10(-6) M) did not influence ACh release. We conclude that exogenous PGE2 and endogenous prostanoids inhibit ACh release from cholinergic nerves in canine but not equine airways.


Assuntos
Acetilcolina/metabolismo , Brônquios/inervação , Dinoprostona/farmacologia , Traqueia/inervação , Animais , Brônquios/metabolismo , Cromatografia Líquida de Alta Pressão , Inibidores de Ciclo-Oxigenase/farmacologia , Cães , Estimulação Elétrica , Feminino , Cavalos , Indometacina/farmacologia , Masculino , Ácido Meclofenâmico/farmacologia , Especificidade da Espécie , Traqueia/metabolismo
16.
Sheng Li Xue Bao ; 44(2): 127-32, 1992 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-1621105

RESUMO

In order to study the effect of central noradrenergic system on the regulation of mean arterial pressure (MAP) by intracarotid sinus pressure (ISP), ISP-MAP relationship curves were constructed using isolated carotid sinus under the condition of injection of 6-OHDA (200 micrograms) into lateral ventricle or cauterization of locus coeruleus (LC) and compared with that obtained under the condition of control. All ISP-MAP curves can be fitted by a logistic functional plot whose characteristics can be defined by two parameters, i.e. coordinates of the inversion point of the slope of the curve and the MAP range related to the rate of change of slope factor with which carotid sinus pressure exerts its control. The results were as follows: After injection of 6-OHDA, the rate of change of the slope of the ISP-MAP curve is considerably slower than that of the normal control, thus showing a much compressed range of MAP by ISP, while the abscissa (i.e. position of ISP) of the slope inversion point of the curve shows practically no change. In comparison with the control, cauterization of LC causes a similar but less striking change of ISP-MAP curve than that of 6-OHDA injection experiment. All such differences were illustrated in Fig. 3. The above results indicated that the central noradrenergic system facilitates carotid sinus reflex and LC plays a dominant role.


Assuntos
Fibras Adrenérgicas/fisiologia , Seio Carotídeo/fisiologia , Locus Cerúleo/fisiologia , Oxidopamina/farmacologia , Animais , Feminino , Injeções Intraventriculares , Masculino , Microinjeções , Norepinefrina/fisiologia , Ratos , Ratos Endogâmicos , Reflexo
17.
Biochemistry ; 31(5): 1331-9, 1992 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-1310609

RESUMO

This work broadens the scope and improves the time resolution of spin-probe oximetry, a technique in which small nitroxide spin probes detect oxygen consumption via change in their relaxation properties [Froncisz, W., Lai, C.-S., & Hyde, J. S. (1985) Proc. Natl. Acad. Sci. U.S.A. 82, 411-415]. For rapid oxygen kinetic studies we combined the methodology of spin-probe oximetry with a recently developed loop-gap resonator, stopped-flow EPR system [Hubbell, W. L., Froncisz, W., & Hyde, J. S. (1987) Rev. Sci. Instrum. 58, 1879-1886]. The technique used microliter volumes of reactant solutions. Enzymatic consumption of oxygen by cytochrome c oxidase in the presence of ferrocytochrome c substrate was followed continuously in time under limited-turnover conditions, where the concentration of oxygen consumed often was comparable to or less than the amount of enzyme present. In detecting less than micromolar oxygen concentration changes, we have achieved a time resolution of the order 30 ms when flow is stopped. Oxygen consumption was followed under two different limited-turnover conditions: In the first, the amount of oxygen consumed was limited by available ferrocytochrome c, and the time course of oxygen consumption and its pH dependence were compared with the optically detected ferrocytochrome c consumption. In the second, the oxygen consumed was ultimately limited by the availability of oxygen itself while ferrocytochrome c was regenerated and remained in excess.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Espectroscopia de Ressonância de Spin Eletrônica , Complexo IV da Cadeia de Transporte de Elétrons/química , Consumo de Oxigênio , Animais , Bovinos , Óxidos N-Cíclicos , Grupo dos Citocromos c/química , Espectroscopia de Ressonância de Spin Eletrônica/métodos , Cinética , Oximetria , Marcadores de Spin
18.
Chin J Biotechnol ; 7(2): 121-6, 1991.
Artigo em Inglês | MEDLINE | ID: mdl-1806022

RESUMO

Tumor necrosis factor (TNF alpha) plays an important role in cytotoxicity and inhibition of tumor cells. Further studies on the structure, function and clinical application of TNF alpha will be useful. Nine clones of hybridoma secreting monoclonal antibodies against recombinant human tumor necrosis factor alpha (rHTNF alpha) were obtained by using cell fusion technology. None of the monoclonal antibodies cross-reacted with rIL-1, rIL-2, rIFN gamma, rIFN alpha and E. coli lysates. Western blot demonstrated that they specifically recognized the rHTNF antigen of M. W. 17000 daltons. Some of the antibodies can also recognize native rHTNF. These antibodies neutralized the cytotoxicity of rHTNF alpha to different extents. They will be utilized as immunoaffinity column to purify rHTNF alpha from recombinant E. coli lysates.


Assuntos
Anticorpos Monoclonais/imunologia , Fator de Necrose Tumoral alfa/imunologia , Animais , Anticorpos Monoclonais/biossíntese , Especificidade de Anticorpos , Cromatografia de Afinidade , Clonagem Molecular , Eletroforese em Gel de Poliacrilamida , Escherichia coli/genética , Humanos , Hibridomas , Camundongos , Camundongos Endogâmicos BALB C , Testes de Neutralização , Proteínas Recombinantes/imunologia
19.
Zhongguo Yao Li Xue Bao ; 10(4): 332-5, 1989 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-2624118

RESUMO

The effect of high frequency stimulation on rate-dependent depression of depolarization of action potentials was studied with computer and standard microelectrode techniques in guinea pig papillary muscles. After increasing driving frequency from 0.5 to 6 Hz, decreases in Vmax, APA and OS were found. Changes of upstroke velocity during phase 0 between driving frequency 6 and 0.5 Hz could be described as a parabola. The rate-dependent depression of depolarization was exaggerated by tetrodotoxin (TTX), particularly during the accelerating period of phase 0. A progressive decline in Vmax, which could be fitted by a power function curve, was observed after changing driving frequency from 1 to 5 Hz. TTX significantly influenced the decline in Vmax and the regression coefficients in fitted equations.


Assuntos
Músculos Papilares/fisiologia , Potenciais de Ação/efeitos dos fármacos , Animais , Estimulação Elétrica , Feminino , Cobaias , Masculino , Microeletrodos , Tetrodotoxina/farmacologia
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