1. Oral pharmacological treatment for patent ductus arteriosus in premature neonates with hemodynamic repercussions
Clarissa DE ALBUQUERQUE BOTURA ; Bruno Ambrósio DA ROCHA ; Franciele Queiroz AMES ; Ciomar Aparecida BERSANI-AMADO ; Roberto Kenji NAKAMURA CUMAN ; Thiely BALENSIEFER
Asian Pacific Journal of Tropical Medicine 2017;10(11):1080-1083
Objective To evaluate the efficacy of oral indomethacin, ibuprofen, and paracetamol in oral dosage form on patent ductus arteriosus (PDA) in premature neonates with significant clinical and hemodynamic repercussions (CHRs) and to determine the effect of these respective treatments on renal function. Methods A retrospective study of cases of PDA in premature neonates in the Neonatal Intensive Care Unit was conducted. The treatments consisted of indomethacin [0.2 mg/(kg·d), 3-day cycle], ibuprofen [10 mg/(kg·d) followed by 5 mg/(kg·d), 3-day cycle], and paracetamol (15 mg/kg every 6 h, 5-day cycle). The drugs were administered as an oral solution. The following variables were considered: gestational age, newborn weight at birth, Apgar score, diuresis, serum creatinine and urea levels, and serum electrolyte levels (sodium and potassium). Results Treatment with indomethacin presented efficacy of 87.5% in closure of the ductus with a mean outcome period of 3.5 d. In premature neonates with CHRs and contraindications for indomethacin, the initial treatment with either ibuprofen or paracetamol failed to close the ductus. However, when this treatment was followed by indomethacin, closure occurred in 66.7% of the neonates, with an outcome period of 9.66 d. The initial treatment with one cycle of ibuprofen followed by one or two cycles of paracetamol failed to close the ductus. Conclusions Oral indomethacin was effective for closure of the PDA in premature neonates with severe CHRs. Oral paracetamol or ibuprofen for PDA closure in premature neonates with severe CHRs and contraindications for indomethacin was ineffective. However, results in clinical improvements of neonates allowed the subsequent use of indomethacin and successful closure of the ductus. A significant reduction of diuresis occurred in neonates who were treated with indomethacin, either as a first-line treatment or after the failure of ibuprofen or paracetamol.
2. Canova medication changes TNF-α and IL-10 serum levels in mice infected with Trypanosoma cruzi Y strain
Áurea Regina Telles PUPULIN ; Lívia BRACHT ; Márcia Machado DE OLIVEIRA DALALIO ; Francielli Maria DE SOUZA SILVA-COMAR ; Bruno Ambrósio DA ROCHA ; Franciele Queiroz AMES ; Roberto Kenji Nakamura CUMAN ; Ciomar Aparecida BERSANI-AMADO
Asian Pacific Journal of Tropical Medicine 2016;9(9):860-865
Objective To identify whether Canova medication changes TNF-α and IL-10 serum levels in mice infected with Trypanosoma cruzi Y strain. Methods Animals were divided into five groups: non-treated infected animals (I); benznidazole-treated infected animals (Bz; 100 mg/kg body weight, single daily dose by gavage); Canova medication (CM) treated infected animals (CM; 0.2 mL/animal, single daily dose by gavage); benznidazole- and Canova medication-treated infected animals with the above-mentioned dose (Bz+CM); and non-infected animals (C). TNF-α and IL-10 levels were determined in serum aliquots after 4, 7, 10, 13, and 29 days of infection. An ELISA technique was employed with R&D System Inc. antibody pairs. Results A high increase in TNF-α and IL-10 levels occurred in the infected and CM-treated groups within the treatment employed on the 10th day after infection, coupled with a IL-10 decrease on the 13th day after infection when compared with the other experimental groups. Conclusions CM may change the balance between plasma cytokine levels (TNF-α and IL-10) in mice infected with Y strain T. cruzi, with important consequences leading towards a more severe infection.