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‣ Avaliação nutricional do cardiopata crítico em terapia de substituição renal: dificuldade diagnóstica; Nutritional assessment of the critically ill patients with cardiac disease under renal replacement therapy: diagnostic difficulty

JARDIM, Maria das Neves; COSTA, Helenice Moreira da; KOPEL, Liliane; LAGE, Silvia Gelás
Fonte: Associação de Medicina Intensiva Brasileira - AMIB Publicador: Associação de Medicina Intensiva Brasileira - AMIB
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
67.42294%
OBJETIVO: Realizar avaliação nutricional em pacientes cardiopatas críticos que necessitem de terapia de substituição renal. MÉTODOS: Pacientes cardiopatas críticos, internados em unidade de terapia intensiva, que apresentavam insuficiência renal com indicação de terapia de substituição renal foram submetidos à avaliação nutricional com a utilização de medidas antropométricas e análise laboratorial. RESULTADOS: Foram avaliados 43 pacientes, com idade de 64±15 anos, 26 do sexo masculino. A média da fração de ejeção do ventrículo esquerdo foi de 0,36±0,16. Avaliação do estado nutricional com base no índice de massa corpórea revelou 18 pacientes eutróficos, 6 pacientes com baixo peso, 19 pacientes com sobrepeso ou obesidade. Baseado na medida da prega cutânea tricipital, 16 pacientes eram eutróficos, 27 pacientes apresentaram algum grau de depleção e, com base na circunferência do braço e na circunferência muscular do braço, 41 pacientes apresentaram algum grau de depleção. Dados laboratoriais evidenciaram depleção grave baseado na albumina em 28 pacientes e 27 pacientes tinham depleção grave de acordo com a contagem de linfócitos. CONCLUSÃO: A desnutrição é comum em pacientes cardiopatas críticos em terapia de substituição renal. Avaliação nutricional baseada no índice de massa corpórea não revelou ser bom método para diagnóstico de distúrbios nutricionais nesta população. Há necessidade de complementar a avaliação nutricional para identificação de desnutrição e possibilitar introdução precoce de suporte nutricional adequado.; OBJECTIVE: Evaluate the nutritional status of patients with cardiac disease and concomitant renal dysfunction requiring renal replacement therapy. METHODS: Patients with cardiac disease and renal failure receiving renal replacement therapy...

‣ Effect of estrogen receptor-alpha (ESR1) gene polymorphism on high density lipoprotein levels in response to hormone replacement therapy

NOGUEIRA-DE-SOUZA, N.C.; GUERREIRO DA SILVA, I.D.C.; DE CARVALHO, C.V.; PULCHINELLI, A.; HAIDAR, M.A.; BARACAT, E.C.; MASSAD-COSTA, A.M.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
67.45659%
Studies have shown that estrogen replacement therapy and estrogen plus progestin replacement therapy alter serum levels of total, LDL and HDL cholesterol levels. However, HDL cholesterol levels in women vary considerably in response to hormone replacement therapy (HRT). A significant portion of the variability of these levels has been attributed to genetic factors. Therefore, we investigated the influence of estrogen receptor-alpha (ESR1) gene polymorphisms on HDL levels in response to postmenopausal HRT. We performed a prospective cohort study on 54 postmenopausal women who had not used HRT before the study and had no significant general medical illness. HRT consisted of conjugated equine estrogen and medroxyprogesterone acetate continuously for 1 year. The lipoprotein levels were measured from blood samples taken before the start of therapy and after 1 year of HRT. ESR1 polymorphism (MspI C>T, HaeIII C>T, PvuII C>T, and XbaI A>G) frequencies were assayed by restriction fragment length polymorphism. A general linear model was used to describe the relationships between HDL levels and genotypes after adjusting for age. A significant increase in HDL levels was observed after HRT (P = 0.029). Women with the ESR1 PvuII TT genotype showed a statistically significant increase in HDL levels after HRT (P = 0.032). No association was found between other ESR1 polymorphisms and HDL levels. According to our results...

‣ Discontinuation of continuous renal replacement therapy: A post hoc analysis of a prospective multicenter observational study

UCHINO, Shigehiko; BELLOMO, Rinaldo; MORIMATSU, Hiroshi; MORGERA, Stanislao; SCHETZ, Miet; TAN, Ian; BOUMAN, Catherine; MACEDO, Ettiene; GIBNEY, Noel; TOLWANI, Ashita; STRAATEN, Heleen Oudemans-van; RONCO, Claudio; KELLUM, John A.
Fonte: LIPPINCOTT WILLIAMS & WILKINS Publicador: LIPPINCOTT WILLIAMS & WILKINS
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
67.787285%
Objectives: To describe current practice for the discontinuation of continuous renal replacement therapy in a multinational setting and to identify variables associated with successful discontinuation. The approach to discontinue continuous renal replacement therapy may affect patient outcomes. However, there is lack of information on how and under what conditions continuous renal replacement therapy is discontinued. Design: Post hoc analysis of a prospective observational study. Setting. Fifty-four intensive care units in 23 countries. Patients: Five hundred twenty-nine patients (52.6%) who survived initial therapy among 1006 patients treated with continuous renal replacement therapy. Interventions: None. Measurements and Main Results., Three hundred thirteen patients were removed successfully from continuous renal replacement therapy and did not require any renal replacement therapy for at least 7 days and were classified as the ""success"" group and the rest (216 patients) were classified as the ""repeat-RRT"" (renal replacement therapy) group. Patients in the ""success"" group had lower hospital mortality (28.5% vs. 42.7%, p < .0001) compared with patients in the ""repeat-RRT"" group. They also had lower creatinine and urea concentrations and a higher urine output at the time of stopping continuous renal replacement therapy. Multivariate logistic regression analysis for successful discontinuation of continuous renal replacement therapy identified urine output (during the 24 hrs before stopping continuous renal replacement therapy: odds ratio...

‣ Timing of renal replacement therapy and clinical outcomes in critically ill patients with severe acute kidney injury

BAGSHAW, Sean M.; UCHINO, Shigehiko; BELLOMO, Rinaldo; MORIMATSU, Hiroshi; MORGERA, Stanislao; SCHETZ, Miet; TAN, Ian; BOUMAN, Catherine; MACEDO, Ettiene; GIBNEY, Noel; TOLWANI, Ashita; STRAATEN, Heleen M. Oudemans-van; RONCO, Claudio; KELLUM, John A.; BE
Fonte: W B SAUNDERS CO-ELSEVIER INC Publicador: W B SAUNDERS CO-ELSEVIER INC
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
67.311113%
Purpose: The aim of this study is to evaluate the relationship between timing of renal replacement therapy (RRT) in severe acute kidney injury and clinical outcomes. Methods: This was a prospective multicenter observational study conducted at 54 intensive care units (ICUs) in 23 countries enrolling 1238 patients. Results: Timing of RRT was stratified into ""early"" and ""late"" by median urea and creatinine at the time RRT was started. Timing was also categorized temporally from ICU admission into early (<2 days), delayed (2-5 days), and late (>5 days). Renal replacement therapy timing by serum urea showed no significant difference in crude (63.4% for urea <= 24.2 mmol/L vs 61.4% for urea >24.2 mmol/L; odds ratio [OR], 0.92; 95% confidence interval [CI], 0.73-1.15; P = .48) or covariate-adjusted mortality (OR, 1.25; 95% CI, 0.91-1.70; P = .16). When stratified by creatinine, late RRT was associated with lower crude (53.4% for creatinine >309 mu mol/L vs 71.4% for creatinine <= 309 mu mol/L; OR, 0.46; 95% CI, 0.36-0.58; P < .0001) and covariate-adjusted mortality (OR, 0.51; 95% CI, 0.37-0.69; P < .001).However, for timing relative to ICU admission, late RRT was associated with greater crude (72.8% vs 62.3% vs 59%, P < .001) and covariate-adjusted mortality (OR...

‣ "Análise da deficiência androgênica e terapia de reposição em homens idosos" ; Analysis of the androgenic deficiency and replacement therapy in elderdy men

Lopes, Eduardo José Andrade
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 10/09/2004 Português
Relevância na Pesquisa
67.376353%
A deficiência androgênica acomete um percentual de homens idosos ainda não bem definido na literatura. São usados parâmetros séricos hormonais de homens jovens, e apesar disto, a terapia de reposição da testosterona vem sendo defendida e utilizada largamente por muitos autores. Várias vias de reposição são usadas tentando simular o ciclo fisiológico de produção das testosteronas. Parece que a transdérmica é a que mais se aproxima do ideal. A relação câncer de próstata e testosterona é pouco compreendida. O receio do estímulo de um câncer oculto pela terapia de reposição não foi devidamente afastado. O tratamento deve ser instituído quando o quadro clínico e laboratorial for evidente.; The androgenic deficiency attacks a percentage of elderly men not well defined in literature yet. Hormonal serum parameters of young men are used and, in spite of that, the testosterone replacement therapy has been widely supported and used by many authors. Various ways of replacement are used trying to simulate the physiological cycle of the testosterone production. It seems that the transdermic is the one closest to the ideal. The relation of prostate cancer and testosterone is little understood. The fear of the stimulation of a concealed cancer by the replacement therapy has not been properly eliminated. The treatment should be indicated when the clinical and laboratorial was defined.

‣ "Alterações cognitivas em mulheres com quadros depressivos na perimenopausa: o efeito da terapia de reposição hormonal com estradiol transdérmico" ; Cognitive alterations in perimenopaused women with clinical depression: estradiol transdermic hormone replacement therapy effects

Silva, Maria Fernanda Gouveia da
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 06/04/2004 Português
Relevância na Pesquisa
67.357705%
A perimenopausa é a fase da vida reprodutiva feminina caracterizada diversas alterações, inclusive cognitivas devido ao hipoestrogenismo. Através de estudo duplo-cego randomizado com 16 mulheres na perimenopausa deprimidas que receberam estradiol e 16 que receberam placebo analisou-se as alterações cognitivas da atenção, memória e linguagem; o efeito da reposição hormonal com estradiol e a correlação entre os sintomas depressivos e menopausais com as alterações destas funções. Os resultados mostraram: melhora do controle inibitório, memória imediata e tardia (verbal e visual) e da capacidade de nomeação nos dois grupos; melhora dos sintomas depressivos e menopausais para o grupo que recebeu reposição hormonal: e não correlação entre a melhora destes sintomas e a melhora das funções cognitivas; Perimenopause is the female reproductive life period characterized by several changes including cognitive impairments related to hypoestrogenism. In a randomized double-blind study 16 depressive perimenopaused women took estradiol, while another group of 16 depressive perimenopaused women took placebo. Cognitive alterations associated to attention, memory and language, and estradiol hormone replacement therapy effects were evaluated. In addition...

‣ Efeitos da terapia de reposição estrogênica nas respostas hemodinâmicas e neurais ao exercício físico agudo em mulheres no período pós-menopausa; Effects of estrogen replacement therapy in hemodinamic and neural responses to acute aerobic exercise in post-menopausal women

Oneda, Bruna
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 17/04/2006 Português
Relevância na Pesquisa
67.357705%
A pós-menopausa é marcada por alterações fisiológicas hemodinâmicas e metabólicas. A terapia de reposição estrogênica é uma forma de amenizar as conseqüências da deficiência hormonal e o exercício físico contribui significativamente para a redução do risco cardiovascular. O objetivo desse estudo foi avaliar em mulheres pós-menopausadas os efeitos isolados e associados da terapia oral estrogênica (TRH) e do treinamento físico aeróbio (TF) nas respostas hemodinâmicas e neurais basais e durante os exercícios com handgrip. Quarenta e cinco mulheres (51±3 anos), histerectomizadas, com e sem ovários, saudáveis, realizaram uma sessão experimental e, posteriormente foram divididas em 4 grupos SED-PLA (n=11), SED-TRH (n=14), TF-PLA (n=12) e TF-TRH (n=8). Os grupos TRH e receberam valerato de estradiol 1mg/dia; PLA receberam placebo; TF, realizaram exercício aeróbio em cicloergômetro por 50 minutos, 3 vezes por semana e SED permaneceram sedentárias. Todas as voluntárias participaram de uma segunda sessão experimental após 6 meses de acompanhamento. Nas sessões experimentais foram avaliadas a atividade nervosa simpática periférica (ANSP - microneurografia), pressão arterial, freqüência cardíaca (FC - método oscilométrico Dixtal no membro inferior)...

‣ Efeitos isolados e associados da terapia de reposição oral estrogênica e do exercício físico aeróbico nas respostas hemodinâmicas e neurais em mulheres no período pós-menopausa; Effects of estrogen replacement therapy in hemodinamic and neural responses to acute aerobic exercise in post-menopausal women

Oneda, Bruna
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 22/02/2010 Português
Relevância na Pesquisa
67.357705%
A pós-menopausa é marcada por alterações fisiológicas hemodinâmicas e metabólicas. A terapia de reposição estrogênica é uma forma de amenizar as conseqüências da deficiência hormonal e o exercício físico contribui significativamente para a redução do risco cardiovascular. O objetivo desse estudo foi avaliar em mulheres pós-menopausadas os efeitos isolados e associados da terapia oral estrogênica (TRH) e do treinamento físico aeróbio (TF) nas respostas hemodinâmicas e neurais basais e durante os exercícios com handgrip. Quarenta e cinco mulheres (51±3 anos), histerectomizadas, com e sem ovários, saudáveis, realizaram uma sessão experimental e, posteriormente foram divididas em 4 grupos SED-PLA (n=11), SED-TRH (n=14), TF-PLA (n=12) e TF-TRH (n=8). Os grupos TRH e receberam valerato de estradiol 1mg/dia; PLA receberam placebo; TF, realizaram exercício aeróbio em cicloergômetro por 50 minutos, 3 vezes por semana e SED permaneceram sedentárias. Todas as voluntárias participaram de uma segunda sessão experimental após 6 meses de acompanhamento. Nas sessões experimentais foram avaliadas a atividade nervosa simpática periférica (ANSP - microneurografia), pressão arterial, freqüência cardíaca (FC - método oscilométrico Dixtal no membro inferior)...

‣ Tratamento inovador da compressão medular com reposição enzimática intratecal nas mucopolissacaridoses tipos I e VI : relato de uma série de casos; Innovative treatment of cord compression with trathecal enzyme replacement therapy in mucopolysaccharidoses I and VI: report of a case series

Munõz Rojas, Maria Verônica
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Tese de Doutorado Formato: application/pdf
Português
Relevância na Pesquisa
67.62857%
As mucopolissacaridoses apresentam uma história natural progressiva, causada por defeitos no metabolismo dos glicosaminoglicanos. Frequentemente graves, as mucopolissacaridoses encurtam de forma considerável a expectativa de vida do paciente. Apesar de que em muitos casos a função intelectual é normal, morbidade neurológica considerável pode ser causada por compressão medular secundária ao acúmulo de glicosaminoglicanos nas meninges. O tratamento deste problema pode requerer a descompressão medular através de laminectomia cervical. A terapia de reposição enzimática endovenosa, para o tratamento de mucopolissacaridose, reduz o acúmulo lisossômico e alivia muitos dos sintomas da doença, porém não oferece benefício direto para o sistema nervoso central uma vez que não atravessa a barreira hemato-encefálica. Esta limitação da reposição enzimática endovenosa levou alguns pesquisadores a trabalhar com uma nova opção de via de liberação medicamentosa de alcance direto no sistema nervoso central, aproveitando o extenso contato que existe entre o líquido cefaloraquidiano e as meninges e com as granulações aracnoideas, para o tratamento de algumas doenças de depósito lisossomal. Estudos em modelos animais têm sido conduzidos e com resultados promissores. Este trabalho se propõe a estudar uma nova via de administração da enzima recombinante...

‣ Changes in the profile of lipoprotein subfractions associated with hormone replacement therapy

Vieira,José Luiz da Costa; Gomes,Marcos Emanuel W.; Almeida,Áurea Beltrão de; Moriguchi,Emílio H.
Fonte: Sociedade Brasileira de Cardiologia - SBC Publicador: Sociedade Brasileira de Cardiologia - SBC
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2001 Português
Relevância na Pesquisa
67.503706%
OBJECTIVE: To report the effects of 2 regimens of hormone replacement therapy during the postmenopausal period on the profile of the major lipoprotein subfractions (HDL, LDL, and VLDL). METHODS: We carried out a cohort study in 38 postmenopausal patients who were starting their hormone replacement therapy due to gynecological indications, for a period of 12 weeks. Analysis of lipoprotein subclasses was performed through nuclear magnetic resonance spectroscopy. RESULTS: Hormone replacement therapy cause an increase in the proportion of larger subfractions of VLDL and HDL (p=0.008 and 0.03, respectively) and in the proportion of larger particles of VLDL due to a 36% increase in the levels of larger particles (p=0.004), concomitantly with a 15% reduction in the levels of smaller particles (p=0.04). In regard to HDL, the increase occurred only a 17% increase in the levels of larger particles (p=0.002). No significant change occurred in the distribution pattern of LDL subfractions. CONCLUSION: The proportion of larger subfractions of VLDL and HDL increases after hormone replacement therapy. The increase in the proportion of larger particles of VLDL occurs due to an increase in the levels of the larger subclasses concomitantly with a reduction in the smaller particles. However...

‣ Percutaneous 17ß-estradiol replacement therapy in hypertensive postmenopausal women

Osório-Wender,M.C.; Vitola,D.; Spritzer,P.M.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/1997 Português
Relevância na Pesquisa
67.391353%
The present study evaluated the short-term effects of percutaneous 17ß-estradiol on blood pressure, metabolic profile and hormonal levels in postmenopausal women with systemic arterial hypertension. After a wash-out period of 15 days, 10 hypertensive patients were treated with guanabenz acetate to control blood pressure, followed by 17ß-estradiol in the form of hydroalcoholic gel administered for 21 of 28 days of each cycle, for 3 cycles. Patients were evaluated before, during and 2 months after estrogen administration. Systolic and diastolic blood pressure or heart rate did not present any significant change in any patient when compared to those periods with the antihypertensive drug only (pretreatment period and 60 days after estrogen therapy was discontinued). Plasma biological markers of hepatic estrogenic action (plasma renin activity, antithrombin III, triglycerides, total cholesterol and lipoproteins) also remained unchanged during the study. Hormone treatment was effective, as indicated by the relief of menopausal symptoms, a decrease in FSH levels (73.48 ± 27.21 to 35.09 ± 20.44 IU/l, P<0.05), and an increase in estradiol levels (15.06 ± 8.76 to 78.7 ± 44.6 pg/ml, P<0.05). There was no effect on LH (18.0 ± 9.5 to 14.05 ± 8.28 IU/l). Hormone levels returned to previous values after estrogen treatment was discontinued. The data indicate that short-term percutaneous 17ß-estradiol replacement therapy...

‣ Effect of estrogen receptor-alpha (ESR1) gene polymorphism on high density lipoprotein levels in response to hormone replacement therapy

Nogueira-de-Souza,N.C.; Guerreiro da Silva,I.D.C.; de Carvalho,C.V.; Pulchinelli,A.; Haidar,M.A.; Baracat,E.C.; Massad-Costa,A.M.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2009 Português
Relevância na Pesquisa
67.45659%
Studies have shown that estrogen replacement therapy and estrogen plus progestin replacement therapy alter serum levels of total, LDL and HDL cholesterol levels. However, HDL cholesterol levels in women vary considerably in response to hormone replacement therapy (HRT). A significant portion of the variability of these levels has been attributed to genetic factors. Therefore, we investigated the influence of estrogen receptor-alpha (ESR1) gene polymorphisms on HDL levels in response to postmenopausal HRT. We performed a prospective cohort study on 54 postmenopausal women who had not used HRT before the study and had no significant general medical illness. HRT consisted of conjugated equine estrogen and medroxyprogesterone acetate continuously for 1 year. The lipoprotein levels were measured from blood samples taken before the start of therapy and after 1 year of HRT. ESR1 polymorphism (MspI C>T, HaeIII C>T, PvuII C>T, and XbaI A>G) frequencies were assayed by restriction fragment length polymorphism. A general linear model was used to describe the relationships between HDL levels and genotypes after adjusting for age. A significant increase in HDL levels was observed after HRT (P = 0.029). Women with the ESR1 PvuII TT genotype showed a statistically significant increase in HDL levels after HRT (P = 0.032). No association was found between other ESR1 polymorphisms and HDL levels. According to our results...

‣ Colorectal cancer and oestrogen replacement therapy, a meta analysis of the epidemiological studies

MacLennan, S.; MacLennan, A.; Ryan, P.
Fonte: Australasian Medical Publishing Publicador: Australasian Medical Publishing
Tipo: Artigo de Revista Científica
Publicado em //1995 Português
Relevância na Pesquisa
67.503706%
OBJECTIVE: To determine if non-contraceptive oestrogen replacement therapy alters the risk of colorectal cancer. DATA SOURCES: A search was made of the MEDLINE database (January 1974 to October 1993) and Current Contents (October-December 1993) and of reference lists of articles identified in the search. Sixteen studies were identified and fourteen met defined criteria for analysis. DATA SYNTHESIS: The overall relative risk of oestrogen replacement therapy use and colorectal cancer was 0.92 (95% confidence interval, 0.74-1.15), which was not significantly different from unity (P > 0.05). The separate overall relative risks of oestrogen replacement therapy use for colon or rectal cancer were also not significantly different from unity. CONCLUSION: When the results of all studies published to date are combined, there is no association between oestrogen replacement therapy and the incidence of colorectal cancer. However, long term randomised control trials are required to confirm this.

‣ Analgesic nephropathy and renal replacement therapy in Australia: Trends, Comorbidities and outcomes

Chang, S.; Mathew, T.; McDonald, S.
Fonte: American Society of Nephrology Publicador: American Society of Nephrology
Tipo: Artigo de Revista Científica
Publicado em //2008 Português
Relevância na Pesquisa
67.73132%
Background and objectives: This study examined age-specific incidence and prevalence of renal replacement therapy attributed to analgesic nephropathy from 1971 through 2005 and adjusted comorbidity prevalence and survival of patients who had analgesic nephropathy and were on renal replacement therapy (compared with control subjects without diabetes). Design, setting, participants, & measurements: This retrospective cohort study, using data from the Australia and New Zealand Dialysis and Transplant registry, included all patients who were aged 35 to 84 yr and started long-term renal replacement therapy in Australia from 1971 through 2006. Results: Of 31,654 incident renal replacement therapy patients, 10.2% had analgesic nephropathy. Incidence and prevalence of renal replacement therapy attributed to analgesic nephropathy decreased earlier and faster among younger (age <55 yr) patients. Prevalence of analgesic nephropathy among 75- to 84-yr-old renal replacement therapy patients is still increasing. Compared with control subjects without diabetes, comorbidities (coronary artery, cerebrovascular, peripheral vascular, and chronic lung diseases) were more prevalent among patients with analgesic nephropathy at renal replacement therapy start. All-cause...

‣ α-L-Iduronidase and enzyme replacement therapy for mucopolysaccharidosis I; alpha-L-Iduronidase and enzyme replacement therapy for mucopolysaccharidosis I

Brooks, D.
Fonte: Ashley Publications Ltd Publicador: Ashley Publications Ltd
Tipo: Artigo de Revista Científica
Publicado em //2002 Português
Relevância na Pesquisa
67.45659%
Mucopolysaccharidosis I (McKusick 25280, Hurler syndrome, Scheie syndrome) is caused by a deficiency in the lysosomal hydrolase, α-L-iduronidase (EC 3.2.1.76) and results in a failure to degrade the glycosaminoglycans, dermatan sulfate and heparan sulfate. Mucopolysaccharidosis I patients present within a spectrum of clinical phenotypes, where Hurler and Scheie syndromes represent the two extremes. In the 80 or more years since the discovery of mucopolysaccharidosis I, the molecular defect has been defined, the α-L-iduronidase protein purified and characterised, the α-L-iduronidase (IDUA) gene cloned, molecular genetic studies performed and expression systems developed. These advances have allowed the development of α-L-iduronidase enzyme replacement therapy as a treatment strategy for mucopolysaccharidosis I patients. Using animal models of mucopolysaccharidosis I, the efficacy of α-L-iduronidase replacement therapy has been evaluated and justified the initiation of human clinical trials in mucopolysaccharidosis I patients. Phase I/II and Phase III clinical trials have recently been conducted and demonstrated that this therapy is effective in treating patients with the attenuated forms of mucopolysaccharidosis I (that is, little or no neuronal involvement). Further development of this technology is required to effectively treat the problem sites of neuronal and skeletal pathology...

‣ Enzyme replacement therapy for mucopolysaccharidosis VI: long-term cardiac effects of galsulfase (Naglazyme®) therapy; Enzyme replacement therapy for mucopolysaccharidosis VI: long-term cardiac effects of galsulfase (Naglazyme(r)) therapy

Braunlin, E.; Rosenfeld, H.; Kampmann, C.; Johnson, J.; Beck, M.; Giugliani, R.; Guffon, N.; Ketteridge, D.; Miranda, C.; Scarpa, M.; Schwartz, I.; Teles, E.; Wraith, J.; Barrios, P.; Dias da Silva, E.; Kurio, G.; Richardson, M.; Gildengorin, G.; Hopwood,
Fonte: Kluwer Academic Publ Publicador: Kluwer Academic Publ
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
Relevância na Pesquisa
67.391353%
Characteristic cardiac valve abnormalities and left ventricular hypertrophy are present in untreated patients with mucopolysaccharidosis type VI (MPS VI). Cardiac ultrasound was performed to investigate these findings in subjects during long-term enzyme replacement therapy (ERT) with recombinant human arylsulfatase B (rhASB, rhN-acetylgalactosamine 4-sulfatase, galsulfase, Naglazyme®). Studies were conducted in 54 subjects before ERT was begun and at specific intervals for up to 96 weeks of weekly infusions of rhASB at 1 mg/kg during phase 1/2, phase 2, and phase 3 trials of rhASB. At baseline, mitral and aortic valve obstruction was present and was significantly greater in those ≥12 years of age. Mild mitral and trace aortic regurgitation were present, the former being significantly greater in those <12 years. Left ventricular hypertrophy, with averaged z-scores ranging from 1.6–1.9 SD greater than normal, was present for ages both <12 and ≥12 years. After 96 weeks of ERT, ventricular septal hypertrophy regressed in those <12 years. For those ≥12 years, septal hypertrophy was unchanged, and aortic regurgitation increased statistically but not physiologically. Obstructive gradients across mitral and aortic valves remained unchanged. The results suggest that long-term ERT is effective in reducing intraventricular septal hypertrophy and preventing progression of cardiac valve abnormalities when administered to those <12 years of age.; E. Braunlin...

‣ Main morbidities recorded in the women's international study of long duration oestrogen after menopause (WISDOM): a randomised controlled trial of hormone replacement therapy in postmenopausal women

Vickers, M.; MacLennan, A.; Lawton, B.; Ford, D.; Martin, J.; Meredith, S.; De Stavola, B.; Rose, S.; Dowell, A.; Wilkes, H.; Darbyshire, J.; Meade, T.
Fonte: British Med Journal Publ Group Publicador: British Med Journal Publ Group
Tipo: Artigo de Revista Científica
Publicado em //2007 Português
Relevância na Pesquisa
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Objective To assess the long term risks and benefits of hormone replacement therapy (combined hormone therapy versus placebo, and oestrogen alone versus combined hormone therapy). Design Multicentre, randomised, placebo controlled, double blind trial. Setting General practices in UK (384), Australia (91), and New Zealand (24). Participants Postmenopausal women aged 50-69 years at randomisation. At early closure of the trial, 56 583 had been screened, 8980 entered run-in, and 5692 (26% of target of 22 300) started treatment. Interventions Oestrogen only therapy (conjugated equine oestrogens 0.625 mg orally daily) or combined hormone therapy (conjugated equine oestrogens plus medroxyprogesterone acetate 2.5/5.0 mg orally daily). Ten years of treatment planned. Main outcome measures Primary outcomes: major cardiovascular disease, osteoporotic fractures, and breast cancer. Secondary outcomes: other cancers, death from all causes, venous thromboembolism, cerebrovascular disease, dementia, and quality of life. Results The trial was prematurely closed during recruitment, after a median follow-up of 11.9 months (interquartile range 7.1-19.6, total 6498 women years) in those enrolled, after the publication of early results from the women's health initiative study. The mean age of randomised women was 62.8 (SD 4.8) years. When combined hormone therapy (n=2196) was compared with placebo (n=2189)...

‣ Study of enzyme replacement therapy for Gaucher Disease: comparative analysis of clinical and laboratory parameters at diagnosis and after two, five and ten years of treatment

Souza,Ana Maria Almeida; Muniz,Thiago Pimentel; Brito,Rafael Maciel
Fonte: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular Publicador: Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2014 Português
Relevância na Pesquisa
67.529146%
Objective: To evaluate the impact of enzyme replacement therapy for Gaucher Disease on clinical and laboratory parameters after two, five and ten years of treatment. Methods: Data were collected from patient records and analyzed using BioEstat software (version 5.0). Student's t-test, Analysis of Variance (ANOVA), Wilcoxon test and Kruskal–Wallis test were used for statistical analysis. Hepatomegaly and splenomegaly were analyzed using the Kappa test. Results: There was a significant increase in hemoglobin levels (p-value <0.01) and platelet counts (p-value = 0.01) within two years of therapy. At the same time, the frequencies of splenomegaly (p-value <0.01) and hepatomegaly (p-value <0.05) reduced. These results were similar at five and ten years of enzyme replacement therapy. Conclusions: There are substantial and quick (within two years) laboratory and clinical responses to enzyme replacement therapy. These improvements continue as long as enzyme replacement therapy is administered every two weeks, as recommended by the literature.

‣ Hormonal replacement therapy and quality of sex life among women in climateric; Terapia de reposição hormonal e qualidade da vida sexual de mulheres no climatério

Brito, Regina Célia Souza; UFPA; Makiama, Sheila Tetsume; UFPA
Fonte: UFPR Publicador: UFPR
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; avaliado por pares; Formato: application/pdf
Publicado em 01/09/2009 Português
Relevância na Pesquisa
67.41679%
O climatério caracteriza-se pelo declínio gradual da produção de hormônios sexuais devido a perda da atividade folicular ovariana. Esta diminuição produz alterações físicas, como redução da elasticidade e da lubrificação vaginal, provocando desconforto durante a atividade sexual. Por isso, a Terapia de Reposição Hormonal (TRH) é considerada um importante tratamento para mulheres pré e pós-menopausadas. A proposta deste estudo foi avaliar a qualidade da vida sexual de mulheres entre 40 e 60 anos e sua possível correlação com a prática de reposição hormonal. Noventa e duas mulheres esta faixa etária, todas servidoras públicas com escolaridade igual ou superior ao nível médio completo, responderam voluntariamente a um questionário autoaplicável. Os dados foram coletados e analisados obedecendo às normas éticas de pesquisa com seres humanos. Encontrou-se uma possível correlação entre a idade e a falta de lubrificação vaginal. Entretanto, não houve diferença significativa entre a realização de terapia hormonal e a ausência de dificuldades sexuais. Infere-se que a qualidade da vida sexual não depende unicamente de variáveis fisiológicas...

‣ Safety of hormone replacement therapy: a review

Lucas,Raquel
Fonte: ArquiMed - Edições Científicas AEFMUP Publicador: ArquiMed - Edições Científicas AEFMUP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2006 Português
Relevância na Pesquisa
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The recent publication of a number of large observational and experimental studies that assessed the safety of hormone replacement therapy (HRT) raised a generalised debate. These studies were conducted during a period of clear and rapid expansion of HRT in almost every country, and provided alarming associations between this therapy and several frequent chronic diseases. Subsequently to these findings, a substantial drop in the volume of prescriptions was observed internationally. However, many of the findings of these studies had already been suggested previously. Moreover, a number of methodological issues concerning the recent studies was raised and the validity of their associations questioned. The current absence of clear-cut guidelines on the use of HRT is probably a consequence of the conflicting evidence. In the Portuguese population this may partially account for the notorious lack of association between this therapy and hysterectomy or oophorectomy. Additionally, although sales data seemed to indicate an increasing trend in the prevalence of HRT up to 2002, the uptake of HRT was then a privilege of women in higher socioeconomic strata. Presently, the contribution of long-term hormone replacement therapy to women’s health remains unclear and this subject increasingly demands a multidisciplinary approach.