854 resultados para drug dose increase


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An experiment was conducted to examine the luteolytic effectiveness of using low or micro doses of PGF2α when administered at the BAI HUI acupuncture point, which is frequently used to treat ovarian disturbances in veterinary acupuncture. The results indicate that PGF2α given at a very low micro dose of 0.5 mg (one tenth the conventional recommended dose) administered at the BAI HUI acupuncture point located at the sacral lumbar space is equally effective at inducing luteolysis in mid-luteal phase mares as conventional PGF2α i.m. treatment using a tenfold higher dose. Therefore, based on the results of the present study, we suggest that the BAI HUI sacrai lumbar route somehow provides an extremely efficient pathway for the drug to the ovarian level.

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To re-evaluate the safety of hormonal contraceptives (HC) after uterine evacuation of complete hydatidiform mole (CHM). Historical database review. Charing Cross Hospital Gestational Trophoblastic Disease Centre, London, United Kingdom. Two thousand four hundred and twenty-three women with CHM of whom 154 commenced HC while their human chorionic gonadotropin (hCG) was still elevated, followed between 2003 and 2012. We compared time to hCG remission between HC users and nonusers. The relationship between HC use and gestational trophoblastic neoplasia (GTN) development was assessed. The relationship between HC use and a high International Federation of Gynecology and Obstetrics (FIGO) risk score was determined. Time to hCG remission, risk of developing postmolar GTN and proportion of women with high FIGO risk score. No relationship was observed between HC use with mean time to hCG remission (HC users versus non-users: 12 weeks in both, P = 0.19), GTN development (HC users versus non-users: 20.1 and 16.7%, P = 0.26) or high-risk FIGO score (HC users versus nonusers: 0% and 8%, P = 0.15). Moreover, no association between HC and GTN development was found, even when an age-adjusted model was used (OR = 1.37, 95% CI 0.91-2.08, P = 0.13). The use of current HC is not associated with development of postmolar GTN or delayed time to hCG remission. Therefore, HC can be safely used to prevent a new conception following CHM regardless of hCG level. Non-concurrent cohort study to re-evaluate the safety of low dose HCs after uterine evacuation of CHM.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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In recent decades there has been a significant increase in the consumption of legal and illegal drugs, and most of such compounds are able to induce dependence and this increase was observed mainly in females. This drug addiction increases susceptibility to several infectious agents, especially opportunistic microorganisms. The objective of this study was to evaluate the occurrence of opportunistic bacteria and yeasts in the mouth of drug addiction patients and non-addicted patients with different periodontal conditions. The study included 50 addiction patients and 200 non-addiction subjects. Intra and extraoral clinical examinations were performed and saliva samples were transferred to saline solution and the presence of members of the family Enterobacteriaceae, genera Enterococcus and Pseudomonas, as well fungi of the genus Candida was evaluated by culture. Samples were cultivated onto selective and non-selective media under aerobic conditions, at 37oC, for 24 -48 h. Identification of selected microorganisms were carried out through biochemical tests. Chi-square test was used to evaluate the data when three or more categories were involved. Higher detection frequencies of Candida species, family Enterobacteriaceae, E. faecalis, Pseudomonas sp. and P. aeruginosa in addiction patients were verified. It was found that patients addicted to both genders showed a higher occurrence of members of the Enterobacteriaceae, which were also associated with bone loss only in patients with drug addiction.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Objective: Identifying the main causes for underreporting of Adverse Drug Reaction (ADR) by health professionals. Method: A systematic review carried out in the following databases: LILACS, PAHO, SciELO, EMBASE and PubMed in the period between 1992 and 2012. Descriptors were used in the search for articles, and the identified causes of underreporting were analyzed according to the classification of Inman. Results: In total, were identified 149 articles, among which 29 were selected. Most studies were carried out in hospitals (24/29) for physicians (22/29), and pharmacists (10/29). The main causes related to underreporting were ignorance (24/29), insecurity (24/29) and indifference (23/29). Conclusion: The data show the eighth sin in underreporting, which is the lack of training in pharmacovigilance. Therefore, continuing education can increase adherence of professionals to the service and improve knowledge and communication of risks due to drug use.

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Purpose: To assess the bone mineral density (BMD) and bone mineral content (BMC) of female adolescents in use of standard low-dose combined oral contraceptives (COC) (EE 20 mcg/ Desogestrel 150 mcg) for a one-year period and to compare results against healthy controls matched for age and gender not in use of COC. Methods: A prospective, longitudinal study was conducted.Fifty adolescents, 12 to 20 years of age, were divided into a COC user group (n 35) and a control group (n 15) and submitted to a Bone Densitometry scan using dual-energy X-ray absorptiometry (DXA) at study inclusion and again at 12-month follow-up. Results: Results showed no statistically significant differences between the COC user and control groups at the initial moment. However, at 12-month follow-up, COC users showed negative mean percentage variation between initial and follow-up values for lumbar spine BMD and BMC of -1.09% and -1.58%, respectively, whereas controls had positive variations of +12.44% and +15.87%, respectively. Thus, the adolescents in use of COC showed a loss, albeit slight, in bone mass whereas the control group showed an increase. Conclusions: The low dose COC assessed (EE 20 mcg/Desogestrel 150 mcg) appeared to negatively affect the process of bone mass acquisition which occurs during adolescence.

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Context: Hibiscus sabdariffa L. (Malvaceae) is a species widely used in folk medicine for the treatment of some disorders. Objective: This study evaluated the effects of H. sabdariffa (HS) on the development of the male reproductive tract in rats following in utero exposure. Materials and methods: Pregnant rats received 250 or 500 mg/kg of HS extract or vehicle from gestational day 12 until day 21 of lactation. Results and discussion: Both doses of HS increased the body weight of male offspring at weaning, without compromising the puberty onset parameters. At puberty, there was a significant increase in the vas deferens absolute weight and a significant reduction in the relative weight of kidney at higher dose. These animals also presented a significant reduction in the sperm number in the caput/corpus of epididymis after exposure to both doses and a reduction in the sperm number in the cauda epididymis for the lower dose. At adulthood, the highest dose significantly reduced the sperm production in relation to controls and both doses provoked a reduction in the relative sperm number in the epididymis without affecting the sperm morphology. Conclusion: These findings demonstrated that maternal exposure to H. sabdariffa can adversely influence the male reproductive system in rats.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Iptakalim is a novel putative adenosine triphosphate (ATP)-sensitive potassium (KATP) channel opener. In the brain, iptakalim is thought to act on the neuronal and astrocytic plasma membrane and/or mitochondrial KATP channels. Because iptakalim demonstrates an action on the regulation of dopamine and glutamate release in the forebrain regions, we examined its potential antipsychotic efficacy in several preclinical tests. First, we show that iptakalim is effective in reducing amphetamine- and phencyclidine-induced hyperlocomotion as well as selectively disrupting conditioned avoidance responding. Next, we show that combined iptakalim and amphetamine treatment produces a reduction on prepulse inhibition of acoustic startle and this combined drug effect is also found with haloperidol, but not with clozapine. Finally, we show that iptakalim and clozapine preferentially increase c-Fos expression in the medial prefrontal cortex, nucleus accumbens and lateral septal nucleus, whereas haloperidol induces a greater increase in the nucleus accumbens, the dorsolateral striatum and lateral septal nucleus. Collectively, our findings indicate that iptakalim is likely to be a potential antipsychotic drug with distinct mechanisms of action. This study also suggests that neuronal and astrocytic plasma membrane and/or mitochondrial KATP channels may be a novel target that deserves attention for antipsychotic drug development. Future research using other sensitive tests is needed to confirm this property of iptakalim.

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Background: Great efforts have been made to increase accessibility of HIV antiretroviral therapy (ART) in low and middle-income countries. The threat of wide-scale emergence of drug resistance could severely hamper ART scale-up efforts. Population-based surveillance of transmitted HIV drug resistance ensures the use of appropriate first-line regimens to maximize efficacy of ART programs where drug options are limited. However, traditional HIV genotyping is extremely expensive, providing a cost barrier to wide-scale and frequent HIV drug resistance surveillance. Methods/Results: We have developed a low-cost laboratory-scale next-generation sequencing-based genotyping method to monitor drug resistance. We designed primers specifically to amplify protease and reverse transcriptase from Brazilian HIV subtypes and developed a multiplexing scheme using multiplex identifier tags to minimize cost while providing more robust data than traditional genotyping techniques. Using this approach, we characterized drug resistance from plasma in 81 HIV infected individuals collected in Sao Paulo, Brazil. We describe the complexities of analyzing next-generation sequencing data and present a simplified open-source workflow to analyze drug resistance data. From this data, we identified drug resistance mutations in 20% of treatment naive individuals in our cohort, which is similar to frequencies identified using traditional genotyping in Brazilian patient samples. Conclusion: The developed ultra-wide sequencing approach described here allows multiplexing of at least 48 patient samples per sequencing run, 4 times more than the current genotyping method. This method is also 4-fold more sensitive (5% minimal detection frequency vs. 20%) at a cost 3-5 x less than the traditional Sanger-based genotyping method. Lastly, by using a benchtop next-generation sequencer (Roche/454 GS Junior), this approach can be more easily implemented in low-resource settings. This data provides proof-of-concept that next-generation HIV drug resistance genotyping is a feasible and low-cost alternative to current genotyping methods and may be particularly beneficial for in-country surveillance of transmitted drug resistance.

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Albendazole sulfoxide (ABZSO), a broad spectrum anthelmintic drug extensively used in veterinary medicine, exhibits a low and erratic bioavailability due to its poor solubility in biological fluids. The aims of this study were the development, physicochemical characterization, and in vitro release profile evaluation of ABZSO-loaded Eudragit RS PO (R) microparticles (MPs) in order to improve the rate of dissolution and the dissolved percentage of the drug in pH 7.4. MPs were successfully obtained by the emulsification/solvent evaporation method, achieving entrapment efficiency and process yield of about 60% and mean size of 254 nm. The in vitro release profile study showed that dissolution of ABZSO followed a pseudo-second order kinetics and MPs were able to increase significantly (p < 0.05) the rate of dissolution of ABZSO compared to the micronized and non-micronized free drug, what could lead to an improvement in bioavailability and, consequently, in the antiparasitic activity. (C) 2011 The Society of Powder Technology Japan. Published by Elsevier B.V. and The Society of Powder Technology Japan. All rights reserved.

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An optimal control strategy for the highly active antiretroviral therapy associated to the acquired immunodeficiency syndrome should be designed regarding a comprehensive analysis of the drug chemotherapy behavior in the host tissues, from major viral replication sites to viral sanctuary compartments. Such approach is critical in order to efficiently explore synergistic, competitive and prohibitive relationships among drugs and, hence, therapy costs and side-effect minimization. In this paper, a novel mathematical model for HIV-1 drug chemotherapy dynamics in distinct host anatomic compartments is proposed and theoretically evaluated on fifteen conventional anti-retroviral drugs. Rather than interdependence between drug type and its concentration profile in a host tissue, simulated results suggest that such profile is importantly correlated with the host tissue under consideration. Furthermore, the drug accumulative dynamics are drastically affected by low patient compliance with pharmacotherapy, even when a single dose lacks. (C) 2012 Elsevier Inc. All rights reserved.

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OBJECTIVE: To analyze drug use trends among college students in 1996, 2001 and 2009. METHODS: A cross-sectional epidemiological study with a multistage stratified cluster sample with 9,974 college students was conducted in the city of Sao Paulo, southeastern Brazil. An anonymous self-administered questionnaire was used to collect information on drug use assessed in lifetime, the preceding 12 months and the preceding 30 days. The Bonferroni correction was used for multiple comparisons of drug use rates between surveys. RESULTS: There were changes in the lifetime use of tobacco and some other drugs (hallucinogens [6.1% to 8.8%], amphetamines [4.6% to 8.7%], and tranquilizers [5.7% to 8.2%]) from 1996 to 2009. Differences in the use of other drugs over the 12 months preceding the survey were also seen: reduced use of inhalants [9.0% to 4.8%] and increased use of amphetamines [2.4% to 4.8%]. There was a reduction in alcohol [72.9% to 62.1%], tobacco [21.3% to 17.2%] and marijuana [15.0% to 11.5%] use and an increase in amphetamine use [1.9% to 3.3%] in the preceeding 30 days. CONCLUSIONS: Over the 13-year study period, there was an increase in lifetime use of tobacco, hallucinogens, amphetamines, and tranquilizers. There was an increase in amphetamine use and a reduction in alcohol use during the preceding 12 months. There was an increase in amphetamine use during the preceding 30 days.