Base de dados : MEDLINE
Pesquisa : D27.505.696.277.600 [Categoria DeCS]
Referências encontradas : 14845 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 1485 ir para página                         

  1 / 14845 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29390443
[Au] Autor:Ye F; Wu Y; Zhou C
[Ad] Endereço:Department of Anesthesiology, Xiangyang Central Hospital (The Affiliated Hospital of Hubei University of Arts and Science), Xiangyang, China.
[Ti] Título:Effect of intravenous ketamine for postoperative analgesia in patients undergoing laparoscopic cholecystectomy: A meta-analysis.
[So] Source:Medicine (Baltimore);96(51):e9147, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We conducted a meta-analysis to assess the efficacy and safety of ketamine for reducing pain and narcotic use for patients undergoing laparoscopic cholecystectomy (LC). METHODS: PubMed, Embase, Web of science, Medline, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) were regarded as eligible in our study. After testing the heterogeneity across RCTs, data were aggregated for fixed/random effect model according to the I statistic. The meta-analysis was conducted using Stata 11.0 software. RESULTS: Five studies were included, with a total sample size of 212 patients. Current meta-analysis revealed that there were significant differences regarding postoperative pain score at 12 hours [standard mean difference (SMD) = -0.322, 95% confidence interval (95% CI): -0.594 to -0.050, P = .020], 24 hours (SMD = -0.332, 95% CI: -0.605 to -0.059, P = .017), and 48 hours (SMD = -0.340, 95% CI: -0.612 to -0.068, P = .014). Ketamine intervention was found to significantly decrease narcotic use at 12 hours (SMD = -0.296, 95% CI: -0.567 to -0.025, P = .033), 24 hours (SMD = -0.310, 95% CI: -0.581 to -0.039, P = .025), and 48 hours (SMD = -0.338, 95% CI: -0.609 to -0.066, P = .015). CONCLUSION: Ketamine appeared to significantly reduce postoperative pain and narcotic use following LC. On the basis of the current evidence available, higher quality RCTs are still required for further research.
[Mh] Termos MeSH primário: Analgésicos/uso terapêutico
Colecistectomia Laparoscópica
Ketamina/uso terapêutico
Dor Pós-Operatória/tratamento farmacológico
[Mh] Termos MeSH secundário: Uso de Medicamentos
Seres Humanos
Infusões Intravenosas
Entorpecentes/uso terapêutico
Medição da Dor
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Analgesics); 0 (Narcotics); 690G0D6V8H (Ketamine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009147


  2 / 14845 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28939122
[Au] Autor:Guan M; Fang W; Ullah S; Zhang X; Saquib Q; Al-Khedhairy AA
[Ad] Endereço:State Key Laboratory of Pollution Control & Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, PR China.
[Ti] Título:Functional genomics assessment of narcotic and specific acting chemical pollutants using E. coli.
[So] Source:Environ Pollut;232:146-153, 2018 Jan.
[Is] ISSN:1873-6424
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The knowledge of gene-chemical interaction can be used to derive toxicological mechanism of chemical pollutants, therefore, it might be useful to discriminate chemicals with different mechanisms. In this study, three narcotic chemicals (4-chlorophenol (4-CP), 3, 4-dichloroaniline (DCA) and 2, 2, 2-trichloroethanol (TCE)) and three specific acting chemicals (triclosan (TCS), clarithromycin (CLARY), sulfamethoxazole (SMX)) were assessed by Escherichia coli (E. coli) genome-wide knockout screening. 66, 97, 88, 144, 198 and 180 initial robust hits were identified by exposure to 4-CP, DCA, TCE, TCS, CLARY and SMX with two replicates at the concentration of IC50, respectively. The average fold change values of responsive mutants to the three narcotic chemicals were smaller than the three specific acting chemicals. The common gene ontology (GO) term of biological process enriched by the three narcotic chemicals was "response to external stimulus" (GO: 0009605). Other GO terms like "lipopolysaccharide biosynthetic process" (induced by 4-CP) and "purine nucleotide biosynthetic process" (induced by DCA) were also influenced by the narcotic chemicals. The toxic target of three known specific acting chemicals could be validated by GSEA of responsive genes. Four genes (flhC, fliN, fliH and flhD) might serve as potential biomarkers to distinguish narcotic chemicals and specific acting chemicals. The E. coli functional genomic approach presented here has shown great potential not only for the molecular mechanistic screening of chemicals, rather it can discriminate chemicals based on their mode-of-action.
[Mh] Termos MeSH primário: Poluentes Ambientais/toxicidade
Escherichia coli/genética
Entorpecentes/toxicidade
[Mh] Termos MeSH secundário: Clorofenóis/toxicidade
Escherichia coli/efeitos dos fármacos
Genômica
Testes de Toxicidade
Triclosan/toxicidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Chlorophenols); 0 (Environmental Pollutants); 0 (Narcotics); 3DLC36A01X (4-chlorophenol); 4NM5039Y5X (Triclosan)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170924
[St] Status:MEDLINE


  3 / 14845 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28953686
[Au] Autor:Zhang HS; Xu YM; Zhu JH; Zhong BL
[Ad] Endereço:Department of Psychiatry, Affiliated Wuhan Mental Health Center (The Ninth Clinical School), Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, China.
[Ti] Título:Poor sleep quality is significantly associated with low sexual satisfaction in Chinese methadone-maintained patients.
[So] Source:Medicine (Baltimore);96(39):e8214, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Sleep disturbance negatively affects sexual function. Sleep problem and sexual dysfunction are common in methadone-maintained patients; however, their association is understudied in this patient population.This study examined the association between sleep quality and sexual satisfaction in Chinese patients receiving methadone maintenance treatment (MMT).This was a cross-sectional study. A total of 480 MMT patients who had sex with their sex partners within 1 month before the survey were recruited from 3 MMT clinics in Wuhan, China. Sexual satisfaction was assessed with a single question, and sociodemographic and clinical data were collected with a standardized questionnaire. Sleep quality was assessed with the Pittsburgh Sleep Quality Index. Multiple ordinary logistic regression was used to control for potential confounders that may bias the sleep-sexual satisfaction relationship.Sexual satisfaction scores were significantly higher in poor sleepers than normal sleepers (3.2 ±â€Š0.9 vs. 2.8 ±â€Š1.0, t = 4.297, P < .001). After controlling for potential confounders, results of the multiple regression analysis reveal that poor sleep quality was still significantly and independently associated with low sexual satisfaction (odd ratio = 1.58, P = .009).Poor sleep quality is significantly associated with low sexual satisfaction of methadone-maintained patients. Improving sleep quality might improve sexual satisfaction of patients receiving MMT.
[Mh] Termos MeSH primário: Metadona/uso terapêutico
Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico
Orgasmo/fisiologia
Qualidade de Vida
Distúrbios do Início e da Manutenção do Sono
[Mh] Termos MeSH secundário: Adulto
China
Feminino
Seres Humanos
Masculino
Meia-Idade
Entorpecentes/uso terapêutico
Tratamento de Substituição de Opiáceos/efeitos adversos
Tratamento de Substituição de Opiáceos/métodos
Tratamento de Substituição de Opiáceos/psicologia
Transtornos Relacionados ao Uso de Opioides/psicologia
Distúrbios do Início e da Manutenção do Sono/complicações
Distúrbios do Início e da Manutenção do Sono/psicologia
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Narcotics); UC6VBE7V1Z (Methadone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008214


  4 / 14845 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28651404
[Au] Autor:Yao T; Feng D; Pan MH; Cheng YP; Li CX; Wang J; Feng YL; Shi J; Su T; Chen Q; Shi S; Wang SP
[Ad] Endereço:Department of Epidemiology, Shanxi Medical University, Taiyuan 030001, China.
[Ti] Título:[Correlation between insufficient methadone dosage and morphine positive urine on drop out of treatment in patients with access to methadone maintenance treatment].
[So] Source:Zhonghua Liu Xing Bing Xue Za Zhi;38(5):646-650, 2017 May 10.
[Is] ISSN:0254-6450
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To estimate the incidence of drop out of treatment in patients with access to methadone maintenance treatment and explore the correlation and interaction between insufficient methadone dosage and morphine positive urine on the drop out in Guangxi Zhuang Autonomous Region. Face to face interview was conducted in 1 031 patients at 3 methadone maintenance treatment clinics in Guangxi. The study included 1 031 participants, 40.6 of them (419/1 031) had stopped treatment. The drop out rates in urine morphine positive group and methadone dosage<100 mg/d group were 57.6 (99/172) and 37.4 (347/929) respectively, higher than those in urine morphine negative group and methadone dosage ≥100 mg/d group (42.3 , 363/859, and 26.5 , 27/102). Orderly logistic regression analysis results showed that after adjusted factors, such as gender, age, marital status, ethnic group, patients who received a dosage less than 100 mg/day ( =3.05, 95 : 1.84-5.06) and had morphine positive urine ( =2.25, 95 : 1.59-3.19) were more likely to drop out of the treatment. Interaction analysis showed that dosage less than 100 mg/d and morphine positive urine during treatment had additive interaction ( =256.46, =0.87, = 8.05) and multiplication interaction ( =2.45, 95 : 1.71-3.49). Insufficient dosage and morphine positive urine were significantly correlated with drop out of treatment in patients with access to methadone maintenance treatment.
[Mh] Termos MeSH primário: Metadona/uso terapêutico
Dependência de Morfina/reabilitação
Morfina/urina
Entorpecentes/uso terapêutico
Tratamento de Substituição de Opiáceos
Pacientes Desistentes do Tratamento/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
China/epidemiologia
Relação Dose-Resposta a Droga
Feminino
Acesso aos Serviços de Saúde
Seres Humanos
Incidência
Entrevistas como Assunto
Masculino
Metadona/administração & dosagem
Metadona/provisão & distribuição
Dependência de Morfina/epidemiologia
Dependência de Morfina/urina
Detecção do Abuso de Substâncias
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Narcotics); 76I7G6D29C (Morphine); UC6VBE7V1Z (Methadone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170628
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0254-6450.2017.05.018


  5 / 14845 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28631765
[Au] Autor:Battistoni I; Marini M; Caretta G; Vagnarelli F; Lucà F; Biscottini E; Lavorgna A; Procaccini V; Riva L; Vianello G; Aspromonte N; Iacoviello M; De Maria R; Valente S; Gulizia MM
[Ad] Endereço:S.O.D. Cardiologia-Emodinamica-UTIC, Dipartimento di Scienze Cardiovascolari, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona - Area Scompenso Cardiaco ANMCO.
[Ti] Título:[Noninvasive ventilation and sedation: evidence and practical tools for its utilization].
[Ti] Título:Ventilazione non invasiva e sedazione: evidenze a supporto e consigli pratici..
[So] Source:G Ital Cardiol (Rome);18(6):513-518, 2017 Jun.
[Is] ISSN:1827-6806
[Cp] País de publicação:Italy
[La] Idioma:ita
[Ab] Resumo:Noninvasive ventilation (NIV) has gained increased acceptance inside the critical area, since it has been shown to be effective in reducing or avoiding the need for oro-tracheal intubation. NIV efficacy is dependent on the selection of the appropriate patients and on their compliance to therapy. Actually, full collaboration is not easily reached especially in agitated patients.Sedation during NIV is useful to reduce the rate of treatment failure, but robust data to guide the development of best practice are limited and sometimes local customs appear to exert a strong influence on patterns of care. Different sedative drugs are ready for use but none of currently available agents fulfill the criteria for the ideal drug. Knowledge of the pharmacological and hemodynamic characteristics of every single sedative agent is crucial to choose the right drug for every clinical scenario. Close monitoring is mandatory to avoid adverse effects. The aim of this article is to review the currently available literature, to recognize the contraindications for sedation use and to provide practical guidance.
[Mh] Termos MeSH primário: Hipnóticos e Sedativos/uso terapêutico
Ventilação não Invasiva
[Mh] Termos MeSH secundário: Analgésicos/uso terapêutico
Hemodinâmica/efeitos dos fármacos
Seres Humanos
Hipnóticos e Sedativos/efeitos adversos
Hipnóticos e Sedativos/farmacologia
Entorpecentes/efeitos adversos
Entorpecentes/farmacologia
Entorpecentes/uso terapêutico
Cooperação do Paciente
Seleção de Pacientes
Agitação Psicomotora/tratamento farmacológico
Tranquilizantes/efeitos adversos
Tranquilizantes/farmacologia
Tranquilizantes/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Analgesics); 0 (Hypnotics and Sedatives); 0 (Narcotics); 0 (Tranquilizing Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170621
[St] Status:MEDLINE
[do] DOI:10.1714/2700.27612


  6 / 14845 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28562267
[Au] Autor:Grossman MR; Berkwitt AK; Osborn RR; Xu Y; Esserman DA; Shapiro ED; Bizzarro MJ
[Ad] Endereço:Departments of Pediatrics, matthew.grossman@yale.edu.
[Ti] Título:An Initiative to Improve the Quality of Care of Infants With Neonatal Abstinence Syndrome.
[So] Source:Pediatrics;139(6), 2017 Jun.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: The incidence of neonatal abstinence syndrome (NAS), a constellation of neurologic, gastrointestinal, and musculoskeletal disturbances associated with opioid withdrawal, has increased dramatically and is associated with long hospital stays. At our institution, the average length of stay (ALOS) for infants exposed to methadone in utero was 22.4 days before the start of our project. We aimed to reduce ALOS for infants with NAS by 50%. METHODS: In 2010, a multidisciplinary team began several plan-do-study-act cycles at Yale New Haven Children's Hospital. Key interventions included standardization of nonpharmacologic care coupled with an empowering message to parents, development of a novel approach to assessment, administration of morphine on an as-needed basis, and transfer of infants directly to the inpatient unit, bypassing the NICU. The outcome measures included ALOS, morphine use, and hospital costs using statistical process control charts. RESULTS: There were 287 infants in our project, including 55 from the baseline period (January 2008 to February 2010) and 44 from the postimplementation period (May 2015 to June 2016). ALOS decreased from 22.4 to 5.9 days. Proportions of methadone-exposed infants treated with morphine decreased from 98% to 14%; costs decreased from $44 824 to $10 289. No infants were readmitted for treatment of NAS and no adverse events were reported. CONCLUSIONS: Interventions focused on nonpharmacologic therapies and a simplified approach to assessment for infants exposed to methadone in utero led to both substantial and sustained decreases in ALOS, the proportion of infants treated with morphine, and hospital costs with no adverse events.
[Mh] Termos MeSH primário: Custos Hospitalares/estatística & dados numéricos
Tempo de Internação/estatística & dados numéricos
Metadona/efeitos adversos
Entorpecentes/uso terapêutico
Síndrome de Abstinência Neonatal/terapia
Efeitos Tardios da Exposição Pré-Natal/epidemiologia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Recém-Nascido
Masculino
Metadona/uso terapêutico
Morfina/uso terapêutico
Gravidez
Efeitos Tardios da Exposição Pré-Natal/terapia
Indicadores de Qualidade em Assistência à Saúde
Qualidade da Assistência à Saúde
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Narcotics); 76I7G6D29C (Morphine); UC6VBE7V1Z (Methadone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170601
[St] Status:MEDLINE


  7 / 14845 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28506507
[Au] Autor:Moore PQ; Weber J; Cina S; Aks S
[Ad] Endereço:1900 W Polk St., 10th Floor, Administration Building, Chicago, IL 60612, USA. Electronic address: moore.quincy@gmail.com.
[Ti] Título:Syndrome surveillance of fentanyl-laced heroin outbreaks: Utilization of EMS, Medical Examiner and Poison Center databases.
[So] Source:Am J Emerg Med;35(11):1706-1708, 2017 Nov.
[Is] ISSN:1532-8171
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Describe surveillance data from three existing surveillance systems during an unexpected fentanyl outbreak in a large metropolitan area. METHODS: We performed a retrospective analysis of three data sets: Chicago Fire Department EMS, Cook County Medical Examiner, and Illinois Poison Center. Each included data from January 1, 2015 through December 31, 2015. EMS data included all EMS responses in Chicago, Illinois, for suspected opioid overdose in which naloxone was administered and EMS personnel documented other criteria indicative of opioid overdose. Medical Examiner data included all deaths in Cook County, Illinois, related to heroin, fentanyl or both. Illinois Poison Center data included all calls in Chicago, Illinois, related to fentanyl, heroin, and other prescription opioids. Descriptive statistics using Microsoft Excel® were used to analyze the data and create figures. RESULTS: We identified a spike in opioid-related EMS responses during an 11-day period from September 30-October 10, 2015. Medical Examiner data showed an increase in both fentanyl and mixed fentanyl/heroin related deaths during the months of September and October, 2015 (375% and 550% above the median, respectively.) Illinois Poison Center data showed no significant increase in heroin, fentanyl, or other opioid-related calls during September and October 2015. CONCLUSION: Our data suggests that EMS data is an effective real-time surveillance mechanism for changes in the rate of opioid overdoses. Medical Examiner's data was found to be valuable for confirmation of EMS surveillance data and identification of specific intoxicants. Poison Center data did not correlate with EMS or Medical Examiner data.
[Mh] Termos MeSH primário: Surtos de Doenças
Overdose de Drogas/epidemiologia
Fentanila/envenenamento
Heroína/envenenamento
Entorpecentes/envenenamento
[Mh] Termos MeSH secundário: Chicago/epidemiologia
Médicos Legistas
Estudos Transversais
Bases de Dados Factuais
Contaminação de Medicamentos
Overdose de Drogas/tratamento farmacológico
Overdose de Drogas/etiologia
Overdose de Drogas/mortalidade
Serviços Médicos de Emergência
Seres Humanos
Illinois/epidemiologia
Naloxona/uso terapêutico
Antagonistas de Entorpecentes/uso terapêutico
Centros de Controle de Intoxicações
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Narcotic Antagonists); 0 (Narcotics); 36B82AMQ7N (Naloxone); 70D95007SX (Heroin); UF599785JZ (Fentanyl)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170517
[St] Status:MEDLINE


  8 / 14845 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28502792
[Au] Autor:Sutcliffe KJ; Henderson G; Kelly E; Sessions RB
[Ad] Endereço:School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol BS8 1TD, UK; School of Biochemistry, University of Bristol, Bristol BS8 1TD, UK. Electronic address: katy.sutcliffe@bristol.ac.uk.
[Ti] Título:Drug Binding Poses Relate Structure with Efficacy in the µ Opioid Receptor.
[So] Source:J Mol Biol;429(12):1840-1851, 2017 Jun 16.
[Is] ISSN:1089-8638
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The µ-opioid receptor (MOPr) is a clinically important G protein-coupled receptor that couples to G proteins and arrestins. At present, the receptor conformational changes that occur following agonist binding and activation are poorly understood. This study has employed molecular dynamics simulations to investigate the binding mode and receptor conformational changes induced by structurally similar opioid ligands of widely differing intrinsic agonist efficacy, norbuprenorphine, buprenorphine, and diprenorphine. Bioluminescence resonance energy transfer assays for G activation and arrestin-3 recruitment in human embryonic kidney 293 cells confirmed that norbuprenorphine is a high efficacy agonist, buprenorphine a low efficacy agonist, and diprenorphine an antagonist at the MOPr. Molecular dynamics simulations revealed that these ligands adopt distinct binding poses and engage different subsets of residues, despite sharing a common morphinan scaffold. Notably, norbuprenorphine interacted with sodium ion-coordinating residues W293 and N150 , whilst buprenorphine and diprenorphine did not. Principal component analysis of the movements of the receptor transmembrane domains showed that the buprenorphine-bound receptor occupied a distinct set of conformations to the norbuprenorphine-bound receptor. Addition of an allosteric sodium ion caused the receptor and ligand to adopt an inactive conformation. The differences in ligand-residue interactions and receptor conformations observed here may underlie the differing efficacies for cellular signalling outputs for these ligands.
[Mh] Termos MeSH primário: Entorpecentes/química
Entorpecentes/metabolismo
Receptores Opioides mu/agonistas
Receptores Opioides mu/química
[Mh] Termos MeSH secundário: Buprenorfina/análogos & derivados
Buprenorfina/química
Buprenorfina/metabolismo
Linhagem Celular
Diprenorfina/química
Diprenorfina/metabolismo
Seres Humanos
Medições Luminescentes
Simulação de Dinâmica Molecular
Ligação Proteica
Conformação Proteica
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Narcotics); 0 (Receptors, Opioid, mu); 1F0L5N25ZZ (Diprenorphine); 40D3SCR4GZ (Buprenorphine); 7E53B4O073 (norbuprenorphine)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170714
[Lr] Data última revisão:
170714
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170516
[St] Status:MEDLINE


  9 / 14845 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28482247
[Au] Autor:Argo A; Spatola GF; Zerbo S; Sortino C; Lanzarone A; Uzzo ML; Pitruzzella A; Farè F; Roda G; Gambaro V; Procaccianti P; Karch SB
[Ad] Endereço:Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro", Forensic Section, Via Del Vespro, 133, 90127, Palermo, Italy. Electronic address: antonella.argo@unipa.it.
[Ti] Título:A possible biomarker for methadone related deaths.
[So] Source:J Forensic Leg Med;49:8-14, 2017 Jul.
[Is] ISSN:1878-7487
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Methadone (MTH) concentrations in those dying of MTH toxicity totally overlap concentrations where the presence of MTH is only an incidental finding, making it very difficult to make distinctions in actual cases. A biomarker, be it anatomical or biochemical for MTH toxicity is badly needed, particularly if that markers were known to disrupt effective ventilation. Because the brainstem houses the regulatory centers for cardiorespiratory-control enters, it would seem to be the most likely anatomical site to seek abnormalities in cardiorespiratory control. OBJECTIVE: To locate and describe the cells of nucleus of the solitary tract (TS)(NTS) in human brainstem and determine if neuronal cell death, either necrotic or apoptotic, within the TS of humans is more common in deaths due directly to MTH toxicity than with in the solitary tract itself. DESIGN, SETTING, PARTICIPANTS: This was a single cohort study of MTH related decedents autopsied at a large university hospital. Each decedent had a recent history of non medical/illicit MTH use and had been pronounced dead in the field, prior to ever reaching the hospital. Complete autopsy and complete toxicology testing were performed on the formalin fixed brains of each individual. Multiple blocks were prepared of the area of interest, namely the tissue lying immediately between the inferior and the super colliculi. This volume, by definition, would have included the area of the Rostral Ventrolateral Medulla (RVLM), the location of the TS. Immunohistochemistry studies utilizing caspase-9 reaction (a protease enzyme involved in the process of preprogrammed death) were performed in order to estimate the degree and proportion of neuronal apoptosis, and also access the degree of classical necrosis within the NTS. MAIN OUTCOMES AND MEASURES: The primary outcome measure was the presence or absence of neuronal apoptosis and/or necrosis within the NTS. RESULTS: Cells displaying evidence of early apoptosis and advanced apoptosis, consisting primarily of nuclear fragmentation, admixed with other neurons displaying the features of classic necrosis were found. Evidence of classic necrosis was identifiable in most of the controls, though minor degrees of apoptosis were identifiable with Caspase staining and quantitative image analysis of immunohistochemical stains. CONCLUSIONS: and Relevance: Our study shows that neurons, primarily along the TS, but occasionally in other cell nuclei (even controls) are vulnerable, both to direct MTH toxicity (via apoptosis) and indirectly (via hypoxia leading to classical cell necrosis). When MTH is found to be present in significant concentrations, but apoptotic lesions are absent, it would be reasonable to assume that MTH was not primarily the cause of cardiorespiratory arrest.
[Mh] Termos MeSH primário: Metadona/envenenamento
Entorpecentes/envenenamento
Neurônios/patologia
Núcleo Solitário/patologia
[Mh] Termos MeSH secundário: Adulto
Apoptose
Tronco Encefálico/patologia
Caspase 9/metabolismo
Estudos de Coortes
Feminino
Patologia Legal
Toxicologia Forense
Seres Humanos
Imuno-Histoquímica
Masculino
Metadona/análise
Entorpecentes/análise
Necrose
Envenenamento/diagnóstico
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Narcotics); EC 3.4.22.- (Caspase 9); UC6VBE7V1Z (Methadone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170509
[St] Status:MEDLINE


  10 / 14845 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28446428
[Au] Autor:Sordo L; Barrio G; Bravo MJ; Indave BI; Degenhardt L; Wiessing L; Ferri M; Pastor-Barriuso R
[Ad] Endereço:National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
[Ti] Título:Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies.
[So] Source:BMJ;357:j1550, 2017 Apr 26.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo: To compare the risk for all cause and overdose mortality in people with opioid dependence during and after substitution treatment with methadone or buprenorphine and to characterise trends in risk of mortality after initiation and cessation of treatment. Systematic review and meta-analysis. Medline, Embase, PsycINFO, and LILACS to September 2016. Prospective or retrospective cohort studies in people with opioid dependence that reported deaths from all causes or overdose during follow-up periods in and out of opioid substitution treatment with methadone or buprenorphine. Two independent reviewers performed data extraction and assessed study quality. Mortality rates in and out of treatment were jointly combined across methadone or buprenorphine cohorts by using multivariate random effects meta-analysis. There were 19 eligible cohorts, following 122 885 people treated with methadone over 1.3-13.9 years and 15 831 people treated with buprenorphine over 1.1-4.5 years. Pooled all cause mortality rates were 11.3 and 36.1 per 1000 person years in and out of methadone treatment (unadjusted out-to-in rate ratio 3.20, 95% confidence interval 2.65 to 3.86) and reduced to 4.3 and 9.5 in and out of buprenorphine treatment (2.20, 1.34 to 3.61). In pooled trend analysis, all cause mortality dropped sharply over the first four weeks of methadone treatment and decreased gradually two weeks after leaving treatment. All cause mortality remained stable during induction and remaining time on buprenorphine treatment. Overdose mortality evolved similarly, with pooled overdose mortality rates of 2.6 and 12.7 per 1000 person years in and out of methadone treatment (unadjusted out-to-in rate ratio 4.80, 2.90 to 7.96) and 1.4 and 4.6 in and out of buprenorphine treatment. Retention in methadone and buprenorphine treatment is associated with substantial reductions in the risk for all cause and overdose mortality in people dependent on opioids. The induction phase onto methadone treatment and the time immediately after leaving treatment with both drugs are periods of particularly increased mortality risk, which should be dealt with by both public health and clinical strategies to mitigate such risk. These findings are potentially important, but further research must be conducted to properly account for potential confounding and selection bias in comparisons of mortality risk between opioid substitution treatments, as well as throughout periods in and out of each treatment.
[Mh] Termos MeSH primário: Buprenorfina/efeitos adversos
Overdose de Drogas/mortalidade
Metadona/efeitos adversos
Entorpecentes/efeitos adversos
Tratamento de Substituição de Opiáceos/efeitos adversos
Transtornos Relacionados ao Uso de Opioides/mortalidade
[Mh] Termos MeSH secundário: Buprenorfina/uso terapêutico
Seres Humanos
Metadona/uso terapêutico
Entorpecentes/uso terapêutico
Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Narcotics); 40D3SCR4GZ (Buprenorphine); UC6VBE7V1Z (Methadone)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j1550



página 1 de 1485 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde