Navegando por Palavras-chave "Adverse effects"
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- ItemSomente MetadadadosAnterior thalamus deep brain stimulation at high current impairs memory in rats(Elsevier B.V., 2010-09-01) Hamani, Clement [UNIFESP]; Dubiela, Francisco Paulino [UNIFESP]; Soares, Juliana C. K. [UNIFESP]; Shin, Damian; Bittencourt, Simone [UNIFESP]; Covolan, Luciene [UNIFESP]; Carlen, Peter L.; Laxton, Adrian W.; Hodaie, Mojgan; Stone, Scellig S. D.; Ha, Yoon; Hutchison, William D.; Lozano, Andres M.; Mello, Luiz E. [UNIFESP]; Oliveira, Maria Gabriela M. [UNIFESP]; Toronto Western Hosp; Universidade Federal de São Paulo (UNIFESP)Deep brain stimulation (DBS) of the anterior thalamic nucleus (AN), an important relay in the circuitry of memory, is currently being proposed as a treatment for epilepsy. Despite the encouraging results with the use of this therapy, potential benefits and adverse effects are yet to be determined. we show that AN stimulation at relatively high current disrupted the acquisition of contextual fear conditioning and impaired performance on a spatial alternating task in rats. This has not been observed at parameters generating a charge density that approximated the one used in clinical practice. At settings that impaired behavior, AN stimulation induced a functional depolarization block nearby the electrode, increased c-Fos expression in cerebral regions projecting to and receiving projections from the AN, and influenced hippocampal activity. This suggests that complex mechanisms might be involved in the effects of AN DBS, including a local target inactivation and the modulation of structures at a distance. Though translating data from animals to humans has to be considered with caution, our study underscores the need for carefully monitoring memory function while selecting stimulation parameters during the clinical evaluation of AN DBS. (C) 2010 Elsevier Inc. All rights reserved.
- ItemAcesso aberto (Open Access)Are adverse effects of antiepileptic drugs different in symptomatic partial and idiopathic generalized epilepsies? the Portuguese-Brazilian validation of the Liverpool Adverse Events Profile(Elsevier B.V., 2011-11-01) Martins, Heloise Helena [UNIFESP]; Alonso, Neide Barreira [UNIFESP]; Vidal-Dourado, Marcos [UNIFESP]; Carbonel, Thiago Delfino [UNIFESP]; Araujo Filho, Gerardo Maria de [UNIFESP]; Caboclo, Luís Otávio Sales Ferreira [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Guilhoto, Laura Maria de Figueiredo Ferreira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)We report the results of administration of the Portuguese-Brazilian translation of the Liverpool Adverse Events Profile (LAEP) to 100 patients (mean age = 34.5, SD = 12.12; 56 females), 61 with symptomatic partial epilepsy (SPE) and 39 with idiopathic generalized epilepsy (ICE) (ILAE, 1989) who were on a stable antiepileptic drug (AED) regimen and being treated in a Brazilian tertiary epilepsy center. Carbamazepine was the most commonly used AED (43.0%), followed by valproic acid (32.0%). Two or more AEDs were used by 69.0% of patients. the mean LAEP score (19 questions) was 37.6 (SD = 13.35). the most common adverse effects were sleepiness (35.0%), memory problems (35.0%), and difficulty in concentrating (25.0%). Higher LAEP scores were associated with polytherapy with three or more AEDs (P=0.005), female gender (P<0.001), older age (P<0.001), and uncontrolled seizures (P = 0.045). the intraclass coefficient (test-retest reliability) for LAEP overall score was 0.848 (95% CI = 0.782-0.895), with a range from 0.370 (unsteadiness) to 0.750 (memory problems). Cronbach's alpha coefficient (internal consistency) was 0.903. the LAEP was highly correlated with Quality of Life in Epilepsy-31 inventory (r = -0.804, P>0.001) and Hospital Anxiety and Depression Scale (Depression: r = 0.637, P<0.001; Anxiety: r = 0.621, P<0.001) dimensions. LAEP overall scores were similar in people with SPE and IGE and were not helpful in differentiating adverse effects in these two groups. Clinical variables that influenced global LAEP were seizure frequency (P = 0.050) and generalized tonic-clonic seizures in the last month (P = 0.031) in the ICE group, and polytherapy with three or more AEDs (P = 0.003 and P = 0.003) in both ICE and SPE groups. (C) 2011 Elsevier Inc. All rights reserved.
- ItemAcesso aberto (Open Access)Avaliação da orientação médica sobre os efeitos colaterais de benzodiazepínicos(Associação Brasileira de Psiquiatria - ABP, 2004-03-01) Auchewski, Luciana; Andreatini, Roberto; Galduróz, José Carlos Fernandes [UNIFESP]; Lacerda, Roseli Boerngen de; Universidade Federal do Paraná Departamento de Farmacologia; Universidade Federal de São Paulo (UNIFESP); Centro Brasileiro de Informações sobre Drogas PsicotrópicasOBJECTIVES: Benzodiazepines are among the most prescribed drugs indicated as anxiolytics, hypnotics, myorrelaxants or antiepileptics. Their main side effects are: reduced psychomotor activities, interaction to other drugs, like alcohol, and the development of dependence. In the present study it was evaluated the quality of the medical directions given to patients about those side effects. METHODS: One hundred and twenty patients (39 men and 81 women), mean age of 48 years old, who visited pharmacies in Curitiba to buy prescribed benzodiazepines, were interviewed by an open or directive questionnaire designed to obtain the medical directions about benzodiazepines side effects. RESULTS: Directions about the three main benzodiazepines side effects were observed only in 13% of the patients, 27% had received at least two and 40% only one, while 19% reported no directions. It suggested that the medical orientation was precarious and its quality was not influenced by the patients' educational level, the kind of medical attendance or the specialty of the physician. The main orientation cited was ''don't drink'' (85%), followed by ''don't drive or operate machines'' (46%), while few orientations about the risk to develop dependence on benzodiazepines was observed (31%). CONCLUSION: This suggests that physicians were worried about the alcohol interaction risk, which can be dangerous for the patients. The high number of patients using benzodiazepines continuously for more than one year (61%), the unsuccessfully attempt to stop using BZD (94%) and the poor information about the duration of the treatment (22%) were all related to the low medical worry about dependence on benzodiazepines.
- ItemSomente MetadadadosEffects of daily intake of zidovudine-stavudine on rat pregnancy outcome: biological essay(I R O G Canada, Inc, 2012-01-01) Antonio, Eliana Maria Restum [UNIFESP]; Fontes, Tereza Maria Pereira [UNIFESP]; Simoes, Ricardo Santos [UNIFESP]; Carvalho, Adelino Moreira de [UNIFESP]; Espiridião, Silvia [UNIFESP]; Nakamura, Mary Uchiyama [UNIFESP]; Kulay Júnior, Luiz [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Jose do Rosario Vellano Univ; ABC Med Fdn FUABCPurpose: To evaluate the effects at term of a highly active antiretroviral drug association when administered for the whole period of rat pregnancy. Methods: Forty pregnant rats weighing about 200 g were randomly divided into four groups: a control group (Ctr = drug vehicle control, n = 10) and three experimental groups. which were treated with an oral solution of zidovudine-stavudine (Exp1x = 10/1 mg/kg b.w., n = 10; Exp3x = 30/3 mg/kg b.w., n = 10; Exp9x = 90/9 mg/kg b.w., n = 10) from day 0 up to the 20th day of pregnancy. Maternal body weights were recorded at the start of the experiment and on the 7th, 14th and 20th day thereafter. At term (20th day) the rats were anesthetized and submitted to hysterotomy. Implantations, reabsorptions, living fetuses, placentae and intrauterine deaths were looked for and recorded. The collected fetuses and placentae were weighed and the concepts were examined by a stereoscopic microscope looking for external malformations. Results: No significant alterations due to the antiretroviral drug treatment could be detected regarding the number of implantations, fetuses, placentae, absorptions and malformations nor regarding maternal and fetal mortality. Conclusions: Administration of the association zidovudine/stavudine for the whole period of rat pregnancy did not interfere with the maternal, fetal and placental weight gain as well as abnormalities detectable by the employed methodology.
- ItemSomente MetadadadosThe Effects of So-Called 'Forbidden Acupuncture Points' on Pregnancy Outcome in Wistar Rats(Karger, 2011-01-01) Guerreiro da Silva, Andre Vilella [UNIFESP]; Nakamura, Mary Uchiyama [UNIFESP]; Cordeiro, Jose Antonio; Silva, João Bosco Guerreiro da; Mendes, Gloria Elisa Florido; Burdmann, Emmanuel de Almeida; Rio Preto Med Coll; Universidade Federal de São Paulo (UNIFESP)Background: This study sought to determine if acupuncture in LI4 and SP6, or in sacral points could harm the pregnancy outcome in Wistar rats as is believed according to traditional knowledge. Methods: 48 pregnant Wistar rats were randomly divided into 4 groups: total control where the rats were left in cages without manipulation; anesthetized control where the rats were manipulated and anesthetized but did not received electroacupuncture; peripheral points and sacral points were the rats were anesthetized and received 4 acupuncture points - LI4-SP6 and BL27-28, respectively. the primary end point was embryonic loss after implantation, defined as (number of implantations - number of embryos in development) x 100 / number of implantations. Other evaluated parameters were fetal death, abortions, number of fetuses, and resorptions, resorption index (number of resorptions / total of implantations), maternal weight gain, and fetal weight. Results: There were no differences in embryonic loss after implantation (p = 0.45), fetal death (p = 1), abortions (p = 1), number of fetuses (p = 0.79), resorptions (p = 0.3), and resorption index (p = 0.45). There were differences in maternal weight gain and fetal weight, but they seemed unrelated to the treatment. Conclusions: We found no evidence that acupuncture in LI4-SP6 and sacral points could be harmful to the pregnancy outcome in Wistar rats.
- ItemAcesso aberto (Open Access)O impacto na saúde de indivíduos que utilizam recursos ergogênicos(Universidade Federal de São Paulo, 2023-06-19) Pissinato, Giovanna Cristina Pinheiro [UNIFESP]; Garcia, Raphael Caio Tamborelli [UNIFESP]; http://lattes.cnpq.br/7921656182943609Os esteroides anabolizantes (EA) são moléculas derivadas da testosterona que possuem funções anabólicas. Essas substâncias são usadas principalmente por atletas, mas seu uso também é muito difundido na academia para melhorar a aparência física. Devido ao impacto negativo dos efeitos colaterais na saúde dos usuários, o uso de EAAs tornou-se uma preocupação de saúde pública. Este estudo tem como objetivo abordar o uso de recursos ergogênicos em indivíduos para fins estéticos e esportivos, alertando o seu impacto em cada sistema do corpo humano, bem como os principais efeitos adversos à saúde. Para tal, realizou-se a busca de artigos científicos no site Pubmed/Medline (www.pubmed.com.br) utilizando as palavras-chaves e seus descritores de Mesh: “Anabolism”, “Ergogenic” e “Anabolic Steroids”. Foram incluídas revisões sistemáticas, estudos clínicos e observacionais, sendo eles em inglês, português e espanhol, entre 1987 e 2022, resultando em 52 publicações selecionadas. Embora existam evidências de melhora na performance dos usuários, ainda é relatada uma alta prevalência de efeitos adversos decorrentes do uso de EAAs. A literatura descreve diversos efeitos negativos em todos os sistemas do corpo humano, tais como acne, ginecomastia, impotência e infertilidade, diminuição do número de espermatozoides, hipertrofia do clitóris, redução da função do miocárdio e agressividade. Tal fato gera preocupações sobre o uso dessas substâncias e reforça a necessidade de compreender e ponderar os benefícios e malefícios acerca dos impactos advindos do uso de EAAs.
- ItemAcesso aberto (Open Access)Os impactos sociais e de saúde do anticoncepcional hormonal oral na vida da mulher(Universidade Federal de São Paulo, 2021-02-11) Oliveira, Laura Alves de [UNIFESP]; Nappo, Solange Aparecida [UNIFESP]; http://lattes.cnpq.br/4675292090990088A descoberta e posterior comercialização do anticoncepcional hormonal oral foi um marco que uniu as reivindicações sociais da época. Ainda, atrelando os hormônios sexuais estrógeno e progesterona ao comportamento das mulheres, foram abertas as portas para o início desta inovação que se tornou um dos métodos contraceptivos mais utilizados pelo público feminino atualmente. Juntos, os hormônios agem no organismo mimetizando a funcionalidade do estrógeno e progesterona endógenos, impedindo que ocorra o processo de ovulação, e, consequentemente, a fertilização. O anticoncepcional hormonal oral é útil para outras indicações além da contracepção como quadros de endometriose e síndrome do ovário policístico, por outro lado, apresenta efeitos adversos que podem comprometer a saúde da mulher. Existem fatores contribuintes para a ocorrência do uso irracional deste medicamento. Algumas empresas realizaram a divulgação de benefícios secundários que o anticoncepcional hormonal oral pode oferecer como função principal para promover sua venda. No Brasil, a abertura para uso irracional ocorre por ser um medicamento onde a venda sem receita médica não é incentivada, é sinalizado no próprio medicamento, porém ocorre. Frente a este cenário, o presente trabalho apresenta os impactos, em um contexto social e de saúde, do anticoncepcional hormonal oral na vida da mulher. Analisa, através da revisão da literatura, que a responsabilidade da contracepção foi atrelada a mulher sem dar a devida importância para as consequências e demonstrando que o olhar para chance de ocorrência de fatores de risco de acordo com cada perfil individual é fundamental ao considerar este medicamento para uso. Ressalta-se que atualmente existem outras opções de métodos contraceptivos que não utilizam hormônios e devem chegar ao alcance do conhecimento da população. Foram pesquisados artigos em bases cientifcas como Scielo, Google Acadêmico, Web of Science e PubMed e livros que possuíam em seu conteúdo o assunto buscado. A metodologia adotada para busca foram artigos e livros publicados entre os anos de 1994 e 2020 em idiomas em português, espanhol e inglês.
- ItemSomente MetadadadosInjuries caused by Veress needle insertion for creation of pneumoperitoneum: a systematic literature review(Springer, 2009-07-01) Azevedo, Joao Luiz Moreira Coutinho [UNIFESP]; Azevedo, Otavio Cansancao [UNIFESP]; Miyahira, Susana Abe [UNIFESP]; Miguel, Gustavo Peixoto Soares [UNIFESP]; Becker, Otavio Monteiro [UNIFESP]; Hypolito, Octavio Henrique Mendes [UNIFESP]; Machado, Afonso Cesar Cabral Guedes [UNIFESP]; Cardia, Wellington [UNIFESP]; Aguiar-Yamaguchi, Gilmara Silva [UNIFESP]; Godinho, Lola [UNIFESP]; Almeida, Carlos Eduardo Saldanha [UNIFESP]; Moreira, Camila Hobi [UNIFESP]; Freire, Dalmer Faria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background the aim of this study was to assess the prevalence, risks, and outcomes of injuries caused by the Veress needle described in the literature.Methods Iatrogenic injuries caused by Veress needle insertion during diagnostic or therapeutic laparoscopies in humans were researched, with no language restriction, in the Medline, Lilacs, Embase, Scielo, and Cochrane Library databases. the following words were combined: Veress'' or insufflation needle'' or pneumoperitoneum needle,'' and complications'' or injuries'' or lesions.'' the bibliographic references of the selected articles were also analyzed. We considered the following: (1) number of injuries described in the literature, (2) relationship between number of injuries and number of patients who underwent Veress needle insertion in the studies that reported Veress needle injury, (3) organs and structures injured (retroperitoneal vessels, digestive tract, and self-limited, minor injuries), and (4) outcome (death, conversion to laparotomy, laparoscopic repair, spontaneous resolution).Results Thirty-eight selected articles included 696,502 laparoscopies, with 1,575 injuries (0.23%), 126 (8%) of which involved blood vessels or hollow viscera (0.018% of all laparoscopies). of the 98 vascular injuries, 8 (8.1%) were injuries to major retroperitoneal vessels. There were 34 other reported retroperitoneal injuries, but the authors were not specific as to which vessel was injured. of the 28 injuries to hollow viscera, 17 were considered major injuries, i.e., 60.7% (0.0024% of the total cases assessed).Conclusion the insertion of the Veress needle in the abdominal midline, at the umbilicus, poses serious risk to the life of patients. Therefore, further studies should be conducted to investigate alternative sites for Veress needle insertion.
- ItemSomente MetadadadosInterruption of a study of cervical ripening with isosorbide mononitrate due to adverse effects(I R O G Canada, Inc, 2012-01-01) Hatanaka, Alan Roberto [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Aquino, Márcia Maria Auxiliadora de [UNIFESP]; Souza, E. de [UNIFESP]; Bussamra, Luiz Claudio de Silva [UNIFESP]; Araujo, E. [UNIFESP]; Mattar, R. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose of investigation: The objective of this study was to evaluate cervix length and the presence of cervical gland area (CGA) in ultrasounds performed before and after the administration of vaginal isosorbide mononitrate (IMN) for cervical ripening. Methods: We performed an observational, descriptive, and longitudinal study of pregnant patients indicated for labor induction and with a Modified Bishop Score (MBS) lower than six. For cervical ripening, 40 mg of vaginal IMN was administered at 0, 16, and 24 hours after the initiation of cervix preparation. Results: After enrolling 11 patients, the study had to be discontinued due to adverse effects. Three patients requested that they be withdrawn. Headaches were reported by all patients. Nausea, dizziness, dyspnea, and vomiting were also reported. The average cervical lengths at 0, 16, 24 and 36 hours were 27.6, 27.7, 25.9, and 23.0 mm, respectively. CGA disappeared in one of seven patients. Conclusions: The use of IMN appears to increase the MBS, slightly reducing cervical length without altering the appearance of CGA. Considering the importance of maternal wellbeing during labor, the routine use of IMN cannot be recommended for cervical ripening in the third trimester due to the frequency and intensity of side-effects.