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Pesquisa : D02.455.326.271.884.533.699 [Categoria DeCS]
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[PMID]:29378097
[Au] Autor:Shumakova; Shipelin VA; Sidorova YS; Trushina EN; Mustafina OK; Pridvorova SM; Gmoshinsky IV; Khotimchenko SA
[Ti] Título:[Toxicological evaluation of nanosized colloidal silver, stabilized with polyvinylpyrrolidone. I. Characterization of nanomaterial, integral, hematological parameters, level of thiol compounds and liver cell apoptosis].
[So] Source:Vopr Pitan;84(6):46-57, 2015.
[Is] ISSN:0042-8833
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:Nano-sized colloidal silver (NCS) is currently one of the most widely used nanomaterials in medicine and consumer's products. Nanoparticles (NPs) of silver, in addition to the direct exposition through products may expose human via various environmental objects. The aim of the study is to assess the safe doses of silver NP received orally. The investigated NCS contained silver NPs with diameter of 10­60 nm, predominantly with a nearly spherical form stabilized with polyvinylpyrrolidone (PVP). The experiment was performed during 92 days in 5 groups of male Wistar rats (n=15 in each group), receiving a balanced semisynthetic diet. Animal of group 1 (control) received vehicle (deionized water) intragastrically for 30 days and then with food, groups from 2nd to 4th ­ PVP and groups from 3rd to 5th NCS, in doses respectively, 0.1; 1.0 and 10 mg/kg body weight (b.w.) in terms of silver. The dose of PVP in groups from 2nd to 5th did not differ, amounting to 200 mg/kg b.w. During the experiment, the weight gain, skin condition, activity, stool, cognitive function were assessed. At the end of the feeding period weight of internal organs, intestinal wall permeability to protein macromolecules, liver thiols, standard values of blood erythrocytes, leukocytes and platelets, hepatocyte apoptosis by flow cytometry were studied. These results suggest that in terms of weight gain, lung relative mass, average erythrocyte volume, hemoglobin content and concentration in erythrocytes, the relative proportion of lymphocytes and neutrophils adverse changes have been observed at a dose of 10 mg NPs per kg of b.w. At lower levels of exposure (0.1 and 1.0 mg/kg b.w.) some specific changes were also observed (in terms of thiols pool in liver, cognitive function, relative abundance of monocytes, the number of dead hepatocytes), which, however, did not possess an unambiguous dependence on the dose. Possible mechanisms of the toxic action of the NCS have been discussed.
[Mh] Termos MeSH primário: Apoptose/efeitos dos fármacos
Hepatócitos/metabolismo
Fígado/metabolismo
Nanopartículas Metálicas/toxicidade
Povidona/análogos & derivados
Prata/toxicidade
Compostos de Sulfidrila/metabolismo
[Mh] Termos MeSH secundário: Animais
Coloides
Hepatócitos/patologia
Fígado/patologia
Masculino
Nanopartículas Metálicas/química
Povidona/química
Povidona/toxicidade
Ratos
Ratos Wistar
Prata/química
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Colloids); 0 (Sulfhydryl Compounds); 25249-54-1 (polyvinylpolypyrrolidone); 3M4G523W1G (Silver); FZ989GH94E (Povidone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE


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[PMID]:29304068
[Au] Autor:Drake AC; Lee Y; Burgess EM; Karlsson JOM; Eroglu A; Higgins AZ
[Ad] Endereço:School of Chemical, Biological and Environmental Engineering, Oregon State University, Corvallis, Oregon, United States of America.
[Ti] Título:Effect of water content on the glass transition temperature of mixtures of sugars, polymers, and penetrating cryoprotectants in physiological buffer.
[So] Source:PLoS One;13(1):e0190713, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Long-term storage of viable mammalian cells is important for applications ranging from in vitro fertilization to cell therapy. Cryopreservation is currently the most common approach, but storage in liquid nitrogen is relatively costly and the requirement for low temperatures during shipping is inconvenient. Desiccation is an alternative strategy with the potential to enable viable cell preservation at more convenient storage temperatures without the need for liquid nitrogen. To achieve stability during storage in the dried state it is necessary to remove enough water that the remaining matrix forms a non-crystalline glassy solid. Thus, the glass transition temperature is a key parameter for design of cell desiccation procedures. In this study, we have investigated the effects of moisture content on the glass transition temperature (Tg) of mixtures of sugars (trehalose or raffinose), polymers (polyvinylpyrrolidone or Ficoll), penetrating cryoprotectants (ethylene glycol, propylene glycol, or dimethyl sulfoxide), and phosphate buffered saline (PBS) solutes. Aqueous solutions were dried to different moisture contents by equilibration with saturated salt solutions, or by baking at 95°C. The glass transition temperatures of the dehydrated samples were then measured by differential scanning calorimetry. As expected, Tg increased with decreasing moisture content. For example, in a desiccation medium containing 0.1 M trehalose in PBS, Tg ranged from about 360 K for a completely dry sample to about 220 K at a water mass fraction of 0.4. Addition of polymers to the solutions increased Tg, while addition of penetrating cryoprotectants decreased Tg. Our results provide insight into the relationship between relative humidity, moisture content and glass transition temperature for cell desiccation solutions containing sugars, polymers and penetrating cryoprotectants.
[Mh] Termos MeSH primário: Crioprotetores/química
Polímeros/química
Açúcares/química
Temperatura de Transição
Água/química
[Mh] Termos MeSH secundário: Tampões (Química)
Varredura Diferencial de Calorimetria
Criopreservação/métodos
Dessecação/métodos
Dimetil Sulfóxido/química
Etilenoglicol/química
Ficoll/química
Vidro/química
Modelos Teóricos
Povidona/química
Propilenoglicol/química
Rafinose/química
Soluções/química
Trealose/química
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Buffers); 0 (Cryoprotective Agents); 0 (Polymers); 0 (Solutions); 0 (Sugars); 059QF0KO0R (Water); 25702-74-3 (Ficoll); 6DC9Q167V3 (Propylene Glycol); B8WCK70T7I (Trehalose); FC72KVT52F (Ethylene Glycol); FZ989GH94E (Povidone); N5O3QU595M (Raffinose); YOW8V9698H (Dimethyl Sulfoxide)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180106
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190713


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[PMID]:28967287
[Au] Autor:Wei Q; Keck CM; Müller RH
[Ad] Endereço:a Department of Pharmaceutics, Biopharmaceutics and NutriCosmetics, Institute of Pharmacy , Freie Universität Berlin , Berlin , Germany.
[Ti] Título:Solidification of hesperidin nanosuspension by spray drying optimized by design of experiment (DoE).
[So] Source:Drug Dev Ind Pharm;44(1):1-12, 2018 Jan.
[Is] ISSN:1520-5762
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To accelerate the determination of optimal spray drying parameters, a "Design of Experiment" (DoE) software was applied to produce well redispersible hesperidin nanocrystals. SIGNIFICANCE: For final solid dosage forms, aqueous liquid nanosuspensions need to be solidified, whereas spray drying is a large-scale cost-effective industrial process. METHODS: A nanosuspension with 18% (w/w) of hesperidin stabilized by 1% (w/w) of poloxamer 188 was produced by wet bead milling. The sizes of original and redispersed spray-dried nanosuspensions were determined by laser diffractometry (LD) and photon correlation spectroscopy (PCS) and used as effect parameters. In addition, light microscopy was performed to judge the redispersion quality. RESULTS: After a two-step design of MODDE 9, screening model and response surface model (RSM), the inlet temperature of spray dryer and the concentration of protectant (polyvinylpyrrolidone, PVP K25) were identified as the most important factors affecting the redispersion of nanocrystals. As predicted in the RSM modeling, when 5% (w/w) of PVP K25 was added in an 18% (w/w) of hesperidin nanosuspension, subsequently spray-dried at an inlet temperature of 100 °C, well redispersed solid nanocrystals with an average particle size of 276 nm were obtained. By the use of PVP K25, the saturation solubility of the redispersed nanocrystals in water was improved to 86.81 µg/ml, about 2.5-fold of the original nanosuspension. In addition, the dissolution velocity was accelerated. CONCLUSIONS: This was attributed to the additional effects of steric stabilization on the nanocrystals and solubilization by the PVP polymer from spray drying.
[Mh] Termos MeSH primário: Dessecação/métodos
Hesperidina/química
Nanopartículas/química
Povidona/química
Tecnologia Farmacêutica/métodos
[Mh] Termos MeSH secundário: Solubilidade
Água/química
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
059QF0KO0R (Water); E750O06Y6O (Hesperidin); FZ989GH94E (Povidone)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180111
[Lr] Data última revisão:
180111
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171003
[St] Status:MEDLINE
[do] DOI:10.1080/03639045.2017.1285309


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[PMID]:28956647
[Au] Autor:Chen K; Wen H; Yang F; Yu Y; Gai X; Wang H; Li P; Pan W; Yang X
[Ad] Endereço:a Department of Pharmaceutics , School of Pharmaceutical Sciences, Shenyang Pharmaceutical University , Shenyang , China.
[Ti] Título:Study of controlled-release floating tablets of dipyridamole using the dry-coated method.
[So] Source:Drug Dev Ind Pharm;44(1):116-124, 2018 Jan.
[Is] ISSN:1520-5762
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Dipyridamole (DIP), having a short biological half-life, has a narrow absorption window and is primarily absorbed in the stomach. So, the purpose of this study was to prepare controlled-release floating (CRF) tablets of dipyridamole by the dry-coated method. The influence of agents with different viscosity, hydroxypropylmethylcellulose (HPMC) and polyvinylpyrollidon K30 (PVP K30) in the core tablet and low-viscosity HPMC and PVP K30 in the coating layer on drug release, were investigated. Then, a study with a three-factor, three-level orthogonal experimental design was used to optimize the formulation of the CRF tablets. After data processing, the optimized formulation was found to be: 80 mg HPMC K4M in the core tablet, 80 mg HPMC E15 in core tablet and 40 mg PVP K30 in the coating layer. Moreover, an in vitro buoyancy study showed that the optimized formulation had an excellent floating ability and could immediately float without a lag time and this lasted more than 12 h. Furthermore, an in vivo gamma scintigraphic study showed that the gastric residence time of the CRF tablet was about 8 h.
[Mh] Termos MeSH primário: Química Farmacêutica/métodos
Dipiridamol/química
Excipientes/química
Derivados da Hipromelose/química
Povidona/análogos & derivados
Povidona/química
Comprimidos/química
[Mh] Termos MeSH secundário: Preparações de Ação Retardada
Dipiridamol/farmacocinética
Meia-Vida
Comprimidos/farmacocinética
Viscosidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Delayed-Action Preparations); 0 (Excipients); 0 (Tablets); 0 (polyvinylpyrollidon K30); 3NXW29V3WO (Hypromellose Derivatives); 64ALC7F90C (Dipyridamole); FZ989GH94E (Povidone)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180111
[Lr] Data última revisão:
180111
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170929
[St] Status:MEDLINE
[do] DOI:10.1080/03639045.2017.1386198


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[PMID]:28832224
[Au] Autor:Chaudhary RS; Patel C; Sevak V; Chan M
[Ad] Endereço:a Apotex Inc., Technical Operations - Technical Support Services , Toronto , Canada.
[Ti] Título:Effect of Kollidon VA 64 particle size and morphology as directly compressible excipient on tablet compression properties.
[So] Source:Drug Dev Ind Pharm;44(1):19-29, 2018 Jan.
[Is] ISSN:1520-5762
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The study evaluates use of Kollidon VA 64 and a combination of Kollidon VA 64 with Kollidon VA 64 Fine as excipient in direct compression process of tablets. The combination of the two grades of material is evaluated for capping, lamination and excessive friability. Inter particulate void space is higher for such excipient due to the hollow structure of the Kollidon VA 64 particles. During tablet compression air remains trapped in the blend exhibiting poor compression with compromised physical properties of the tablets. Composition of Kollidon VA 64 and Kollidon VA 64 Fine is evaluated by design of experiment (DoE). A scanning electron microscopy (SEM) of two grades of Kollidon VA 64 exhibits morphological differences between coarse and fine grade. The tablet compression process is evaluated with a mix consisting of entirely Kollidon VA 64 and two mixes containing Kollidon VA 64 and Kollidon VA 64 Fine in ratio of 77:23 and 65:35. A statistical modeling on the results from the DoE trials resulted in the optimum composition for direct tablet compression as combination of Kollidon VA 64 and Kollidon VA 64 Fine in ratio of 77:23. This combination compressed with the predicted parameters based on the statistical modeling and applying main compression force between 5 and 15 kN, pre-compression force between 2 and 3 kN, feeder speed fixed at 25 rpm and compression range of 45-49 rpm produced tablets with hardness ranging between 19 and 21 kp, with no friability, capping, or lamination issue.
[Mh] Termos MeSH primário: Excipientes/química
Povidona/química
Comprimidos/química
[Mh] Termos MeSH secundário: Dureza
Tamanho da Partícula
Povidona/análise
Pressão
Solubilidade
Tecnologia Farmacêutica
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Excipients); 0 (Tablets); FZ989GH94E (Povidone)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180111
[Lr] Data última revisão:
180111
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1080/03639045.2017.1371735


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[PMID]:29045414
[Au] Autor:Gharibshahi L; Saion E; Gharibshahi E; Shaari AH; Matori KA
[Ad] Endereço:Department of Physics, Faculty of Science, University of Putra Malaysia (UPM), Serdang, Selangor, Malaysia.
[Ti] Título:Influence of Poly(vinylpyrrolidone) concentration on properties of silver nanoparticles manufactured by modified thermal treatment method.
[So] Source:PLoS One;12(10):e0186094, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Very narrow and pure silver nanoparticles were synthesized by modified thermal treatment method via oxygen and nitrogen flow in succession. The structural and optical properties of the calcined silver nanoparticles at 600°C with diverse Poly(vinylpyrrolidone) concentrations varied from 2% to 4% were studied by means of different techniques. Fourier transform infrared spectroscopy was used to monitor the production of pure Ag nanoparticles at a given Poly(vinylpyrrolidone) concentration. The X-ray powder diffraction spectra are evidence for the transformation of the amorphous sample at 30°C to the cubic crystalline nanostructures at the calcination temperatures for all Poly(vinylpyrrolidone) concentrations. The transmission electron microscopy images showed the creation of spherical silver nanoparticles with the average particle size decreased by increasing Poly(vinylpyrrolidone) concentrations from 4.61 nm at 2% to 2.49 nm at 4% Poly(vinylpyrrolidone). The optical properties were investigated by means of UV-vis absorption spectrophotometer, which showed an increase in the conduction band of Ag nanoparticles with increasing Poly(vinylpyrrolidone) concentrations from 2.83 eV at 2% Poly(vinylpyrrolidone) to 2.94 eV at 4% Poly(vinylpyrrolidone) due to decreasing particle size. This was due to less attraction between conduction electrons and metal ions for smaller particle size corresponding to fewer atoms that made up the metal nanoparticles.
[Mh] Termos MeSH primário: Nanopartículas Metálicas/química
Nanotecnologia/métodos
Povidona/farmacologia
Prata/farmacologia
Temperatura Ambiente
[Mh] Termos MeSH secundário: Nanopartículas Metálicas/ultraestrutura
Fenômenos Ópticos
Tamanho da Partícula
Pós
Espectrofotometria Ultravioleta
Espectroscopia de Infravermelho com Transformada de Fourier
Difração de Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Powders); 3M4G523W1G (Silver); FZ989GH94E (Povidone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171019
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186094


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[PMID]:28934220
[Au] Autor:Khan WS; Hamadneh NN; Khan WA
[Ad] Endereço:Department of Mechanical & Industrial Engineering, College of Engineering Majmaah University, Majmaah, Kingdom of Saudi Arabia.
[Ti] Título:Prediction of thermal conductivity of polyvinylpyrrolidone (PVP) electrospun nanocomposite fibers using artificial neural network and prey-predator algorithm.
[So] Source:PLoS One;12(9):e0183920, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In this study, multilayer perception neural network (MLPNN) was employed to predict thermal conductivity of PVP electrospun nanocomposite fibers with multiwalled carbon nanotubes (MWCNTs) and Nickel Zinc ferrites [(Ni0.6Zn0.4) Fe2O4]. This is the second attempt on the application of MLPNN with prey predator algorithm for the prediction of thermal conductivity of PVP electrospun nanocomposite fibers. The prey predator algorithm was used to train the neural networks to find the best models. The best models have the minimal of sum squared error between the experimental testing data and the corresponding models results. The minimal error was found to be 0.0028 for MWCNTs model and 0.00199 for Ni-Zn ferrites model. The predicted artificial neural networks (ANNs) responses were analyzed statistically using z-test, correlation coefficient, and the error functions for both inclusions. The predicted ANN responses for PVP electrospun nanocomposite fibers were compared with the experimental data and were found in good agreement.
[Mh] Termos MeSH primário: Eletricidade
Nanocompostos/química
Nanotecnologia
Redes Neurais (Computação)
Povidona/química
Condutividade Térmica
[Mh] Termos MeSH secundário: Compostos Férricos/química
Nanotubos de Carbono/química
Níquel/química
Zinco/química
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Ferric Compounds); 0 (Nanotubes, Carbon); 0 (nickel ferrite); 7OV03QG267 (Nickel); FZ989GH94E (Povidone); J41CSQ7QDS (Zinc)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170922
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0183920


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[PMID]:28764094
[Au] Autor:Wu YX; Liang P; Dong QM; Bai Y; Yu Z; Huang J; Zhong Y; Dai YC; Ni D; Shu HB; Pittman CU
[Ad] Endereço:College of Optical and Electronic Technology, China Jiliang University, 310018 Hangzhou, China.
[Ti] Título:Design of a silver nanoparticle for sensitive surface enhanced Raman spectroscopy detection of carmine dye.
[So] Source:Food Chem;237:974-980, 2017 Dec 15.
[Is] ISSN:0308-8146
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Flower-shaped silver nanoparticles have been successfully synthesized by a simple aqueous phase silver nitrate reduction by ascorbic acid in the presence of polyvinylpyrrolidone (PVP) surfactant. The nanoparticles diameters were adjusted from 450 to 1000nm with surface protrusions up to 10-25nm. The growth direction of silver nuclei is controlled by their degree of coating by PVP. The flower-shaped silver nanostructures obtained were used as stable Surface Enhanced Raman Scattering (SERS) substrates with high SERS activity for detecting Rhodamine 6G (R6G), at a concentration of only 10 M, where the SERS signal is still clear. SERS spectra of the dye carmine was analysed and the characteristic bands were identified. An improved principle component analysis (PCA) was used for carmine detection, at concentrations down to 10 M. The characteristic peaks of the carmine (1019, 1360, and 1573cm ) remained at 10 M. This indicated that the minimum detection limit of AgNP-based substrate for carmine is about 10 M.
[Mh] Termos MeSH primário: Nanopartículas Metálicas/química
[Mh] Termos MeSH secundário: Carmim
Povidona
Prata
Análise Espectral Raman
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
3M4G523W1G (Silver); CID8Z8N95N (Carmine); FZ989GH94E (Povidone)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE


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[PMID]:28762858
[Au] Autor:García-Pérez ME; Lemus-Rodríguez Z; Hung-Arbelo M; Vistel-Vigo M
[Ad] Endereço:a Laboratorio Farmacéutico Oriente , Santiago de Cuba , Cuba.
[Ti] Título:Influence of polyvinylpyrrolidone, microcrystalline cellulose and colloidal silicon dioxide on technological characteristics of a high-dose Petiveria alliacea tablet.
[So] Source:Drug Dev Ind Pharm;43(12):2011-2015, 2017 Dec.
[Is] ISSN:1520-5762
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Petiveria alliacea L. (Phytolaccaceae) is a perennial shrub used by its immunomodulatory, anticancerogenic and anti-inflammatory properties. This study determined the influence of polyvinylpyrrolidone (PVP), colloidal silicon dioxide (CSD) and microcrystalline cellulose (MC) on the technological characteristic of a high-dose P. alliacea tablet prepared by the wet granulation method. METHODOLOGY: The botanical and pharmacognostic analysis of the plant material was firstly performed, followed by a 2 factorial design considering three factors at two levels: (a) the binder (PVP) incorporated in formulation at 10% and 15% (w/w); (b) the compacting agent (CSD) added at 10% and 15% (w/w) and; (c) the diluent (MC) included at 7.33% and 12.46% (w/w). The analysis of pharmaceutical performance and the accelerated and long-term stability of the best prototype were also completed. RESULT AND DISCUSSION: The binder, compacting agent and the interaction binder/diluent had a significant impact on breaking force of high-dose P. alliacea tablet. The optimum formula was found to contain 15% (w/w) of CSD, 7.33% (w/w) of MC and 10% (w/w) of PVP. At these conditions, the tablet shows a breaking force of 77.96 N, a friability of 0.39%, a total phenol content of 1.30 mg/tablet and a maximum disintegration time of 6 min. CONCLUSIONS: The use of adequate amounts of PVP, MC and CSD as per the factorial design allowed the preparation of a tablet suitable for administration, despite the inappropriate flow and compressibility properties of the P. alliacea powder.
[Mh] Termos MeSH primário: Anti-Inflamatórios/administração & dosagem
Celulose/administração & dosagem
Excipientes/química
Phytolaccaceae/química
Povidona/administração & dosagem
Dióxido de Silício/administração & dosagem
Comprimidos/administração & dosagem
[Mh] Termos MeSH secundário: Anti-Inflamatórios/química
Anti-Inflamatórios/farmacologia
Celulose/química
Química Farmacêutica
Povidona/química
Pós
Dióxido de Silício/química
Comprimidos/química
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 0 (Excipients); 0 (Powders); 0 (Tablets); 7631-86-9 (Silicon Dioxide); 9004-34-6 (Cellulose); FZ989GH94E (Povidone); OP1R32D61U (microcrystalline cellulose)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170802
[St] Status:MEDLINE
[do] DOI:10.1080/03639045.2017.1359621


  10 / 5602 MEDLINE  
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[PMID]:28639707
[Au] Autor:Westby MJ; Dumville JC; Soares MO; Stubbs N; Norman G
[Ad] Endereço:Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester Academic Health Science Centre, Jean McFarlane Building, Oxford Road, Manchester, UK, M13 9PL.
[Ti] Título:Dressings and topical agents for treating pressure ulcers.
[So] Source:Cochrane Database Syst Rev;6:CD011947, 2017 06 22.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pressure ulcers, also known as bedsores, decubitus ulcers and pressure injuries, are localised areas of injury to the skin or the underlying tissue, or both. Dressings are widely used to treat pressure ulcers and promote healing, and there are many options to choose from including alginate, hydrocolloid and protease-modulating dressings. Topical agents have also been used as alternatives to dressings in order to promote healing.A clear and current overview of all the evidence is required to facilitate decision-making regarding the use of dressings or topical agents for the treatment of pressure ulcers. Such a review would ideally help people with pressure ulcers and health professionals assess the best treatment options. This review is a network meta-analysis (NMA) which assesses the probability of complete ulcer healing associated with alternative dressings and topical agents. OBJECTIVES: To assess the effects of dressings and topical agents for healing pressure ulcers in any care setting. We aimed to examine this evidence base as a whole, determining probabilities that each treatment is the best, with full assessment of uncertainty and evidence quality. SEARCH METHODS: In July 2016 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses, guidelines and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA: Published or unpublished randomised controlled trials (RCTs) comparing the effects of at least one of the following interventions with any other intervention in the treatment of pressure ulcers (Stage 2 or above): any dressing, or any topical agent applied directly to an open pressure ulcer and left in situ. We excluded from this review dressings attached to external devices such as negative pressure wound therapies, skin grafts, growth factor treatments, platelet gels and larval therapy. DATA COLLECTION AND ANALYSIS: Two review authors independently performed study selection, risk of bias assessment and data extraction. We conducted network meta-analysis using frequentist mega-regression methods for the efficacy outcome, probability of complete healing. We modelled the relative effectiveness of any two treatments as a function of each treatment relative to the reference treatment (saline gauze). We assumed that treatment effects were similar within dressings classes (e.g. hydrocolloid, foam). We present estimates of effect with their 95% confidence intervals for individual treatments compared with every other, and we report ranking probabilities for each intervention (probability of being the best, second best, etc treatment). We assessed the certainty (quality) of the body of evidence using GRADE for each network comparison and for the network as whole. MAIN RESULTS: We included 51 studies (2947 participants) in this review and carried out NMA in a network of linked interventions for the sole outcome of probability of complete healing. The network included 21 different interventions (13 dressings, 6 topical agents and 2 supplementary linking interventions) and was informed by 39 studies in 2127 participants, of whom 783 had completely healed wounds.We judged the network to be sparse: overall, there were relatively few participants, with few events, both for the number of interventions and the number of mixed treatment contrasts; most studies were small or very small. The consequence of this sparseness is high imprecision in the evidence, and this, coupled with the (mainly) high risk of bias in the studies informing the network, means that we judged the vast majority of the evidence to be of low or very low certainty. We have no confidence in the findings regarding the rank order of interventions in this review (very low-certainty evidence), but we report here a summary of results for some comparisons of interventions compared with saline gauze. We present here only the findings from evidence which we did not consider to be very low certainty, but these reported results should still be interpreted in the context of the very low certainty of the network as a whole.It is not clear whether regimens involving protease-modulating dressings increase the probability of pressure ulcer healing compared with saline gauze (risk ratio (RR) 1.65, 95% confidence interval (CI) 0.92 to 2.94) (moderate-certainty evidence: low risk of bias, downgraded for imprecision). This risk ratio of 1.65 corresponds to an absolute difference of 102 more people healed with protease modulating dressings per 1000 people treated than with saline gauze alone (95% CI 13 fewer to 302 more). It is unclear whether the following interventions increase the probability of healing compared with saline gauze (low-certainty evidence): collagenase ointment (RR 2.12, 95% CI 1.06 to 4.22); foam dressings (RR 1.52, 95% CI 1.03 to 2.26); basic wound contact dressings (RR 1.30, 95% CI 0.65 to 2.58) and polyvinylpyrrolidone plus zinc oxide (RR 1.31, 95% CI 0.37 to 4.62); the latter two interventions both had confidence intervals consistent with both a clinically important benefit and a clinically important harm, and the former two interventions each had high risk of bias as well as imprecision. AUTHORS' CONCLUSIONS: A network meta-analysis (NMA) of data from 39 studies (evaluating 21 dressings and topical agents for pressure ulcers) is sparse and the evidence is of low or very low certainty (due mainly to risk of bias and imprecision). Consequently we are unable to determine which dressings or topical agents are the most likely to heal pressure ulcers, and it is generally unclear whether the treatments examined are more effective than saline gauze.More research is needed to determine whether particular dressings or topical agents improve the probability of healing of pressure ulcers. The NMA is uninformative regarding which interventions might best be included in a large trial, and it may be that research is directed towards prevention, leaving clinicians to decide which treatment to use on the basis of wound symptoms, clinical experience, patient preference and cost.
[Mh] Termos MeSH primário: Bandagens
Fármacos Dermatológicos/uso terapêutico
Lesão por Pressão/terapia
Cicatrização
[Mh] Termos MeSH secundário: Alginatos/uso terapêutico
Curativos Hidrocoloides
Colagenases/uso terapêutico
Clara de Ovo
Géis/uso terapêutico
Ácido Glucurônico/uso terapêutico
Ácidos Hexurônicos/uso terapêutico
Seres Humanos
Metanálise em Rede
Pomadas/uso terapêutico
Excipientes Farmacêuticos/uso terapêutico
Fenitoína/uso terapêutico
Povidona/uso terapêutico
Ensaios Clínicos Controlados Aleatórios como Assunto
Óxido de Zinco/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Alginates); 0 (Dermatologic Agents); 0 (Gels); 0 (Hexuronic Acids); 0 (Ointments); 0 (Pharmaceutic Aids); 6158TKW0C5 (Phenytoin); 8A5D83Q4RW (Glucuronic Acid); 8C3Z4148WZ (alginic acid); EC 3.4.24.- (Collagenases); FZ989GH94E (Povidone); SOI2LOH54Z (Zinc Oxide)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD011947.pub2



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