In Vitro Characterization of Chitosan Gels for Buccal Delivery of Celecoxib: Influence of a Penetration Enhancer

Celecoxib (Cx) shows high efficacy in the treatment of osteoarthritis and rheumatoid arthritis as a result of its high specificity for COX-2, without gastrolesivity or interference with platelet function at therapeutic concentrations. Besides of anti-inflammatory effects, Cx also has a potential role for oral cancer chemoprevention. For these conditions, oral administration in long-term treatment is a concern due to its systemic side effects. However, local application at the site of injury (e.g., buccal inflammation conditions or chemoprevention of oral cancer) is a promising way to reduce its toxicity. In this study, the in vitro characterization of mucoadhesive chitosan (CHT) gels associated to AzoneA (R) was assessed to explore the potential buccal mucosal administration of Cx in this tissue. Rheological properties of gels were analyzed by a rheometer with cone-plate geometry. In vitro Cx release and permeability studies used artificial membranes and pig cheek mucosa, respectively. Mucoadhesion were measured with a universal test machine. CHT gels (3.0%) containing 2.0% or 3.0% Az showed more appropriate characteristics compared to the others: pH values, rheology, higher amount of Cx retained in the mucosa, and minimal permeation through mucosa, besides the highest mucoadhesion values, ideal for buccal application. Moreover, the flux (J) and amounts of drug released decreased with increased CHT and Az concentrations. CHT gels (3.0%) associated with 2.0% or 3.0% Az may be considered potential delivery systems for buccal administration of Cx.

Strategies and results of the oral cancer prevention campaign among the elderly in Sao Paulo, Brazil, 2001 to 2009

Objective. To describe the strategies and results obtained by the early diagnosis and prevention of an oral cancer campaign targeting the population aged 60 years or older developed since 2001 in the state of Sao Paulo. Methods. The main strategies used to develop the campaign were described based on the review of documents issued by the Health Ministry, National Cancer Institute, Sao Paulo State Health Department, Oncocentro Foundation of Sao Paulo, Sao Paulo City Health Department, School of Public Health at the University of Sao Paulo (USP), and Santa Marcelina Health Care Center. The impact of the campaign on the incidence of new cases of oral cancer in the target population was evaluated. Results. In 2001, 90 886 elderly were examined vs. 629 613 in 2009. The following strategies were identified: training of professionals, development of printed materials to guide municipal governments in developing the campaign and using standardized codes and criteria, guidelines for data consolidation, establishment of patient referral flows, practical training with a specialist at the basic health care unit after the follow-up examination of individuals presenting changes in soft tissues, and increase in the number of oral diagnosis services. Between 2005 and 2009, there was a significant reduction in the rate of confirmed cases of oral cancer per 100 000 individuals examined, from 20.89 to 11.12 (P = 0.00003). Conclusions. The campaign was beneficial to the oral health of the elderly and could be extended to include other age groups and regions of the country. It may also provide a basis for the development of oral cancer prevention actions in other countries, as long as local characteristics are taken into account.

Magnetic Ionic Liquids Produced by the Dispersion of Magnetic Nanoparticles in 1-n-Butyl-3-methylimidazolium bis(trifluoromethanesulfonyl)imide (BMI.NTf2)

This paper reports on the advancement of magnetic ionic liquids (MILs) as stable dispersions of surface-modified gamma-Fe2O3, Fe3O4, and CoFe2O4 magnetic nanoparticles (MNPs) in a hydrophobic ionic liquid, 1-n-butyl 3-methylimidazolium bis(trifluoromethanesulfonyl)imide (BMI.NTf2). The MNPs were obtained via coprecipitation and were characterized using powder X-ray diffraction, transmission electron microscopy, Raman spectroscopy and Fourier transform near-infrared (FT-NIR) spectroscopy, and magnetic measurements. The surface-modified MNPs (SM-MNPs) were obtained via the silanization of the MNPs with the aid of 1-butyl-3[3-(trimethoxysilyl)propyl]imidazolium chloride (BMSPI.Cl). The SM-MNPs were characterized by Raman spectroscopy and Fourier trail: form infrared attenuated total reflectance (FTIR-ATR) spectroscopy and by magnetic measurements. The FTIR-ATR spectra of the SM-MNPs exhibited characteristic absorptions of the imidazolium and those of the Fe-O-Si-C moieties, confirming the presence of BMSPI.Cl on the MNP surface. Thermogravimetric analysis (TGA) showed that the SM-MNPs were modified by at least one BMSPI.Cl monolayer. The MILs were characterized using Raman spectroscopy, differential scanning calorimetry (DSC), and magnetic measurements. The Raman and DSC results indicated an interaction between the SM-MNPs and the IL. This interaction promotes the formation of a supramolecular structure close to the MNP surface that mimics the IL structure and is responsible for the stability of the MIL. Magnetic measurements of the MILs indicated no hysteresis. Superparamagnetic behavior and a saturation magnetization of similar to 22 emu/g could be inferred from the magnetic measurements of a sample containing 50% w/w gamma-Fe2O3 SM-MNP/BMI-NTf2.

Validade discriminante do questionário de qualidade de vida da Universidade de Washington no contexto brasileiro

OBJETIVO: Avaliar a validade discriminante do questionário de qualidade de vida da Universidade de Washington para pacientes com câncer de cabeça e pescoço e identificar possíveis fatores sociodemográficos que modifiquem seus resultados. MÉTODOS: Foram entrevistados 47 pacientes com câncer de boca e orofaringe em estágio pré-cirúrgico em um hospital no sul do município de São Paulo em 2007, e 141 pacientes sem câncer, pareados por sexo e idade em uma proporção de três para um, que foram atendidos em ambulatórios do mesmo hospital em 2008. Os resultados obtidos para os dois grupos foram comparados pelo teste t de Student. Para os pacientes sem câncer utilizou-se análise de regressão de Poisson para avaliar possíveis fatores de modificação da qualidade de vida. RESULTADOS: O escore geral de qualidade de vida foi significantemente mais elevado (p < 0,001) para os pacientes sem câncer (91,1) do que para os pacientes com câncer (80,6). Observações análogas foram efetuadas para oito dos doze domínios de qualidade de vida compreendidos no questionário (dor, aparência, deglutição, mastigação, fala, ombros, paladar e ansiedade). Como possíveis fatores de modificação dos escores de qualidade de vida foram identificados renda familiar (com impacto nos domínios de recreação, p = 0,017, e função dos ombros, p = 0,049), escolaridade (em ansiedade, p = 0,003), sexo (em função dos ombros, p = 0,038) e dor de dente (em mastigação, p = 0,015). CONCLUSÕES: O questionário tem validade discriminante, pois seus escores são especificamente mais afetados para pacientes com câncer. Reforça-se a indicação do questionário para monitorar o tratamento e recomenda-se avaliar os fatores que podem causar impacto nesses indicadores.