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1.
Rev. argent. coloproctología ; 35(1): 40-44, mar. 2024. ilus
Artigo em Espanhol | LILACS | ID: biblio-1551683

RESUMO

En este reporte presentamos tres pacientes en quienes ocurrieron condiciones inflamatorias perianales tardías, luego de la administración de sustancias modeladoras no identificadas en los glúteos. El diagnóstico inicial y supuesto no fue correcto, ya que no se investigó durante la evaluación preliminar el antecedente de la administración de elementos modeladores. Recomendamos que los pacientes con patologías inflamatorias del ano, sobre todo aquellos cuyo curso es extraño, se les pregunte acerca de la administración de agentes modeladores en los glúteos. Esta práctica puede contribuir a la eficacia del diagnóstico de manifestaciones perianales caracterizadas por flogosis, que se presentan de forma inusual. (AU)


In this report we present three patients in which late perianal inflammatory conditions occurred after administration of unidentified modeling agents to the buttocks. The initial diagnosis was not correct because of the administration of modeling agents was not investigated during the initial eval-uation. We recommend inquiring patients with inflammatory pathologies of the anus, especially those whose course is unusual, about the adminis-tration of modeling agents to the buttocks. This approach can contribute to the efficiency of the diagnosis of perianal complaints characterized by inflammation, but rare in its appearance. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Doenças do Ânus/cirurgia , Doenças do Ânus/etiologia , Biopolímeros/efeitos adversos , Nádegas/cirurgia , Doenças do Ânus/diagnóstico , Técnicas Cosméticas , Migração de Corpo Estranho , Implantação de Prótese/efeitos adversos
2.
Rev Alerg Mex ; 70(4): 203, 2023 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-37933944

RESUMO

Background: Fixed erythema pigmento (FPE) is an allergic drug reaction, the pathophysiology of which is not exactly known. It is more common in women with location on the face. Clinical presentation: round or oval red-purple macule, well defined, with swelling, pain, itching, and burning. Diagnosis is clinical, oral chal- lenge is contraindicated due to possible severe reaction. On withdrawal of the drug, residual violaceous hyperpigmentation remains. Case report: 34-year-old female diagnosed with allergic rhinitis and asthma. She received treatment with ibuprofen and cephalexin 1 month ago due to dental infection. For the past 2 weeks, she has presented dermatological lesions characterized by hyperpigmentation under the lower eyelids, accompanied by pain, burning, and itching. On physical examination, well-defined red-purple pigmentation was observed in both periocular regions. The challenge test is not justified, the clinical history is the diagnostic pillar. The indication is to stop the medication immediately and continue monitoring. Conclusions: EPF is a drug reaction related to drug use. It creates a challenge for diagnosis due to poor knowledge of the characteristics of the dermatosis and poor clinical and pharmacological questioning. The EPF approach requires knowing the clinical characteristics of this dermatosis, making a differential diagnosis with other lesions and indicating the suspension of the responsible medication.


Antecedentes: El eritema pigmentado fijo (EPF) es una reacción alérgica medicamentosa, de la cual no se conoce con exactitud la fisiopatología. Es más frecuente en la mujer con localización en la cara. Presentación clínica: mácula redonda u oval de color rojo-violáceo, bien delimitada, con edema con dolor, prurito y ardor. El diagnóstico es clínico, contraindicado el reto oral por posible reacción grave. Al retirar el fármaco, queda una hiperpigmentación residual violácea. Reporte de caso: Femenina de 34 años con diagnóstico de rinitis alérgica y asma, Recibió tratamiento con Ibuprofeno y cefalexina hace 1 mes debido a proceso infeccioso dental. Desde hace 2 semanas presenta lesiones dermatológicas caracterizadas por hiperpigmentación debajo de párpados inferiores, acompañado de dolor, ardor y prurito. A la exploración física en ambas regiones perioculares se observa pigmentación bien delimitada rojo-violáceo. La prueba de reto no se justifica, la historia clínica es el pilar diagnóstico. La indicación es suspender el medicamento de inmediato y vigilancia continua. Conclusiones: El EPF es una reacción a medicamentos relacionada con el consumo de fármacos. Genera un desafío para el diagnóstico debido al pobre conocimien- to de las características de la dermatosis y un deficiente interrogatorio clínico y farmacológico. El abordaje del EPF requiere conocer las características clínicas de esta dermatosis, realizar el diagnostico diferencial con otras lesiones e indicar la suspensión del medicamento responsable.


Assuntos
Asma , Hiperpigmentação , Humanos , Feminino , Adulto , Hiperpigmentação/diagnóstico , Hiperpigmentação/patologia , Prurido/diagnóstico , Diagnóstico Diferencial , Asma/diagnóstico
3.
J Clin Apher ; 38(6): 694-702, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37548357

RESUMO

BACKGROUND: Major bleeding in patients undergoing therapeutic plasma exchange (TPE) has been studied in large databases; but without standardizing bleeding definitions. Therefore, we used standardized definitions to evaluate major bleeding in hospitalized patients undergoing TPE using public use data files from the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III). STUDY DESIGN AND METHODS: In a retrospective cross-sectional analysis, we identified TPE-treated adults in a first inpatient encounter. We evaluated major bleeding prevalence using (1) International Classification of Diseases (ICD) or Current Procedural Terminology (CPT) codes, (2) packed red blood cell (PRBC) transfusion, or (3) hemoglobin (Hgb) decline. Patients with major bleeding prior to their first TPE were excluded from the analysis. RESULTS: Among 779 patients undergoing TPE, major bleeding by at least one of the three bleeding definitions occurred in 135 patients (17.3%). For each of the ICD/CPT, PRBC, and Hgb definitions, the prevalence of major bleeding was 2.8% (n = 31), 7.4% (n = 81), and 5.4% (n = 59), respectively. Only 3.7% of bleeds (5/135) were captured by all three definitions and 19.3% (26/135) exclusively by any two pairwise definitions. The addition of PRBC transfusion and Hgb decline to ICD/CPT code definitions increased bleeding prevalence threefold. CONCLUSION: Among hospitalized adults undergoing TPE in the REDS-III study, the prevalence of major bleeding was 17.3%. The addition of PRBC and Hgb decline to ICD codes increased bleeding prevalence threefold. Future studies are needed to develop validated models that identify patients at risk for major bleeding during TPE.


Assuntos
Hemorragia , Troca Plasmática , Adulto , Humanos , Troca Plasmática/efeitos adversos , Estudos Retrospectivos , Estudos Transversais , Prevalência , Hemorragia/epidemiologia , Hemorragia/etiologia , Hemorragia/terapia
4.
Medicina (B.Aires) ; Medicina (B.Aires);83(1): 145-148, abr. 2023. graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1430786

RESUMO

Resumen El síndrome de Nicolau es una complicación infrecuente de la aplicación parenteral de diversos fármacos. Se caracteriza por la aparición de dolor, seguido de edema, eritema y luego una placa necrótica. Se reporta el caso de un hombre de 31 años que presenta este síndrome luego de la aplicación de penicilina benzatínica intramuscular. La biopsia apoyó el diagnóstico. Recibió tratamiento con enoxaparina y cilostazol con posterior mejoría.


Abstract Nicolau syndrome is a rare complication of the parenteral application of various drugs. It is char acterized by the appearance of pain, followed by edema, erythema, and then a necrotic plaque. We present the case of a 31-year-old male with this syndrome, after the application of intramuscular benzathine penicillin. The diagnosis was supported by the biopsy. He received treatment with enoxaparin and cilostazol with subsequent improvement.

5.
Medicina (B Aires) ; 83(1): 145-148, 2023.
Artigo em Espanhol | MEDLINE | ID: mdl-36774612

RESUMO

Nicolau syndrome is a rare complication of the parenteral application of various drugs. It is characterized by the appearance of pain, followed by edema, erythema, and then a necrotic plaque. We present the case of a 31-year-old male with this syndrome, after the application of intramuscular benzathine penicillin. The diagnosis was supported by the biopsy. He received treatment with enoxaparin and cilostazol with subsequent improvement.


El síndrome de Nicolau es una complicación infrecuente de la aplicación parenteral de diversos fármacos. Se caracteriza por la aparición de dolor, seguido de edema, eritema y luego una placa necrótica. Se reporta el caso de un hombre de 31 años que presenta este síndrome luego de la aplicación de penicilina benzatínica intramuscular. La biopsia apoyó el diagnóstico. Recibió tratamiento con enoxaparina y cilostazol con posterior mejoría.


Assuntos
Síndrome de Nicolau , Masculino , Humanos , Adulto , Síndrome de Nicolau/diagnóstico , Síndrome de Nicolau/tratamento farmacológico , Síndrome de Nicolau/etiologia , Injeções Intramusculares/efeitos adversos , Penicilina G Benzatina/uso terapêutico , Necrose/complicações , Necrose/tratamento farmacológico
6.
J Voice ; 2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36610808

RESUMO

INTRODUCTION: The analysis of drugs with adverse effects on voice provides relevant data for the vocal clinic. It is essential that professionals involved in voice care are aligned on the topic of voice pharmacovigilance in order to understand adverse effects from safe and reliable sources. OBJECTIVES: To compare the voice adverse effects of self-reported medications by dysphonic individuals in different sources of information. METHODS: Descriptive and analytical study based on self-reported active ingredients by dysphonic individuals and their adverse effects on voice listed in Electronic Database of the National Health Surveillance Agency of Brazil (Anvisa). Adverse effects were comparatively analyzed between the Anvisa's Electronic Database and information from the Micromedex and UpToDate databases. Data were analyzed using descriptive and inferential statistics that compared the three sources researched in relation to the number of adverse effects and in relation to the occurrence of adverse effects to the voice. RESULTS: There was a statistically significant difference between the databases regarding the occurrence of adverse effects of cough, dyspnea, xerostomia, vomiting and hoarseness, with a higher occurrence in the UpToDate database. The UpToDate database showed a statistically significant difference in the amount of drug effects compared to the Anvisa database (P < 0.001, d = 0.744) and compared to the Micromedex database (P < 0.001, d = 0.598), and in the two cases the mean number of drug effects was higher for the UpToDate database. CONCLUSIONS: UpToDate proved to be the most suitable source to complement the data from the medication package inserts at the time of the speech-language pathology assessment. It is recommended that professionals from all countries involved in voice care seek additional evidence-based sources of information to gain access to accurate and up-to-date data on adverse effects of drugs on voice.

7.
J Voice ; 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36658034

RESUMO

Pembrolizumab is an immune checkpoint inhibitor (ICI) approved for multiple indications in a variety of malignancies. Although generally well tolerated, the potential for significant adverse effects, specifically immune related adverse effects (irAEs) needs to be taken into consideration. Several cases of bullous pemphigoid have been reported as a cutaneous adverse effect of ICIs since 2015, and there are recent reports of mucous membrane pemphigoid (MMP). We present the case of an 84-year-old male with metastatic urothelial carcinoma on treatment with pembrolizumab, who developed laryngeal mucous membrane pemphigoid as an irAE. The diagnosis was based on patient's clinical history and serologic testing, and supported by symptomatic improvement after ICI discontinuation and immunosuppression. Pembrolizumab-induced MMP is a newly described and infrequent irAE, requiring early suspicion and close monitoring for its diagnosis and management.

8.
Braz. J. Anesth. (Impr.) ; 73(1): 101-103, Jan.-Feb. 2023. graf
Artigo em Inglês | LILACS | ID: biblio-1420643

RESUMO

Abstract Sugammadex is a distinctive neuromuscular reversal drug that acts by encapsulating the neuromuscular relaxant molecule and dislodging it from its site of action. Sugammadex has been approved for pediatric patients over 2 years of age. Although arrhythmias have been reported, there is no report of adverse effects in healthy children, such as severe bradycardia requiring intervention. We report two cases of severe bradycardia immediately after the administration of sugammadex in healthy children. Our aim is to alert to the occurrence of one of the most severe adverse effects of sugammadex, in the healthy pediatric population as well.


Assuntos
Humanos , Criança , Fármacos Neuromusculares não Despolarizantes , Bloqueio Neuromuscular , Bradicardia/induzido quimicamente , Sugammadex/efeitos adversos
9.
Braz J Anesthesiol ; 73(1): 101-103, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35121059

RESUMO

Sugammadex is a distinctive neuromuscular reversal drug that acts by encapsulating the neuromuscular relaxant molecule and dislodging it from its site of action. Sugammadex has been approved for pediatric patients over 2 years of age. Although arrhythmias have been reported, there is no report of adverse effects in healthy children, such as severe bradycardia requiring intervention. We report two cases of severe bradycardia immediately after the administration of sugammadex in healthy children. Our aim is to alert to the occurrence of one of the most severe adverse effects of sugammadex, in the healthy pediatric population as well.


Assuntos
Bloqueio Neuromuscular , Fármacos Neuromusculares não Despolarizantes , Criança , Humanos , Sugammadex/efeitos adversos , Bradicardia/induzido quimicamente
10.
Probiotics Antimicrob Proteins ; 15(3): 716-727, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-35029787

RESUMO

Despite functional goat milk products having emerged due to their importance for human nutrition and health, few studies have assessed the safety of consumption of goat dairy products containing potentially probiotic autochthonous lactic acid bacteria supplemented with prebiotic carbohydrates. Aiming this field, this study evaluated the safety of goat's milk fermented with Streptococcus thermophilus QGE, the autochthonous Limosilactobacillus mucosae CNPC007 culture, and the prebiotic inulin, through single- and repeated-dose oral toxicity tests (SDT and RDT, respectively) in animals. Ten female Swiss Webster mice were used for SDT evaluation - 2 groups, SDTc (20 mL/kg of filtered water) and SDTt (20 mL/kg of fermented milk) - and 40 Wistar rats for RDT - RDT3, RDT6, and RDT12 (treated with fermented milk at doses of 3 mL/kg, 6 mL/kg, and 12 mL/kg, respectively) and also RDTc (12 mL/kg of filtered water). For SDT, no signs of mortality or toxicity were observed, and the animals maintained the expected weight gain and feed intake. The RDT trials did not show mortality or signs of toxicity, as well as no change in body weight and organs, in the hematological and biochemical parameters, and also in relation to morphology and histology. Since the fermented milk did not cause any toxic effect in the conditions evaluated, it can be said that its no-adverse effect level (NOAEL) was considered to be higher than 20 mL/kg/day. Thus, the fermented milk with L. mucosae CNPC007 and inulin was considered to be of low toxicity, safe for use in rodents, and allowed for use in further studies.


Assuntos
Produtos Fermentados do Leite , Probióticos , Animais , Humanos , Ratos , Camundongos , Feminino , Leite/microbiologia , Prebióticos , Inulina/metabolismo , Streptococcus thermophilus/metabolismo , Técnicas de Cocultura , Fermentação , Ratos Wistar , Cabras , Água , Produtos Fermentados do Leite/microbiologia
11.
Braz. J. Pharm. Sci. (Online) ; 59: e21067, 2023. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1429947

RESUMO

Abstract We critically analyzed clinical trials performed with chloroquine (CQ) and hydroxychloroquine (HCQ) with or without macrolides during the first wave of COVID-19 and discussed the design and limitations of peer-reviewed studies from January to July 2020. Seventeen studies were eligible for the discussion. CQ and HCQ did not demonstrate clinical advantages that justified their inclusion in therapeutic regimens of free prescription for treatment or prophylactic purposes, as suggested by health authorities, including in Brazil, during the first wave. Around August 2020, robust data had already indicated that pharmacological effects of CQ, HCQ and macrolides as anti-SARS-CoV-2 molecules were limited to in vitro conditions and largely based on retrospective trials with low quality and weak internal validity, which made evidence superficial for decision-making. Up to that point, most randomized and nonrandomized clinical trials did not reveal beneficial effects of CQ or HCQ with or without macrolides to reduce lethality, rate of intubation, days of hospitalization, respiratory support/mechanical ventilation requirements, duration, type and number of symptoms, and death and were unsuccessful in increasing virus elimination and/or days alive in hospitalized or ambulatory patients with COVID-19. In addition, many studies have demonstrated that side effects are more common in CQ-or HCQ-treated patients.


Assuntos
Macrolídeos/análise , Pandemias/classificação , COVID-19/patologia , Antimaláricos/análise , Comorbidade , Ensaios Clínicos como Assunto/instrumentação , Coronavirus/efeitos dos fármacos , Aminoquinolinas/agonistas , Hospitalização
12.
Front Cell Infect Microbiol ; 12: 993338, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36211958

RESUMO

Background: Pentavalent antimonials (PAs) are the primary therapeutic option for American tegumentary leishmaniasis (ATL). However, the use of these drugs is complicated by adverse events (AEs), resistance and contraindications. Alternative therapies relative effectiveness is not well established. Objective: This study compared the effectiveness of liposomal amphotericin B (LAB) with intravenous meglumine antimoniate (NMG) in the treatment of ATL. We also analysed and compared associated AEs and treatment interruption rates. Methods: This was a retrospective cohort study from Brazil. The potential risk factors for the primary outcome were age, sex, total cutaneous lesion area, presence of mucosal lesions, AEs and treatment interruption. The primary outcome was lesion healing within 6 months of treatment. AEs and treatment interruption were also analysed. Multiple analytic strategies were employed to evaluate the reliability of the results. Results: Before propensity score (PS) matching, patients in the LAB group were older and had a higher frequency of mucosal lesions. The NMG group had a higher cure rate than the LAB group (cure rate 88% versus 55% respectively) in the adjusted analysis (relative risk (RR)=1.55 95% CI: 1.19 - 2.02) and after PS matching (RR=1.63 95% CI: 1.20 - 2.21). NMG group had a higher AE rate (event rate 52% versus 44%) in the adjusted analysis (RR= 1.61, 95% CI: 1.06 - 2.43, p=0.02), but this result was not observed after PS matching (RR= 0.87, 95% CI: 0.49 -1.52, p= 0.61). Conclusions: We observed that the NMG group had a higher cure rate than the LAB group, with an equivocally higher EV rate in the adjusted analysis.


Assuntos
Antiprotozoários , Leishmania braziliensis , Leishmaniose Cutânea , Anfotericina B , Antiprotozoários/uso terapêutico , Humanos , Leishmaniose Cutânea/tratamento farmacológico , Antimoniato de Meglumina/efeitos adversos , Antimoniato de Meglumina/uso terapêutico , Reprodutibilidade dos Testes , Estudos Retrospectivos , Resultado do Tratamento
13.
São Paulo med. j ; São Paulo med. j;140(3): 372-377, May-June 2022. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1377393

RESUMO

ABSTRACT BACKGROUND: Favipiravir is generally used in treating coronavirus disease 2019 (COVID-19) pneumonia in Turkey. OBJECTIVE: To determine the side effects of favipiravir and whether it is a good treatment option. DESIGN AND SETTING: Retrospective study conducted in Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey. METHODS: 357 patients who completed favipiravir treatment at the recommended dose were included. 37 patients with drug side effects and 320 patients without drug side effects were examined in two groups. RESULTS: Side effects were observed in 37 (10.36%) out of 357 patients using favipiravir. The most common side effect was liver dysfunction, in 26 (7.28%) of the patients. The following other side effects were also observed: diarrhea (1.4%), nausea (0.84%), abdominal pain (0.28%) and thrombocytopenia (0.28%). One patient (0.28%) presented both increased transaminases and nausea. CONCLUSION: In this study, it was determined that favipiravir may constitute an alternative for treating COVID-19 pneumonia given that its side effects are generally well tolerated and not serious.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/tratamento farmacológico , COVID-19/tratamento farmacológico , Antivirais/efeitos adversos , Pirazinas , Estudos Retrospectivos , Resultado do Tratamento , Amidas , SARS-CoV-2 , Náusea/induzido quimicamente , Náusea/tratamento farmacológico
14.
Arq. bras. oftalmol ; Arq. bras. oftalmol;85(3): 309-319, May-June 2022. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1383803

RESUMO

ABSTRACT Dermal filler injection is among facial rejuvenation treatments that have been increasingly used. Despite being a minimally invasive procedure, it can lead to severe complications such as blindness. A review of all cases of filler- -induced visual loss in the world literature was conducted to summarize the mechanisms, anatomical considerations, and clinical ophthalmologic course, current strategies of prevention and management, and trends over the years. We identified 233 cases of filler-induced visual loss, and 172 patients had a severe visual impairment in at least one eye. The typical patients are young women who received injections of hyaluronic acid or autologous fat in the glabella or nose, and the typical presentations were sudden ocular pain, ptosis, and ophthalmoplegia due to vascular occlusion. The findings of this study also suggest an increase in the number of unlicensed professionals performing the procedure. Even though the continued development of dermal fillers has improved the treatment options available, further studies and strategies are necessary to reduce the incidence and minimize the consequences of filler-induced visual loss.


RESUMO O uso de preenchedores dérmicos é uma prática bem estabelecida de rejuvenescimento facial. Embora seja um procedimento minimamente invasivo, pode levar a complicações graves como cegueira. Uma revisão de casos de perda visual pós preenchimento facial estético foi conduzida para descrever os mecanismos, considerações anatômicas, quadro oftalmológico, atuais estratégias de prevenção e manejo, e tendências ao longo dos anos. Foram identificados 233 casos, e 172 pacientes tiveram ao menos um olho com baixa visão ao final do seguimento. O paciente típico é uma mulher jovem submetida a preenchimento de ácido hialurônico na glabela ou nariz, apresentando dor ocular súbita, ptose e oftalmoplegia devido à oclusão vascular. Este estudo também destaca um possível aumento de profissionais não habilitados realizando este procedimento. Apesar do contínuo desenvolvimento dos preenchedores dérmicos e aprimoramento das opções de tratamento disponíveis, mais estudos e estratégias são necessários para reduzir a incidência de complicações e minimizar suas consequências.

15.
Vaccines (Basel) ; 11(1)2022 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-36679910

RESUMO

Vaccine-associated rubella is a very rare adverse effect after rubella vaccination; we report the characteristics of a young women who, after a vaccination campaign where she received three different vaccines against influenza, tetanus/diphtheria, and measles/rubella, developed a fever and rash consistent with rubella disease that was confirmed by sequencing of the virus. The evolution was favorable. The woman had two close contacts who did not develop the disease. Follow-up of the patient and her contacts was important to detect complications and for epidemiology surveillance.

16.
Biomed Pharmacother ; 142: 112009, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34388523

RESUMO

Genetic factors that affect variability in metformin response have been poorly studied in the Latin American population, despite its being the initial drug therapy for type 2 diabetes, one of the most prevalent diseases in that region. Metformin pharmacokinetics is carried out by members of the membrane transporters superfamily (SLCs), being the multidrug and toxin extrusion protein 1 (MATE1), one of the most studied. Some genetic variants in MATE1 have been associated with reduced in vitro metformin transport. They include rs77474263 p.[L125F], a variant present at a frequency of 13.8% in Latin Americans, but rare worldwide (less than 1%). Using exome sequence data and TaqMan genotyping, we revealed that the Mexican population has the highest frequency of this variant: 16% in Mestizos and 27% in Amerindians, suggesting a possible Amerindian origin. To elucidate the metformin pharmacogenetics, a children cohort was genotyped, allowing us to describe, for the first time, a MATE1 rs77474263 TT homozygous individual. An additive effect of the L125F variant was observed on blood metformin accumulation, revealing the highest metformin and lactate serum levels in the TT homozygote, and intermediate metformin values in the heterozygotes. Moreover, a molecular dynamics analysis suggested that the genetic variant effect on metformin efflux could be due to a decreased protein permeability. We conclude that pharmacogenetics could be useful in enhancing metformin pharmacovigilance in populations having a high frequency of the risk genotype, especially considering that these populations also have a higher susceptibility to the diseases for which metformin is the first-choice drug.


Assuntos
Hipoglicemiantes/farmacocinética , Metformina/farmacocinética , Proteínas de Transporte de Cátions Orgânicos/genética , Farmacogenética , Adolescente , Adulto , Criança , Estudos de Coortes , Feminino , Variação Genética , Genótipo , Humanos , Indígenas Norte-Americanos/genética , Ácido Láctico/sangue , Masculino , México , Simulação de Dinâmica Molecular
17.
Ocul Immunol Inflamm ; 29(6): 1200-1206, 2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34402726

RESUMO

PURPOSE: To describe a case of acute thyroiditis and bilateral optic neuritis associated with SARS-CoV-2 vaccination. METHODS: A single case report from a tertiary referral center. RESULTS: The patient described in the following case report developed acute thyroiditis and bilateral optic neuritis following SARS-CoV-2 vaccination. The patient underwent pulse therapy followed by oral tapering corticosteroid therapy with an improvement of the bilateral disc swelling and the visual field, and recovery of thyroid-stimulating hormone to the normal limits. CONCLUSION: Although the association between immunization and the onset of demyelinating manifestations of the central nervous system is well documented, this is the first reported case of bilateral optic neuritis and acute thyroiditis and subsequent to administration of vaccination against SARS-CoV-2.


Assuntos
Vacinas contra COVID-19/efeitos adversos , COVID-19/prevenção & controle , Neurite Óptica/etiologia , SARS-CoV-2 , Tireoidite/etiologia , Vacinação/efeitos adversos , Doença Aguda , Adulto , Feminino , Glucocorticoides/uso terapêutico , Humanos , Imageamento por Ressonância Magnética , Neurite Óptica/diagnóstico , Neurite Óptica/tratamento farmacológico , Órbita/diagnóstico por imagem , Pulsoterapia , Tireoidite/diagnóstico , Tireoidite/tratamento farmacológico , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia
18.
Front Med (Lausanne) ; 8: 622225, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33665199

RESUMO

Glucocorticoids therapy has greatly improved the outcome of lupus nephritis patients. Since their discovery, their adverse effects have counterbalanced their beneficial anti-inflammatory effects. Glucocorticoids exert their effects through both genomic and non-genomic pathways. Differential activation of these pathways is clinically relevant in terms of benefit and adverse effects. Ongoing aims in lupus nephritis treatment development focus on a better use of glucocorticoids combined with immunosuppressant drugs and biologics. Newer regimens aim to decrease the peak glucocorticoid dose, allow a rapid glucocorticoid tapering, and intend to control disease activity with a lower cumulative glucocorticoid exposure. In this review we discuss the mechanisms, adverse effects and recent strategies to limit glucocorticoid exposure without compromising treatment efficacy.

19.
Rev. cuba. med. gen. integr ; 37(1): e1248, tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1280318

RESUMO

Introducción: Los eventos adversos atribuibles a procesos de vacunación e inmunización, son efectos no deseables aparecidos tras la aplicación de una vacuna que genera miedo y desconfianza en las madres al sentirse incapaces de identificarlos y manejarlos de manera apropiada. Objetivo: Determinar el conocimiento que tienen las madres de niños menores de dos años de edad sobre el reconocimiento y cuidado de los efectos adversos posvacunales. Métodos: Estudio descriptivo transversal, con una muestra por conveniencia de 50 madres que acudieron al centro de salud Nuevo Israel en la provincia de Santo Domingo de los Tsáchilas, Ecuador. Las variables de estudio fueron el tipo de eventos posvacunales, el conocimiento sobre el manejo de los mismos y la fuente de información del cuidado para cada tipo de evento. Se determinaron las frecuencias absolutas y relativas en función de las variables edad y nivel de instrucción que fueron expresadas mediante tablas de contingencia. Resultados: Se identificó la fiebre como el evento adverso más común y la administración de paracetamol para su manejo. Independientemente de la edad y el nivel de instrucción, la identificación y conocimiento sobre cuidado de las reacciones posvacunales fueron adecuados. La información manejada proviene en su mayoría (94,6 por ciento) del personal de enfermería. Conclusiones: Las madres conocen los efectos posvacunales y los manejan de manera adecuada en un contexto en el que el personal de enfermería es el encargado de transmitir las buenas prácticas en su rol de educador(AU)


Introduction: Adverse events attributable to vaccination and immunization processes are undesirable effects that appear after application of a vaccine that generates fear and mistrust in mothers, as they feel unable to identify and handle them appropriately. Objective: To determine the knowledge that mothers of children under two years of age have about the recognition and care of postvaccination adverse effects. Methods: Cross-sectional descriptive study carried out with a convenience sample of 50 mothers who attended Nuevo Israel Health Center in Santo Domingo de los Tsáchilas Province, Ecuador. The study variables were type of postvaccination events, knowledge about their management, and source of information about care for each type of event. Absolute and relative frequencies were determined according to the variables age and level of education, expressed through contingency tables. Results: Fever was identified as the most common adverse event and administration of paracetamol was identified as a way for its management. Regardless the age and level of education, the identification and knowledge about the care of postvaccination reactions were adequate. The information handled comes mostly from the nursing staff, a source accounting for 94.6 percent. Conclusions: Mothers know postvaccination effects and manage them appropriately in a context in which the nursing staff is in charge of transmitting good practices in their role as educator.


Assuntos
Humanos , Masculino , Feminino , Lactente , Vacinas/efeitos adversos , Comportamento Materno , Acetaminofen/uso terapêutico , Epidemiologia Descritiva , Estudos Transversais , Equador
20.
Arq. bras. med. vet. zootec. (Online) ; 73(1): 91-98, Jan.-Feb. 2021. tab
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1153050

RESUMO

The metabolic peculiarities of felines favor an intoxication. Fifty healthy female cats were divided into five groups: PG (placebo group), G2 (cefazolin), G3 (ceftriaxone), G4 (enrofloxacin) and G5 (ampicillin) were used. The parameters evaluated were: total expired carbon dioxide (ETCO2), oxygen saturation in hemoglobin (SpO2), heart rate (HR), respiratory rate (RR), body temperature (BT), systolic, mean and diastolic blood pressure (SBP, mBP and DBP) by invasive method, at T0, 5 (T5), 10 (T10), 15 (T15), 20 (T20), 25 (T25) and 30 (T30) minutes after administration of the treatments. HR presented reduction in G2 compared to PG at all times, except T20, and in G4, T25 and T30 were lower than the T0 values (P<0.05). BT showed increase in the G3 at T0 and T5 and all groups showed reduction in the values of BT relative to T0 (P<0.05). ETCO2 increased in G2 and G5 at all times compared to PG (P<0.05) and there were no differences among the times within each group. It was concluded that ceftriaxone is safer for the prophylactic antimicrobial use in cats, however the other antimicrobials are also indicated, because all the parameters, in all groups, basically did not change over the study and when this occurs it remains in reference interval.(AU)


As peculiaridades metabólicas dos felinos favorecem quadro de intoxicação. Foram utilizadas 50 gatas saudáveis, que foram divididas em cinco grupos: GP (grupo placebo), G2 (grupo cefazolina), G3 (grupo ceftriaxona), G4 (grupo enrofloxacina) e G5 (grupo ampicilina). Os seguintes parâmetros foram avaliados: dióxido de carbono expirado (ETCO2), saturação de oxigênio na hemoglobina (SpO2), frequência cardíaca (FC), frequência respiratória (FR), temperatura corporal (T°C), pressão arterial sistólica,média e diastólica (PAS, PAM e PAD), pelo método invasivo, em 0 (T0), 5 (T5), 10 (T10), 15 (T15), 20 (T20), 25 (T25) e 30 (T30) minutos após a administração dos tratamentos. A FC apresentou redução no G2 em relação ao GP em todos os momentos, exceto no T20, e, no G4, o T25 e o T30 foram inferiores aos valores do T0 (P<0,05). A T°C apresentou aumento no G3 no T0 e no T5, e todos os grupos apresentaram redução nos valores da T°C em relação ao T0 (P<0,05). O ETCO2 apresentou aumento no G2 e no G5, em todos os momentos, em relação ao GP (P<0,05). Concluiu-se que a ceftriaxona é mais segura para uso profilático em gatos, entretanto os outros antibióticos também são recomendados, pois todos os parâmetros praticamente não se modificaram e, quando alterados, mantiveram-se dentro dos padrões de referência.(AU)


Assuntos
Animais , Gatos , Ceftriaxona/administração & dosagem , Taxa Respiratória/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Anti-Infecciosos/administração & dosagem , Anti-Infecciosos/efeitos adversos , Hemodinâmica , Anestesia Intravenosa/veterinária
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