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Adverse drug events in an intensive care unit of a university hospital

REIS, Adriano Max Moreira; CASSIANI, Silvia Helena De Bortoli
Fonte: SPRINGER Publicador: SPRINGER
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
45.89%
Purpose Adverse drug events (ADEs) are harmful and occur with alarming frequency in critically ill patients. Complex pharmacotherapy with multiple medications increases the probability of a drug interaction (DI) and ADEs in patients in intensive care units (ICUs). The objective of the study is to determine the frequency of ADEs among patients in the ICU of a university hospital and the drugs implicated. Also, factors associated with ADEs are investigated. Methods This cross-sectional study investigated 299 medical records of patients hospitalized for 5 or more days in an ICU. ADEs were identified through intensive monitoring adopted in hospital pharmacovigilance and also ADE triggers. Adverse drug reactions (ADR) causality was classified using the Naranjo algorithm. Data were analyzed through descriptive analysis, and through univariate and multiple logistic regression. Results The most frequent ADEs were ADRs type A, of possible causality and moderate severity. The most frequent ADR was drug-induced acute kidney injury. Patients with ADEs related to DIs corresponded to 7% of the sample. The multiple logistic regression showed that length of hospitalization (OR = 1.06) and administration of cardiovascular drugs (OR = 2.2) were associated with the occurrence of ADEs. Conclusion Adverse drug reactions of clinical significance were the most frequent ADEs in the ICU studied...

Risco de reação adversa ao contraste iodado : validação de conteúdo diagnóstico, resultados e intervenções de enfermagem; Risk for adverse reaction to iodinated contrast media : diagnosis, outcomes and interventions content validation; Riesgo de reacción adversa a los medios de contraste yodados : validación de contenido diagnóstico, resultados y intervenciones de enfermería

Juchem, Beatriz Cavalcanti
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Tese de Doutorado Formato: application/pdf
POR
Relevância na Pesquisa
45.87%
O Processo de Enfermagem (PE) vem sendo desenvolvido com a utilização de linguagens padronizadas que incluem a classificação diagnóstica da NANDA International, Inc (NANDA-I) e as classificações de intervenções e resultados de enfermagem segundo a Nursing Interventions Classification (NIC) e a Nursing Outcomes Classification (NOC), respectivamente. Estudos de validação de conteúdo, por meio de consenso entre peritos, vêm sendo realizados para o refinamento dessas taxonomias e qualificação do cuidado de enfermagem nas diferentes especialidades. Recentemente foi inserido na classificação da NANDA-I o diagnóstico de enfermagem (DE) Risco de reação adversa ao contraste iodado, contemplando as áreas de diagnóstico por imagem. Os objetivos desta pesquisa consistiram em: 1) realizar a validação de conteúdo diagnóstico do DE Risco de reação adversa ao contraste iodado (código 00218), incluindo título, definição, fatores de risco e inserção na estrutura da Taxonomia II da NANDA-I; 2) realizar a validação de conteúdo de resultados de enfermagem da NOC e de intervenções de enfermagem da NIC para o DE em estudo, a partir dos fatores de risco validados como principais. Consistiu em objetivo secundário investigar diferenças entre os grupos de peritos médicos e enfermeiros quanto ao julgamento dos elementos propostos. Para isso...

Ocular surface adverse effects of ambient levels of air pollution

Torricelli,André Augusto Miranda; Novaes,Priscila; Matsuda,Monique; Alves,Milton Ruiz; Monteiro,Mário Luiz Ribeiro
Fonte: Conselho Brasileiro de Oftalmologia Publicador: Conselho Brasileiro de Oftalmologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2011 EN
Relevância na Pesquisa
45.95%
It is widely recognized today that outdoor air pollution can affect human health. Various chemical components that are present in ambient pollution may have an irritant effect on the mucous membranes of the body, particularly those of the respiratory tract. Much less attention has been focused on the adverse effect on the ocular surface, despite the fact that this structure is even more exposed to air pollution than the respiratory mucosa since only a very thin tear film separates the corneal and conjunctival epithelia from the air pollutants. So far, clinical data are the more widespread tools used by ophthalmologists for assessing possible aggression to the ocular surface; however, clinical findings alone appears not to correlate properly with the complaints presented by the patients pointing out the need for further clinical and laboratory studies on the subject. The purpose of this study is to review signs and symptoms associated with chronic long-term exposure to environmental air pollutants on the ocular structures currently defined as the ocular surface and to review clinical and laboratory tests used to investigate the adverse effects of air pollutants on such structures. We also review previous studies that investigated the adverse effects of air pollution on the ocular surface and discuss the need for further investigation on the subject.

ADVERSE EFFECT VERSUS QUALITY CONTROL OF THE FUENZALIDA-PALACIOS ANTIRABIES VACCINE

NOGUEIRA,Yeda L.
Fonte: Instituto de Medicina Tropical Publicador: Instituto de Medicina Tropical
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/1998 EN
Relevância na Pesquisa
55.96%
We evaluated the components of the Fuenzalida-Palacios antirabies vaccine, which is till used in most developing countries in human immunization for treatment and prophylaxis. This vaccine is prepared from newborn mouse brains at 1% concentration. Even though the vaccine is considered to have a low myelin content, it is not fully free of myelin or of other undesirable components that might trigger adverse effects after vaccination. The most severe effect is a post-vaccination neuroparalytic accident associated with Guillain-Barré syndrome. In the present study we demonstrate how the vaccines produced and distributed by different laboratories show different component patterns with different degrees of impurity and with varying protein concentrations, indicating that production processes can vary from one laboratory to another. These differences, which could be resolved using a better quality control process, may affect and impair immunization, with consequent risks and adverse effects after vaccination. We used crossed immunoelectrophoresis to evaluate and demonstrate the possibility of quality control in vaccine production, reducing the risk factors possibly involved in these immunizing products.

Adverse effects of alternative therapy (minocycline, ofloxacin, and clofazimine) in multibacillary leprosy patients in a recognized health care unit in Manaus, Amazonas, Brazil

Maia,Marina Valente; Cunha,Maria da Graça Souza; Cunha,Carolina Souza
Fonte: Sociedade Brasileira de Dermatologia Publicador: Sociedade Brasileira de Dermatologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2013 EN
Relevância na Pesquisa
45.87%
BACKGROUND: After the introduction of the multidrug therapy, there was a decline in the coefficients of prevalence and detection of new cases of leprosy. However, the records of drug resistance and relapses are threatening factors in leprosy control. Hence, new alternative schemes and monitoring of adverse effects to avoid treatment abandonment are important considerations. OBJECTIVE: Describe the side effects of a multidrug regimen containing minocycline, ofloxacin, and clofazimine in multibacillary leprosy patients. METHODS: We conducted a prospective, descriptive, and observational study with multibacillary patients, including cases of intolerance to standard MDT and relapses. The study was carried out at Fundação Alfredo da Matta (Alfredo da Matta Foundation), in Manaus, Amazonas, from April 2010 to January 2012. The patients received alternative therapy, which consisted of daily self-administered doses of 100mg of minocycline, 400 mg of ofloxacin, and 50mg of clofazimine and a supervised monthly dose of 300mg of clofazimine for six months, followed by eighteen months of daily doses of ofloxacin 400mg...

Sacroiliitis after use of oral isotretinoin - association with acne fulminans or adverse effect?

Geller,Ariane Silva Bastos; Alagia,Roberta Ferreira Nazareth
Fonte: Sociedade Brasileira de Dermatologia Publicador: Sociedade Brasileira de Dermatologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2013 EN
Relevância na Pesquisa
45.91%
Acne fulminans is a rare and severe form of acne that may evolve from acne vulgaris, especially in male adolescents, or occur as an adverse effect of oral isotretinoin. Arthritis is a serious clinical manifestation when the musculoskeletal system is compromised by AF and has been reported as a rare adverse effect of isotretinoin. Involvement of the sacroiliac joints occurs in 21% of acne fulminans cases. We present the case of a 18-year-old male patient in whom acne fulminans evolved from acne vulgaris grade IV and after inflammation resolution started treatment with oral isotretinoin. Within a 30-day period of retinoid treatment he presented with back pain followed by rapid, progressive inability to deambulate.

Evidence that the adverse effect of urea fertilizer on seed germination in soil is due to ammonia formed through hydrolysis of urea by soil urease

Bremner, John M.; Krogmeier, Michael J.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /11/1989 EN
Relevância na Pesquisa
45.91%
Studies using seeds of wheat (Triticum aestivum L.), rye (Secale cereale L.), barley (Hordeum vulgare L.), and corn (Zea mays L.) indicated that the adverse effect of urea fertilizer on seed germination in soil is due to ammonia formed through hydrolysis of urea by soil urease and is not due to urea itself, to urea fertilizer impurities such as biuret, or to nitrite formed by nitrification of urea nitrogen. Support for this conclusion was obtained from (i) comparison of the effects on seed germination in soil of purified urea, urea fertilizers, urea fertilizer impurities, and compounds formed by enzymatic and microbial transformations of urea in soil; (ii) studies showing that ammonia volatilized from soils treated with urea completely inhibited germination of seeds close to, but not in contact with, these soils; and (iii) experiments showing that the adverse effect of urea fertilizer on seed germination in soil was completely eliminated when the soil was autoclaved to destroy urease or was treated with phenylphosphorodiamidate to inhibit soil urease activity before treatment with urea fertilizer.

In Silico Elucidation of the Molecular Mechanism Defining the Adverse Effect of Selective Estrogen Receptor Modulators

Xie, Lei; Wang, Jian; Bourne, Philip E
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46%
Early identification of adverse effect of preclinical and commercial drugs is crucial in developing highly efficient therapeutics, since unexpected adverse drug effects account for one-third of all drug failures in drug development. To correlate protein–drug interactions at the molecule level with their clinical outcomes at the organism level, we have developed an integrated approach to studying protein–ligand interactions on a structural proteome-wide scale by combining protein functional site similarity search, small molecule screening, and protein–ligand binding affinity profile analysis. By applying this methodology, we have elucidated a possible molecular mechanism for the previously observed, but molecularly uncharacterized, side effect of selective estrogen receptor modulators (SERMs). The side effect involves the inhibition of the Sacroplasmic Reticulum Ca2+ ion channel ATPase protein (SERCA) transmembrane domain. The prediction provides molecular insight into reducing the adverse effect of SERMs and is supported by clinical and in vitro observations. The strategy used in this case study is being applied to discover off-targets for other commercially available pharmaceuticals. The process can be included in a drug discovery pipeline in an effort to optimize drug leads and reduce unwanted side effects.

Adverse effect profile of Lidocaine injections for occipital nerve block in occipital neuralgia

Sahai-Srivastava, Soma; Subhani, Dawood
Fonte: Springer Milan Publicador: Springer Milan
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
45.92%
To determine whether there are differences in the adverse effect profile between 1, 2 and 5% Lidocaine when used for occipital nerve blocks (ONB) in patients with occipital neuralgia. Occipital neuralgia is an uncommon cause of headaches. Little is known regarding the safety of Lidocaine injections for treatment in larger series of patients. Retrospective chart analysis of all ONB was performed at our headache clinic during a 6-year period on occipital neuralgia patients. 89 consecutive patients with occipital neuralgia underwent a total of 315 ONB. All the patients fulfilled the IHS criteria for Occipital Neuralgia. Demographic data were collected including age, gender, and ethnicity. The average age of this cohort was 53.25 years, and the majority of patients were females 69 (78%). Ethnicity of patients was diverse, with Caucasian 48(54%), Hispanics 31(35%), and others 10 (11%). 69 patients had 1%, 18 patients had 2% and 29 patient were given 5% Lidocaine. All Lidocaine injections were given with 20 mg Depo-medrol and the same injection technique and location were used for all the procedures. Eight patients (9%)had adverse effects to the Lidocaine and Depo-medrol injections, of which 5 received 5% and 3 received 1% Lidocaine. Majority of patients who had adverse effects were female 7(87%)...

Sacroiliitis after use of oral isotretinoin - association with acne fulminans or adverse effect?*

Geller, Ariane Silva Bastos; Alagia, Roberta Ferreira Nazareth
Fonte: Sociedade Brasileira de Dermatologia Publicador: Sociedade Brasileira de Dermatologia
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
45.91%
Acne fulminans is a rare and severe form of acne that may evolve from acne vulgaris, especially in male adolescents, or occur as an adverse effect of oral isotretinoin. Arthritis is a serious clinical manifestation when the musculoskeletal system is compromised by AF and has been reported as a rare adverse effect of isotretinoin. Involvement of the sacroiliac joints occurs in 21% of acne fulminans cases. We present the case of a 18-year-old male patient in whom acne fulminans evolved from acne vulgaris grade IV and after inflammation resolution started treatment with oral isotretinoin. Within a 30-day period of retinoid treatment he presented with back pain followed by rapid, progressive inability to deambulate.

Adverse effect of inhalational anesthetics on the developing brain

Wang, Mike; Zhang, John H; Applegate, Richard L
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 14/02/2014 EN
Relevância na Pesquisa
45.93%
We did a PubMed search and summarized studies on the potential adverse effect of anesthetics especially neurotoxicity in the developing brain, so named anesthesia-induced developmental neurotoxicity. Even though many experimental studies using animal models indicated some adverse effect of anesthetics, more evidence is needed before a recommendation can be made to change the way those anesthetics are used in the pediatric population. Two large clinical trials are underway and may provide insight to the potential human neurotoxic effect of anesthetics.

Peroxisome Proliferator-Activated Receptor α Activation Induces Hepatic Steatosis, Suggesting an Adverse Effect

Yan, Fang; Wang, Qi; Xu, Chao; Cao, Mingfeng; Zhou, Xiaoming; Wang, Tingting; Yu, Chunxiao; Jing, Fei; Chen, Wenbin; Gao, Ling; Zhao, Jiajun
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em 13/06/2014 EN
Relevância na Pesquisa
45.86%
Non-alcoholic fatty liver disease (NAFLD) is characterized by hepatic triglyceride accumulation, ranging from steatosis to steatohepatitis and cirrhosis. NAFLD is a risk factor for cardiovascular diseases and is associated with metabolic syndrome. Antihyperlipidemic drugs are recommended as part of the treatment for NAFLD patients. Although fibrates activate peroxisome proliferator-activated receptor α (PPARα), leading to the reduction of serum triglyceride levels, the effects of these drugs on NAFLD remain controversial. Clinical studies have reported that PPARα activation does not improve hepatic steatosis. In the present study, we focused on exploring the effect and mechanism of PPARα activation on hepatic triglyceride accumulation and hepatic steatosis. Male C57BL/6J mice, Pparα-null mice and HepG2 cells were treated with fenofibrate, one of the most commonly used fibrate drugs. Both low and high doses of fenofibrate were administered. Hepatic steatosis was detected through oil red O staining and electron microscopy. Notably, in fenofibrate-treated mice, the serum triglyceride levels were reduced and the hepatic triglyceride content was increased in a dose-dependent manner. Oil red O staining of liver sections demonstrated that fenofibrate-fed mice accumulated abundant neutral lipids. Fenofibrate also increased the intracellular triglyceride content in HepG2 cells. The expression of sterol regulatory element-binding protein 1c (SREBP-1c) and the key genes associated with lipogenesis were increased in fenofibrate-treated mouse livers and HepG2 cells in a dose-dependent manner. However...

A Tool to Utilize Adverse Effect Profiles to Identify Brain-Active Medications for Repurposing

McCoy, Thomas H.; Perlis, Roy H.
Fonte: Oxford University Press Publicador: Oxford University Press
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
56.08%
Background: To shorten the time required to bring new treatments to clinics, recent efforts have focused on repurposing existing Food and Drug Administration (FDA)-approved drugs with established safety data for new indications. We hypothesized that adverse effect profiles might aid in prioritizing compounds for investigation in central nervous system (CNS) applications by providing an indication of their abilities to cross the blood-brain barrier. Methods: Data were drawn from an investigation of similarity of adverse effect profiles, utilizing pre- and post-marketing data. A panel of known CNS-active drugs was utilized to estimate aggregate similarity profiles for all other FDA drugs in the database. Permutations were used to test whether similarities for any given drug exceeded that expected under the null hypothesis. To estimate the performance of algorithms using such profiles, manually-curated lists of known CNS-active and -inactive medications were classified using logistic regression. Algorithms with and without this similarity data were compared for prediction of CNS penetrance. Results: Models incorporating adverse effect similarity data exhibited greater discrimination of brain-penetrant and non-penetrant drugs than models without this data. A visualization tool was developed to allow any medication to be evaluated for adverse effect similarity to the CNS panel or a custom panel. Conclusions: Consideration of adverse effect profiles allows in silico prioritization of compounds for follow-up investigation for CNS indications. In concert with chemical screening approaches...

Oral toxicity of the cyanobacterial toxin cylindrospermopsin in male Swiss albino mice: Determination of no observed adverse effect level for deriving a drinking water guideline value

Humpage, A.; Falconer, I.
Fonte: John Wiley & Sons Inc Publicador: John Wiley & Sons Inc
Tipo: Artigo de Revista Científica
Publicado em //2003 EN
Relevância na Pesquisa
65.93%
The cyanobacterial toxin cylindrospermopsin (CYN) is a frequent contaminant of freshwaters throughout the world, including those that are sources of drinking water. The first cases of human poisoning attributed to this toxin occurred from a treated drinking water supply in Queensland, Australia, in 1979. The toxin causes extensive damage to the liver, kidneys, spleen, heart, and other organs. It is known to be a potent protein synthesis inhibitor, but there is mounting evidence for genotoxicity and that it metabolizes to even more toxic forms. As part of a risk assessment process leading to a guideline for a safe drinking water level for this toxin, we performed a series of experiments to determine a no-observed-adverse-effect level (NOAEL) for this toxin. In the first trial male mice were exposed to CYN-containing cyanobacterial extract in their drinking water (0-657 microg CYN kg(-1) day(-1)) for 10 weeks. In the second trial mice received purified CYN by daily gavage (0-240 microg CYN kg(-1) day(-1)) for 11 weeks. Body and organ weights were recorded; urine, serum, and hematology analyses were performed; and histopathological examination of tissues was carried out. Body weights were significantly increased at low doses (30 and 60 microg kg(-1) day(-1)) and decreased at high doses (432 and 657 microg kg(-1) day(-1)). Liver and kidney weights were significantly increased at doses of 240 microg kg(-1) day(-1) and 60 microg kg(-1) day(-1)...

Maternal adverse effects with different loading infusion rates of antenatal magnesium sulphate for preterm fetal neuroprotection: the IRIS randomised trial

Bain, E.S.; Middleton, P.F.; Yelland, L.N.; Ashwood, P.J.; Crowther, C.A.
Fonte: Wiley Publicador: Wiley
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
45.93%
OBJECTIVE: To evaluate a slower (compared with a standard) infusion rate of the loading dose of magnesium sulphate for preterm fetal neuroprotection as a strategy to reduce maternal adverse effects. DESIGN: Randomised controlled trial. SETTING: South Australian maternity hospital. POPULATION: Fifty-one women at <30 weeks of gestation, where birth was planned or expected within 24 hours. METHODS: Women received a loading infusion of 4 g of magnesium sulphate over either 60 or 20 minutes (followed by maintenance of 1 g/hour until birth, or for up to 24 hours). MAIN OUTCOME MEASURES: Any maternal adverse effects associated with the infusion. RESULTS: Overall, 71% of women experienced adverse effects during the first hour of their infusion; the difference between groups was not significant [15/25 (60%) 60-minute loading; 21/26 (81%) 20-minute loading; risk ratio (RR) 0.74; 95% confidence interval (95% CI) 0.51-1.08]. Although no serious maternal complications occurred, adverse effects led to three women ceasing the loading treatment (1/25 in the 60-minute loading group; 2/26 in the 20-minute loading group; RR 0.52; 95% CI 0.05-5.38). Women in the 60-minute loading group experienced significantly less warmth and flushing at 20 minutes into the infusion (7/25 in the 60-minute loading group; 15/26 in the 20-minute loading group; RR 0.49; 95% CI 0.24-0.99). No other differences between groups for maternally reported and clinical adverse effects were shown. CONCLUSIONS: A slower rate of administering the loading dose of magnesium sulphate did not reduce the occurrence of maternal adverse effects overall. Flushing and warmth at 20 minutes into the infusion was reduced with a slower infusion.; ES Bain...

Maternal adverse effects of different antenatal magnesium sulphate regimens for improving maternal and infant outcomes: a systematic review

Bain, E.; Middleton, P.; Crowther, C.
Fonte: BioMed Central Ltd. Publicador: BioMed Central Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
56.04%
Background: Antenatal magnesium sulphate, widely used in obstetrics to improve maternal and infant outcomes, may be associated with adverse effects for the mother sufficient for treatment cessation. This systematic review aimed to quantify maternal adverse effects attributed to treatment, assess how adverse effects vary according to different regimens, and explore women’s experiences with this treatment. Methods: Bibliographic databases were searched from their inceptions to July 2012 for studies of any design that reported on maternal adverse effects associated with antenatal magnesium sulphate given to improve maternal or infant outcomes. Primary outcomes were life-threatening adverse effects of treatment (death, cardiac arrest, respiratory arrest). For randomised controlled trials, data were meta-analysed, and risk ratios (RR) pooled using fixed-effects or random-effects models. For non-randomised studies, data were tabulated by design, and presented as RR, odds ratios or percentages, and summarised narratively. Results: A total of 143 publications were included (21 randomised trials, 15 non-randomised comparative studies, 32 case series and 75 reports of individual cases), of mixed methodological quality. Compared with placebo or no treatment...

Sunshine Works : Comment on "The Adverse Effects of Sunshine: A Field Experiment on Legislative Transparency in an Authoritarian Assembly"

Anderson, James H.
Fonte: World Bank, Washington, Dc Publicador: World Bank, Washington, Dc
Tipo: Publications & Research :: Policy Research Working Paper; Publications & Research
ENGLISH; EN_US
Relevância na Pesquisa
45.93%
Transparency -- sunshine -- is often touted as a core element of the governance agenda, and one that is most important in environments with low transparency to begin with. In a provocative paper published in the American Political Science Review, Edmund Malesky, Paul Schuler, and Anh Tran present the results of a creative experiment in which they provided an additional spotlight on the activities of a random sample of delegates to Vietnam's National Assembly. They report that the effect of sunshine was negative, that delegates subject to this treatment curtailed their speech, and that those who spoke most critically were punished through the subsequent election and promotion processes. The present paper argues that Malesky, Schuler, and Tran's results, if interpreted correctly, actually predict a net positive effect of transparency. The differences in interpretation stem primarily from three sources: the interpretation of regression results for models with interaction terms, the interpretation of the variable for Internet penetration...

Demand Collapse or Credit Crunch to Firms? Evidence from the World Bank's Financial Crisis Survey in Eastern Europe

Nguyen, Ha; Qian, Rong
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Policy Research Working Paper; Publications & Research
ENGLISH; EN_US
Relevância na Pesquisa
45.91%
While there is a consensus that the 2008-2009 crisis was triggered by financial market disruptions in the United States, there is little agreement on whether the transmission of the crisis and the subsequent prolonged recession are due to credit factors or to a collapse of demand for goods and services. This paper assesses whether the primary effect of the global crisis on Eastern European firms took the form of an adverse demand shock or a credit crunch. Using a unique firm survey conducted by the World Bank in six Eastern European countries during the 2008-2009 financial crisis, the paper shows that the drop in demand for firms' products and services was overwhelmingly reported as the most damaging adverse effect of the crisis. Other "usual suspects," such as rising debt or reduced access to credit, are reported as minor. The paper also finds that the changes in firms' sales and installed capacity are significantly and robustly correlated with the demand sensitivity of the sector in which the firms operate. However...

Efeitos adversos associados à aplicação de toxina botulínica na face: revisão sistemática com meta-análise; Adverse effects associated with facial application of botulinum toxin: a systematic review with meta-analysis

ZAGUI, Roberta Melissa Benetti; MATAYOSHI, Suzana; MOURA, Frederico Castelo
Fonte: Conselho Brasileiro de Oftalmologia Publicador: Conselho Brasileiro de Oftalmologia
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
46.06%
OBJETIVO: Verificar a ocorrência dos efeitos adversos relacionados ao uso da toxina botulínica na face, por meio de revisão sistemática, usando meta-análise. MÉTODOS: Foi realizada pesquisa eletrônica de artigos publicados no MEDLINE e Cochrane Library até setembro de 2007. A ocorrência dos efeitos adversos foi verificada pela freqüência relativa para os relatos de casos e do risco relativo para os estudos randomizados. A heterogeneidade foi avaliada pelo teste Q e pelo índice I². Foi utilizado o teste de significância de Egger para identificar viés de publicação e a análise de sensibilidade para verificar o efeito dos viéses de publicação. RESULTADOS: Oito estudos randomizados e treze relatos de casos preencheram os critérios de inclusão. Na revisão sistemática dos relatos de casos, 1.003 pacientes foram estudados, dos quais 182 (18,14%) apresentaram efeitos adversos. O efeito adverso mais freqüente foi a ptose palpebral ocorrendo em 34 (3,39%) pacientes dos relatos de casos. Na meta-análise dos estudos randomizados, o risco relativo global para os efeitos adversos como cefaléia, ptose palpebral, reação local e infecção foi 1,07, 3,25, 0,99 e 0,94, respectivamente. Para todas as comparações, o valor de P foi maior que 0...

Vitiligo during Treatment of Crohn's Disease with Adalimumab: Adverse Effect or Co-Occurrence?

Posada, Celia; Flórez, Ángeles; Batalla, Ana; Alcázar, Juan José; Carpio, Daniel
Fonte: S. Karger AG Publicador: S. Karger AG
Tipo: Artigo de Revista Científica
Publicado em 05/02/2011 EN
Relevância na Pesquisa
45.87%
Adalimumab is a fully human monoclonal anti-tumor necrosis factor-a agent that is approved for the treatment of Crohn's disease. It has a good safety profile, injection site reactions being the most common adverse effect. We report a case of a 54-year-old woman with a 30-year history of Crohn's disease who developed achromic patches on the trunk and upper extremities after initiating treatment with adalimumab. Cutaneous biopsy confirmed diagnosis of vitiligo and laboratory testing ruled out thyroid disease. Concomitant occurrence of vitiligo and inflammatory bowel disease, although rare, has been described. A common autoimmune basis could explain this fact. Moreover, multiple cutaneous adverse effects have been described in the literature secondary to biologic treatments, including vitiligo. In this report, we discuss the possibility of vitiligo as secondary to adalimumab treatment or as an association between both diseases.