974 resultados para TRATAMENTOS FARMACOLÓGICOS
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Tese de mestrado, Biologia Molecular e Genética, Universidade de Lisboa, Faculdade de Ciências, 2015
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Resumen Introducción Una posible opción de tratamiento para el manejo del trastorno depresivo mayor (TDM) es la estimulación magnética transcraneal (EMT) que ha mostrado propiedades antidepresivas superiores al placebo con un buen perfil de seguridad. El objetivo del presente trabajo es determinar la reducción en la severidad del TDM y la proporción de eventos adversos (EA) en pacientes con TDM refractario y no refractario, posterior al uso de EMT administrada en monoterapia o tratamiento coadyuvante comparado con terapia farmacológica. Metodología Se planteó una pregunta PICOT de la cual se realizó una búsqueda sistemática de estudios clínicos en las bases de datos Medline, EMBASE y Cochrane. Dos investigadores en forma independiente realizaron la selección de artículos, evaluación de calidad con la herramienta de la colaboración Cochrane y extracción de datos. Se extrajeron datos de eficacia como tasa de respuesta, porcentaje de remisión, calidad de vida, diminución sintomática del trastorno depresivo mayor en la escala de Hamilton y capacidad funcional. Igualmente, proporción de pacientes con EA. Se realizó un meta-análisis de estas variables teniendo en cuenta la heterogeneidad. Resultados La presente revisión sistemática incluyó 26 estudios clínicos aleatorizados de baja calidad metodológica mostrando que la EMT presentó una eficacia superior cuando es usada como coadyuvante a las terapias con que venían siendo tratados los pacientes con TDM refractario y no refractario en los desenlaces de tasa de respuesta y porcentaje de remisión. En el caso de intervenciones farmacológicas específicas, la EMT presento eficacia similar, tanto en terapia coadyuvante como en monoterapia comparado con las intervenciones farmacológicas. En cuanto a seguridad, la EMT presenta un buen perfil de seguridad debido a que en todos los escenarios estudiados los EA fueron no serios y baja frecuencia Conclusiones La evidencia disponible sugiere que la EMT mostró ser efectivo y seguro para el manejo del TDM refractario y no refractario. Sin embargo, la evidencia es débil por lo tanto se necesita mayor investigación clínica que soporte su uso.
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RESUMO: O trabalho realiza uma revisão de literatura sobre tratamentos breves fundamentados na psicanálise lacaniana. Para atingir esta finalidade, a pesquisa parte de um corpus constituído por publicações electrónicas de livre acesso de membros das Escolas de Psicanálise filiadas à Associação Mundial de Psicanálise. Considerando o período de 2000 a 2009, identificou-se que os periódicos latino-americanos contribuíram com 96 (83,47%) trabalhos sobre o tema investigado, em um total de 115 documentos seleccionados. A literatura consultada indica que os tratamentos breves são possibilitados pela construção de um dispositivo específico, no qual são estabelecidos parâmetros como gratuidade e tempo limitado de atendimento. Verificou-se, contudo, o predomínio de intervenções individuais voltadas, principalmente, à clientela formada por adultos de grandes centros urbanos. ABSTRACT: The paper outlines the profile of the scientific production about brief treatments based on the Lacanian Psychoanalysis. In order to accomplish this, the research focuses on online journals with free full-text articles written by members of Lacanian Schools listed on the website of the World Psychoanalysis Association. The work analyses studies from 2000 to 2009. In a total of 115 selected documents, the research has identified that online journals from Latin America contributed with 96 (83,47%) works. The literature review indicates that brief treatments are made possible by a construction of a specific mechanism, in which parameters of gratuity and limited time of care are established. However, a key conclusion from this review is that individual interventions with adults from big cities are still predominant
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O presente estudo teve por objetivo avaliar se a aplicação tópica de flúor fosfato acidulado (FFA) em alta concentração tem efeito adicional no controle de lesões de esmalte, comparado ao uso de dentifrício fluoretado (baixa concentração). A freqüência de FFA como auxiliar no tratamento de lesões de cárie e a deposição de flúor no esmalte após diferentes aplicações de flúor am alta e baixa concentração também foram avaliadas. Para tanto, 5 indivíduos utilizaram, por 42 dias, próteses parciais removíveis inferiores contendo blocos de esmalte bovino desmineralizados. Os espécimes de esmalte forma divididos em 5 grupos: (1) escovação 3 vezes ao dia com dentifrício fluoretado (DF) (1100 ppm F), (2) DF+1 aplicação tópica FFA (12300 ppm F), (3) DF+2 FFA, (4) DF+3 FFA, e 5) DF+4 FFA. O intervalo entre as aplicações foi de uma semana. Cinco blocos hígidos e 5 blocos desmineralizados foram utilizados como controle e não foram submetidos ao período intraoral. As alterações clínicas foram registradas com relação à textura, coloração e brilho superficiais. Análises de microdureza superficial (MS) e em cortes longitudinais (MCL), de rugosidade superficial (RS) e de conteúdo de flúor depositado no esmalte foram realizadas. Modificações clínicas semelhantes de coloração foram observadas em todos os grupos após formação da lesão in vitro, apesar da ausência de mudanças na textura e brilho superficiais. Após escovação e tratamento com flúor, todos os blocos desmineralizados (esbranquiçados), independentemente do tratamento, tornaram-se mais amarelados. Não foram detectadas mudanças na textura e brilho superficiais. Os valores de MS e de conteúdo de flúor aumentaram (p<0,05) em relação aos blocos demineralizados somente a partir de 2 FFA. Os valores de MCL não mostraram diferenças entre os blocos tratados e os desmineralizados em qualquer distância da superfície do esmalte. Os grupos DF+3 FFA e DF+ 4 FFA foram os únicos capazes de aumentar os valores de MS em relação aos blocos desmineralizados. Estes tratamentos levaram a um aumento significativo de flúor solúvel e insolúvel comparado aos espécimes hígidos e desmineralizados. Ainda que todas as lesões tenham sido controladas clinicamente e não mostrem diferenças de microdureza, parece que aquelas tratadas com maior número de FFA produziram um maior reservatório de flúor disponível para inibir novos processos de desmineralização.
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Introdução: Poucos estudos sobre a farmacogenética do Transtorno de Déficit de Atenção/Hiperatividade (TDAH) foram conduzidos até o momento, apesar da extensa literatura sobre a participação de genes na etiologia do TDAH. Os estudos farmacogenéticos podem auxiliar na identificação a priori dos indivíduos que se beneficiarão de determinados tratamentos e dos que possivelmente apresentarão intolerância aos agentes farmacológicos. A maior parte dos estudos, até o momento, avaliou genes do sistema dopaminérgico e resultou em achados tanto positivos quanto negativos. Métodos: em um estudo naturalístico avaliamos os efeitos dos polimorfismos dos genes candidatos dopaminérgicos (DRD4, DAT1) e serotoninérgicos (HTR1B, HTR2A e 5-HTT) na resposta ao tratamento em 111 pacientes para os quais foi prescrito metilfenidato. As medidas de desfecho (Swanson, Nolan, and Pelham scale - versão IV – anexo I, Children Global Assessment Scale – anexo II, Barkley’s Stimulants Side Effects Rating Scale – anexo III) foram aplicadas no momento de avaliação e um mês após a intervenção. Resultados: Participaram do estudo 111 famílias de crianças e adolescentes eurobrasileiros de ambos os sexos que apresentavam TDAH segundo o DSM-IV. Estes pacientes foram consecutivamente triados no Programa de Déficit de Atenção/Hiperatividade do Hospital de Clínicas de Porto Alegre entre janeiro de 2003 e maio de 2004. Não foi detectada associação significativa entre os polimorfismos dos genes dopaminérgicos e serotoninérgicos avaliados e a resposta ao metilfenidato ou presença de eventos adversos. Conclusão: Os achados deste estudo quanto aos genes dopaminérgicos são negativos, concordando com três outros estudos disponíveis na literatura. Este foi o primeiro estudo a avaliar o efeito dos genes serotoninérgicos isolados na resposta ao metilfenidato e na presença de eventos adversos. Não foi encontrada nenhuma associação significativa. Os resultados dos estudos existentes são de difícil comparação devido à grande variabilidade metodológica existente entre os estudos. Assim, ensaios controlados multicêntricos prospectivos com maiores tamanhos amostrais são necessários para desvendar o papel dos genes candidatos na resposta ao tratamento para o TDAH.
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The present study examines the chemical composition and their effects on free radicals, inflammation, angiogenesis, coagulation, VEGF effects and cellular proliferation of a polysaccharides from alga Sargassum vulgare. The sulfated polysaccharide was extracted from brown seaweed by proteolysis with enzymes maxataze. The presence of proteins and sugars were observed in crude polysaccharides. Fractionation of this crude extract was made with growing concentration of acetone (0.3-1.5 v) and produced four groups of polysaccharides. Anionic polysaccharides from brown seaweed Sargassum vulgare, SV1and PSV1 were fractionated (SV1) and purified (PSV1), and displayed with high total sugars and sulfate content and very low level of protein. This fucan SV1 contains low levels of protein and high carbohydrate and sulfate content. This polysaccharides prolonged activated partial thromboplastin time (aPTT) at 50 μg (>240 s). SV1 was found to have no effect on prothrombin time (PT), corresponding to the extrinsic pathway of coagulation. SV1 exhibits high antithrombotic action in vivo, with a concentration ten times higher than heparin. Polysaccharides from S. vulgare promoted direct inhibition enzymatic activity of thrombin and stimulated enzymatic activity of FXa. SV1 showed optimal inhibitory activity of thrombin (50.2±0.28%) at a concentration of 25 μg/mL. Its antioxidant action on scavenging radicals by DPPH was (22%), indicating the polymer has no cytotoxic action (hemolytic) on ABO and Rh blood types in different erythrocyte groups and displays strong anti-inflammatory action on all concentrations tested in the carrageenan-induced paw edema model, demonstrated by reduced edema and cellular infiltration. Angiogenesis is a dynamic process of proliferation and differentiation. It requires endothelial proliferation, migration, and tube formation. In this context, endothelial cells are a preferred target for several studies and therapies. The antiangiogenic efficacy of polysaccharides was examined in vivo in the chick chorioallantoic membrane (CAM) model by using fertilized eggs. Decreases in the density of the capillaries were assessed and scored. The results showed that SV1 and PSV1 have an inhibitory effect on angiogenesis. These results were also confirmed by inhibition tubulogenesis in rabbit aorta endothelial cell (RAEC) in matrigel. These compounds were assessed in Apoptosis assay (Annexin V - FITC / PI) and cell viability by MTT assay of RAEC. These polysaccharides do not affect the viability and do not have apoptotic or necrotic action. RAEC cell when incubated with SV1 and PSV1showed inhibition of VEGF secretion, observed when compounds were incubated at 25, 50 and 100 μg/μL. The VEGF secretion with the RAEC cell line for 24 h, was more effective for PSV1 at 50 μg/μL(71.4%) than SV1 100 μg/μL (75.9%). SV1 and PSV1 had an antiproliferative action (47%) against tumor cell line HeLa. Our results indicate that these sulfated polysaccharides have antiangiogenic and antitumoral actions
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Plasma diagnostics by Optical Emission Spectroscopy were performed for electrical discharge in three gas mixture respecting the combinations z N2 y Ar x H2, z N2 y Ar x O2 e z N2 y Ar x CH4, in which the indexes z and y systematically vary from 1 to 4 and x varies from 0 to 4, every one has dimension SCCM, resulting in 80 combinations. From the all obtained spectrums, the species CH (387,1 nm), N2+ (391,4 nm), Hβ (486,1 nm), Hα (656,3 nm), Ar (750,4 nm), O (777,4 nm) e O (842,6 nm) were analyzed because of their abundance and importance on the kinetic of reaction from the plasma to surface, besides their high dependences on the gases flows. Particularly interesting z, y and x combinations were chosen in order to study the influence of active species on the surface modification during the thermochemical treatment. From the mixtures N2 Ar O2 e N2 Ar CH4 were chosen three peculiar proportions which presented luminous intensity profile with unexpected maximum or minimum values, denominated as plasma anomaly. Those plasma concentrations were utilized as atmosphere of titanium treatment maintaining constant the control parameters pressure and temperature. It has been verified a relation among luminous intensity associated to N2+ and roughness, nanohardness and O atoms diffusion into the crystalline lattice of treated titanium and it has been seen which those properties becomes more intense precisely in the higher points found in the optical profile associated to the N2+ specie. Those parameters were verified for the mixture which involved O2 gas. For the mixture which involves CH4 gas, the relation was determinate by roughness, number of nitrogen and carbon atoms diffused into the titanium structure which presented direct proportionality with the luminous intensity referent to the N2+ and CH. It has been yet studied the formation of TiCN phases on the surface which presented to be essentially directly proportional to the increasing of the CH specie and inversely proportional to the increasing of the specie N2+
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The use of raw materials from renewable sources for production of materials has been the subject of several studies and researches, because of its potential to substitute petrochemical-based materials. The addition of natural fibers to polymers represents an alternative in the partial or total replacement of glass fibers in composites. In this work, carnauba leaf fibers were used in the production of biodegradable composites with polyhydroxybutyrate (PHB) matrix. To improve the interfacial properties fiber / matrix were studied four chemical treatments to the fibers..The effect of the different chemical treatments on the morphological, physical, chemical and mechanical properties of the fibers and composites were investigated by scanning electron microscopy (SEM), infrared spectroscopy, X-ray diffraction, tensile and flexural tests, dynamic mechanical analysis (DMA), thermogravimetry (TGA) and diferential scanning calorimetry (DSC). The results of tensile tests indicated an increase in tensile strength of the composites after the chemical treatment of the fibers, with best results for the hydrogen peroxide treated fibers, even though the tensile strength of fibers was slightly reduced. This suggests a better interaction fiber/matrix which was also observed by SEM fractographs. The glass transition temperature (Tg) was reduced for all composites compared to the pure polymer which can be attributed to the absorption of solvents, moisture and other low molecular weight molecules by the fibers
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Studies indicate that a variation in the degree of crystallinity of the components of a polymer blend influences the mechanical properties. This variation can be obtained by subjecting the blend to heat treatments that lead to changes in the spherulitic structure. The aim of this work is to analyze the influence of different heat treatments on the variation of the degree of crystallinity and to establish a relationship between this variation and the mechanical behavior of poly(methyl methacrylate)/poly(ethylene terephthalate) recycled (PMMA / PETrec) with and without the use of compatibilizer agent poly(methyl methacrylate-al-glycidyl methacrylate-al-ethyl acrylate) (MMAGMA- EA). All compositions were subjected to two heat treatments. T1 heat treatment the samples were treated at 130 ° C for 30 minutes and cooled in air. In T2, the samples were treated at 230 ° C for 5 minutes and cooled to approximately -10 ° C. The variation of the degree of crystallinity was determined by the proportional relationship between crystallinity and density, with the density measured by pycnometry. The mechanical behavior was verified by tensile tests with and without the presence of notches and pre-cracks, and by method of fracture toughness in plane strain (KIC). We used the scanning electron microscopy (SEM) to analyze the fracture surface of the samples. The compositions subjected to heat treatment T1, in general, showed an increase in the degree of crystallinity in tensile strength and a tendency to decrease in toughness, while compositions undergoing treatment T2 showed that the opposite behavior. Therefore, this work showed that heat treatment can give a polymer blend further diversity of its properties, this being caused by changes in the crystal structure
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Malaria is a disease of global distribution, recognized by governments around the world as a serious public health problem, affecting more than 109 countries and territories and endangering more than 3.3 billion people. The economic costs of this disease are also relevant: the African continent itself has malaria-related costs of about $ 12 billion annually. Nowadays, in addition to chloroquine, Plasmodium falciparum is resistant to many drugs used in the treatment of malaria, such as amodiaquine, mefloquine, quinine and sulfadoxine-pyrimethamine; resistance of Plasmodium vivax to treatments, although less studied, is also reported. Nature, in general, is responsible for the production of most known organic substances, and the plant kingdom is responsible for the most of the chemical diversity known and reported in the literature. Most medicinal plants commercialized in Brazil, however, are of exotic origin, which makes the search for endemic medicinal plants, besides a patent necessity, a fascinating subject of academic research and development. This study aimed to: (i) verify the antimalarial activity of ethanolic and hydroalcoholic extracts of Boerhavia paniculata Rich. And acetonic extract of Clethra scabra Pers. in Swiss albino mice infected by Plasmodium berghei NK65, (ii) observe possible combined effects between the course of infection by P. berghei NK65 and administration of these extracts in Swiss albino mice, and (iii) conduct a preliminary study of the acute toxicity of these extracts in Swiss albino mice. All extracts notable pharmacological activities - with parasite infections inhibitions ranging from 22% to 54%.These characteristics suggest that the activities are relevant, although comparatively lower than the activity displayed by the positive control group (always above 90%). The general framework of survival analysis demonstrates an overall reduction in survival times for all groups. Necroscopy has not pointed no change in color, shape, size and/or consistency in the evaluated organs - the only exception was the livers of rats submitted to treatment to hydroalcoholic extracts: these organs have been presented in a slightly congestive aspect with mass increasing roughly 28% higher than the other two groups and a p-value of 0.0365. The 250 mg/Kg ethanolic group has been pointed out by the Dunn s post test, as the only class with simultaneous inequalities (p<0.05) between positive and negative control groups. The extracts, notably ethanol extract, have, in fact, a vestigial antimalarial activity, although well below from the ones perceived to chloroquine-treated groups; nevertheless, the survival times of the animals fed with the extracts do not rise by presence of such therapy. Both the toxicopharmacological studies of the synergism between the clinical course of malaria and administration of extracts and the isolated evaluation of toxicity allow us to affirm the absence of toxicity of the extracts at the level of CNS and ANS, as well as their non-influence on food and water consumption patterns, until dosages of 500 mg/Kg. Necroscopic analysis leads us to deduct a possible hepatotoxic effect of hydroalcoholic extract at dosages of 500 mg/Kg, and an innocuous tissue activity of the ethanol extract, in the same dosage. We propose a continuation of the studies of these extracts, with protocol modifications capable of addressing more clearly and objectively their pharmacological and toxicological aspects
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)