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[PMID]: 29248913 [Au] Autor: Pessoa B; Coelho J; Correia N; Ferreira N; Beirão M; Meireles A [Ad] Endereço: Serviço de Oftalmologia, Centro Hospitalar do Porto, Hospital de Santo Antonio, Porto, Portugal. [Ti] Título: Fluocinolone Acetonide Intravitreal Implant 190 µg (ILUVIEN®) in Vitrectomized versus Nonvitrectomized Eyes for the Treatment of Chronic Diabetic Macular Edema. [So] Source: Ophthalmic Res;59(2):68-75, 2018. [Is] ISSN: 1423-0259 [Cp] País de publicação: Switzerland [La] Idioma: eng [Ab] Resumo: PURPOSE: To compare the functional and anatomical outcomes after a 0.2 µg/day fluocinolone acetonide (FAc) implant between vitrectomized and nonvitrectomized eyes with chronic diabetic macular edema (DME). METHODS: This is a retrospective, comparative analysis of 43 eyes with chronic DME. All eyes were treated with a single 0.2 µg/day FAc implant and followed up for a mean period of 8.5 months (median, 6.0 months; range, 1-21 months). The patients with a 0.2 µg/day FAc implant were divided into 2 groups: 24 eyes which had undergone pars plana vitrectomy prior to 0.2 µg/day FAc (group 1) and 19 eyes which had not been vitrectomized (group 2). Outcome measures included mean changes in best corrected visual acuity (BCVA) in Early Treatment Diabetic Retinopathy Study letters, central subfield foveal thickness (CSFT), and intraocular pressure (IOP), and were measured prior to administration of the 0.2 µg FAc implant, in the first week, at month 1, and quarterly thereafter. RESULTS: Following the 0.2 µg/day FAc implant, the mean change in BCVA at the last observation point, from baseline, was +16.9 ± 3.39 (mean ± SE) letters (p ≤ 0.001) in group 1 and +8.2 ± 4.62 letters (p = 0.092) in group 2. From baseline, a gain of ≥15 letters was achieved in 37.5 and 36.8% of the eyes in group 1 and group 2, respectively. Additionally, an improvement in vision ≥20/40 in 29.2% of group 1 and 15.8% of group 2 was observed. The mean change in CSFT was -217.7 ± 40.8 µm and -155.6 ± 43.4 µm in group 1 and group 2, respectively. The mean change in IOP was +1.6 ± 0.7 mm Hg in group 1 and +0.8 ± 1.3 mm Hg in group 2, relative to baseline. At the last observation point, there were no significant differences between groups 1 and 2 (p > 0.05) in terms of their changes in BCVA, CSFT, and IOP. CONCLUSION: The results from the real-life practice study demonstrate that the 0.2 µg/day FAc implant is effective and well tolerated in vitrectomized and nonvitrectomized eyes of patients with chronic DME. Our results support the use of a 0.2 µg/day FAc implant to obtain long-term functional and anatomical improvements (mean, 8.5 months; median, 6.0 months) in vitrectomized and nonvitrectomized eyes. [Mh] Termos MeSH primário: Retinopatia Diabética/tratamento farmacológico Fluocinolona Acetonida/administração & dosagem Glucocorticoides/administração & dosagem Edema Macular/tratamento farmacológico Vitrectomia [Mh] Termos MeSH secundário: Idoso Doença Crônica Retinopatia Diabética/cirurgia Implantes de Medicamento Feminino Seres Humanos Pressão Intraocular Injeções Intravítreas Edema Macular/cirurgia Masculino Meia-Idade Estudos Retrospectivos Acuidade Visual [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Drug Implants); 0 (Glucocorticoids); 0CD5FD6S2M (Fluocinolone Acetonide) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180308 [Lr] Data última revisão: 180308 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171218 [St] Status: MEDLINE [do] DOI: 10.1159/000484091

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[PMID]: 29442030 [Au] Autor: Resende AFC; Pereira AF; Moreira TP; Patrício PSO; Fialho SL; Cunha GMF; Silva-Cunha A; Magalhães JT; Silva GR [Ti] Título: PLGA Implants containing vancomycin and dexamethasone: development, characterization and bactericidal effects. [So] Source: Pharmazie;71(8):439-446, 2016 08 01. [Is] ISSN: 0031-7144 [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: Post-operative endophthalmitis is an infection and an inflammation of the eye following a surgical procedure. Its treatment is based on drug injections into the eye. However, this treatment can lead to ocular complications. Intraocular implants could substitute the conventional therapy. Poly(lactic-co-glycolic acid) (PLGA) implants comprising on vancomycin and dexamethasone were evaluated as drug delivery system to treat endophthalmitis after cataract surgery. Implants were characterized by drug content uniformity, Fourier Transform Infrared Spectroscopy (FTIR), Differential Scanning Calorimetry (DSC), Wide Angle X-ray Scattering (WAXS), Scanning Electron Microscopy (SEM) and in vitro drug release. The bactericidal effect of vancomycin, eluted from the implants, was demonstrated against Staphylococcus aureus and Staphylococcus epidermidis. The drugs were uniformly distributed in the polymer. The analytical techniques revealed the chemical integrity of the drugs incorporated into the polymer and the modification of dexamethasone semi-crystalline nature. Drugs were controlled released from implants; and the eluted vancomycin showed bactericidal effects. In conclusion, PLGA implants containing vancomycin and dexamethasone may represent a therapeutic alternative to treat post-operative endophthalmitis. [Mh] Termos MeSH primário: Antibacterianos/administração & dosagem Antibacterianos/uso terapêutico Anti-Inflamatórios/administração & dosagem Anti-Inflamatórios/uso terapêutico Bactérias/efeitos dos fármacos Dexametasona/administração & dosagem Dexametasona/uso terapêutico Portadores de Fármacos Ácido Láctico Ácido Poliglicólico Infecção da Ferida Cirúrgica/prevenção & controle Vancomicina/administração & dosagem Vancomicina/uso terapêutico [Mh] Termos MeSH secundário: Antibacterianos/farmacologia Implantes de Medicamento Liberação Controlada de Fármacos Endoftalmite/microbiologia Endoftalmite/prevenção & controle Seres Humanos Testes de Sensibilidade Microbiana Procedimentos Cirúrgicos Oftalmológicos Staphylococcus aureus/efeitos dos fármacos Staphylococcus epidermidis/efeitos dos fármacos Vancomicina/farmacologia [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nome de substância: 0 (Anti-Bacterial Agents); 0 (Anti-Inflammatory Agents); 0 (Drug Carriers); 0 (Drug Implants); 0 (polylactic acid-polyglycolic acid copolymer); 26009-03-0 (Polyglycolic Acid); 33X04XA5AT (Lactic Acid); 6Q205EH1VU (Vancomycin); 7S5I7G3JQL (Dexamethasone) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180307 [Lr] Data última revisão: 180307 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180215 [St] Status: MEDLINE [do] DOI: 10.1691/ph.2016.6009

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[PMID]: 29486754 [Au] Autor: Fusi-Rubiano W; Mukherjee C; Lane M; Tsaloumas MD; Glover N; Kidess A; Denniston AK; Palmer HE; Manna A; Morjaria R [Ad] Endereço: Ophthalmology Department, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHSFT, Mindelsohn Way, Birmingham, B15 2TH, United Kingdom. [Ti] Título: Treating Diabetic Macular Oedema (DMO): real world UK clinical outcomes for the 0.19mg Fluocinolone Acetonide intravitreal implant (Iluvien™) at 2 years. [So] Source: BMC Ophthalmol;18(1):62, 2018 Feb 27. [Is] ISSN: 1471-2415 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: To compare visual function and structural improvements in pseudophakic eyes with diabetic macular oedema (DMO) treated with the 0.19mg Fluocinolone Acetonide (FAc) intravitreal implant (Iluvien ) in a 'real world' setting. METHODS: A single centre retrospective evaluation of patients with DMO unresponsive to conventional treatment treated with the FAc implant according to UK guidelines. Primary efficacy endpoint was best corrected visual acuity (BCVA); secondary endpoints included optical coherence tomography evaluations of the macula (a) central retinal and (b) peak macular thickness collected at annual time points. Primary safety endpoint was new rise in IOP >27mmHg or glaucoma surgery. Patients with <1 year follow-up were excluded. RESULTS: Twenty-nine eyes were included, with mean(SD) follow up of 792(270) days. Improvement in BCVA and reduction in macular oedema was noted at all timepoints. Mean improvement in BCVA from baseline was 6 ETDRS letters at year 1(n=29), 6.5L at year 2(n=22) and 11L at year 3(n=6). Mean central retinal thickness at baseline was 451 microns, 337 microns at year 1, 342 microns at year 2 and 314 microns at year 3. Two eyes required IOP-lowering drops post implant. Supplementary treatment for persistence or recurrence of DMO was necessary in 18 eyes over the total study period of 3 years with mean time to supplementary treatment being 12 months. CONCLUSIONS: Our evaluation of the 0.19mg FAc implant delivered in a real-world setting, provides additional evidence that it is effective and safe in the treatment of patients with DMO, and can provide sustained benefit for patients with previously refractory disease. [Mh] Termos MeSH primário: Retinopatia Diabética/tratamento farmacológico Fluocinolona Acetonida/administração & dosagem Glucocorticoides/administração & dosagem Edema Macular/tratamento farmacológico [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Retinopatia Diabética/patologia Retinopatia Diabética/fisiopatologia Implantes de Medicamento Feminino Seres Humanos Injeções Intravítreas Edema Macular/patologia Edema Macular/fisiopatologia Masculino Meia-Idade Retina/patologia Estudos Retrospectivos Reino Unido Acuidade Visual/fisiologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Drug Implants); 0 (Glucocorticoids); 0CD5FD6S2M (Fluocinolone Acetonide) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180306 [Lr] Data última revisão: 180306 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180301 [St] Status: MEDLINE [do] DOI: 10.1186/s12886-018-0726-1

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[PMID]: 27771997 [Au] Autor: Fan J; Guo M; Im CS; Pi-Anfruns J; Cui ZK; Kim S; Wu BM; Aghaloo TL; Lee M [Ad] Endereço: 1 Division of Advanced Prosthodontics, School of Dentistry, University of California , Los Angeles, Los Angeles, California. [Ti] Título: Enhanced Mandibular Bone Repair by Combined Treatment of Bone Morphogenetic Protein 2 and Small-Molecule Phenamil. [So] Source: Tissue Eng Part A;23(5-6):195-207, 2017 03. [Is] ISSN: 1937-335X [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Growth factor-based therapeutics using bone morphogenetic protein 2 (BMP-2) presents a promising strategy to reconstruct craniofacial bone defects such as mandible. However, clinical applications require supraphysiological BMP doses that often increase inappropriate adipogenesis, resulting in well-documented, cyst-like bone formation. Here we reported a novel complementary strategy to enhance osteogenesis and mandibular bone repair by using small-molecule phenamil that has been shown to be a strong activator of BMP signaling. Phenamil synergistically induced osteogenic differentiation of human bone marrow mesenchymal stem cells with BMP-2 while suppressing their adipogenic differentiation induced by BMP-2 in vitro. The observed pro-osteogenic and antiadipogenic activity of phenamil was mediated by expression of tribbles homolog 3 (Trb3) that enhanced BMP-smad signaling and inhibited expression of peroxisome proliferator-activated receptor gamma (PPARγ), a master regulator of adipogenesis. The synergistic effect of BMP-2+phenamil on bone regeneration was further confirmed in a critical-sized rat mandibular bone defect by implanting polymer scaffolds designed to slowly release the therapeutic molecules. These findings indicate a new complementary osteoinductive strategy to improve clinical efficacy and safety of current BMP-based therapeutics. [Mh] Termos MeSH primário: Amilorida/análogos & derivados Proteína Morfogenética Óssea 2 Mandíbula/metabolismo Traumatismos Mandibulares/tratamento farmacológico [Mh] Termos MeSH secundário: Amilorida/farmacocinética Amilorida/farmacologia Animais Proteína Morfogenética Óssea 2/farmacocinética Proteína Morfogenética Óssea 2/farmacologia Implantes de Medicamento/farmacocinética Implantes de Medicamento/farmacologia Seres Humanos Mandíbula/patologia Traumatismos Mandibulares/metabolismo Traumatismos Mandibulares/patologia Células Mesenquimais Estromais/metabolismo Células Mesenquimais Estromais/patologia Ratos Sprague-Dawley [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nome de substância: 0 (Bmp2 protein, rat); 0 (Bone Morphogenetic Protein 2); 0 (Drug Implants); 2038-35-9 (phenylamil); 7DZO8EB0Z3 (Amiloride) [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 180301 [Lr] Data última revisão: 180301 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161025 [St] Status: MEDLINE [do] DOI: 10.1089/ten.TEA.2016.0308

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[PMID]: 29172413 [Au] Autor: Deshmukh P; Antell K; Brown EJ [Ti] Título: Contraception Update: Progestin-Only Implants and Injections. [So] Source: FP Essent;462:25-29, 2017 Nov. [Is] ISSN: 2159-3000 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Progestin-only contraception is a popular method of birth control in the United States and worldwide. Progestin-only implants and injections allow patients access to long-term contraception with simple options for reversal or removal. The implant is one of the most effective forms of contraception and there are few contraindications. Manufacturer-led training is required to become certified in insertion and removal. The most common adverse effect of the implant is a change in menstrual bleeding patterns. Little evidence has shown weight gain or decreased bone mineral density with use. The depot medroxyprogesterone acetate (DMPA) injection is used widely and is effective. Adverse effects that may limit use include changes in bleeding patterns and bone mineral density loss, which is reversible after discontinuation. The risk of weight gain with DMPA is greatest in obese adolescents and black patients. There is no significantly increased risk of cancer with either method. Both are safe for use in the postpartum period, during breastfeeding, and immediately after abortion. [Mh] Termos MeSH primário: Anticoncepcionais Femininos/uso terapêutico Implantes de Medicamento Serviços de Planejamento Familiar Medicina de Família e Comunidade Acetato de Medroxiprogesterona/uso terapêutico Progestinas [Mh] Termos MeSH secundário: Anticoncepcionais Femininos/administração & dosagem Anticoncepcionais Femininos/efeitos adversos Remoção de Dispositivo Interações Medicamentosas Feminino Seres Humanos Injeções Acetato de Medroxiprogesterona/administração & dosagem Acetato de Medroxiprogesterona/efeitos adversos Ganho de Peso [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Contraceptive Agents, Female); 0 (Drug Implants); 0 (Progestins); C2QI4IOI2G (Medroxyprogesterone Acetate) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180227 [Lr] Data última revisão: 180227 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171128 [St] Status: MEDLINE

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[PMID]: 29384620 [Au] Autor: Zhu Y; Li D; Zhang K; Jiang L; Shi C; Fangteng J; Zheng C; Yang B; Sun H [Ti] Título: Novel Synthesized Nanofibrous Scaffold Efficiently Delivered hBMP-2 Encoded in Adenoviral Vector to Promote Bone Regeneration. [So] Source: J Biomed Nanotechnol;13(4):437-46, 2017 Apr. [Is] ISSN: 1550-7033 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Treatment of bone defect, especially large bone defect, is still a challenge for physicians clinically. Bone morphogenetic protein 2 (BMP-2) can induce osteoblast differentiation and promote new bone formation. Recently, nanomaterials have been widely used as a carrier to hold and deliver biomolecules, like human bone morphogenetic protein 2 gene (hBMP-2) in target cells/tissues. Most nanomethods, however, need further modification in order to work more reliably in clinical applications. Therefore, in this study, we created a novel poly(lactic-co-glycolic acid [PLGA]) nanofibrous scaffold using an electrospinning technique; then, using a lyophilization process to allow nanofibrous scaffold to adsorb hBMP-2 adenoviral vector, AdCMV-hBMP2. Results indicate that the lyophilized poly(lactic-co-glycolic acid) nanofibrous scaffold/AdCMVhBMP2 can efficiently release and transduce cells in vitro and in vivo, and secrete functional hBMP-2 to promote osteogenic differentiation in vitro, and new bone generation in vivo. Importantly, the amount of newly formed bone covered >80% of the bone defect area 8 weeks post-implantation in vivo, in which the defect could not be repaired without any treatment in general. Our data demonstrate that the lyophilized PLGA nanofibrous scaffold/AdCMV-hBMP2 created herein stably and efficiently release functional viral vector to transduce local cells, resulting in secretion of hBMP-2 and promote new bone formation in vivo. Our new nanodelivery method has potential clinical application for the repair of large bone defects. [Mh] Termos MeSH primário: Adenoviridae/genética Proteína Morfogenética Óssea 2/genética Proteína Morfogenética Óssea 2/uso terapêutico Implantes de Medicamento/administração & dosagem Terapia Genética/métodos Nanofibras/química Fraturas Cranianas/terapia [Mh] Termos MeSH secundário: Animais Implantes de Medicamento/química Vetores Genéticos/genética Nanocápsulas/administração & dosagem Nanocápsulas/química Nanofibras/administração & dosagem Ratos Fraturas Cranianas/patologia Tecidos Suporte Transfecção/métodos Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nome de substância: 0 (BMP2 protein, human); 0 (Bone Morphogenetic Protein 2); 0 (Drug Implants); 0 (Nanocapsules) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180223 [Lr] Data última revisão: 180223 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180201 [St] Status: MEDLINE

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[PMID]: 29384619 [Au] Autor: Zhao H; Wang YL; Peng JR; Zhang L; Qu Y; Chu BY; Dong ML; Tan LW; Qian ZY [Ti] Título: Biodegradable Self-Assembled Micelles Based on MPEG-PTMC Copolymers: An Ideal Drug Delivery System for Vincristine. [So] Source: J Biomed Nanotechnol;13(4):427-36, 2017 Apr. [Is] ISSN: 1550-7033 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Despite advantageous properties, micelles using methoxy poly(ethylene glycol)-poly(trimethylene carbonate) (MPEGPTMC) have not been widely studied. In this work, we aim to develop a novel vehicle for vincristine (VCR) based on a MPEG-PTMC micelle system. MPEG-PTMC with a series of molecular weights were synthesized and screened for the appropriate range for forming stable VCR micelles. The prepared micelles were then characterized in vitro and in vivo . VCR micelles presented high stability and ideal sustained release profile. The passive targeting effect was also enhanced compared with liposomal VCR. These results provide critical data to give the first clues regarding novel VCR micelles which exhibit potential for clinical application. [Mh] Termos MeSH primário: Implantes Absorvíveis Dioxanos/química Implantes de Medicamento/química Nanocápsulas/química Polietilenoglicóis/química Vincristina/administração & dosagem Vincristina/química [Mh] Termos MeSH secundário: Cristalização/métodos Difusão Composição de Medicamentos/métodos Implantes de Medicamento/administração & dosagem Micelas Nanocápsulas/administração & dosagem [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nome de substância: 0 (Dioxanes); 0 (Drug Implants); 0 (Micelles); 0 (Nanocapsules); 0 (monomethoxy poly(ethylene glycol)-block-poly(trimethylene carbonate)); 30IQX730WE (Polyethylene Glycols); 5J49Q6B70F (Vincristine) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180223 [Lr] Data última revisão: 180223 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180201 [St] Status: MEDLINE

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[PMID]: 29384602 [Au] Autor: Liu M; Wu K; Zhao L; Zhang Y [Ti] Título: Foreign Body Reaction to Biomaterial Nanotubular Surface and the Influence of Silver Loading. [So] Source: J Biomed Nanotechnol;13(4):381-92, 2017 Apr. [Is] ISSN: 1550-7033 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: The impacts of biomaterial surface properties (i.e., surface nanotopography) and dopants (i.e., silver (Ag)) on the biomaterial-associated foreign body reaction (FBR) remain unclear. In this study, an in vivo FBR that was induced by a titania nanotube array (NT) on titanium was examined with and without Ag loading. An NT with an 80 nm diameter that was fabricated by anodization, and the NT samples that were loaded with two Ag concentrations (NT-AgH and NT-AgL) and formed by electrodeposition exhibited high hydrophilicities. A relatively rapid initial Ag+ release with a subsequent gradual reduction was observed for NT-AgH and NT-AgL; the Ag+ release was higher for NT-AgH than for NT-AgL. We found that the NT decreased the biomaterial-associated FBR, evidenced by a decreased fibrous capsule thickness and a number of recruited macrophages. The effect of Ag loading on the FBR was considered acceptable because the FBR induced by the NT-Ag samples was still less severe than that of the PT control. Additionally, the temporary increases in the blood, brain, liver and kidney Ag+ concentrations did not produce general side effects and were considered to be in the safe range. This study demonstrates the ability of nanotopography to alleviate the biomaterial-associated FBR and provides further evidence for future clinical applications of biomaterials with nanostructures and Ag loading. [Mh] Termos MeSH primário: Implantes de Medicamento/administração & dosagem Reação a Corpo Estranho/induzido quimicamente Reação a Corpo Estranho/prevenção & controle Nanopartículas Metálicas/administração & dosagem Nanotubos/efeitos adversos Prata/administração & dosagem Titânio/efeitos adversos [Mh] Termos MeSH secundário: Animais Implantes de Medicamento/química Reação a Corpo Estranho/patologia Masculino Nanopartículas Metálicas/química Nanotubos/química Ratos Ratos Sprague-Dawley Prata/química Propriedades de Superfície Titânio/química Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Nm] Nome de substância: 0 (Drug Implants); 3M4G523W1G (Silver); D1JT611TNE (Titanium) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180223 [Lr] Data última revisão: 180223 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180201 [St] Status: MEDLINE

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[PMID]: 29185099 [Au] Autor: Winterhalter S; Eckert A; Vom Brocke GA; Schneider A; Pohlmann D; Pilger D; Joussen AM; Rehak M; Grittner U [Ad] Endereço: Department of Ophthalmology, Campus Virchow-Klinikum, Charité - University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany. sibylle.winterhalter@charite.de. [Ti] Título: Real-life clinical data for dexamethasone and ranibizumab in the treatment of branch or central retinal vein occlusion over a period of six months. [So] Source: Graefes Arch Clin Exp Ophthalmol;256(2):267-279, 2018 Feb. [Is] ISSN: 1435-702X [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: PURPOSE: To evaluate the therapeutic outcome for dexamethasone implant (DEX) or intravitreal ranibizumab (IVR) injections over 6 months in patients with macular edema due to branch or central retinal vein occlusion (BRVO, CRVO), in a real-life setting. METHODS: A total of 107 patients with BRVO or CRVO were included into this retrospective single-center observational study. Patients were treated with monotherapy consisting of DEX or three monthly IVR injections following a pro re nata regimen (PRN). Best-corrected visual acuity (BCVA), central retinal thickness (CRT) and intraocular pressure (IOP) were compared between the two therapy groups after 1, 3 and 6 months. RESULTS: BRVO patients treated with DEX achieved a statistically significant gain in BCVA measured in logMAR after 1 month (mean gain, 95% CI: 0.21, 0.08-0.34, p = 0.001), 3 months (0.16, 0.03-0.28, p = 0.012) and 6 months (0.19, 0.07-0.32, p = 0.002), whereas patients treated with IVR showed a statistically significant BCVA gain in month 3 (mean improvement, 95% CI: 0.13, 0.01-0.26, p = 0.039) and month 6 (0.16, 0.03-0.29, p = 0.018). BCVA in CRVO patients with DEX worsened slightly at month 6 (mean worsening, 95% CI: -0.08, -0.24 to 0.08, p = 0.305), while IVR treated-patients achieved a statistically significant BCVA gain at 3 months (mean improvement, 95% CI: 0.14, 0.02-0.25, p = 0.021). Both therapies were accompanied by statistically significant CRT reductions of 150 to 200 µm (median). Adverse events reported were predictable and limited. CONCLUSIONS: In a clinical setting, comparable improvement in BCVA and CRT were observed after DEX and IVR injections for treatment of BRVO. CRVO patients showed greater benefit with IVR. [Mh] Termos MeSH primário: Dexametasona/administração & dosagem Edema Macular/tratamento farmacológico Ranibizumab/administração & dosagem Oclusão da Veia Retiniana/tratamento farmacológico Acuidade Visual [Mh] Termos MeSH secundário: Idoso Inibidores da Angiogênese/administração & dosagem Relação Dose-Resposta a Droga Implantes de Medicamento Quimioterapia Combinada Feminino Seguimentos Glucocorticoides/administração & dosagem Seres Humanos Injeções Intravítreas Edema Macular/diagnóstico Edema Macular/etiologia Masculino Oclusão da Veia Retiniana/complicações Oclusão da Veia Retiniana/diagnóstico Estudos Retrospectivos Fatores de Tempo Tomografia de Coerência Óptica Resultado do Tratamento Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores [Pt] Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY [Nm] Nome de substância: 0 (Angiogenesis Inhibitors); 0 (Drug Implants); 0 (Glucocorticoids); 0 (Vascular Endothelial Growth Factor A); 7S5I7G3JQL (Dexamethasone); ZL1R02VT79 (Ranibizumab) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180214 [Lr] Data última revisão: 180214 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171130 [St] Status: MEDLINE [do] DOI: 10.1007/s00417-017-3852-1

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[PMID]: 29382007 [Au] Autor: Lin HY; Lee CY; Huang JY; Yang SF; Chao SC [Ad] Endereço: Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua. [Ti] Título: Concurrent injection of dexamethasone intravitreal implant and anti-angiogenic agent in patients with macular edema: A retrospective cohort study. [So] Source: Medicine (Baltimore);96(47):e8868, 2017 Nov. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: To evaluate the safety and efficiency in macular edema patients who concurrently received a single injection of a dexamethasone intravitreal implant (DEX, 0.7 mg) and ranibizumab (2.3 mg).A retrospective cohort study was conducted, and medical records from 2012 to 2016 were reviewed. Patients who received concurrent DEX and ranibizumab injections with a follow-up period of at least 3 months were enrolled in the study group. An age and gender-matched group received ranibizumab injections and was designated the control group. The best-corrected visual acuity (BCVA), central macular thickness (CMT) and intraocular pressure (IOP) were included in the analysis. Steroid-induced ocular hypertension (SIOH) is defined as either an elevation of more than 10 mmHg from baseline or a single IOP measurement of more than 30 mmHg.A total of 26 patients were enrolled in the current study with 13 patients in each group. Both the BCVA (P = .04) and CMT (P < .01) achieved significant improvement after the follow-up period in the study group. The IOP increased after the injection but no significant elevation was observed throughout the follow-up period in the study group (P = .15). For SIOH, 1 patient in the study group had an elevated IOP of 10 mmHg (7.7%) at 2 postoperative months, and no single IOP measurement of more than 30 mmHg was obtained. Five patients (38.5%) in the study group received medical treatment that successfully retarded their IOP elevation, and no individuals required surgical management. In the control group, there were no significant fluctuations concerning BCVA, CMT, and IOP, and no ocular hypertension was observed. According to the inter-group analysis, the CMT and BCVA recovered more significantly in the study group than in the control group.Concurrent injection of DEX and ranibizumab is a preliminary method that shows effectiveness in treating ME. Furthermore, safety is also guaranteed, with moderate levels of severity and transient IOP elevation being observed. A future large-scale study is necessary to evaluate the long-term effects and safety of this combined treatment. [Mh] Termos MeSH primário: Inibidores da Angiogênese/administração & dosagem Dexametasona/administração & dosagem Edema Macular/tratamento farmacológico Ranibizumab/administração & dosagem [Mh] Termos MeSH secundário: Idoso Implantes de Medicamento Quimioterapia Combinada Feminino Seres Humanos Pressão Intraocular/efeitos dos fármacos Injeções Intravítreas Macula Lutea/efeitos dos fármacos Macula Lutea/patologia Edema Macular/patologia Masculino Meia-Idade Hipertensão Ocular/induzido quimicamente Estudos Retrospectivos Resultado do Tratamento Acuidade Visual/efeitos dos fármacos [Pt] Tipo de publicação: EVALUATION STUDIES; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Angiogenesis Inhibitors); 0 (Drug Implants); 7S5I7G3JQL (Dexamethasone); ZL1R02VT79 (Ranibizumab) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180209 [Lr] Data última revisão: 180209 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180201 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000008868

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