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[PMID]:28631809
[Au] Autor:Naing C; Whittaker MA
[Ad] Endereço:College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville, Australia.
[Ti] Título:Anabolic steroids for treating pressure ulcers.
[So] Source:Cochrane Database Syst Rev;6:CD011375, 2017 06 20.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pressure ulcers, also known as bed sores, pressure sores or decubitus ulcers develop as a result of a localised injury to the skin or underlying tissue, or both. The ulcers usually arise over a bony prominence, and are recognised as a common medical problem affecting people confined to a bed or wheelchair for long periods of time. Anabolic steroids are used as off-label drugs (drugs which are used without regulatory approval) and have been used as adjuvants to usual treatment with dressings, debridement, nutritional supplements, systemic antibiotics and antiseptics, which are considered to be supportive in healing of pressure ulcers. Anabolic steroids are considered because of their ability to stimulate protein synthesis and build muscle mass. Comprehensive evidence is required to facilitate decision making, regarding the benefits and harms of using anabolic steroids. OBJECTIVES: To assess the effects of anabolic steroids for treating pressure ulcers. SEARCH METHODS: In March 2017 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including 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 We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional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 SELECTION CRITERIA: Published or unpublished randomised controlled trials (RCTs) comparing the effects of anabolic steroids with alternative treatments or different types of anabolic steroids in the treatment of pressure ulcers. DATA COLLECTION AND ANALYSIS: Two review authors independently carried out study selection, data extraction and risk of bias assessment. MAIN RESULTS: The review contains only one trial with a total of 212 participants, all with spinal cord injury and open pressure ulcers classed as stage III and IV. The participants were mainly male (98.2%, 106/108) with a mean age of 58.4 (standard deviation 10.4) years in the oxandrolone group and were all male (100%, 104/104) with a mean age of 57.3 (standard deviation 11.6) years in the placebo group. This trial compared oxandrolone (20 mg/day, administered orally) with a dose of placebo (an inactive substance consisting of 98% starch and 2% magnesium stearate) and reported data on complete healing of ulcers and adverse events. There was very low-certainty evidence on the relative effect of oxandrolone on complete ulcer healing at the end of a 24-week treatment period (risk ratio RR) 0.81, 95% confidence interval (CI) 0.52 to 1.26) (downgraded twice for imprecision due to an extremely wide 95% CI, which spanned both benefit and harm, and once for indirectness, as the participants were mostly male spinal cord injury patients). Thus, we are uncertain whether oxandrolone improves or reduces the complete healing of pressure ulcers, as we assessed the certainty of the evidence as very low.There was low-certainty evidence on the risk of non-serious adverse events reported in participants treated with oxandrolone compared with placebo (RR 3.85, 95% CI 1.12 to 13.26) (downgraded once for imprecision and once for indirectness, as the participants were mostly male spinal cord injury patients). Thus, the treatment with oxandrolone may increase the risk of non-serious adverse events reported in participants.There was very low-certainty evidence on the risk of serious adverse events reported in participants treated with oxandrolone compared with placebo (RR 0.54, 95% CI 0.25 to 1.17) (downgraded twice for imprecision due to an extremely wide 95% CI, which spanned both benefit and harm, and once for indirectness, as the participants were mostly male spinal cord injury patients). Of the five serious adverse events reported in the oxandrolone-treated group, none were classed by the trial teams as being related to treatment. We are uncertain whether oxandrolone increases or decreases the risk of serious adverse events as we assessed the certainty of the evidence as very low.Secondary outcomes such as pain, length of hospital stay, change in wound size or wound surface area, incidence of different type of infection, cost of treatment and quality of life were not reported in the included trial.Overall the evidence in this study was of very low quality (downgraded for imprecision and indirectness). This trial stopped early when the futility analysis (interim analysis) in the opinion of the study authors showed that oxandrolone had no benefit over placebo for improving ulcer healing. AUTHORS' CONCLUSIONS: There is no high quality evidence to support the use of anabolic steroids in treating pressure ulcers.Further well-designed, multicenter trials, at low risk of bias, are necessary to assess the effect of anabolic steroids on treating pressure ulcers, but careful consideration of the current trial and its early termination are required when planning future research.
[Mh] Termos MeSH primário: Oxandrolona/uso terapêutico
Lesão por Pressão/tratamento farmacológico
Congêneres da Testosterona/uso terapêutico
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Meia-Idade
Uso Off-Label
Oxandrolona/efeitos adversos
Amido/uso terapêutico
Ácidos Esteáricos/uso terapêutico
Congêneres da Testosterona/efeitos adversos
Cicatrização
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Stearic Acids); 0 (Testosterone Congeners); 4ELV7Z65AP (stearic acid); 7H6TM3CT4L (Oxandrolone); 9005-25-8 (Starch)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170621
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD011375.pub2


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Brandão, Marcos Antonio Fernandes
[PMID]:28557789
[Au] Autor:Ferreira AO; Polonini HC; Loures da Silva S; Cerqueira de Melo VA; de Andrade L; Brandão MAF
[Ad] Endereço:Ortofarma-Quality Control Laboratories, Matias Barbosa, MG, Brazil. anderson@ortofarma.
[Ti] Título:Stability of Alprazolam, Atropine Sulfate, Glutamine, Levofloxacin, Metoprolol Tartrate, Nitrofurantoin, Ondansetron Hydrochloride, Oxandrolone, Pregabaline, and Riboflavin in SyrSpend SF pH4 Oral Suspensions.
[So] Source:Int J Pharm Compd;21(3):255-263, 2017 May-Jun.
[Is] ISSN:1092-4221
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The objective of this study was to evaluate the stability of 10 commonly used active pharmaceutical ingredients compounded in oral suspensions using an internationally used suspending vehicle (SyrSpend SF PH4): alprazolam 1.0 mg/mL, atropine sulfate 0.1 mg/mL, glutamine 250.0 mg/mL, levofloxacin 50.0 mg/mL, metoprolol tartrate 10.0 mg/mL, nitrofurantoin 2.0 mg/mL, ondansetron hydrochloride 0.8 mg/mL, oxandrolone 3.0 mg/mL, pregabaline 20.0 mg/mL, riboflavin 10.0 mg/mL. All suspensions were stored at both controlled refrigeration (2°C to 8°C) and controlled room temperature (20°C to 25°C). Stability was assessed by measuring the percent recovery at varying time points throughout a 90-day period. Active pharmaceutical ingredients quantification was performed by high-performance liquid chromatography via a stability-indicating method. Given the percentage of recovery of the active pharmaceutical ingredients within the suspensions, the beyond-use date of the final products (active pharmaceutical ingredients + vehicle) was at least 90 days for all suspensions with regard to both temperatures. This suggests that the vehicle is stable for compounding active pharmaceutical ingredients from different pharmacological classes.
[Mh] Termos MeSH primário: Preparações Farmacêuticas/química
Suspensões/química
[Mh] Termos MeSH secundário: Alprazolam/química
Atropina/química
Composição de Medicamentos/métodos
Estabilidade de Medicamentos
Armazenamento de Medicamentos/métodos
Glutamina/química
Levofloxacino/química
Metoprolol/química
Nitrofurantoína/química
Ondansetron/química
Oxandrolona/química
Pregabalina/química
Refrigeração/métodos
Riboflavina/química
Temperatura Ambiente
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Pharmaceutical Preparations); 0 (Suspensions); 0RH81L854J (Glutamine); 4AF302ESOS (Ondansetron); 55JG375S6M (Pregabalin); 6GNT3Y5LMF (Levofloxacin); 7C0697DR9I (Atropine); 7H6TM3CT4L (Oxandrolone); 927AH8112L (Nitrofurantoin); GEB06NHM23 (Metoprolol); TLM2976OFR (Riboflavin); YU55MQ3IZY (Alprazolam)
[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:170531
[St] Status:MEDLINE


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[PMID]:28285751
[Au] Autor:Ross JL; Kushner H; Kowal K; Bardsley M; Davis S; Reiss AL; Tartaglia N; Roeltgen D
[Ad] Endereço:Thomas Jefferson University, Department of Pediatrics, Philadelphia, PA; A.I. DuPont Hospital for Children, Wilmington, DE. Electronic address: judith.ross@jefferson.edu.
[Ti] Título:Androgen Treatment Effects on Motor Function, Cognition, and Behavior in Boys with Klinefelter Syndrome.
[So] Source:J Pediatr;185:193-199.e4, 2017 Jun.
[Is] ISSN:1097-6833
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To examine the effects of early low-dose androgen on motor, cognitive, and behavioral function in prepubertal boys with Klinefelter syndrome (47,XXY). STUDY DESIGN: Double-blind trial of 84 boys, ages 4-12 years, randomized to oxandrolone (Ox; 0.06?mg/kg daily; n?=?43) or placebo (Pl; n?=?41) for 24 months. Standardized assessments were performed at baseline and every 12 months for 24 months evaluating motor, cognitive, and behavioral function. RESULTS: The 24-month outcomes were better in the Ox vs. Pl group on 1 of 5 primary endpoints (motor function/strength): Bruininks Visual-Motor scale (P?=?.005), without significant differences between the 2 groups for the other 4 components. Secondary analyses suggested improvement in the Ox vs. Pl group in the anxiety/depression (P?=?.03) and social problems (P?=?.01) scales on the Child Behavior Checklist, anxiety (P?=?.04) on the Piers Harris Self Concept Scale, and interpersonal problems (P?=?.02) on the Children's Depression Inventory, without significant differences in hyperactive or aggressive behaviors. CONCLUSIONS: This double-blind, randomized trial demonstrates that 24 months of childhood low-dose androgen treatment in boys with Klinefelter syndrome benefited 1 of 5 primary endpoints (visual-motor function). Secondary analyses demonstrated positive effects of androgen on aspects of psychosocial function (anxiety, depression, social problems), without significant effects on cognitive function, or hyperactive or aggressive behaviors. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00348946.
[Mh] Termos MeSH primário: Androgênios/uso terapêutico
Comportamento Infantil
Cognição
Síndrome de Klinefelter/tratamento farmacológico
Força Muscular
Oxandrolona/uso terapêutico
[Mh] Termos MeSH secundário: Ansiedade/tratamento farmacológico
Criança
Pré-Escolar
Depressão/tratamento farmacológico
Método Duplo-Cego
Seres Humanos
Relações Interpessoais
Síndrome de Klinefelter/psicologia
Masculino
Testes Neuropsicológicos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Androgens); 7H6TM3CT4L (Oxandrolone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170314
[St] Status:MEDLINE


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[PMID]:27802097
[Au] Autor:Davis SM; Cox-Martin MG; Bardsley MZ; Kowal K; Zeitler PS; Ross JL
[Ad] Endereço:Department of Pediatrics and.
[Ti] Título:Effects of Oxandrolone on Cardiometabolic Health in Boys With Klinefelter Syndrome: A Randomized Controlled Trial.
[So] Source:J Clin Endocrinol Metab;102(1):176-184, 2017 Jan 01.
[Is] ISSN:1945-7197
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Context: Klinefelter syndrome (KS) is a common condition in males, resulting in androgen deficiency and cardiometabolic diseases. These interrelated conditions may be present in prepubertal boys with KS. Objective: To determine whether supplemental low-dose androgen has a beneficial effect on body composition in prepubertal boys with KS. Design, Setting, and Participants: We conducted a secondary analysis of a randomized, double-blind, placebo-controlled clinical trial in 93 boys with KS aged 4 to 12 years. Interventions: Oral oxandrolone (Ox) 0.06 mg/kg/d or placebo for 2 years. Outcome Measures: The primary outcome was percent body fat standard deviation score (%BF SDS) at 2 years. Secondary outcomes included additional measures of cardiometabolic health and safety. Results: The %BF SDS at 2 years was significantly lower in the treatment (0.29 ± 0.76 SDS) compared with placebo group (0.81 ± 0.72 SDS) after adjusting for age and baseline %BF SDS (95% confidence interval for the difference between means -0.86 to -0.19 SDS, P = 0.009). Ox resulted in lower triglycerides (P = 0.043), but also lower high-density lipoprotein (HDL) cholesterol (P < 0.001) and a more rapid advancement in bone age (P = 0.011). Conclusions: Ox has positive effects on measures of cardiometabolic health in prepubertal boys with KS; however, it does lower HDL cholesterol and advance bone age.
[Mh] Termos MeSH primário: Estatura/efeitos dos fármacos
Doenças Cardiovasculares/prevenção & controle
Síndrome de Klinefelter/tratamento farmacológico
Síndrome Metabólica/prevenção & controle
Oxandrolona/uso terapêutico
[Mh] Termos MeSH secundário: Biomarcadores/análise
Composição Corporal
Criança
Método Duplo-Cego
Seguimentos
Seres Humanos
Síndrome de Klinefelter/metabolismo
Síndrome de Klinefelter/patologia
Masculino
Prognóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Biomarkers); 7H6TM3CT4L (Oxandrolone)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161102
[St] Status:MEDLINE
[do] DOI:10.1210/jc.2016-2904


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[PMID]:27535042
[Au] Autor:Wu C; Kovac JR
[Ad] Endereço:McMaster Institute of Urology, Hamilton, ON, Canada.
[Ti] Título:Novel Uses for the Anabolic Androgenic Steroids Nandrolone and Oxandrolone in the Management of Male Health.
[So] Source:Curr Urol Rep;17(10):72, 2016 Oct.
[Is] ISSN:1534-6285
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:There has recently been renewed interest in novel clinical applications of the anabolic-androgenic steroid (AAS) testosterone and its synthetic derivatives, particularly given with the rising popularity of testosterone supplementation therapy (TST) for the treatment of male hypogonadism. In this manuscript, we provide a brief review of the history of AAS and discuss clinical applications of two of the more well-known AAS: nandrolone and oxandrolone. Both agents exhibit favorable myotrophic/androgenic ratios and have been investigated for effectiveness in numerous disease states. We also provide a brief synopsis of selective androgen receptor modulators (SARMs) and postulate how these orally active, non-aromatizing, tissue-selective agents might be used in contemporary andrology. Currently, the applications of testosterone alternatives in hypogonadism are limited. However, it is tempting to speculate that these agents may one day become accepted as alternatives, or adjuncts, to the treatment of male hypogonadism.
[Mh] Termos MeSH primário: Anabolizantes/uso terapêutico
Nandrolona/uso terapêutico
Oxandrolona/uso terapêutico
[Mh] Termos MeSH secundário: Anabolizantes/farmacologia
Antagonistas de Androgênios/farmacologia
Antagonistas de Androgênios/uso terapêutico
Seres Humanos
Masculino
Saúde do Homem
Nandrolona/farmacologia
Oxandrolona/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anabolic Agents); 0 (Androgen Antagonists); 6PG9VR430D (Nandrolone); 7H6TM3CT4L (Oxandrolone)
[Em] Mês de entrada:1612
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160819
[St] Status:MEDLINE
[do] DOI:10.1007/s11934-016-0629-8


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Registro de Ensaios Clínicos
Registro de Ensaios Clínicos
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[PMID]:27433905
[Au] Autor:Herndon DN; Voigt CD; Capek KD; Wurzer P; Guillory A; Kline A; Andersen CR; Klein GL; Tompkins RG; Suman OE; Finnerty CC; Meyer WJ; Sousse LE
[Ad] Endereço:*Department of Surgery †Institute for Translational Sciences, University of Texas Medical Branch ‡Shriners Hospital for Children-Galveston, Galveston, TX §Division of Plastic Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria ¶Department of Orthopedic Surgery and Rehabilitation, University of Texas Medical Branch, Galveston ||Department of Surgery, Massachusetts General Hospital, Boston, MA **Sealy Center for Molecular Medicine ††Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston.
[Ti] Título:Reversal of Growth Arrest With the Combined Administration of Oxandrolone and Propranolol in Severely Burned Children.
[So] Source:Ann Surg;264(3):421-8, 2016 Sep.
[Is] ISSN:1528-1140
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The hypercatabolic response in severely burned pediatric patients is associated with increased production of catecholamines and corticosteroids, decreased formation of testosterone, and reduced strength alongside growth arrest for up to 2 years after injury. We have previously shown that, in the pediatric burned population, the administration of the testosterone analog oxandrolone improves lean body mass accretion and bone mineral content and that the administration of the ß1-, ß2-adrenoceptor antagonist propranolol decreases cardiac work and resting energy expenditure while increasing peripheral lean mass. Here, we determined whether the combined administration of oxandrolone and propranolol has added benefit. METHODS: In this prospective, randomized study of 612 burned children [52% ±â€Š1% of total body surface area burned, ages 0.5-14 years (boys); ages 0.5-12 years (girls)], we compared controls to the individual administration of these drugs, and the combined administration of oxandrolone and propranolol at the same doses, for 1 year after burn. Data were recorded at discharge, 6 months, and 1 and 2 years after injury. RESULTS: Combined use of oxandrolone and propranolol shortened the period of growth arrest by 84 days (P = 0.0125 vs control) and increased growth rate by 1.7 cm/yr (P = 0.0024 vs control). CONCLUSIONS: Combined administration of oxandrolone and propranolol attenuates burn-induced growth arrest in pediatric burn patients. The present study is registered at clinicaltrials.gov: NCT00675714 and NCT00239668.
[Mh] Termos MeSH primário: Queimaduras/complicações
Transtornos do Crescimento/tratamento farmacológico
Oxandrolona/administração & dosagem
Propranolol/administração & dosagem
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Quimioterapia Combinada
Feminino
Crescimento/efeitos dos fármacos
Transtornos do Crescimento/etiologia
Seres Humanos
Lactente
Masculino
Estudos Prospectivos
Testosterona/análogos & derivados
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
3XMK78S47O (Testosterone); 7H6TM3CT4L (Oxandrolone); 9Y8NXQ24VQ (Propranolol)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170902
[Lr] Data última revisão:
170902
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160720
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1097/SLA.0000000000001844


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[PMID]:27394004
[Au] Autor:Rzeppa S; Viet L
[Ad] Endereço:Oslo University Hospital, Norwegian Doping Control Laboratory, Oslo, Norway. Electronic address: Sebastian.Rzeppa@dopinganalyse.no.
[Ti] Título:Analysis of sulfate metabolites of the doping agents oxandrolone and danazol using high performance liquid chromatography coupled to tandem mass spectrometry.
[So] Source:J Chromatogr B Analyt Technol Biomed Life Sci;1029-1030:1-9, 2016 Sep 01.
[Is] ISSN:1873-376X
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:The direct detection of sulfate conjugates of anabolic androgenic steroids (AAS) can be a powerful tool in doping control analysis. By skipping the solvolysis step analysis time can be reduced, and due to long term sulfate metabolites the detection time can be significantly extended as demonstrated for some AAS. This study presents the successful identification of sulfate metabolites of the doping agents oxandrolone and danazol in excretion urines by high performance liquid chromatography coupled to tandem mass spectrometry (HPLC-MS/MS). The sulfate conjugate of 17ß-hydroxymethyl-17α-methyl-18-nor-2-oxa-5α-androsta-13-en-3-one could be identified as a new metabolite of oxandrolone. Sulfate conjugates of the danazol metabolites ethisterone and 2α-hydroxymethylethisterone were identified in an excretion urine for the first time. In addition, these sulfate conjugates were synthesized successfully. For a confirmation analysis, the number of analytes can be increased by additional sulfate conjugates of danazol metabolites (2-hydroxymethyl-1,2-dehydroethisterone and 6ß-hydroxy-2-hydroxymethylethisterone), which were also identified for the first time. The presented validation data underline the suitability of the identified sulfate conjugates for doping analysis with regard to the criteria given by the technical documents of the World Anti-Doping Agency (WADA).
[Mh] Termos MeSH primário: Anabolizantes/urina
Cromatografia Líquida de Alta Pressão/métodos
Danazol/urina
Antagonistas de Estrogênios/urina
Oxandrolona/urina
Sulfatos/urina
Espectrometria de Massas em Tandem/métodos
[Mh] Termos MeSH secundário: Anabolizantes/metabolismo
Danazol/metabolismo
Doping nos Esportes
Antagonistas de Estrogênios/metabolismo
Seres Humanos
Limite de Detecção
Masculino
Oxandrolona/metabolismo
Detecção do Abuso de Substâncias/métodos
Sulfatos/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Nome de substância:
0 (Anabolic Agents); 0 (Estrogen Antagonists); 0 (Sulfates); 7H6TM3CT4L (Oxandrolone); N29QWW3BUO (Danazol)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170823
[Lr] Data última revisão:
170823
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160710
[St] Status:MEDLINE


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[PMID]:27257953
[Au] Autor:Burch PT; Spigarelli MG; Lambert LM; Loftus PD; Sherwin CM; Linakis MW; Sheng X; LuAnn Minich L; Williams RV
[Ad] Endereço:Divisions of Cardiothoracic Surgery, University of Utah and Primary Children's Hospital, Salt Lake City, UT, USA.
[Ti] Título:Use of Oxandrolone to Promote Growth in Neonates following Surgery for Complex Congenital Heart Disease: An Open-Label Pilot Trial.
[So] Source:Congenit Heart Dis;11(6):693-699, 2016 Dec.
[Is] ISSN:1747-0803
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Malnutrition and poor weight gain, common in neonates following repair of complex congenital heart disease (CHD), are associated with increased morbidity and mortality. Oxandrolone, an anabolic steroid, improves weight gain in older children at high-risk for growth failure. We sought to determine feasibility, safety, and efficacy of oxandrolone therapy in neonates following surgery for complex CHD. DESIGN: Neonates with RACHS-1 score >3 were eligible to receive open-label oxandrolone for 28 days in this prospective pilot trial. There were 3 cohorts of 5 subjects receiving oxandrolone therapy under 3 specified dosage and preparation protocols: 0.1 mg/kg/day aqueous solution, 0.2 mg/kg/day aqueous solution, and 0.1 mg/kg/day preparation in medium chain triglyceride (MCT) oil. Age- and diagnosis-matched neonates who underwent surgery, but received no oxandrolone, served as a control cohort. Anthropometric measurements, physical examination for virilization, safety labs, and adverse events were monitored. RESULTS: Of 25 eligible patients, 15 consented (60%, 13/15 with Norwood procedure). There was no evidence of virilization, no changes in safety labs, and no serious adverse events related to oxandrolone among subjects receiving therapy. No subject met criteria for termination of study drug. There was a significant difference in change in weight-for-age z-score among the four cohorts, with subjects receiving 0.1 mg/kg/day in MCT oil having the lowest decline during the study period (-1.8 ± 0.5 for controls, -1.7 ± 0.4 for 0.1 mg/kg/day aqueous, -1.0 ± 0.4 for 0.2 mg/kg/day aqueous, and -0.6 ± 0.7 for 0.1 mg/kg/day MCT oil, P = .012). CONCLUSIONS: Oxandrolone therapy at the doses studied appears safe in neonates after surgery for complex CHD. The decline in weight-for-age z-score was lowest in those receiving the MCT oil preparation suggesting better bioavailability of this preparation and a potential growth benefit with oxandrolone therapy. Further investigation is needed to define optimal dosing and assess efficacy.
[Mh] Termos MeSH primário: Anabolizantes/uso terapêutico
Androgênios/uso terapêutico
Procedimentos Cirúrgicos Cardíacos
Desenvolvimento Infantil/efeitos dos fármacos
Cardiopatias Congênitas/cirurgia
Oxandrolona/uso terapêutico
Ganho de Peso/efeitos dos fármacos
[Mh] Termos MeSH secundário: Anabolizantes/efeitos adversos
Androgênios/efeitos adversos
Antropometria
Procedimentos Cirúrgicos Cardíacos/efeitos adversos
Composição de Medicamentos
Estudos de Viabilidade
Feminino
Cardiopatias Congênitas/diagnóstico
Cardiopatias Congênitas/fisiopatologia
Seres Humanos
Fenômenos Fisiológicos da Nutrição do Lactente
Recém-Nascido
Masculino
Estado Nutricional
Oxandrolona/efeitos adversos
Projetos Piloto
Estudos Prospectivos
Fatores de Tempo
Resultado do Tratamento
Utah
[Pt] Tipo de publicação:COMPARATIVE STUDY; CONTROLLED CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anabolic Agents); 0 (Androgens); 7H6TM3CT4L (Oxandrolone)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170720
[Lr] Data última revisão:
170720
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160604
[St] Status:MEDLINE
[do] DOI:10.1111/chd.12376


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[PMID]:26958749
[Au] Autor:Shepherd SJ; Newman R; Brett SJ; Griffith DM; Enhancing Rehabilitation After Critical Illness Programme Study Investigators
[Ad] Endereço:1Barts & The London School of Anaesthesia, Royal London Hospital, London, United Kingdom. 2University of Edinburgh, Edinburgh, United Kingdom. 3Centre for Peri-Operative Medicine & Critical Care Research, Imperial College Healthcare NHS Trust, London, United Kingdom. 4MRC Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom.
[Ti] Título:Pharmacological Therapy for the Prevention and Treatment of Weakness After Critical Illness: A Systematic Review.
[So] Source:Crit Care Med;44(6):1198-205, 2016 Jun.
[Is] ISSN:1530-0293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: ICU-acquired weakness is a common complication of critical illness and can have significant effects upon functional status and quality of life. As part of preliminary work to inform the design of a randomized trial of a complex intervention to improve recovery from critical illness, we sought to identify pharmacological interventions that may play a role in this area. DATA SOURCES: We systematically reviewed the published literature relating to pharmacological intervention for the treatment and prevention of ICU-acquired weakness. STUDY SELECTION: We searched MEDLINE, EMBASE, CINAHL+, Web of Science, and both U.S. and European trial registries up to July 2014 alongside reviews and reference lists from populations with no age or language restrictions. We included studies that reported a measure of muscle structure or physical function as an outcome measure. DATA EXTRACTION: We estimated pooled odds ratios and 95% CI using data extracted from published articles or where available, original data provided by the authors. Assessment of bias was performed using the Cochrane Collaboration's risk of bias tool. DATA SYNTHESIS: Ten studies met the inclusion criteria. The current body of evidence does not support the use of any pharmacological agent in this setting, although maintaining euglycemia may reduce the prevalence of critical illness polyneuropathy. CONCLUSIONS: At present, no pharmacological intervention can be recommended to prevent or treat ICU-acquired weakness. Further research is required into this field to include more novel agents such as myostatin inhibitors. Challenges in the conduct of research in this area are highlighted.
[Mh] Termos MeSH primário: Hiperglicemia/tratamento farmacológico
Debilidade Muscular/tratamento farmacológico
Debilidade Muscular/prevenção & controle
Polineuropatias/prevenção & controle
[Mh] Termos MeSH secundário: Antagonistas Adrenérgicos beta/uso terapêutico
Anabolizantes/uso terapêutico
Estado Terminal
Glutamina/uso terapêutico
Hormônio do Crescimento/uso terapêutico
Seres Humanos
Hiperglicemia/complicações
Hipoglicemiantes/uso terapêutico
Imunoglobulinas Intravenosas/uso terapêutico
Fatores Imunológicos/uso terapêutico
Insulina/uso terapêutico
Debilidade Muscular/etiologia
Oxandrolona/uso terapêutico
Polineuropatias/etiologia
Propranolol/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Adrenergic beta-Antagonists); 0 (Anabolic Agents); 0 (Hypoglycemic Agents); 0 (Immunoglobulins, Intravenous); 0 (Immunologic Factors); 0 (Insulin); 0RH81L854J (Glutamine); 7H6TM3CT4L (Oxandrolone); 9002-72-6 (Growth Hormone); 9Y8NXQ24VQ (Propranolol)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:171005
[Lr] Data última revisão:
171005
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160310
[St] Status:MEDLINE
[do] DOI:10.1097/CCM.0000000000001652


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[PMID]:26822610
[Au] Autor:Evans L; Larsen M; Cox A; Skyrme R
[Ad] Endereço:Department of Surgery, Abertawe Bro Morgannwg University Health Board, Swansea, UK.
[Ti] Título:Steroids, drugs and stuttering priapism; the rock-and-roll lifestyle of a 24-year-old man.
[So] Source:BMJ Case Rep;2016, 2016 Jan 28.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The authors present a case of a 24-year-old, poorly controlled insulin-dependent type 1 diabetic Caucasian man who presented to the emergency department, with a painful erection of 36 h duration that had failed to resolve with conservative management. This was the patient's seventh priapism, with his most recent attendance 1 week previously for which he underwent a distal cavernosal shunt. He admitted to taking several recreational drugs, including marijuana and cocaine, during the preceding few days, in addition to the long-term use of the oral anabolic steroid oxandrolone. He had no family history of sickle cell disease or trait. On examination, a tensely erect penis was noted. A diagnosis of stuttering priapism was made and 750 mL of blood subsequently drained via a distal corporoglandular shunt resulting in successful detumescence.
[Mh] Termos MeSH primário: Anabolizantes/efeitos adversos
Diabetes Mellitus Tipo 1/fisiopatologia
Fumar Maconha/efeitos adversos
Oxandrolona/efeitos adversos
Pênis/irrigação sanguínea
Priapismo/etiologia
Esteroides/efeitos adversos
[Mh] Termos MeSH secundário: Diabetes Mellitus Tipo 1/tratamento farmacológico
Diabetes Mellitus Tipo 1/psicologia
Aconselhamento Diretivo
Drenagem
Circulação Extracorpórea/instrumentação
Circulação Extracorpórea/métodos
Seres Humanos
Estilo de Vida
Masculino
Fumar Maconha/psicologia
Meia-Idade
Cooperação do Paciente
Priapismo/psicologia
Priapismo/terapia
Encaminhamento e Consulta
Comportamento de Redução do Risco
Autocuidado
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anabolic Agents); 0 (Steroids); 7H6TM3CT4L (Oxandrolone)
[Em] Mês de entrada:1610
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160130
[St] Status:MEDLINE



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