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1.
Asian Pac J Cancer Prev ; 25(7): 2219-2227, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-39068552

RESUMO

OBJECTIVE: To identify the difference in breast cancer mortality rates among young women according to countries' economic classification. METHODS: A systematic literature review included retrospective studies on breast cancer mortality rates in women aged 20 to 49 years. Databases used were PubMed, Web of Science, Scopus, and Virtual Health Library, with articles selected in English, Portuguese, and Spanish. The study selection and analysis were conducted by two pairs of researchers. Data from 54 countries were extracted, including 39 high-income, 12 upper-middle-income, and 3 lower-middle-income countries. A meta-analysis was performed with the quantitative data from two studies. RESULTS: Six articles met the inclusion criteria. Four were analyzed descriptively due to data diversity, and two were included in the meta-analysis. The pooled mortality rate for high-income countries was 10.2 per 100,000 women (95% CI: 9.8-10.6), while for upper-middle-income countries, it was 15.5 per 100,000 women (95% CI: 14.9-16.1). Lower-middle-income countries had a pooled mortality rate of 20.3 per 100,000 women (95% CI: 19.5-21.1). The decrease in mortality rates in high-income countries was statistically significant (p<0.05). CONCLUSION: Mortality rates for breast cancer among young women have decreased significantly in high-income countries but have increased in lower-income countries. This disparity underscores the impact of insufficient investment in preventive measures, health promotion, early diagnosis, and treatment on young women's mortality in lower-income countries.


Assuntos
Neoplasias da Mama , Países Desenvolvidos , Países em Desenvolvimento , Humanos , Feminino , Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Prognóstico , Adulto Jovem , Adulto , Taxa de Sobrevida , Renda , Pessoa de Meia-Idade , Fatores Socioeconômicos
2.
Clinics (Sao Paulo) ; 79: 100396, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38843677

RESUMO

OBJECTIVE: To analyze whether infants admitted to hospital with Acute Viral Bronchiolitis (AVB), who received glucocorticoids and bronchodilators, and who had an atopic phenotype, spent less time in hospital and/or less time on oxygen therapy when compared to those who did not have the phenotype. METHOD: A cross-sectional, retrospective epidemiological study was developed with data from medical records of infants admitted to hospital due to AVB from 2012 to 2019 in a sentinel public hospital. It was verified that the frequency of prescription of glucocorticoids, bronchodilators and antibiotics. Length of stay and oxygen therapy duration were then compared in the group that used glucocorticoids and bronchodilators between those who had a personal or family history of atopy and those who did not. Subsequently, the length of hospital stay was compared among infants who received antibiotic therapy and those who did not. RESULTS: Fifty-eight infants were included. Of these, 62.1 % received an antibiotic, 100 % a bronchodilator and 98.3 % a glucocorticoid. When comparing infants without a family history of atopy, those who received antibiotics had a longer hospital stay (p = 0.01). CONCLUSION: The presence of an atopic phenotype did not interfere with the length of stay and/or oxygen therapy duration of those who received bronchodilators and glucocorticoids. Increased length of stay of infants without a family history of atopy, who used antibiotics without evidence of bacterial co-infection, and the high frequency of prescription of non-recommended drugs call attention to stricter protocol implementation and professional training in AVB diagnosis and care.


Assuntos
Bronquiolite Viral , Broncodilatadores , Glucocorticoides , Tempo de Internação , Fenótipo , Humanos , Broncodilatadores/uso terapêutico , Glucocorticoides/uso terapêutico , Masculino , Estudos Retrospectivos , Estudos Transversais , Bronquiolite Viral/tratamento farmacológico , Feminino , Lactente , Tempo de Internação/estatística & dados numéricos , Doença Aguda , Antibacterianos/uso terapêutico , Oxigenoterapia , Resultado do Tratamento
3.
Crit Rev Toxicol ; 54(1): 35-54, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38288970

RESUMO

Although studies show that pesticides, especially insecticides, may be toxic to humans, publications on the neurological effects of fungicides are scarce. As fungicides are used widely in Brazil, it is necessary to gather evidence to support actions aimed at safely using of these chemicals. We investigated through a systematic review of publications on the use of fungicides and consequences of exposure related to nervous system diseases or neurological disorders in humans. The protocol review was registered on PROSPERO and followed the guidelines of the PRISMA-Statement. As far as it is known, there is no apparent systematic review in the literature on this topic. The search was comprised of the following databases: PubMed; Web of Science; Scopus and EMBASE, using groups of Mesh terms and strategies specific to each database. Thirteen articles were selected for this review. Regarding the substances analyzed in the studies, some reported the use of fungicides in general, without separating them by type, while others summarized the categories of all pesticides by their function (insecticides, herbicides, fungicides, etc.) or chemical class (dithiocarbamate, dicarboximide, inorganic, etc.). However, most of the articles referred to fungicides that contain the metal manganese (Mn) in their composition. As for neurological disorders, articles addressed Parkinson's disease (PD), neurodevelopmental outcomes, extrapyramidal syndrome resembling PD, cognitive disorders, depression, neural tube defects, motor neurone disease, and amyotrophic lateral sclerosis. Most investigations pointed to exposure to fungicides, mainly maneb and mancozeb, leading to the development of at least one neurological disease, which suggests the need for further multicentric clinical trials and prospective studies for greater clarity of the research problem.


Assuntos
Fungicidas Industriais , Doenças do Sistema Nervoso , Humanos , Fungicidas Industriais/toxicidade , Doenças do Sistema Nervoso/induzido quimicamente , Fatores de Risco , Brasil
4.
Clinics ; Clinics;79: 100396, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1564370

RESUMO

Abstract Objective To analyze whether infants admitted to hospital with Acute Viral Bronchiolitis (AVB), who received glucocorticoids and bronchodilators, and who had an atopic phenotype, spent less time in hospital and/or less time on oxygen therapy when compared to those who did not have the phenotype. Method A cross-sectional, retrospective epidemiological study was developed with data from medical records of infants admitted to hospital due to AVB from 2012 to 2019 in a sentinel public hospital. It was verified that the frequency of prescription of glucocorticoids, bronchodilators and antibiotics. Length of stay and oxygen therapy duration were then compared in the group that used glucocorticoids and bronchodilators between those who had a personal or family history of atopy and those who did not. Subsequently, the length of hospital stay was compared among infants who received antibiotic therapy and those who did not. Results Fifty-eight infants were included. Of these, 62.1 % received an antibiotic, 100 % a bronchodilator and 98.3 % a glucocorticoid. When comparing infants without a family history of atopy, those who received antibiotics had a longer hospital stay (p = 0.01). Conclusion The presence of an atopic phenotype did not interfere with the length of stay and/or oxygen therapy duration of those who received bronchodilators and glucocorticoids. Increased length of stay of infants without a family history of atopy, who used antibiotics without evidence of bacterial co-infection, and the high frequency of prescription of non-recommended drugs call attention to stricter protocol implementation and professional training in AVB diagnosis and care.

5.
Future Microbiol ; 18: 1279-1299, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37882762

RESUMO

Aim: To review in vitro, in vivo, and in silico studies examining the antibacterial and immunomodulatory properties of piperine (PPN). Methods: This systematic review followed PRISMA guidelines, and five databases were searched. Results: A total of 40 articles were included in this study. Six aspects of PPN activity were identified, including antibacterial spectrum, association with antibiotics, efflux pump inhibition, biofilm effects, protein target binding, and modulation of immune functions/virulence factors. Most studies focused on Mycobacterium spp. and Staphylococcus aureus. Cell lineages and in vivo models were employed to study PPN antibacterial effects. Conclusion: We highlight PPN as a potential adjuvant in the treatment of bacterial infections. PPN possesses several antibacterial properties that need further exploration to determine the mechanisms behind its pharmacological activity.


Assuntos
Alcaloides , Antibacterianos , Antibacterianos/química , Alcaloides/farmacologia , Benzodioxóis/farmacologia , Piperidinas/farmacologia , Testes de Sensibilidade Microbiana
6.
Biomedicines ; 11(2)2023 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-36830811

RESUMO

Despite the options available for breast cancer (BC) therapy, several adverse effects and resistance limit the success of the treatment. Furthermore, the use of a single drug is associated with a high failure rate. We investigated through a systematic review the in vitro effects of the combination between conventional drugs and bioactive compounds derived from cinnamic acid in BC treatment. The information was acquired from the following databases: PubMed, Web of Science, Embase, Scopus, Lilacs and Cochrane library. We focused on "Cinnamates", "Drug Combinations" and "Breast neoplasms" for publications dating between January 2012 and December 2022, based on the PRISMA statement. The references of the articles were carefully reviewed. Finally, nine eligible studies were included. The majority of these studies were performed using MCF-7, MDA-MB-231, MDA-MB-468 and BT-20 cell lines and the combination between cisplatin, paclitaxel, doxorubicin, tamoxifen, dactolisib and veliparib, with caffeic acid phenethyl ester, eugenol, 3-caffeoylquinic acid, salvianolic acid A, ferulic acid, caffeic acid, rosmarinic acid and ursolic acid. The combination improved overall conventional drug effects, with increased cytotoxicity, antimigratory effect and reversing resistance. Combining conventional drugs with bioactive compounds derived from cinnamic acid could emerge as a privileged scaffold for establishing new treatment options for different BC types.

7.
Phytother Res ; 36(9): 3505-3528, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35858779

RESUMO

Phytolaccaceae is a plant family of the order Caryophyllales, which includes species used in traditional medicine to treat diseases. The purpose of this study was to investigate Phytolaccaceae family plants with potential antimicrobial action, through a systematic review. The study was conducted following the criteria of PRISMA protocol. The search was performed in the electronic databases PubMed, Web of Science, Scopus, and LILACS, in March 2021. The search strategy used free descriptors and terms, limiting articles to the English language, regardless of publication year. The risk of bias and the quality of publications were based on the CONSORT checklist, modified for in vitro studies and SYRCLE's RoB tool for in vivo study. Five independent judges performed quality assessments of publications and risk of bias analysis. Ninety-five publications were retrieved from the databases and, after screening and eligibility criteria, 22 articles remained, from 1998 to 2019. In the selected studies, the plants were obtained from eight countries. In vivo and in vitro studies of extracts from the Phytolaccaceae family plants, evaluating antibacterial (8 publications), antifungal (8), anti-Trypanosoma (2), anti-Leishmania (2), antiviral (1), and antiamoebic (1) activities, are included. The plant species identified belong to genera Petiveria, Phytolacca, Gallesia, Trichostigma, and Seguieria. The risk of bias in the 22 publications both in vitro and in vitro was suboptimal. The evidence obtained showed that the Phytolaccaceae family, a source of plants with antimicrobial action, can serve as a basis for the creation of new herbal medicines, expanding the possibility of treatment for infectious diseases and stimulating their preservation and biodiversity. However, more high-quality studies are needed to establish the clinical efficacy of the plant.


Assuntos
Phytolaccaceae , Plantas Medicinais , Antifúngicos/uso terapêutico , Medicina Tradicional , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico
8.
Int J Antimicrob Agents ; 59(5): 106578, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35367599

RESUMO

The objective of this systematic review was to retrieve and examine published studies related to in vitro and in vivo evaluation of disulfiram for the treatment of bacterial infections. Five scientific databases (PubMed, Embase, Scopus, Web of Science, and Latin American and Caribbean Health Sciences Literature) were searched to retrieve the maximum literature regarding the study's aim. The search strategy retrieved a total of 870 studies, of which 31 were included and 19 approached disulfiram as the primary aim and 12 included it as a secondary finding from other investigational objectives. The evidence pointed out five main aspects of pre-clinical testing regarding disulfiram antibacterial activity, namely spectrum of antimicrobial action, drug combinations, intracellular studies, animal studies and bacterial targets. Findings to emerge from this study are the observed potential of disulfiram as a non-antibiotic drug being proposed as a potential drug to contribute to the treatment of bacterial diseases usually with few treatment alternatives in the context of drug resistance. We evaluated the potency and selectivity of disulfiram, which indeed until now shows potential to be explored for use as an adjunctive chemical to antimicrobial ones. Even with the level of evidence being reserved, the potential of combining disulfiram with other drugs, already used or new to be used for the treatment of mycobacterial diseases, as well as its likely immunomodulatory effect, deserve to be further investigated. Furthermore, the copper-dependent mode of action in Gram-positive bacteria is an alternative to be explored in drug design or repurposing of chemicals.


Assuntos
Anti-Infecciosos , Infecções Bacterianas , Animais , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Dissulfiram/farmacologia , Dissulfiram/uso terapêutico , Bactérias Gram-Positivas
9.
Rev Soc Bras Med Trop ; 55: e0418, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35239907

RESUMO

BACKGROUND: Many human immunodeficiency virus (HIV) and syphilis co-infected patients are not diagnosed, which may evolve into asymptomatic neurosyphilis (ANS). We studied the occurrence of ANS an HIV-infected population. METHODS: This was a cross-sectional study of cerebrospinal fluid (CSF) samples collected from patients co-infected with HIV and Treponema pallidum. Social-demographic and clinical-laboratory characteristics were studied. RESULTS: Of the 348 patients infected with HIV, 33 (9.5%) had reagent treponemic and non-treponemic tests. CSF was collected from 19 asymptomatic patients. Of these, 8 (42.1%) presented with laboratory alterations suggestive of ANS. CONCLUSION: Social-demographic and clinical-laboratory variables should be considered for the indication of CSF collection.


Assuntos
Infecções por HIV , Neurossífilis , Sífilis , Estudos Transversais , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Humanos , Neurossífilis/complicações , Neurossífilis/diagnóstico , Neurossífilis/epidemiologia , Sífilis/complicações , Sífilis/diagnóstico , Sífilis/epidemiologia , Treponema pallidum
10.
Parasitol Res ; 121(5): 1247-1280, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35190878

RESUMO

Leishmaniasis affects millions of people worldwide, and available treatments have severe limitations. Natural and derivative products are significant sources of innovative therapeutic agents. Naphthoquinones are natural or synthetic chemical compounds with broad biological activity. This systematic review aimed to evaluate the potential anti-Leishmania activity of bioactive compounds derived from naphthoquinones in animal models. Conducted in accordance with PRISMA guidelines, two blocks of MeSH terms were assembled: group I, Leishmania OR Leishmaniasis; group II, Atovaquone OR Lapachol OR Beta lapachone OR Naphthoquinones. The search was performed on PubMed, Web of Science, SCOPUS, EMBASE, and Lilacs databases. Twenty-four articles were retrieved and submitted for quality assessment using the SYRCLE critical appraisal tool. The in vivo anti-Leishmania potential of naphthoquinones was evaluated in visceral and cutaneous leishmaniasis using several measurement parameters. Analyzed compounds varied in structure, association with reference drugs, and encapsulation using a drug delivery system. The study design, including treatment protocol, differed between studies. The findings of the studies in this systematic review indicate the anti-Leishmania potential of naphthoquinones in vivo, with different treatment regimens directed against different Leishmania species. The employed drug delivery systems improve the results concerning selectivity, distribution, and required therapeutic dose. The immunomodulatory action was shown to be beneficial to the host, favoring an adequate immune response against infection by Leishmania parasites since it favored Th1 responses. All studies presented a moderate to high risk of bias. These findings suggest that more studies are needed to assess the overall effectiveness and safety of these treatments.


Assuntos
Antiprotozoários , Leishmania , Leishmaniose Cutânea , Naftoquinonas , Animais , Animais de Laboratório , Antiprotozoários/uso terapêutico , Humanos , Leishmaniose Cutânea/tratamento farmacológico , Naftoquinonas/química , Naftoquinonas/farmacologia
11.
Rev. Soc. Bras. Med. Trop ; Rev. Soc. Bras. Med. Trop;55: e0418, 2022. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1360827

RESUMO

ABSTRACT Background: Many human immunodeficiency virus (HIV) and syphilis co-infected patients are not diagnosed, which may evolve into asymptomatic neurosyphilis (ANS). We studied the occurrence of ANS an HIV-infected population. Methods: This was a cross-sectional study of cerebrospinal fluid (CSF) samples collected from patients co-infected with HIV and Treponema pallidum. Social-demographic and clinical-laboratory characteristics were studied. Results: Of the 348 patients infected with HIV, 33 (9.5%) had reagent treponemic and non-treponemic tests. CSF was collected from 19 asymptomatic patients. Of these, 8 (42.1%) presented with laboratory alterations suggestive of ANS. Conclusion: Social-demographic and clinical-laboratory variables should be considered for the indication of CSF collection.

12.
Complement Ther Med ; 63: 102781, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34627993

RESUMO

OBJECTIVE: To investigate evidence for the treatment of childhood colic by supplementing Lactobacillus reuteri in infants breastfed with breast milk. METHODS: The study was conducted according to the PRISMA protocol. The databases used for acquiring data were PubMed and Web of Science, applying MeSH terms and free terms. Meta-analysis was conducted using Stata ™ 12.0. The risk of bias was evaluated by the Review Manager (RevMan) 5.3 tool, and the strength of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS: Ten clinical trials were included in the review. The administration of L. reuteri (DSM 17938 or ATCC55730) was tested in infants (n = 248) versus the control/placebo group (n = 229). Eight articles were included in the meta-analysis. There was a significant response in reducing crying time (minutes/day) and treatment effectiveness (reduction ≥ 50% in average daily crying time) in the first week (p = 0.001 and p = 0.003, respectively). These results were similar in the second, third weeks (p < 0.001 for both outcomes) and fourth weeks (p<0.001 and p = 0.002, respectively). The risk of bias was low for the majority of the studies. Confidence in evidence was considered very low for crying time and low for effectiveness treatment. CONCLUSIONS: The evidence shows that the administration of Lactobacillus reuteri to babies fed with breast milk reduces the crying time in babies diagnosed with colic. But our confidence in the effect estimate is limited.


Assuntos
Cólica , Limosilactobacillus reuteri , Probióticos , Aleitamento Materno , Cólica/prevenção & controle , Choro , Feminino , Humanos , Lactente
13.
Saúde Pesqui. (Online) ; 14(4): e7625, out-dez. 2021.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1358985

RESUMO

O objetivo desta pesquisa foi conhecer o consumo de álcool entre estudantes de uma universidade no sul do Brasil. Realizou-se estudo transversal, quantitativo, com acadêmicos de Biomedicina (n=134) por meio do instrumento Alcohol Use Disorders Identification Test, versão traduzida. Utilizou-se teste estatístico para verificar associação entre variáveis categóricas. Houve predomínio de mulheres, de 18 a 21 anos. Verificou-se início precoce de consumo de álcool, anterior à chegada à universidade, vinculado a festas e companhia de amigos. Após ingressar no curso, 41,04% disseram ter aumentado a ingestão (p=0,0001). Quanto ao risco, 72,38% foram classificados como consumidores de baixo risco, 19,39% como de risco, 5,98% de alto risco e 2,25% dependentes. Ser acadêmico da área da saúde e conhecer os prejuízos associados ao consumo do álcool não favorece a adoção de um estilo de vida saudável. Evidencia-se que o uso de álcool não é exclusivamente influenciado pelo conhecimento dos riscos.


This research aimed to know about alcohol consumption among students at a university in southern Brazil. A cross-sectional, quantitative study was carried out with Biomedicine students (n = 134) using the Alcohol Use Disorders Identification Test, translated version. Statistical tests were used to verify the association between categorical variables. There was a predominance of women, aged 18 to 21 years. There was an early onset of alcohol consumption, prior to arrival at the university, linked to parties and the company of friends. After entering the course, 41.04% said they had increased their intake (p = 0.0001). As for risk, 72.38% were classified as low risk consumers, 19.39% as risk consumers, 5.98% high risk and 2.25% dependent. Being a health academic and knowing the losses associated with alcohol consumption does not favor the adoption of a healthy lifestyle. It is evident that the use of alcohol is not exclusively influenced by the knowledge of the risks.

14.
Saudi Pharm J ; 29(6): 586-596, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34194265

RESUMO

OBJECTIVES: To compare the results of conventional serological tests and molecular technology (NAT, Nucleic Acid Amplification Test), identify donors in the diagnostic window period, and determine the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) among the samples of blood donors blocked by serological screening. METHODS: A retrospective cross-sectional study was carried out by analyzing blood donor information contained in the database of 20 blood centers in Paraná, from January 2018 to December 2019. RESULTS: A total of 1,496 blood bags were reactive for HBV, HCV, or HIV in serological and/or NAT tests. The 20th Regional Health (RH) Unit had the greatest number of unfit individuals with altered screening for the three infections, with a prevalence of 0.70%. The lowest number of blocked blood donors occurred in the 15th RH, with a prevalence of 0.08%. The highest prevalence of HBV occurred in the 8th RH, with a reagent serology of 0.34% and a positive NAT of 0.17%. For HCV, the prevalence for reagent serology was 0.28%, while that for NAT was 0.02%, which occurred in the 20th RH. For HIV and for NAT, the prevalence of blood donors with positive serology occurred in the 20th RH, at 0.25% and 0.04%, retrospectively. The 13th RH had the highest prevalence of HIV in relation to NAT, that is, conventional serology in concomitance with NAT technology, at 0.07%. During the 2-year period, only 1 reactive donor in the 9th was found for NAT (HBV), in a diagnostic window. CONCLUSION: In Paraná's blood centers, the inability to donate due to HBV, HCV, and HIV, occurred mainly in initial donors, men, those with >8 years of education, aged 16-45 years, married, and O positive. The most affected regions were located in the west and northwest of Paraná. Most of the results showed a discrepancy between the methodologies used.

15.
Nanomedicine (Lond) ; 16(17): 1505-1518, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34189952

RESUMO

Background: Nanotechnology is a promising strategy to improve existing antileishmanial agents. Objective: To explore the evidence of encapsulated meglumine antimoniate for cutaneous leishmaniasis treatment in animal models. Materials & methods: The studies were recovered from PubMed, Scopus, EMBASE, LILACS, WoS and Google according to eligibility criteria following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Population, Intervention, Comparison, Outcomes and Study design (PICOS) strategy. Study appraisal was assessed using the Animal Research Reporting of In Vivo Experiments, SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) recommendations. Results: Five studies were included. Liposomes, metallic and polymeric nanoparticles were tested in BALB/c mice against Leishmania major, L. tropica or L. amazonensis. Limitations: Few studies were found to meet the eligibility criteria. Conclusion: All formulations had a significant efficacy, similar to the meglumine antimoniate reference treatment concerning the lesion size and parasite burden. The studies had a high and moderate risk of bias, and the confidence in cumulative evidence was considered low. Therefore, we encourage the development of high-quality preclinical studies. Registration: PROSPERO register CRD42020170191.


Assuntos
Antiprotozoários , Leishmaniose Cutânea , Nanopartículas , Animais , Antiprotozoários/uso terapêutico , Leishmaniose Cutânea/tratamento farmacológico , Antimoniato de Meglumina , Camundongos , Camundongos Endogâmicos BALB C
16.
Immunotherapy ; 13(8): 693-721, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33853344

RESUMO

Aim: Current treatments for leishmaniases are not satisfactory, thus alternatives are needed. We searched for clinical trials with immunotherapeutic approaches for patients with leishmaniasis. Materials & methods: Out of 205 articles, 24 clinical trials were selected, and eight submitted to meta-analysis. Results: A reduction in healing time was observed in patients with tegumentary leishmaniasis treated with pentavalent antimony plus granulocyte-macrophage colony-stimulating factor, and therapeutic vaccines. Overall meta-analysis indicated that immunotherapy associated with the standard chemotherapy generated a significantly reduced risk of treatment failure than the pentavalent antimony alone (p = 0.03). Conclusion: Our review confirmed the efficacy of immunotherapies for the treatment of cutaneous and visceral leishmaniasis and highlighted the importance of clinical trials using immunotherapies for leishmaniases.


Assuntos
Antiprotozoários/uso terapêutico , Imunoterapia/métodos , Leishmaniose/terapia , Humanos , Vacinas contra Leishmaniose/uso terapêutico
17.
Expert Rev Clin Immunol ; 17(5): 513-537, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33749481

RESUMO

OBJECTIVES: The outcomes of tegumentary leishmaniasis (TL) rely on a complex interaction between the host immune system and the parasite. This study assessed the influence of polymorphisms in immune-related genes on TL. METHODS: Web of Science, Scopus, PubMed, and Embase databases were searched systemically. The meta-analysis used a retrospective model in examining alleles, heterozygotes, and homozygotes. A quality assessment and an analysis of cumulative evidence were performed. RESULTS: A total of 29 genes (encoding for cytokines, chemokines, and other immune receptors) and 84 polymorphisms were analyzed. The IL-1ß_rs16944 (OR = 1.341, p = 0.003), TNF-α_rs1800629 (OR = 3.804, p = 0.004), MIF_rs755622 (OR = 3.357, p = 0.001), and INF- γ_rs243056 (OR = 1.670, p = 0.028) polymorphisms were speculated as risk factor for TL. They decrease the expression of the corresponding genes crucial for TL control. The quality assessment score was approximately 50%, suggesting the need for a clear method and polymorphism characterization for further comparison. The relevant risk of bias and other considerations resulted in low and moderate cumulative evidence confidence. CONCLUSIONS: IL-1ß_rs16944, TNF-α_rs1800629, MIF_rs755622, and INF-γ_rs2430561 polymorphisms were speculated as risk factor for TL, corroborating that IL-1ß, TNF-α, INF-γ, and MIF are involved in the TL pathogenesis.


Assuntos
Predisposição Genética para Doença , Sistema Imunitário , Leishmaniose , Humanos , Leishmaniose/genética , Leishmaniose/imunologia , Polimorfismo de Nucleotídeo Único
18.
Saúde Pesqui. (Online) ; 14(1): 161-173, jan-mar 2021.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1252953

RESUMO

Investigamos publicações científicas sobre o padrão prescritivo de medicamentos para hipertensão arterial sistêmica e uso de diretrizes na atenção primária em saúde por revisão sistemática e meta-análise. Os artigos foram selecionados nas bases de dados PubMed, Web of Science e LILACS, de acordo com as declarações PRISMA, de 2004 a 2020. A revisão sistemática mostrou um padrão de prescrição superior para terapia combinada (52,9%). A metanálise confirmou a superioridade para a terapia combinada (OR 1,76; IC 1,29 - 2,41). Foi observada maior prevalência de monoterapia no estudo Sueco (98%) e terapia combinada no Nigeriano (98%). Maior frequência prescritiva de inibidores da enzima de conversão da angiotensina em Trinidade (64%); diuréticos (64%), betabloqueadores (63%) e bloqueadores dos canais de cálcio (53%) na Nigéria; e bloqueadores dos receptores da angiotensina (43%) em Portugal. Quanto ao uso das diretrizes, 53% dos estudos relataram a sua utilização na prescrição de anti-hipertensivos na atenção primária em saúde.


We investigated scientific publications on the prescription pattern of systemic hypertension drugs and use of guidelines in primary health care by systematic review and meta-analysis. Articles were selected in the PubMed, Web of Science and LILACS databases, according to the PRISMA statements, from 2004 to 2020. The systematic review showed a higher prescription pattern for combination therapy (52,9%). The meta-analysis confirmed the superiority of prescription for combination therapy (OR 1.76, CI 1.29 - 2.41). Was observed higher monotherapy prevalence in the Swedish study (98%) and combined therapy in Nigerian (98%). Higher frequency prescriptive of angiotensin-converting enzyme inhibitors in Trinidad (64%); diuretics (64%), beta blockers (63%), and calcium channel blockers (53%) in Nigeria; and angiotensin-receptor blockers (43%) in Portugal. Regarding the use of guidelines, 50% the studies reported their use for the prescription of antihypertensive in primary health care.

19.
Parasitology ; 147(13): 1392-1407, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32741424

RESUMO

This systematic review investigated the evidence for the therapeutic potential of essential oils (EOs) against Leishmania amazonensis. We searched available scientific publications from 2005 to 2019 in the PubMed and Web of Science electronic databases, according to PRISMA statement. The search strategy utilized descriptors and free terms. The EOs effect of 35 species of plants identified in this systematic review study, 45.7% had half of the maximal inhibitory concentration (IC50) 10 < IC50 ⩽ 50 µg mL-1 and 14.3% had a 10 < IC50µg mL-1 for promastigote forms of L. amazonensis. EOs from Cymbopogon citratus species had the lowest IC50 (1.7 µg mL-1). Among the plant species analyzed for activity against intracellular amastigote forms of L. amazonensis, 39.4% had an IC50 10 < IC50 ⩽ 50 µg mL-1, and 33.3% had an IC50 10 < IC50µg mL-1. Aloysia gratissima EO showed the lowest IC50 (0.16 µg mL-1) for intracellular amastigotes. EOs of Chenopodium ambrosioides, Copaifera martii and Carapa guianensis, administered by the oral route, were effective in reducing parasitic load and lesion volume in L. amazonensis-infected BALB/c mice. EOs of Bixa orellana and C. ambrosioides were effective when administered intraperitoneally. Most of the studies analyzed in vitro and in vivo for the risk of bias showed moderate methodological quality. These results indicate a stimulus for the development of new phytotherapy drugs for leishmaniasis treatment.


Assuntos
Antiprotozoários/farmacologia , Leishmania mexicana/efeitos dos fármacos , Magnoliopsida/química , Óleos Voláteis/farmacologia , Especificidade da Espécie
20.
J Altern Complement Med ; 26(10): 866-883, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32551918

RESUMO

Objective: To investigate, through a systematic review, the effects of the use of highly diluted drugs in the treatment of experimental infection with Trypanosoma cruzi. Design: The authors searched for scientific publications in the databases PubMed, Web of Science, SCOPUS, LILACS, and the Google Scholar search system, from 2000 to 2018, following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. According to the criteria established, a total of 22 studies were included. Settings/Location: The study took place at the State University of Maringá, Maringá, PR, Brazil. Subjects: Male mice (Mus musculus) or rats (Rattus norvegicus). Interventions: Highly diluted drugs. Outcome measures: The parameters evaluated in the studies were parasitological, clinical, immunological, histopathological and hematological. Results: The studies demonstrated that the effects of highly diluted drugs are related to their dynamizations, treatment regimen, and host susceptibility to T. cruzi infection, and depend on the initial information transmitted to the treated organism, making this information the "model" of how the treated organism will react. Regardless of the mechanism of action, these drugs provide a decrease in inflammation, which is one of the central phenomena of the pathogenesis of T. cruzi infection. Conclusions: This systematic review brings out the importance of the T. cruzi infection model as a reliable and valid model for studying different effects produced by highly diluted drugs. Considering the findings and in a broader perspective, this study contributes to considering these drugs as a possible way of dealing with "treatment" in general, presents the need to reexamine the biochemical model and develop a model for the effect of high dilutions in general, as well as for the treatment of parasitic infections.


Assuntos
Antiparasitários/farmacologia , Produtos Biológicos/farmacologia , Doença de Chagas/tratamento farmacológico , Homeopatia/métodos , Tripanossomicidas/farmacologia , Trypanosoma cruzi/efeitos dos fármacos , Animais , Antiparasitários/uso terapêutico , Produtos Biológicos/uso terapêutico , Terapia Biológica , Relação Dose-Resposta a Droga , Humanos , Tripanossomicidas/uso terapêutico
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