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[PMID]:28823881
[Au] Autor:Eichenfield LF; Call RS; Forsha DW; Fowler J; Hebert AA; Spellman M; Stein Gold LF; Van Syoc M; Zane LT; Tschen E
[Ad] Endereço:Division of Pediatric Dermatology, Rady Children's Hospital, San Diego, California; Departments of Dermatology and Pediatrics, University of California, San Diego, California. Electronic address: leichenfield@rchsd.org.
[Ti] Título:Long-term safety of crisaborole ointment 2% in children and adults with mild to moderate atopic dermatitis.
[So] Source:J Am Acad Dermatol;77(4):641-649.e5, 2017 Oct.
[Is] ISSN:1097-6787
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Long-term topical treatment is often required for atopic dermatitis (AD), a chronic inflammatory skin disease. OBJECTIVE: To assess the long-term safety results from a multicenter, open-label, 48-week safety study (AD-303) of patients (N = 517) ≥2 years of age with mild to moderate AD who continued crisaborole treatment, a topical phosphodiesterase-4 inhibitor, after completing a 28-day phase 3 pivotal study (AD-301, AD-302). METHODS: Global disease severity was assessed in patients every 4 weeks, and if assessed as mild or greater, a 28-day treatment period with crisaborole applied twice daily was initiated. Adverse events (AEs), including treatment-emergent AEs (TEAEs), and serious AEs were analyzed. RESULTS: During the pivotal studies and AD-303, 65% of patients reported ≥1 TEAE, most of which were mild (51.2%) or moderate (44.6%) and considered unrelated to treatment (93.1%). The frequency and severity of TEAEs were consistent. The most frequently reported treatment-related AEs (overall, 10.2%) were dermatitis atopic (3.1%), application-site pain (2.3%), and application-site infection (1.2%). Nine patients (1.7%) discontinued the long-term study because of TEAEs. LIMITATIONS: Long-term efficacy was not analyzed. CONCLUSION: Crisaborole ointment had a low frequency of treatment-related AEs over 48 weeks of treatment of patients with AD.
[Mh] Termos MeSH primário: Compostos de Boro/efeitos adversos
Compostos Bicíclicos Heterocíclicos com Pontes/efeitos adversos
Dermatite Atópica/tratamento farmacológico
Fármacos Dermatológicos/efeitos adversos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Criança
Pré-Escolar
Dermatite Atópica/induzido quimicamente
Progressão da Doença
Feminino
Seres Humanos
Infecção/induzido quimicamente
Masculino
Meia-Idade
Pomadas
Dor/induzido quimicamente
Inibidores da Fosfodiesterase 4/efeitos adversos
Índice de Gravidade de Doença
Exacerbação dos Sintomas
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (AN2728); 0 (Boron Compounds); 0 (Bridged Bicyclo Compounds, Heterocyclic); 0 (Dermatologic Agents); 0 (Ointments); 0 (Phosphodiesterase 4 Inhibitors)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170927
[Lr] Data última revisão:
170927
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170822
[St] Status:MEDLINE


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[PMID]:28606961
[Au] Autor:Bouman CA; van Herwaarden N; van den Hoogen FH; Fransen J; van Vollenhoven RF; Bijlsma JW; Maas AV; den Broeder AA
[Ad] Endereço:Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
[Ti] Título:Long-term outcomes after disease activity-guided dose reduction of TNF inhibition in rheumatoid arthritis: 3-year data of the DRESS study - a randomised controlled pragmatic non-inferiority strategy trial.
[So] Source:Ann Rheum Dis;76(10):1716-1722, 2017 Oct.
[Is] ISSN:1468-2060
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Tumour necrosis factor inhibitors (TNFi) are effective in rheumatoid arthritis (RA), but disadvantages include adverse events (AEs) and high costs. This can be improved by disease activity-guided dose reduction (DR). We aimed to assess long-term outcomes of TNFi DR in RA by using 3-year data from the DRESS study (Dose REduction Strategy of Subcutaneous TNF inhibitors study). METHODS: In the intervention phase (month 0-18) of the DRESS study (Dutch trial register, NTR 3216), patients were randomised to DR or usual care (UC). In the extension phase (month 18-36), treatment strategies in both groups converged to continuation of protocolised tight control and allowed dose optimisation. Intention-to-treat analyses were done on flare, disease activity (28 joint count-based disease activity score with C reactive protein (DAS28-CRP)), functioning (health assessment questionnaire-disability index (HAQ-DI)), quality of life (Euroqol 5 dimensions 5 levels questionnaire (EQ5D-5L)), medication use, radiographic progression (Sharp van der Heijde score (SvdH)) and AE. RESULTS: 172/180 patients included in the DRESS study were included in the extension phase. Cumulative incidences of major flare were 10% and 12% (-2%, 95% CI -8 to 15) in DR and UC groups in the extension phase, and 17% and 14% (3%, 95% CI -9 to 13) from 0 to 36 months. Cumulative incidences of short-lived flares were 43% (33 to 52%)%) and 35% (23 to 49%)%) in DR and UC groups in the extension phase, and 83% (75 to 90%)%) and 44% (31 to 58%)%) from 0 to 36 months. Mean DAS28-CRP, HAQ-DI, EQ5D-5L and SvdH remained stable and not significantly different between groups. TNFi use remained low in the DR group and decreased in the UC group. Cumulative incidences of AE were not significantly different between groups. CONCLUSIONS: Safety and efficacy of disease activity guided TNFi DR in RA are maintained up to 3 years, with a large reduction in TNFi use, but no other benefits. Implementation of DR would vastly improve the cost-effective use of TNFi.
[Mh] Termos MeSH primário: Adalimumab/administração & dosagem
Antirreumáticos/administração & dosagem
Artrite Reumatoide/tratamento farmacológico
Etanercepte/administração & dosagem
Fator de Necrose Tumoral alfa/antagonistas & inibidores
[Mh] Termos MeSH secundário: Adalimumab/efeitos adversos
Idoso
Antirreumáticos/efeitos adversos
Artrite Reumatoide/sangue
Artrite Reumatoide/diagnóstico por imagem
Proteína C-Reativa/metabolismo
Avaliação da Deficiência
Etanercepte/efeitos adversos
Feminino
Seres Humanos
Masculino
Meia-Idade
Qualidade de Vida
Radiologia
Índice de Gravidade de Doença
Exacerbação dos Sintomas
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRAGMATIC CLINICAL TRIAL; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antirheumatic Agents); 0 (Tumor Necrosis Factor-alpha); 9007-41-4 (C-Reactive Protein); FYS6T7F842 (Adalimumab); OP401G7OJC (Etanercept)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170614
[St] Status:MEDLINE
[do] DOI:10.1136/annrheumdis-2017-211169


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[PMID]:28532618
[Au] Autor:Lachgar A; Sahli N; Benjaafar N
[Ad] Endereço:Centre régional d'oncologie, hôpital Mohamed-V, avenue carabonita, 32000 Al Hoceima, Maroc. Electronic address: mramine@yahoo.fr.
[Ti] Título:[Pain flare following palliative external beam radiotherapy: Prospective study of 41 cases].
[Ti] Título:Éxacerbation de la douleur après la radiothérapie externe antalgique : étude prospective de 41 cas..
[So] Source:Cancer Radiother;21(5):373-376, 2017 Aug.
[Is] ISSN:1769-6658
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:PURPOSE: Radiotherapy plays a major role in relieving pain caused by bone metastases; paradoxically initial flare of symptom is common. Our objectives were to assess prospectively the incidence, and to identify predictor's factors of this acute complication. PATIENT AND METHODS: Forty-one patients treated with analgesic external beam radiotherapy were followed prospectively. Patients recorded pain severity and analgesic intake was documented. Pain flare was defined as an increase of two points in the intensity of pain on the numerical scale with no reduction in analgesic intake and/or 25% increase of the analgesic intake without decreasing pain intensity. RESULTS: Primary cancer was the breast, lung and prostate in 49%, 29% and 22% of patients respectively. Twelve patients (29%) had a pain flare. No factor was significantly associated with the occurrence of this complication. A favorable analgesic response was observed in 27 patients. The pain flare was not related to subsequent analgesic response. CONCLUSION: Radiotherapy is an effective treatment of pain related to bone metastasis, but with a high incidence of painful exacerbation.
[Mh] Termos MeSH primário: Neoplasias Ósseas/radioterapia
Dor do Câncer/epidemiologia
Radioterapia Hipofracionada
Exacerbação dos Sintomas
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Incidência
Masculino
Meia-Idade
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170524
[St] Status:MEDLINE


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[PMID]:28394236
[Au] Autor:Ribeiro FM; Signorelli F
[Ad] Endereço:1 Rheumatology Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
[Ti] Título:The role of infections in neuropsychiatric lupus.
[So] Source:Lupus;26(5):490-496, 2017 Apr.
[Is] ISSN:1477-0962
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Opportunistic infections can cause manifestations that resemble neuropsychiatric systemic lupus erythematosus and they can also trigger lupus flares. Therefore, central nervous system infections as differential diagnosis in neuropsychiatric systemic lupus erythematosus may be difficult, leading to delayed diagnosis and specific treatment. Central nervous system infection in systemic lupus erythematosus is not common but, if left misdiagnosed and not treated promptly, can be fatal. Complementary diagnosis tests are generally non-specific and disappointing. Caution with immunosuppressive drug treatment should be emphasized while an opportunistic infection cannot be ruled out. In this review, we discuss the various types of central nervous system infections reported in systemic lupus erythematosus patients, highlighting the importance of their early recognition in order to improve morbidity and mortality. Prevention with vaccination is a recommended approach.
[Mh] Termos MeSH primário: Doenças do Sistema Nervoso Central/microbiologia
Lúpus Eritematoso Sistêmico/tratamento farmacológico
Vasculite Associada ao Lúpus do Sistema Nervoso Central/diagnóstico
Infecções Oportunistas/diagnóstico
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Diagnóstico Precoce
Feminino
Seres Humanos
Imunossupressores/efeitos adversos
Imunossupressores/uso terapêutico
Lúpus Eritematoso Sistêmico/complicações
Masculino
Infecções Oportunistas/complicações
Exacerbação dos Sintomas
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Immunosuppressive Agents)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170411
[St] Status:MEDLINE
[do] DOI:10.1177/0961203317691375


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[PMID]:28378724
[Au] Autor:Ovcharenko SI; Volel' BA; Galetskaite YK
[Ad] Endereço:I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia.
[Ti] Título:[A personalized approach to the pulmonary rehabilitation of patients with chronic obstructive pulmonary disease].
[Ti] Título:Personalizirovannyi podkhod k legochnoi reabilitatsii bol'nykh khronicheskoi obstruktivnoi bolezn'yu legkikh..
[So] Source:Ter Arkh;89(3):18-23, 2017.
[Is] ISSN:0040-3660
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:AIM: To elaborate and introduce personalized pulmonary rehabilitation (PR) programs adapted in terms of the types of disease response in patients with chronic obstructive pulmonary disease (COPD) and to evaluate the effectiveness of the programs. SUBJECTS AND METHODS: A total of 85 patients with COPD of more than 2 years' duration (the shortest time frame that was valid to assess the type of disease response) were examined. All the patients underwent adequate physical, instrumental, laboratory, and psychiatric examinations, during which the type of COPD response was determined. Before a rehabilitation cycle, after its termination, and 1, 3, and 6 months later, each patient underwent evaluation of the symptoms of COPD, the frequency of its exacerbations, the level of basic knowledge about COPD according to the author's questionnaire, assessment of the quality of life and the symptoms of anxiety and depression, and functional tests. RESULTS: The final sample included 30 patients who met the inclusion criteria and agreed to voluntarily participate in the PR programs. According to the type of a response to the underlying disease, the patients were divided into 2 polar groups: A) those who were anxious about their illness (excessive apprehension, fears that were associated with the perception of lung disease and that led to distress) and depression (despondency, an agonizing understanding of a possible poor outcome and consequences of the impact of COPD on their lives) and B) those who had a newly diagnosed type of COPD response - hyponosognosia (underestimation of disease severity, perception of the symptoms of COPD as age-related changes, and preservation of the old way of life to the detriment of their health). Effective personalized PR programs were elaborated and applied to both groups. CONCLUSION: Group measures focused on learning how to cope with the disease and its symptoms and on the ability to distinguish its manifestations from the signs of psychological distress and to combat them are effective in patients who are anxious about the disease and depressed (Group A). Individual inpatient activities aimed at the formation and maintenance of motivation, the formation of an image of the disease and its manifestations, and early specialized care for smoking cessation are indicated for patients with hyponosognosia (Group B).
[Mh] Termos MeSH primário: Sintomas Comportamentais
Assistência Centrada no Paciente
Doença Pulmonar Obstrutiva Crônica/reabilitação
Qualidade de Vida
Abandono do Hábito de Fumar
[Mh] Termos MeSH secundário: Adulto
Idoso
Sintomas Comportamentais/diagnóstico
Sintomas Comportamentais/fisiopatologia
Sintomas Comportamentais/terapia
Feminino
Seres Humanos
Masculino
Meia-Idade
Motivação
Assistência Centrada no Paciente/métodos
Assistência Centrada no Paciente/organização & administração
Desenvolvimento de Programas
Doença Pulmonar Obstrutiva Crônica/diagnóstico
Doença Pulmonar Obstrutiva Crônica/psicologia
Testes de Função Respiratória/métodos
Federação Russa
Abandono do Hábito de Fumar/métodos
Abandono do Hábito de Fumar/psicologia
Inquéritos e Questionários
Exacerbação dos Sintomas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170406
[St] Status:MEDLINE
[do] DOI:10.17116/terarkh201789318-23


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[PMID]:28303579
[Au] Autor:Moore JS; Gibson PR; Perry RE; Burgell RE
[Ad] Endereço:Department of Gastroenterology, Central Clinical School, Monash University and Alfred Hospital, Melbourne, Victoria, Australia.
[Ti] Título:Endometriosis in patients with irritable bowel syndrome: Specific symptomatic and demographic profile, and response to the low FODMAP diet.
[So] Source:Aust N Z J Obstet Gynaecol;57(2):201-205, 2017 Apr.
[Is] ISSN:1479-828X
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Women with endometriosis are frequently misdiagnosed with irritable bowel syndrome (IBS) for some time before a correct diagnosis is made. Visceral hypersensitivity is a key feature in both conditions. AIMS: To determine if there are distinct symptom patterns in women with IBS and endometriosis, and to determine the response of these women to a low FODMAP diet in comparison to those with IBS alone. MATERIALS AND METHODS: A retrospective analysis of prospectively collected data from women attending a specialist IBS service in Christchurch New Zealand. Data from those who met Rome III criteria for IBS were sorted into two groups: concurrent endometriosis and those with IBS alone. Demographics and symptom patterns were identified from a prospective questionnaire. A low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet was taught to all women as the primary therapeutic intervention. Responses to the diet were noted against their ultimate disposition. RESULTS: Of the 160 women who met Rome III criteria for IBS, 36% had concurrent endometriosis. The presence of dyspareunia (P > 0.0001), referred pain (P = 0.005), bowel symptoms exacerbated by menstruation (P = 0.0004) and a family history of endometriosis (P = 0.0003) were associated with concurrent endometriosis. Seventy two percent of these women reported a >50% improvement in bowel symptoms after four weeks of a low FODMAP diet compared with 49% in those with no known endometriosis (P = 0.001, odds ratio 3.11, 95% CI, 1.5-6.2). CONCLUSIONS: Women with concurrent endometriosis and IBS report a unique symptom phenotype. The low FODMAP diet appears effective in women with gut symptoms and endometriosis.
[Mh] Termos MeSH primário: Endometriose/complicações
Síndrome do Intestino Irritável/complicações
Síndrome do Intestino Irritável/dietoterapia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Dor nas Costas/etiologia
Dissacarídeos/administração & dosagem
Dispareunia/etiologia
Endometriose/genética
Feminino
Seres Humanos
Menstruação/fisiologia
Meia-Idade
Monossacarídeos/administração & dosagem
Oligossacarídeos/administração & dosagem
Dor Pélvica/etiologia
Estudos Retrospectivos
Inquéritos e Questionários
Avaliação de Sintomas
Exacerbação dos Sintomas
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Disaccharides); 0 (Monosaccharides); 0 (Oligosaccharides)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170318
[St] Status:MEDLINE
[do] DOI:10.1111/ajo.12594


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[PMID]:28257602
[Au] Autor:Merrill JT; Immermann F; Whitley M; Zhou T; Hill A; O'Toole M; Reddy P; Honczarenko M; Thanou A; Rawdon J; Guthridge JM; James JA; Sridharan S
[Ad] Endereço:Oklahoma Medical Research Foundation and University of Oklahoma Health Sciences Center, Oklahoma City.
[Ti] Título:The Biomarkers of Lupus Disease Study: A Bold Approach May Mitigate Interference of Background Immunosuppressants in Clinical Trials.
[So] Source:Arthritis Rheumatol;69(6):1257-1266, 2017 Jun.
[Is] ISSN:2326-5205
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Molecular medicine raised expectations for strategically targeted biologic agents in systemic lupus erythematosus (SLE), but clinical trial results have been disappointing and difficult to interpret. Most studies add investigational agents to various, often effective, standard therapy immunosuppressants used at baseline, with unknown treatment interactions. Eliminating polypharmacy in trials of active lupus remains controversial. We undertook the Biomarkers of Lupus Disease study to test withdrawal of immunosuppressants as a novel approach to rendering SLE trials interpretable. METHODS: In 41 patients with active, non-organ-threatening SLE flare (group A), temporary steroids were given while background immunosuppressants were withdrawn. Time to loss of disease suppression (time to disease flare) and safety were evaluated; standard therapy was immediately resumed when symptoms recurred. Immunologic impacts of standard therapy were studied at baseline by multiplex assay, enzyme-linked immunosorbent assay, and messenger RNA array in group A patients plus 62 additional patients donating a single sample (group B). RESULTS: Patients with lower or higher baseline disease activity had median times to flare of 71 or 45 days, respectively; 40 of 41 patients (98%) had disease flares by 6 months. All flares were treated and resolved within 6 weeks. No serious adverse events occurred from flare or infection. Type I interferon (IFN), Th17, and B lymphocyte stimulator pathways tracked together. Baseline immunosuppressants had distinct impacts on Th17 and B lymphocyte stimulator, depending on IFN signature. CONCLUSION: Trials in active, non-organ-threatening SLE can safely withdraw background treatments if patients who have disease flares are designated nonresponders and returned to standard therapy. Immunologic effects of standard therapy vary between IFN-defined subsets. These findings provide a strategy for minimizing or optimizing treatment combinations in lupus trials and clinical care.
[Mh] Termos MeSH primário: Imunossupressores/administração & dosagem
Lúpus Eritematoso Sistêmico/sangue
Esteroides/administração & dosagem
Suspensão de Tratamento
[Mh] Termos MeSH secundário: Adulto
Fator Ativador de Células B/sangue
Biomarcadores/sangue
Estudos Transversais
Feminino
Seres Humanos
Interferon Tipo I/sangue
Lúpus Eritematoso Sistêmico/tratamento farmacológico
Masculino
Meia-Idade
Estudos Prospectivos
RNA Mensageiro/sangue
Exacerbação dos Sintomas
Células Th17/efeitos dos fármacos
Fatores de Tempo
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (B-Cell Activating Factor); 0 (Biomarkers); 0 (Immunosuppressive Agents); 0 (Interferon Type I); 0 (RNA, Messenger); 0 (Steroids)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170304
[St] Status:MEDLINE
[do] DOI:10.1002/art.40086


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[PMID]:28251894
[Au] Autor:Saint-Jean M; Khammari A; Seite S; Moyal D; Dreno B
[Ad] Endereço:Dermatology department, Nantes University Hospital, 1 place A. Ricordeau, 44093 Nantes, France, CRCNA, Inserm U892, CNRS 6299, 9 quai Moncousu, 44093 Nantes Cedex 1, France.
[Ti] Título:Characteristics of premenstrual acne flare-up and benefits of a dermocosmetic treatment: a double-blind randomised trial.
[So] Source:Eur J Dermatol;27(2):144-149, 2017 Apr 01.
[Is] ISSN:1952-4013
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:To date, facial acne flare-ups in adult women during the luteal phase of the menstrual cycle have been poorly investigated. To clinically characterize premenstrual acne flare-up in adult women and investigate the effect of a dermocosmetic treatment. This single-centre study included 32 young adult women with declared premenstrual acne flares and was composed of two phases: (1) an observational phase (two menstrual cycles) and (2) an interventional phase (one menstrual cycle) in a controlled, randomised, double-blind, intra-individual (half-face) setting in which a dermocosmetic (containing lipohydroxyacid, nicotinamide, and piroctone-olamine) and placebo were compared. Initially, during the first part of the study, we observed that premenstrual acne flare-ups in adult women were characterized by a significant increase in the number of papules (20.2 vs. 13.7; p = 0.0008) and to a lesser extent, closed comedones (25.6 vs. 22.7; p = 0.04). Secondly, during the interventional phase, the half-face treated with the dermocosmetic formulation showed a significantly lower number of inflammatory lesions (7.6 vs 9.4; p = 0.01) during the luteal phase compared to the half-face treated with the placebo. Tolerance of the dermocosmetic formulation was rated as good or excellent. Our data indicate a significant increase in the number of papules during premenstrual acne flare-ups in adult women and the use of a dermocosmetic may be of benefit in partially reducing this premenstrual inflammatory flare-up.
[Mh] Termos MeSH primário: Acne Vulgar/tratamento farmacológico
Cosmecêuticos/uso terapêutico
Etanolaminas/uso terapêutico
Fase Luteal
Niacinamida/uso terapêutico
Piridonas/uso terapêutico
Salicilatos/uso terapêutico
[Mh] Termos MeSH secundário: Acne Vulgar/patologia
Adolescente
Adulto
Cosmecêuticos/efeitos adversos
Método Duplo-Cego
Combinação de Medicamentos
Etanolaminas/efeitos adversos
Feminino
Seres Humanos
Niacinamida/efeitos adversos
Piridonas/efeitos adversos
Salicilatos/efeitos adversos
Exacerbação dos Sintomas
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (2-hydroxy-5-octanoylbenzoic acid); 0 (Cosmeceuticals); 0 (Drug Combinations); 0 (Ethanolamines); 0 (Pyridones); 0 (Salicylates); 25X51I8RD4 (Niacinamide); A4V5C6R9FB (piroctone olamine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170303
[St] Status:MEDLINE
[do] DOI:10.1684/ejd.2016.2952


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[PMID]:28224437
[Au] Autor:Zhu CH; Zhao MZ; Chen G; Qi JY; Song JX; Ning Q; Xu D
[Ad] Endereço:Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
[Ti] Título:Baseline HBV load increases the risk of anti-tuberculous drug-induced hepatitis flares in patients with tuberculosis.
[So] Source:J Huazhong Univ Sci Technolog Med Sci;37(1):105-109, 2017 Feb.
[Is] ISSN:1672-0733
[Cp] País de publicação:China
[La] Idioma:eng
[Ab] Resumo:Hepatitis associated anti-tuberculous treatment (HATT) has been a main obstacle in managing patients co-infected with Mycobacterium tuberculosis and hepatitis B virus (HBV). Therefore, we evaluated the factors related to the severity of adverse effects during HATT, especially those associated with liver failure. A retrospective study was carried out at Tongji Hospital from 2007 to 2012. Increases in serum transaminase levels of >3, 5, and 10 times the upper limit of normal (ULN) were used to define liver damage as mild, moderate, and severe, respectively. Patients with elevated total bilirubin (TBil) levels that were more than 10 times the ULN (>171 µmol/L) with or without decreased (<40%) prothrombin activity (PTA) were diagnosed with liver failure. A cohort of 87 patients was analyzed. The incidence of liver damage and liver failure was 59.8% (n=52) and 25.3% (n=22), respectively. The following variables were correlated with the severity of hepatotoxicity: albumin (ALB) levels, PTA, platelet counts (PLT), and the use of antiretroviral therapies (P<0.05). Hypo-proteinemia and antiretroviral therapy were significantly associated with liver failure, and high viral loads were a significant risk factor with an odds ratio (OR) of 2.066. Judicious follow-up of clinical conditions, liver function tests, and coagulation function, especially in patients with high HBV loads and hypoalbuminemia is recommended. It may be advisable to reconsider the use of antiviral drugs failure during the course of anti-tuberculous treatment of HBV infection patients to avoid the occurrence of furious liver failure.
[Mh] Termos MeSH primário: Antituberculosos/efeitos adversos
Doença Hepática Induzida por Substâncias e Drogas/epidemiologia
Hepatite B Crônica/etiologia
Falência Hepática/epidemiologia
Tuberculose/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Doença Hepática Induzida por Substâncias e Drogas/virologia
Feminino
Hepatite B Crônica/epidemiologia
Hepatite B Crônica/fisiopatologia
Seres Humanos
Incidência
Falência Hepática/induzido quimicamente
Falência Hepática/virologia
Testes de Função Hepática
Masculino
Meia-Idade
Estudos Retrospectivos
Fatores de Risco
Exacerbação dos Sintomas
Transaminases/sangue
Tuberculose/metabolismo
Tuberculose/fisiopatologia
Carga Viral
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antitubercular Agents); EC 2.6.1.- (Transaminases)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:171104
[Lr] Data última revisão:
171104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.1007/s11596-017-1702-3


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[PMID]:28166390
[Au] Autor:van Zuuren EJ; Fedorowicz Z; Christensen R; Lavrijsen A; Arents BWM
[Ad] Endereço:Department of Dermatology, Leiden University Medical Center, PO Box 9600, B1-Q, Leiden, Netherlands, 2300 RC.
[Ti] Título:Emollients and moisturisers for eczema.
[So] Source:Cochrane Database Syst Rev;2:CD012119, 2017 02 06.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Eczema is a chronic skin disease characterised by dry skin, intense itching, inflammatory skin lesions, and a considerable impact on quality of life. Moisturisation is an integral part of treatment, but it is unclear if moisturisers are effective. OBJECTIVES: To assess the effects of moisturisers for eczema. SEARCH METHODS: We searched the following databases to December 2015: Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, LILACS, the GREAT database. We searched five trials registers and checked references of included and excluded studies for further relevant trials. SELECTION CRITERIA: Randomised controlled trials in people with eczema. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methodological procedures. MAIN RESULTS: We included 77 studies (6603 participants, mean age: 18.6 years, mean duration: 6.7 weeks). We assessed 36 studies as at a high risk of bias, 34 at unclear risk, and seven at low risk. Twenty-four studies assessed our primary outcome 'participant-assessed disease severity', 13 assessed 'satisfaction', and 41 assessed 'adverse events'. Secondary outcomes included investigator-assessed disease severity (addressed in 65 studies), skin barrier function (29), flare prevention (16), quality of life (10), and corticosteroid use (eight). Adverse events reporting was limited (smarting, stinging, pruritus, erythema, folliculitis).Six studies evaluated moisturiser versus no moisturiser. 'Participant-assessed disease severity' and 'satisfaction' were not assessed. Moisturiser use yielded lower SCORAD than no moisturiser (three studies, 276 participants, mean difference (MD) -2.42, 95% confidence interval (CI) -4.55 to -0.28), but the minimal important difference (MID) (8.7) was unmet. There were fewer flares with moisturisers (two studies, 87 participants, RR 0.40, 95% CI 0.23 to 0.70), time to flare was prolonged (median: 180 versus 30 days), and less topical corticosteroids were needed (two studies, 222 participants, MD -9.30 g, 95% CI -15.3 to -3.27). There was no statistically significant difference in adverse events (one study, 173 participants, risk ratio (RR) 15.34, 95% CI 0.90 to 261.64). Evidence for these outcomes was low quality.With Atopiclair (three studies), 174/232 participants experienced improvement in participant-assessed disease severity versus 27/158 allocated to vehicle (RR 4.51, 95% CI 2.19 to 9.29). Atopiclair decreased itching (four studies, 396 participants, MD -2.65, 95% CI -4.21 to -1.09) and achieved more frequent satisfaction (two studies, 248 participants, RR 2.14, 95% CI 1.58 to 2.89), fewer flares (three studies, 397 participants, RR 0.18, 95% CI 0.11 to 0.31), and lower EASI (four studies, 426 participants, MD -4.0, 95% CI -5.42 to -2.57), but MID (6.6) was unmet. The number of participants reporting adverse events was not statistically different (four studies, 430 participants, RR 1.03, 95% CI 0.79 to 1.33). Evidence for these outcomes was moderate quality.Participants reported skin improvement more frequently with urea-containing cream than placebo (one study, 129 participants, RR 1.28, 95% CI 1.06 to 1.53; low-quality evidence), with equal satisfaction between the two groups (one study, 38 participants, low-quality evidence). Urea-containing cream improved dryness (investigator-assessed) more frequently (one study, 128 participants, RR 1.40, 95% CI 1.14 to 1.71; moderate-quality evidence) with fewer flares (one study, 44 participants, RR 0.47, 95% CI 0.24 to 0.92; low-quality evidence), but more participants in this group reported adverse events (one study, 129 participants, RR 1.65, 95% CI 1.16 to 2.34; moderate-quality evidence).Three studies assessed glycerol-containing moisturiser versus vehicle or placebo. More participants in the glycerol group noticed skin improvement (one study, 134 participants, RR 1.22, 95% CI 1.01 to 1.48; moderate-quality evidence), and this group saw improved investigator-assessed SCORAD (one study, 249 participants, MD -2.20, 95% CI -3.44 to -0.96; high-quality evidence), but MID was unmet. Participant satisfaction was not addressed. The number of participants reporting adverse events was not statistically significant (two studies, 385 participants, RR 0.90, 95% CI 0.68 to 1.19; moderate-quality evidence).Four studies investigated oat-containing moisturisers versus no treatment or vehicle. No significant differences between groups were reported for participant-assessed disease severity (one study, 50 participants, RR 1.11, 95% CI 0.84 to 1.46; low-quality evidence), satisfaction (one study, 50 participants, RR 1.06, 95% CI 0.74 to 1.52; very low-quality evidence), and investigator-assessed disease severity (three studies, 272 participants, standardised mean difference (SMD) -0.23, 95% CI -0.66 to 0.21; low-quality evidence). In the oat group, there were fewer flares (one study, 43 participants, RR 0.31, 95% CI 0.12 to 0.7; low-quality evidence) and less topical corticosteroids needed (two studies, 222 participants, MD -9.30g, 95% CI 15.3 to -3.27; low-quality evidence), but more adverse events were reported (one study, 173 participants; Peto odds ratio (OR) 7.26, 95% CI 1.76 to 29.92; low-quality evidence).All moisturisers above were compared to placebo, vehicle, or no moisturiser. Participants considered moisturisers more effective in reducing eczema (five studies, 572 participants, RR 2.46, 95% CI 1.16 to 5.23; low-quality evidence) and itch (seven studies, 749 participants, SMD -1.10, 95% CI -1.83 to -0.38) than control. Participants in both treatment arms reported comparable satisfaction (three studies, 296 participants, RR 1.35, 95% CI 0.77 to 2.26; low-quality evidence). Moisturisers led to lower investigator-assessed disease severity (12 studies, 1281 participants, SMD -1.04, 95% CI -1.57 to -0.51; high-quality evidence) and fewer flares (six studies, 607 participants, RR 0.33, 95% CI 0.17 to 0.62; moderate-quality evidence), but there was no difference in adverse events (10 studies, 1275 participants, RR 1.03, 95% CI 0.82 to 1.30; moderate-quality evidence).Topical active treatment combined with moisturiser was more effective than active treatment alone in reducing investigator-assessed disease severity (three studies, 192 participants, SMD -0.87, 95% CI -1.17 to -0.57; moderate-quality evidence) and flares (one study, 105 participants, RR 0.43, 95% CI 0.20 to 0.93), and was preferred by participants (both low-quality evidence). There was no statistically significant difference in number of adverse events (one study, 125 participants, RR 0.39, 95% CI 0.13 to 1.19; very low-quality evidence). Participant-assessed disease severity was not addressed. AUTHORS' CONCLUSIONS: Most moisturisers showed some beneficial effects, producing better results when used with active treatment, prolonging time to flare, and reducing the number of flares and amount of topical corticosteroids needed to achieve similar reductions in eczema severity. We did not find reliable evidence that one moisturiser is better than another.
[Mh] Termos MeSH primário: Eczema/tratamento farmacológico
Emolientes/uso terapêutico
[Mh] Termos MeSH secundário: Corticosteroides/uso terapêutico
Emolientes/química
Seres Humanos
Satisfação do Paciente
Ensaios Clínicos Controlados Aleatórios como Assunto
Índice de Gravidade de Doença
Exacerbação dos Sintomas
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones); 0 (Emollients)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170619
[Lr] Data última revisão:
170619
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170207
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD012119.pub2



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