RESUMO
A very sensitive electrochemical biosensor to determine totals triglycerides (TGs) in serum samples has been developed. It is based on the electrochemical oxidation of glycerol at glassy carbon electrodes modified with magnetic nanoparticles bonded to lipase enzyme and copper oxide nanoparticles, both supported on a multiwalled carbon nanotubes/pectin dispersion. Glycerol is produced by enzymatic reaction between the TGs present in samples and the lipase immobilized. The quantification of triglycerides was performed by amperometric measurements. The proposed electrochemical biosensor improves the performance of others methods developed for the TGs quantification. The determination of TGs does not need a pretreatment of serum samples. The PLS-1 algorithm was used for the quantification of TGs. According to this algorithm, the of detection and quantification limits were from 3.2â¯×â¯10-3 gâ¯L-1 to 3.6â¯×â¯10-3 gâ¯L-1, and from 9.6â¯×â¯10-3 to 1.1â¯×â¯10-2 gâ¯L-1, respectively. The sensitivity was 1.64â¯×â¯10-6 Aâ¯L g-1. The proposed electrochemical biosensor exhibited a very good performance, a stability of 20 days, very good reproducibility and repeatability, and it is presented as a very good alternative for the determination of TGs in human serum clinical samples.
Assuntos
Técnicas Biossensoriais/métodos , Lipase/metabolismo , Nanocompostos/química , Triglicerídeos/sangue , Calibragem , Quitosana/química , Cobre/química , Eletroquímica , Eletrodos , Enzimas Imobilizadas/química , Enzimas Imobilizadas/metabolismo , Humanos , Lipase/química , Nanopartículas de Magnetita/química , Nanotubos de Carbono/química , Pectinas/química , Triglicerídeos/químicaRESUMO
PURPOSE: The cure rate in Hodgkin lymphoma is high, but the response along with treatment is still unpredictable and highly variable among patients. Detecting those patients who do not respond to treatment at early stages could bring improvements in their treatment. This research tries to identify the main biological prognostic variables currently gathered at diagnosis and design a simple machine learning methodology to help physicians improve the treatment response assessment. METHODS: We carried out a retrospective analysis of the response to treatment of a cohort of 263 Caucasians who were diagnosed with Hodgkin lymphoma in Asturias (Spain). For that purpose, we used a list of 35 clinical and biological variables that are currently measured at diagnosis before any treatment begins. To establish the list of most discriminatory prognostic variables for treatment response, we designed a machine learning approach based on two different feature selection methods (Fisher's ratio and maximum percentile distance) and backwards recursive feature elimination using a nearest-neighbor classifier (k-NN). The weights of the k-NN classifier were optimized using different terms of the confusion matrix (true- and false-positive rates) to minimize risk in the decisions. RESULTS AND CONCLUSIONS: We found that the optimum strategy to predict treatment response in Hodgkin lymphoma consists in solving two different binary classification problems, discriminating first if the patient is in progressive disease; if not, then discerning among complete and partial remission. Serum ferritin turned to be the most discriminatory variable in predicting treatment response, followed by alanine aminotransferase and alkaline phosphatase. The importance of these prognostic variables suggests a close relationship between inflammation, iron overload, liver damage and the extension of the disease.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Doença de Hodgkin/tratamento farmacológico , Inflamação/epidemiologia , Sobrecarga de Ferro/epidemiologia , Hepatopatias/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Bleomicina/uso terapêutico , Dacarbazina/uso terapêutico , Doxorrubicina/uso terapêutico , Feminino , Seguimentos , Doença de Hodgkin/patologia , Humanos , Incidência , Aprendizado de Máquina , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Indução de Remissão , Estudos Retrospectivos , Vimblastina/uso terapêuticoRESUMO
Intrinsic body fluid regulation is critical for optimizing endurance performance. Aquaporins (AQPs) are a family of transmembrane proteins that transport water and glycerol across cellular membranes. A recent report revealed an association between a single nucleotide polymorphism (SNP) in the 3' untranslated region of the aquaporin-1 (AQP1) gene and endurance performance. The purpose of the study was to explore the association between the AQP1 SNP and acute body fluid loss in long distance runners. The subjects (N=91, Age=26±3 yrs; Ht=170±11 cm; Wt=61±5 kg; mean±SD) were biologically unrelated male long distance runners. Data were collected before and after an international 10 km road race. Body fluid loss was determined by the difference between nude body weight before and after the 10 km run. The AQP1 (GâC) gene variation was detected by the ARMS-PCR procedure. Genotypes were determined by PCR product size. Carriers of the AQP1 SNP had a significantly greater adjusted body fluid loss (3.7±0.9 kg) than non-carriers (1.5±1.1 kg) (P<0.05). In conclusion, our study found an association between the AQP1 SNP and acute body fluid loss in long distance runners.
Assuntos
Aquaporina 1/genética , Tolerância ao Exercício/genética , Polimorfismo de Nucleotídeo Único , Corrida/fisiologia , Sudorese/fisiologia , Adulto , Líquidos Corporais/fisiologia , Regulação da Temperatura Corporal , Cromossomos Humanos Par 7/genética , Tolerância ao Exercício/fisiologia , Variação Genética , Genótipo , Acessibilidade aos Serviços de Saúde , Humanos , Masculino , Análise e Desempenho de Tarefas , Fatores de TempoRESUMO
Between 1982 and 2002, applying the uterine/cervix cancer prevention protocol of the Gynecology Institute of the University of Padua [1] modified to our needs, we diagnosed 5,008 (53.8%) cases of oncogenic risk out of 9,312 evaluated patients. Values were obtained through the analysis of three diagnostic methodologies: colposcopy, cytology and directed biopsy, taking into consideration the limitations of each one of these and their effectiveness in identifying specific abnormalities or pathologies. The results fully demonstrate that the integration of the three diagnostic methodologies is necessary to decrease false-negative results.
Assuntos
Doenças dos Genitais Femininos/epidemiologia , Doenças dos Genitais Femininos/patologia , Programas de Rastreamento/estatística & dados numéricos , Lesões Pré-Cancerosas/epidemiologia , Lesões Pré-Cancerosas/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia/estatística & dados numéricos , Colposcopia/estatística & dados numéricos , Citodiagnóstico/estatística & dados numéricos , Feminino , Humanos , Anamnese/estatística & dados numéricos , Pessoa de Meia-Idade , Panamá/epidemiologia , Estudos Retrospectivos , Esfregaço Vaginal/estatística & dados numéricosRESUMO
It is uncommon for a cancer to be diagnosed because of skin metastases. Cutaneous metastases as initial manifestation of internal neoplasias, represent only 0.8% of total cases and implies, in general, a very advanced grade of the disease and short survival. When skin metastases of an unknown primary site appear, lung cancer is the first option to be discarded in case of men, and breast cancer in case of women. Lung cancer spreads to the skin in 2.8-8.7% of the cases, in advanced phases of the disease, although just in 7-23.8% of the cases, cutaneous metastases appear as first manifestation of the primary tumor. Sometimes, a complete examination to discover the tumor reveals no metastases elsewhere.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/secundário , Neoplasias Pulmonares/patologia , Neoplasias Cutâneas/secundário , Adulto , Idoso , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Neoplasias Primárias Desconhecidas/diagnóstico , Neoplasias Primárias Desconhecidas/patologia , Estudos Prospectivos , Estudos Retrospectivos , Neoplasias Cutâneas/mortalidadeRESUMO
During 20 years of preventive study of the oncogenic risk of cervix-uterine cancer in the Republic of Panama, applying the protocol of the Gynecology Institute of the University of Padua, Italy, we diagnosed 5,009 cases out of the 9,312 patients studied. We classified them according to the degree of the pathology, guiding the patients to the appropriate treatment and the respective follow-up, and concluding that those women who do not follow recommendations have five times more probability of suffering from cervix-uterine cancer. Moreover, the age groups between 20 and 40 years old with HPV infection that do not have access to these procedures are highly vulnerable.
Assuntos
Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/patologia , Neoplasias Uterinas/epidemiologia , Neoplasias Uterinas/patologia , Biópsia/estatística & dados numéricos , Colposcopia/estatística & dados numéricos , Feminino , Humanos , Panamá/epidemiologia , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/virologia , Neoplasias Uterinas/prevenção & controle , Neoplasias Uterinas/virologiaRESUMO
BACKGROUND: The Quality of Life Questionnaire (QOL-Q) is used widely to evaluate the quality of life of persons with intellectual disability (ID). Its validity for use with Spanish-speaking cultures has been demonstrated for individuals with visual disabilities, but not for those with physical or intellectual disabilities. Such was the purpose of the present study. METHOD: Two samples were administered the QOL-Q under standardized procedures. The first sample was composed of 209 Mexican participants with physical disabilities; the second was composed of 424 Spanish participants with ID. The hypothesis tested was: the applicability (i.e. etic properties) of the measure across countries and respondents would be demonstrated if reliability data and if factor composition were similar to the original measure. Cronbach's alpha was used to test reliability and exploratory factor analyses were used to test validity (i.e. factor structure). RESULTS: Data indicated that the reliability and factor structure was similar to that reported in the questionnaire's standardization manual and consistent with that reported in a number of Anglo-Saxon countries. CONCLUSION: The present study offers additional support for the valid use of the QOL-Q with Spanish-speaking populations.
Assuntos
Deficiência Intelectual/etnologia , Deficiência Intelectual/psicologia , Qualidade de Vida/psicologia , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Análise Fatorial , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , EspanhaRESUMO
Sr2CoUO6 double perovskite has been prepared as a polycrystalline powder by solid-state reaction, in air. This material has been studied by X-ray, neutron powder diffraction (NPD) and magnetic measurements. At room temperature, the crystal structure is monoclinic, space group P2(1)/n, Z= 2, with a= 5.7916(2), b= 5.8034(2), c= 8.1790(3) A, beta= 90.1455(6)degrees. The perovskite lattice consists of a completely ordered array of CoO6 and UO6 octahedra, which exhibit an average tilting angle phi= 11.4 degrees. Magnetic and neutron diffraction measurements indicate an antiferromagnetic ordering below TN = 10 K. The low-temperature magnetic structure was determined by NPD, selected among the possible magnetic solutions compatible with the P2(1)/n space group, according with the group theory representation. The propagation vector is k= 0. A canted antiferromagnetic structure is observed below TN = 10 K, which remains stable down to 3 K, with an ordered magnetic moment of 2.44(7)mu(B) for Co2+ cations. The magnetic moment calculated from the Curie-Weiss law at high temperatures (5.22 mu(B)/f.u.) indicates that the orbital contribution is unquenched at high temperatures, which is consistent with high-spin Co2+((4)T(1g) ground state) in a quasi-regular octahedral environment. Magnetic and structural features are consistent with an electronic configuration Co2+[3d(7)]-U6+[Rn].
RESUMO
A study was carried out on the clinical response to antibiotics in 105 patients with chronic bacterial prostatitis. Two groups of patients were compared in a retrospective study. The results of rectal examination, ultrasound scan, microbiological analysis, and response to different antibiotic therapy regimens were compared. There was a high incidence of perineal-testicular pain and sexual potency reduction; prostate congestion and pain on rectal examination were frequently reported. All the patients had positive microbial cultures, with Gram-negative microorganisms being predominantly isolated. Following the administration of different antibiotic therapy regimens, symptoms either disappeared or diminished, irrespective of whether positive cultures remained. A poorer clinical response was observed in patients with positive prostate ultrasound and rectal examination, and with isolated Gram-negative bacilli. No differences were observed between either group in clinical response to different antimicrobial regimens.
Assuntos
Prostatite/microbiologia , Adulto , Antibacterianos/uso terapêutico , Doença Crônica , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Prostatite/diagnóstico , Prostatite/tratamento farmacológico , Estudos RetrospectivosRESUMO
BACKGROUND: The analgesic efficacy and bioavailability of 30 mg intramuscular ketorolac was studied in 24 patients with severe or very severe postoperative pain. METHODS: Pain and pain relief were determined by a five-point verbal rating scale and data were submitted to a probability analysis. Ketorolac plasma levels were determined by high-performance liquid chromatography. RESULTS: Two patients chose not to finish the study; 22 patients completed the study achieving at least good pain relief. Of these 22 patients, 13 reached complete pain relief. Ketorolac was rapidly absorbed. Notwithstanding, pain relief increased gradually, showing considerable delay with regard to plasma concentrations. Analysis of the probability-time curves revealed that 25% of the patients obtained moderate pain relief at 7 min after ketorolac administration, 50% at 11 min, 75% at 29 min, and 95% at 60 min. Good pain relief was achieved in 25, 50, and 75% of the patients at 1.1, 1.8, and 2.7 h, respectively. Complete pain relief was achieved in 25% and 50% of the patients at 2.6 h and 3.7 h, respectively. The probability of exhibiting an acceptable pain relief in responsive patients for more than 5 h was 0.97. No serious side effects were detected. CONCLUSIONS: Results show that 30 mg intramuscular ketorolac is an adequate treatment for postoperative pain in the Mexican population. Therefore, the use of higher doses is not justified. Due to gradual installation of analgesia, administration of additional analgesic medication before 1 h is not recommended.
Assuntos
Analgésicos não Narcóticos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Cetorolaco/uso terapêutico , Dor Pós-Operatória/tratamento farmacológico , Adulto , Analgésicos não Narcóticos/administração & dosagem , Analgésicos não Narcóticos/sangue , Analgésicos não Narcóticos/farmacocinética , Anti-Inflamatórios não Esteroides/administração & dosagem , Anti-Inflamatórios não Esteroides/sangue , Anti-Inflamatórios não Esteroides/farmacocinética , Disponibilidade Biológica , Cromatografia Líquida de Alta Pressão , Procedimentos Cirúrgicos Eletivos , Feminino , Humanos , Injeções Intramusculares , Cetorolaco/administração & dosagem , Cetorolaco/sangue , Cetorolaco/farmacocinética , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/sangue , Resultado do TratamentoRESUMO
A patients with multiple splenic abscesses of fungal origin ist presented. It is a unusual pathology that generally, only by postmortem ist diagnosed. The etiology, clinical features, diagnostic methods and therapeutic measures are discussed, and the necessity of early and accurate diagnostic and treatment. The prognosis of the splenic abscess is still associated with a high mortality.
Assuntos
Abscesso/diagnóstico , Candidíase/diagnóstico , Esplenopatias/diagnóstico , Abscesso/terapia , Idoso , Candidíase/terapia , Terapia Combinada , Quimioterapia Combinada , Evolução Fatal , Humanos , Masculino , Reoperação , Baço/diagnóstico por imagem , Esplenectomia , Esplenopatias/terapia , Tomografia Computadorizada por Raios XRESUMO
Hispanic clinicians in Texas, United States of America, and in the neighboring state of Nuevo Leon, Mexico, were surveyed to determine their educational needs in the area of HIV/AIDS. Two-thirds of the 74 Texan and 22% of the 104 Mexican physicians queried had seen at least one HIV/AIDS patient in the previous year. The majority of the respondents were primary care physicians who: 1) were in private practice; 2) saw more than 1,000 patients per year; 3) had been out of training for more than 10 years; 4) provided some HIV prevention education to patients based on their perceived risk of infection; 5) rated their own knowledge of HIV/AIDS as average but rated their knowledge of treatments for the disease below average; 6) received most of their information about HIV/AIDS from journals rather than formal continuing education programs; 7) thought Hispanic patients had special needs with regard to HIV/AIDS care; and 8) were willing to attend education programs to improve their HIV/AIDS management skills. The greatest barriers to caring for HIV patients were lack of clinical knowledge and fear of infection. These results point to a need for a large-scale training program to improve the HIV/AIDS management skills of Hispanic clinicians in Texas and Nuevo Leon.
Assuntos
Síndrome da Imunodeficiência Adquirida/diagnóstico , Educação Médica Continuada , Infecções por HIV/diagnóstico , Americanos Mexicanos , Síndrome da Imunodeficiência Adquirida/terapia , Adulto , Infecções por HIV/terapia , Humanos , México , Pessoa de Meia-Idade , Padrões de Prática Médica , Inquéritos e Questionários , TexasRESUMO
Objetivo: El momento ideal para indicar la cirugía en un paciente con rotura traumática de aorta torácica sigue siendo controvertido. Parece, a tenor de las últimas publicaciones, que existe una opinión favorable a demorar en lo posible dicha indicación. Revisamos con este objetivo nuestra experiencia. Material y métodos: Nuestra casuística es de 13 pacientes. Once fueron operados, 8 de ellos con carácter emergente y 3 programados a los 4, 15 y 120 días. Dos pacientes recibieron sólo tratamiento médico. Resultados: Cinco pacientes fallecieron (mortalidad operatoria del 38 por ciento). Tres de estos fallecidos fueron por fracaso multiorgánico a los 3, 10 y 40 días respectivamente. Estos tres pacientes fueron dos de ellos los que siguieron tratamiento médico y el tercero uno de los operados emergentemente. Los otros dos exitus fueron por shock hemorrágico. La mortalidad de los pacientes operados programadamente fue del 0 por ciento y la de los operados emergentemente del 37 por ciento. Conclusiones: Aunque en la mortalidad hospitalaria intervienen diversos factores, como grado e importancia de las lesiones asociadas, técnica quirúrgica, etc., consideramos que el tiempo ideal de indicación quirúrgica debe ser lo más precoz posible si no existen lesiones cerebrales o abdominales graves y el paciente está estabilizado metabólica y hemodinámicamente. Aunque existen diversas posibilidades de corrección, nos inclinamos por usar by pass parcial izquierdo lo que permite mejor protección medular y desarrollo de la técnica quirúrgica. Generalmente hemos usado la interposición de un injerto protésico
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Aorta Torácica/lesões , Traumatismos Torácicos/cirurgia , Aorta Torácica/cirurgia , Aorta Torácica , Procedimentos Cirúrgicos Cardiovasculares/métodos , Procedimentos Cirúrgicos Eletivos/normasRESUMO
Objetivo: El momento ideal para indicar la cirugía en un paciente con rotura traumática de aorta torácica sigue siendo controvertido. Parece, a tenor de las últimas publicaciones, que existe una opinión favorable a demorar en lo posible dicha indicación. Revisamos con este objetivo nuestra experiencia. Material y métodos: Nuestra casuística es de 13 pacientes. Once fueron operados, 8 de ellos con carácter emergente y 3 programados a los 4, 15 y 120 días. Dos pacientes recibieron sólo tratamiento médico. Resultados: Cinco pacientes fallecieron (mortalidad operatoria del 38 por ciento). Tres de estos fallecidos fueron por fracaso multiorgánico a los 3, 10 y 40 días respectivamente. Estos tres pacientes fueron dos de ellos los que siguieron tratamiento médico y el tercero uno de los operados emergentemente. Los otros dos exitus fueron por shock hemorrágico. La mortalidad de los pacientes operados programadamente fue del 0 por ciento y la de los operados emergentemente del 37 por ciento. Conclusiones: Aunque en la mortalidad hospitalaria intervienen diversos factores, como grado e importancia de las lesiones asociadas, técnica quirúrgica, etc., consideramos que el tiempo ideal de indicación quirúrgica debe ser lo más precoz posible si no existen lesiones cerebrales o abdominales graves y el paciente está estabilizado metabólica y hemodinámicamente. Aunque existen diversas posibilidades de corrección, nos inclinamos por usar by pass parcial izquierdo lo que permite mejor protección medular y desarrollo de la técnica quirúrgica. Generalmente hemos usado la interposición de un injerto protésico (AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Aorta Torácica/lesões , Traumatismos Torácicos/cirurgia , Procedimentos Cirúrgicos Cardiovasculares/métodos , Procedimentos Cirúrgicos Eletivos/normas , Aorta Torácica/cirurgia , Aorta Torácica/diagnóstico por imagemRESUMO
1. Cardiovascular responses to acetaldehyde (AChO) were investigated in rat isolated atria. 2. Results show that two different doses of AChO (0.29 and 0.88 mM) induce positive inotropic effects on rat atria, and express Ca2+ dependence when analyzed at three external Ca2+ concentrations (0.6, 1.1, 2.2 mM). 3. Cocaine (3.5 and 35 microM) produced significant potentiation of the AChO-positive (0.29 and 0.88 mM) inotropic effect in 1.1 mM Ca2+ medium. 4. Clonidine (40 microM) increased the peak tension developed (PTD) induced by AChO (both 0.29 and 0.88 mM) only 1.1 mM Ca2+ medium. 5. It is suggested that the positive inotropic effect produced by AChO involves a Ca2(+)-dependent mechanism, which can be potentiated by the additional stimulation of alpha-adrenergic receptors.
Assuntos
Acetaldeído/farmacologia , Cálcio/metabolismo , Clonidina/farmacologia , Cocaína/farmacologia , Átrios do Coração/efeitos dos fármacos , Animais , Feminino , Técnicas In Vitro , Masculino , Contração Miocárdica/efeitos dos fármacos , Ratos , Ratos WistarRESUMO
1. To test the hypothesis that lithium-induced body weight gain is related to an unbalance in the reproductive hormones, lithium carbonate (900 mg/day) or placebo was administered to healthy men for 1 month. 2. Body weight, skin folds and the serum levels of thyrotropic hormone, tetraiodothyroxine, prolactin, follicle-stimulating hormone, luteinizing hormone, testosterone (T5), dehydroepiandrosterone sulfate (DHEAS), estradiol (E2), cortisol, the ratios E2/T5 and T5/DHEA-S, and blood lipids were evaluated before and during treatment. 3. Body weight, skin folds, hormones and lipids serum levels were not significantly affected by the treatment with Li. These results agree with previous reports of lack of effects of 1 month-Li administration on appetite and body weight in normal male subjects (Chen et al., 1992), and question the appropriateness of studying Li-induced obesity in healthy volunteers, given the short-term administration and low doses of Li that must be used.
Assuntos
Peso Corporal/efeitos dos fármacos , Hormônios Esteroides Gonadais/sangue , Carbonato de Lítio/farmacologia , Adulto , Análise de Variância , Índice de Massa Corporal , Peso Corporal/fisiologia , Sulfato de Desidroepiandrosterona/sangue , Estradiol/sangue , Hormônio Foliculoestimulante/sangue , Humanos , Hidrocortisona/sangue , Lítio/sangue , Hormônio Luteinizante/sangue , Masculino , Prolactina/sangue , Radioimunoensaio , Valores de Referência , Reprodutibilidade dos Testes , Reprodução , Dobras Cutâneas , Testosterona/sangue , Hormônios Tireóideos/sangue , Tireotropina/sangue , Aumento de Peso/efeitos dos fármacosRESUMO
A case of diffuse mesothelioma in a young patient is presented. He had a history of asbestos exposure and was treated surgically with pleuropericardiopneumonectomy and intrapleural cysplatinum as the initial phase of the therapeutic strategy. It was followed by systemic cysplatinum and mytomicin C, and radiotherapy of the hemithorax. The patient survived 9 months with an aceptable relief of the pain and dyspnea. The different therapeutic procedures available are discussed. It is emphasized the utility of the extramusculoperiosteal resection in the extirpation of the costal pleura which results in a wider tumor free margin. The authors also discuss the indications and benefits of the pleuropneumonectomy as much as the use of intrapleural cysplatinum as the initial phase of the treatment followed by postoperative systemic chemotherapy.
Assuntos
Humanos , Masculino , Adulto , Pericárdio/cirurgia , Pleura/cirurgia , Neoplasias Pleurais/terapia , Pneumonectomia , Mesotelioma/terapia , Neoplasias Pleurais/cirurgia , Mesotelioma/cirurgiaRESUMO
Metabolic and endocrine abnormalities secondary to hyperprolactinemia, particularly hypogonadism, may be involved in the excessive body weight gain observed during treatment with antipsychotic drugs. The present study was conducted in healthy men in order to detect an endocrine imbalance secondary to antipsychotic drug administration, which, if sustained in the long term, might be involved in the development of obesity. Sulpiride (200 mg daily for 30 days) or placebo was nonblindly administered, and body weight gain was correlated with the serum levels of prolactin, luteinizing hormone, follicle-stimulating hormone, estradiol, free testosterone, thyrotropic hormone, free tetraiodothyroxine, cortisol, dehydroepiandrosterone sulphate (DHEA-S), and the ratios estradiol/testosterone and testosterone/DHEA-S; the blood lipids were also assessed. Body weight gain and the serum levels of prolactin were significantly increased by sulpiride; in addition, a significant positive correlation was observed between prolactin levels and body weight gain. Other endocrine parameters were not significantly affected by the drug. These short-term results show that in healthy men, body weight can be increased by antipsychotic drug administration; this effect may be related to hyperprolactinemia alone, since other endocrine parameters were normal at the time of treatment. A more prolonged treatment with antipsychotic agents might be required to observe the alterations in gonadal and adrenal steroids often detected in subjects with primary obesity.
Assuntos
Antipsicóticos/efeitos adversos , Peso Corporal/efeitos dos fármacos , Doenças do Sistema Endócrino/induzido quimicamente , Prolactina/sangue , Sulpirida/efeitos adversos , Adulto , Hormônios Esteroides Gonadais/sangue , Gonadotropinas Hipofisárias/sangue , Humanos , Lipídeos/sangue , Masculino , Estado Nutricional , Hormônios Tireóideos/sangueRESUMO
Metabolic and endocrine abnormalities secondary to hyperprolactinemia, such as hypogonadism and hyperandrogenicity, may be involved in the excessive body weight gain induced by antipsychotic drugs in women. The present study was conducted in healthy premenopausal women, in order to detect an endocrine imbalance secondary to antipsychotic drug administration, which, if sustained in the long term, might be involved in the development of obesity. After a control menstrual cycle, sulpiride (200 mg/day) or placebo was nonblindly administered for 28 days; blood lipids and the serum levels of the following hormones which are involved in body weight regulation were assessed at days 3, 10, 20 and 26 of the cycle: prolactin (PRL), 17-beta estradiol (E2), progesterone (P4), follicle stimulating hormone (FSH), luteinizing hormone (LH), free testosterone (T5), dehydroepiandrosterone sulfate (DHEAS), cortisol, tyrotropic hormone (TSH), tetraiodothyroxine (T4), and the areas under the insulin and glucose tolerance curve. During sulpiride administration, the following changes were observed when compared to placebo administration: PRL levels were significantly increased; E2 levels were significantly reduced at days 10 and 20; P4 levels were significantly reduced at day 20, and the area under the glucose tolerance curve was significantly increased. The other variables were not significantly affected. The body weight gain was higher during sulpiride than during placebo administration, but it did not reach statistical significance, perhaps because the period of treatment was too short. The decrease in the serum levels of E2 during sulpiride administration is probably secondary to hyperprolactinemia. It affects the E2/T5 ratio in the direction of increasing the androgenic activity, as observed in women with well-established obesity. This effect, along with a genetic predisposition, increased appetite, hypoactivity and ignorance of proper dietary habits, may explain the excessive weight gain and obesity observed in women during chronic treatment with sulpiride and other antipsychotic agents.