RESUMEN

BACKGROUND: Hepatorenal syndrome (HRS) is the deadliest complication of cirrhosis. The purpose of this study is to analyze if the use of a protocol for HRS is associated with higher survival in these patients. METHODS: An evidence-based protocol for the diagnosis and treatment of HRS was instituted in 2013. Data from medical records from 2010 to 2016 were obtained by searching the hospital database for patients who received terlipressin, in the three years before and after the institution of the protocol. Data were reviewed to confirm the diagnosis of HRS and multiple variables were collected. Liver-specific scores were calculated and a stepwise Cox regression approach was used for univariate and multivariate analysis. RESULTS: The study included 46 patients, 20 from the pre-protocol period and 26 from the post-protocol period. Respectively, mortality at 30 days, 90 days and 365 days was 75%, 75% and 90% for the pre-protocol period, and 61%, 69% and 80% for the post-protocol period. In the multivariate analysis, an aspartate aminotransferase (AST) of <40U/L, the pre-protocol period and higher Child-Turcotte-Pugh scores were associated with higher 30-day and 90-day mortality. The total mean dose of terlipressin and human albumin used per patient was reduced from 27mg to 22mg and from 236g to 144g, respectively, after the institution of the protocol. This was not associated with higher mortality. CONCLUSION: The use of an evidence-based protocol for the treatment of HRS translated into a higher survival. The authors suggest that the use of evidence-based protocols for the diagnosis and treatment of HRS could reduce cost and mortality in tertiary hospitals.

Asunto(s)

Protocolos Clínicos , Medicina Basada en la Evidencia , Síndrome Hepatorrenal , Terlipresina/uso terapéutico , Vasoconstrictores/uso terapéutico , Albúminas/administración & dosificación , Análisis de Varianza , Aspartato Aminotransferasas/sangre , Femenino , Síndrome Hepatorrenal/diagnóstico , Síndrome Hepatorrenal/tratamiento farmacológico , Síndrome Hepatorrenal/enzimología , Síndrome Hepatorrenal/mortalidad , Humanos , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Centros de Atención Terciaria

RESUMEN

Introduction and objectives It has been suggested that albumin administration could alter the natural history of cirrhosis, and also, that long-term treatment with albumin might be associated with improvement in survival, control of ascites, reduction in the incidence bacterial infections, renal dysfunction, hepatic encephalopathy (HE) and hyponatremia, as well as reduction in length of hospitalization in patients with cirrhosis and ascites. The objective of the present study is to evaluate the role of albumin in the management of HE. Materiales and methods:: This is a systematic review of randomized controlled trials that evaluated the use of albumin in adult patients with cirrhosis and HE. The search for eligible studies was performed in MEDLINE, EMBASE, and Cochrane CENTRAL databases until June 2020. The outcomes of interest were the complete reversal of HE and mortality. Meta-analysis was performed using the random effects model, through the Mantel-Haenszel method. Results: This systematic review was registered at the PROSPERO platform (CRD42020194181). The search strategy retrieved 1,118 articles. After reviewing titles and abstracts, 24 studies were considered potentially eligible, but 22 were excluded after full-text analysis. Finally, 2 studies were included. In the meta-analysis, albumin was associated to significant lower risks of persistent HE (risk ratio - RR = 0.60; 95% confidence interval - CI = 0.38-0.95, p = 0.03) and mortality (RR = 0.54; 95% CI = 0.33-0.90, p = 0.02). Conclusion: Albumin administration improves HE and reduces mortality in patients with cirrhosis and HE.

Asunto(s)

Albúminas/administración & dosificación , Encefalopatía Hepática/tratamiento farmacológico , Calidad de Vida , Administración Oral , Humanos

RESUMEN

BACKGROUND AND AIM: Ascites is a common complication of cirrhosis, and it is associated with increased mortality. The aim of this study was to evaluate the efficacy of long-term albumin administration in decreasing mortality and other complications of patients with cirrhosis and ascites. METHODS: A systematic review was performed using MEDLINE and Embase databases. Randomized controlled trials evaluating long-term albumin administration in patients with cirrhosis and ascites were considered eligible, as long as at least one of the following outcomes was evaluated: mortality, recurrence of ascites/need for paracentesis, refractory ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, gastrointestinal bleeding, or adverse events. Meta-analysis was performed using the random-effects model, through the Mantel-Haenszel method. The study protocol was registered at PROSPERO platform (CRD42019130078). RESULTS: The literature search yielded 1517 references. Five randomized controlled trials fulfilled the selection criteria and were included in this meta-analysis, involving 716 individuals. Patients receiving long-term albumin had significantly lower risk of recurrence of ascites/need for paracentesis when compared with controls (risk ratio = 0.56, 95% confidence interval = 0.48-0.67, P < 0.00001). There was no evidence of significant difference between the long-term albumin and control groups regarding mortality, refractory ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, gastrointestinal bleeding, or adverse events. CONCLUSIONS: Long-term albumin administration in patients with cirrhosis and ascites decreases recurrence of ascites/need for paracentesis. At this point, there is no evidence of significant benefits of long-term albumin administration regarding mortality or other complications of cirrhosis.

Asunto(s)

Albúminas/administración & dosificación , Ascitis/tratamiento farmacológico , Cirrosis Hepática/tratamiento farmacológico , Ensayos Clínicos Controlados Aleatorios como Asunto , Ascitis/complicaciones , Ascitis/mortalidad , Humanos , Cirrosis Hepática/complicaciones , Cirrosis Hepática/mortalidad , Recurrencia , Riesgo , Prevención Secundaria , Factores de Tiempo , Resultado del Tratamiento

RESUMEN

OBJECTIVES: To compare 5% albumin with 0.9% saline for large-volume resuscitation (> 60 mL/Kg within 24 hr), on mortality and development of acute kidney injury. DESIGN: Retrospective cohort study. SETTING: Patients admitted to ICUs in 13 hospitals across Western Pennsylvania. We analyzed two independent cohorts, the High-Density Intensive Care databases: High-Density Intensive Care-08 (July 2000 to October 2008, H08) and High-Density Intensive Care-15 (October 2008 to December 2014, H15). PATIENTS: Total of 18,629 critically ill patients requiring large-volume resuscitation. INTERVENTIONS: Five percent of albumin in addition to saline versus 0.9% saline. MEASUREMENTS AND MAIN RESULTS: After excluding patients with acute kidney injury prior to large-volume resuscitation, 673 of 2,428 patients (27.7%) and 1,814 of 16,201 patients (11.2%) received 5% albumin in H08 and H15, respectively. Use of 5% albumin was associated with decreased 30-day mortality by multivariate regression in H08 (odds ratio 0.65; 95% CI 0.49-0.85; p = 0.002) and in H15 (0.52; 95% CI 0.44-0.62; p < 0.0001) but was associated with increased acute kidney injury in H08 (odds ratio 1.98; 95% CI 1.56-2.51; p < 0.001) and in H15 (odds ratio 1.75; 95% CI 1.58-1.95; p < 0.001). However, 5% albumin was not associated with persistent acute kidney injury and resulted in decreased major adverse kidney event at 30, 90, and 365 days. Propensity matched analysis confirmed similar associations with mortality and acute kidney injury. CONCLUSIONS: During large-volume resuscitation, 5% albumin was associated with reduced mortality and major adverse kidney event at 30, 90, and 365 days. However, a higher rate of acute kidney injury of any stage was observed that did not translate into persistent renal dysfunction.

Asunto(s)

Albúminas/uso terapéutico , Enfermedad Crítica/terapia , Resucitación/métodos , Solución Salina/uso terapéutico , Albúminas/administración & dosificación , Enfermedad Crítica/mortalidad , Mortalidad Hospitalaria , Humanos , Modelos de Riesgos Proporcionales , Resucitación/mortalidad , Estudios Retrospectivos , Solución Salina/administración & dosificación , Análisis de Supervivencia

RESUMEN

Patients receiving peritoneal dialysis historically have difficulty keeping albumin and phosphorus levels within therapeutic ranges on a consistent basis. The purpose of this quantitative study was to assess if patients receiving peritoneal dialysis had a working nutritional knowledge related to albumin levels and to determine if increasing egg consumption would result in an increase of albumin levels. This study was conducted using a prospective quantitative pre-test/post-test knowledge test and assessing the recorded pre-albumin and pre-phosphorus lab values from the electronic medical record, which are drawn each month, and compare them over a one-month period. A convenience sample collection was conducted among 30 adult individuals receiving peritoneal dialysis. Findings in this study suggest that education continues to be a key component for positive outcomes for this patient population.

Asunto(s)

Albúminas/administración & dosificación , Conocimientos, Actitudes y Práctica en Salud , Diálisis Peritoneal/enfermería , Adulto , Humanos , Estudios Prospectivos

Asunto(s)

Humanos , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Albúminas/administración & dosificación , Cirrosis Hepática/tratamiento farmacológico , Ascitis/complicaciones , Ascitis/etiología , Ascitis/tratamiento farmacológico , Factores de Tiempo , Reproducibilidad de los Resultados , Medicina Basada en la Evidencia , Diuréticos/administración & dosificación , Quimioterapia Combinada , Furosemida/administración & dosificación , Cirrosis Hepática/complicaciones

RESUMEN

One of the major challenges related to solvent-based taxanes administration in clinical practice is the high rate of hypersensitivity reactions (HSRs). Nab-paclitaxel is a solvent-free, albumin-bound, paclitaxel, which minimize the risk of HSR occurrence. In this single-institution, retrospective analysis, we evaluated stage IIIc-IV epithelial ovarian cancer (EOC) patients, treated with first-line carboplatin/nab-paclitaxel (± bevacizumab), after the occurrence of an HSR with solvent-based paclitaxel (and/or docetaxel). Between April 2012 and December 2018, ten patients (20.8%) received carboplatin/nab-paclitaxel (± bevacizumab) after the occurrence of an HSR to solvent-based taxanes. Among the evaluable patients, ORR was 100%. At median follow-up of 28.5 months, median PFS was 16.7 months, and median OS was 65.4 months, respectively. Median received dose intensity (DI) was 86% and 80% of the projected DI for nab-paclitaxel and carboplatin, respectively. There were no treatment-related grade 4 adverse events. Most relevant treatment-related grade 3 adverse events were: asthenia (10%), hypertransaminasemia (10%), neutropenia (20%), thrombocytopenia (20%), and anemia (10%). No HSR recurrence was observed. The high rate of HSR occurrence could limit first-line treatment options in clinical practice. Carboplatin/nab-paclitaxel association could represent a valid treatment option in this setting.

Asunto(s)

Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Hipersensibilidad/etiología , Neoplasias Ováricas/tratamiento farmacológico , Solventes/efectos adversos , Adulto , Anciano , Albúminas/administración & dosificación , Carboplatino/administración & dosificación , Femenino , Estudios de Seguimiento , Humanos , Hipersensibilidad/patología , Masculino , Persona de Mediana Edad , Neoplasias Ováricas/patología , Paclitaxel/administración & dosificación , Pronóstico , Estudios Retrospectivos , Solventes/química , Taxoides/administración & dosificación

Asunto(s)

Albúminas/administración & dosificación , Infecciones Bacterianas , Cirrosis Hepática/tratamiento farmacológico , Peritonitis/microbiología , Femenino , Humanos , Infusiones Intravenosas , Masculino , Persona de Mediana Edad , Resultado del Tratamiento

RESUMEN

OBJECTIVE: To investigate the effects of the administration of 4% albumin on lactated Ringer's, when compared with lactated Ringer's alone, in the early phase of sepsis in cancer patients. DESIGN: Single-center, randomized, double-blind, controlled-parallel trial. SETTING: A tertiary care university cancer hospital. PATIENTS: Cancer patients with severe sepsis or septic shock. INTERVENTIONS: Between October 2014 and December 2016, patients were randomly assigned to receive either bolus of albumin in a lactated Ringer's solution or lactated Ringer's solution alone during the first 6 hours of fluid resuscitation after intensive care medicine (ICU) admission. Primary outcome was defined as death from any cause at 7 days. Secondary outcomes were defined as death from any cause within 28 days, change in Sequence Organ Failure Assessment scores from baseline to day 7, days alive and free of mechanical ventilation, days alive and free of vasopressor, renal replacement therapy during ICU stay, and length of ICU and hospital stay. MEASUREMENTS AND MAIN RESULTS: A total of 360 patients were enrolled in the trial. At 7 days, 46 of 180 patients (26%) died in the albumin group and 40 of 180 (22%) died in the lactated Ringer's group (p = 0.5). At 28 days, 96 of 180 patients (53%) died in the albumin group and 83 of 180 (46%) died in the lactated Ringer's group (p = 0.2). No significant differences in secondary outcomes were observed. CONCLUSIONS: Adding albumin to early standard resuscitation with lactated Ringer's in cancer patients with sepsis did not improve 7-day survival.

Asunto(s)

Albúminas/administración & dosificación , Fluidoterapia , Lactato de Ringer/administración & dosificación , Sepsis/terapia , Anciano , Método Doble Ciego , Quimioterapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/complicaciones , Proyectos Piloto , Prevención Secundaria , Sepsis/complicaciones

RESUMEN

Traumatic spinal cord injury (TSCI) is a health problem for which there is currently no treatment or definitive therapy. Medicine has explored therapeutic options for patients with TSCI with the aim to improve their quality of life. One alternative has been the development of biomaterials that offer neuroprotection or neuroregeneration of damaged nerve tissue. The microinjection of iodine-doped polypyrrole particles synthesised by plasma (PPPy/I) has shown neuroprotective effects that favour motor function recovery in experimental animals with TSCI. However, their ability to migrate into the tissue has led to the need to test a suspension vehicle that enables the concentration of particles at the site of injury. To achieve this, two biomaterials of PPPy/I (P1 and P2) were studied. The superficial physicochemical characterisation of the polymers was performed by infrared spectroscopy, X-ray photoelectron spectroscopy and contact angle. The rheological performance under oscillatory shear rate of suspensions containing both polymers alone and in combination with bovine serum albumin was also studied. In vivo tests were performed on animals with and without TSCI that were microinjected with particles of P1 or P2 in suspension using a solution of rat serum albumin. Exposure to the protein solutions generates a protein multilayer on the surface of the biomaterials that can drastically change the behaviour of both P1 and P2, which led to severe repercussions in the in vivo assays. The results showed that surface chemistry plays an important role in the performance and that it is possible to treat TSCI with these materials. The interaction of the surface of materials PPPy/I.1 (P1) and PPPy/I.2 (P2) with bovine serum albumin (BSA) resulted in a series of changes in the surface chemistry of both biomaterials. The contact angle study (Fig. A) showed the presence of a critical BSA concentration ([BSA]c), in which a monolayer was formed on both polymers and then a stable protein multilayer, as evidenced by the establishment of a plateau in the determination of the contact angle. In vivo tests showed that this interaction may be beneficial in the treatment of traumatic spinal cord injury (TSCI), depending on the surface characteristics with or without rat serum albumin (RSA). The TSCI + P1 and TSCI + P2 + RSA groups obtained significant differences in functional recovery compared with the control group according to the Basso, Beattie and Bresnahan scale (BBB).

Asunto(s)

Albúminas/administración & dosificación , Polímeros/química , Pirroles/química , Traumatismos de la Médula Espinal/tratamiento farmacológico , Adsorción , Animales , Bovinos , Química Física , Femenino , Humanos , Concentración de Iones de Hidrógeno , Yodo/química , Oscilometría , Calidad de Vida , Ratas , Ratas Long-Evans , Reología , Albúmina Sérica/química , Albúmina Sérica Bovina/química , Espectroscopía Infrarroja por Transformada de Fourier , Propiedades de Superficie , Temperatura

Asunto(s)

Masculino , Femenino , Humanos , Adulto , Adulto Joven , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Albúminas/administración & dosificación , Antibacterianos/administración & dosificación , Infecciones Bacterianas/tratamiento farmacológico , Infecciones Bacterianas/etiología , Cirrosis Hepática/complicaciones , Reproducibilidad de los Resultados

Asunto(s)

Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Síndrome Hepatorrenal/mortalidad , Síndrome Hepatorrenal/tratamiento farmacológico , Octreótido/administración & dosificación , Albúminas/administración & dosificación , Terlipresina/administración & dosificación , Midodrina/administración & dosificación , Síndrome Hepatorrenal/diagnóstico , Esquema de Medicación , Análisis de Supervivencia , Reproducibilidad de los Resultados , Estudios de Seguimiento , Resultado del Tratamiento , Medicina Basada en la Evidencia , Quimioterapia Combinada , Pruebas de Función Hepática

Asunto(s)

Humanos , Síndrome Hepatorrenal/tratamiento farmacológico , Albúminas/administración & dosificación , Terlipresina/administración & dosificación , Cirrosis Hepática/complicaciones , Estados Unidos , Vasoconstrictores/uso terapéutico , Canadá , Reproducibilidad de los Resultados , Resultado del Tratamiento , Medicina Basada en la Evidencia , Quimioterapia Combinada , Riñón/efectos de los fármacos

RESUMEN

We report the case of a 22-year-old primiparous, admitted to our hospital with a 2-week history of vulvar edema that had evolved within 24 hours to the point of stopping urine flow and hindering ambulation. The only remarkable finding in relation with the edema was hypoalbuminemia for no apparent cause. The correction of hypoalbuminemia and the establishment of diuretic treatment, with the drainage of the edema allowed for a complete resolution of the edema.

Asunto(s)

Edema/etiología , Hipoalbuminemia/complicaciones , Complicaciones del Embarazo , Enfermedades de la Vulva/etiología , Albúminas/administración & dosificación , Albúminas/uso terapéutico , Antiinfecciosos/uso terapéutico , Anticoagulantes/uso terapéutico , Cesárea , Edema/tratamiento farmacológico , Enoxaparina/uso terapéutico , Exudados y Transudados , Femenino , Rotura Prematura de Membranas Fetales , Furosemida/uso terapéutico , Humanos , Hipoalbuminemia/tratamiento farmacológico , Hipoproteinemia/complicaciones , Infusiones Intravenosas , Limitación de la Movilidad , Prednisona/uso terapéutico , Embarazo , Inhibidores del Simportador de Cloruro Sódico y Cloruro Potásico/uso terapéutico , Trastornos Urinarios/etiología , Enfermedades de la Vulva/tratamiento farmacológico , Adulto Joven

RESUMEN

INTRODUCTION: Ménétrier disease is a rare disorder characterized by gastric foveolar hyperplasia associated with secondary protein loss. In children, this condition is presented as an edematous syndrome without renal or hepatic impairment and differs from the adult form by the constant presence of edema and spontaneous remission. It has been related to infections in most published cases, especially to Cytomegalovirus (CMV) and Helicobacter pylori (H. pylori). OBJECTIVE: To present a pediatric case of Ménétrier disease and endoscopic imaging obtained during the evolution of the patient. CASE REPORT: A five year old preschooler who presented a generalized edema, abdominal pain and malaise. After ruling out renal and hepatic pathologies, an upper endoscopy revealed a severe compromise of the gastric mucosa. Urease test for H. pylori and IgG test for CMV resulted positive. Albumin and H2 receptor antagonists were administered. The evolution was favorable and the patient was discharged after 14 days; 8 month follow-up endoscopy showed no abnormalities. CONCLUSION: The medical profile and endoscopy are enough evidence to suggest the diagnosis of hypertrophic protein-losing gastropathy. Further studies need to be developed that include a considerable number of patients to assess their association with CMV or H. pylori infections, as these viruses are very common in our population.

Asunto(s)

Infecciones por Citomegalovirus/diagnóstico , Mucosa Gástrica/patología , Gastritis Hipertrófica/diagnóstico , Infecciones por Helicobacter/diagnóstico , Dolor Abdominal/etiología , Albúminas/administración & dosificación , Preescolar , Edema/etiología , Femenino , Estudios de Seguimiento , Gastritis Hipertrófica/tratamiento farmacológico , Gastritis Hipertrófica/patología , Gastroscopía/métodos , Helicobacter pylori/aislamiento & purificación , Antagonistas de los Receptores H2 de la Histamina/uso terapéutico , Humanos

RESUMEN

There is clinical and experimental evidence suggesting that antiprogestins might be used for the treatment of selected breast cancer patients. Our aim was to evaluate the effect of albumin-bound paclitaxel (Nab-paclitaxel) and pegylated doxorubicin liposomes (PEG-LD) in combination with mifepristone (MFP) in experimental breast cancer models expressing different ratios of progesterone receptor (PR) isoforms A and B. We used two antiprogestin-responsive (PRA>PRB) and two resistant (PRA

Asunto(s)

Antineoplásicos/administración & dosificación , Neoplasias de la Mama/metabolismo , Mifepristona/administración & dosificación , Receptores de Progesterona/metabolismo , Albúminas/administración & dosificación , Animales , Doxorrubicina/administración & dosificación , Femenino , Técnica del Anticuerpo Fluorescente , Humanos , Inmunohistoquímica , Liposomas , Ratones , Ratones Endogámicos BALB C , Ratones Desnudos , Nanopartículas , Paclitaxel/administración & dosificación , Isoformas de Proteínas , Ensayos Antitumor por Modelo de Xenoinjerto

RESUMEN

The aim of this work was to evaluate the influence of the addition of foaming agent and drying temperature on the powders characteristics produced using tomato pulp. The influence of the treatments on the pH, titratable acidity, ascorbic acid, tapped density, solubility and hygroscopicity of the powders produced at drying temperatures of 60ºC and 80 ºC, with addition of albumin and with no albumin were evaluated. Higher values of acidity and lower values of pH were observed for the treatments added with albumin in both temperatures were verified. The ascorbic acid content in the pulp was significant (p 0.05) decreased with the increasing oh the drying temperature compared to the pulp in natura. The application of albumin also contributes to a decrease in the ascorbic acid content. By the other hand, the albumin addition, with consequent foaming formation in the tomato pulp, favored the production of powder materials with lower density when compared to the control treatments without albumin. The presence of albumin also caused a significant reduction (p 0.05) in the powder materials hygroscopicity. The powders solubility was increased with addition of the foaming agent where significant difference (p 0.05) among the treatments with and without albumin in both temperatures were observed.(AU)

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Este trabalho foi realizado com o objetivo de avaliar a influência da adição de agente espumante e da temperatura de secagem nas características dos pós produzidos a partir de polpa de tomate in natura. Foi avaliada a influência destes tratamentos nas variáveis pH, acidez titulável, ácido ascórbico, densidade compactada, solubilidade e higroscopicidade dos pós produzidos nas temperaturas de secagem de 60ºC e 80 ºC, adicionados ou não de albumina. Verificou-se a ocorrência de maiores valores de acidez e menores valores de pH para os tratamentos adicionados de albumina em ambas temperaturas. A concentração de ácido ascórbico da polpa foi reduzida significativamente (p 0,05) com o aumento da temperatura de secagem em relação à polpa in natura. Verificou-se ainda que a aplicação de albumina contribuiu para uma redução no teor de ácido ascórbico. Por outro lado, a adição de albumina, com consequente formação de espuma na polpa de tomate, favoreceu a produção de materiais em pó com menor densidade quando comparados aos tratamentos controle sem adição de albumina. A presença de albumina causou ainda redução significativa (p 0,05) na higroscopicidade dos materiais em pó. A solubilidade foi aumentada com adição do agente espumante onde foi verificada diferença significativa (p 0,05) entre os tratamentos com e sem adição de albumina em ambas as temperaturas.(AU)

Asunto(s)

Solanum lycopersicum , Conservación de Alimentos , Albúminas/administración & dosificación , Calentadores

RESUMEN

The aim of this work was to evaluate the influence of the addition of foaming agent and drying temperature on the powders characteristics produced using tomato pulp. The influence of the treatments on the pH, titratable acidity, ascorbic acid, tapped density, solubility and hygroscopicity of the powders produced at drying temperatures of 60ºC and 80 ºC, with addition of albumin and with no albumin were evaluated. Higher values of acidity and lower values of pH were observed for the treatments added with albumin in both temperatures were verified. The ascorbic acid content in the pulp was significant (p 0.05) decreased with the increasing oh the drying temperature compared to the pulp in natura. The application of albumin also contributes to a decrease in the ascorbic acid content. By the other hand, the albumin addition, with consequent foaming formation in the tomato pulp, favored the production of powder materials with lower density when compared to the control treatments without albumin. The presence of albumin also caused a significant reduction (p 0.05) in the powder materials hygroscopicity. The powders solubility was increased with addition of the foaming agent where significant difference (p 0.05) among the treatments with and without albumin in both temperatures were observed.

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Este trabalho foi realizado com o objetivo de avaliar a influência da adição de agente espumante e da temperatura de secagem nas características dos pós produzidos a partir de polpa de tomate in natura. Foi avaliada a influência destes tratamentos nas variáveis pH, acidez titulável, ácido ascórbico, densidade compactada, solubilidade e higroscopicidade dos pós produzidos nas temperaturas de secagem de 60ºC e 80 ºC, adicionados ou não de albumina. Verificou-se a ocorrência de maiores valores de acidez e menores valores de pH para os tratamentos adicionados de albumina em ambas temperaturas. A concentração de ácido ascórbico da polpa foi reduzida significativamente (p 0,05) com o aumento da temperatura de secagem em relação à polpa in natura. Verificou-se ainda que a aplicação de albumina contribuiu para uma redução no teor de ácido ascórbico. Por outro lado, a adição de albumina, com consequente formação de espuma na polpa de tomate, favoreceu a produção de materiais em pó com menor densidade quando comparados aos tratamentos controle sem adição de albumina. A presença de albumina causou ainda redução significativa (p 0,05) na higroscopicidade dos materiais em pó. A solubilidade foi aumentada com adição do agente espumante onde foi verificada diferença significativa (p 0,05) entre os tratamentos com e sem adição de albumina em ambas as temperaturas.

Asunto(s)

Albúminas/administración & dosificación , Calentadores , Conservación de Alimentos , Solanum lycopersicum

RESUMEN

INTRODUCTION: An increasing research interest has been directed toward nanoparticle-based drug delivery systems for their advantages. The appropriate amalgamation of pH sensitivity and tumor targeting is a promising strategy to fabricate drug delivery systems with high efficiency, high selectivity and low toxicity. MATERIALS AND METHODS: A novel pH sensitive Cremophor-free paclitaxel formulation, Nanoxel(TM), was developed in which the drug is delivered as nanomicelles using a polymeric carrier that specifically targets tumors. The efficiency and mechanism of intracellular paclitaxel delivery by Nanoxel(TM) was compared with two other commercially available paclitaxel formulations: Abraxane(TM) and Intaxel(TM), using different cell lines representing target cancers [breast, ovary and non-small cell lung carcinoma (NSCLC)] by transmission electron microscopy and quantitative intracellular paclitaxel measurements by high performance liquid chromatography. RESULTS: The data obtained from the present study revealed that the uptake of nanoparticle-based formulations Nanoxel(TM) and Abraxane(TM) is mediated by the process of endocytosis and the uptake of paclitaxel was remarkably superior to Intaxel(TM) in all cell lines tested. Moreover, the intracellular uptake of paclitaxel in Nanoxel(TM)- and Abraxane(TM)-treated groups was comparable. Hence, the nanoparticle-based formulations of paclitaxel (Nanoxel(TM) and Abraxane(TM)) are endowed with higher efficiency to deliver the drug to target cells as compared to the conventional Cremophor-based formulation. CONCLUSION: Nanoxel(TM) appears to be of great promise in tumor targeting and may provide an advantage for paclitaxel delivery into cancer cells.

Asunto(s)

Antineoplásicos Fitogénicos/administración & dosificación , Nanopartículas , Neoplasias/tratamiento farmacológico , Paclitaxel/administración & dosificación , Paclitaxel Unido a Albúmina , Albúminas/administración & dosificación , Antineoplásicos Fitogénicos/uso terapéutico , Línea Celular Tumoral , Sistemas de Liberación de Medicamentos , Femenino , Humanos

RESUMEN

Este artigo, ao fazer uma revisão da literatura no que tange ao tratamento da ascite no paciente com cirrose, enfatiza a importância da dieta com restrição de sal; do papel da espironolactona no início do tratamento em pacientes com um primeiro episódio de ascite e do tratamento combinado (espironolactona e furosemida) nas ascites recorrentes e da paracentese terapêutica, com reposição de albumina, na ascite tensa. Conclui ressaltando a importância da avaliação do transplante hepático nesta população de doentes.

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The present article, reviewing medical literature regarding treatment of ascites in cirrhotic patients, emphasizes the importance of a sodium restricted diet; it also explains the role of espironolactone as the first treatment in a patient with the first episode of ascites, that of the combined treatment with espironolactone and furosemide in cases of recurrent ascites and that of therapeutical paracentesis with albumin replacement in patients with tense ascites. It concludes highlighting the importance of evaluating cirrhotic patients with ascites for liver transplantation.

Asunto(s)

Humanos , Masculino , Femenino , Ascitis/diagnóstico , Ascitis/etiología , Cirrosis Hepática/complicaciones , Hepatopatías/etiología , Albúminas/administración & dosificación , Dieta Hiposódica , Espironolactona/administración & dosificación , Espironolactona/uso terapéutico , Furosemida/uso terapéutico , Hiponatremia , Paracentesis/métodos , Trasplante de Hígado