Brazilian network for the surveillance of maternal potentially life threatening morbidity and maternal near-miss and a multidimensional evaluation of their long term consequences

Background. It has been suggested that the study of women who survive life-threatening complications related to pregnancy (maternal near-miss cases) may represent a practical alternative to surveillance of maternal morbidity/mortality since the number of cases is higher and the woman herself is able to provide information on the difficulties she faced and the long-term repercussions of the event. These repercussions, which may include sexual dysfunction, postpartum depression and posttraumatic stress disorder, may persist for prolonged periods of time, affecting women's quality of life and resulting in adverse effects to them and their babies. Objective. The aims of the present study are to create a nationwide network of scientific cooperation to carry out surveillance and estimate the frequency of maternal near-miss cases, to perform a multicenter investigation into the quality of care for women with severe complications of pregnancy, and to carry out a multidimensional evaluation of these women up to six months. Methods/Design. This project has two components: a multicenter, cross-sectional study to be implemented in 27 referral obstetric units in different geographical regions of Brazil, and a concurrent cohort study of multidimensional analysis. Over 12 months, investigators will perform prospective surveillance to identify all maternal complications. The population of the cross-sectional component will consist of all women surviving potentially life-threatening conditions (severe maternal complications) or life-threatening conditions (the maternal near miss criteria) and maternal deaths according to the new WHO definition and criteria. Data analysis will be performed in case subgroups according to the moment of occurrence and determining cause. Frequencies of near-miss and other severe maternal morbidity and the association between organ dysfunction and maternal death will be estimated. A proportion of cases identified in the cross-sectional study will comprise the cohort of women for the multidimensional analysis. Various aspects of the lives of women surviving severe maternal complications will be evaluated 3 and 6 months after the event and compared to a group of women who suffered no severe complications in pregnancy. Previously validated questionnaires will be used in the interviews to assess reproductive function, posttraumatic stress, functional capacity, quality of life, sexual function, postpartum depression and infant development. © 2009 Cecatti et al.

Estudo de perfil de dissolução dos medicamentos de referência, genérico e similar contendo cefalexina na forma farmacêutica cápsula

With recent advances in technology and research into drug delivery, the modernization of tests and greater emphasis on the predictability of therapeutic effect by means of in vitro tests, the dissolution test and the study of dissolution profiles are gaining more and more importance. Though introduced initially as a way of characterizing the release profile of poorly soluble drugs, dissolution tests are currently part of pharmacopoeial monographs on almost all the oral solid pharmaceutical forms. The objective of this study was to determine the dissolution profile (percent drug dissolved versus time) of the pioneer brand, generic and similar pharmaceutical capsules containing 500mg cephalexin. Three pharmaceutical brands (reference, generic and similar) were subjected to the dissolution test and in vitro dissolution profiles were recorded. From the results of the dissolution test, it was concluded that the samples met the acceptance criterion, as no difference was observed in the percentage of the drug dissolved in a standard time. The dissolution profile indicated that this medicine, in this pharmaceutical form, dissolves readily (85% of the drug dissolved in 15 minutes) and the curves showed great similarity, suggesting that the 3 brands are pharmaceutically equivalent.

Realimentação derivativa e modelo fuzzy Takagi-Sugeno paracontrole da articulação do joelho de pacientes paraplégicos com o uso de acelerômetros

Feedback control systems have been used to move the muscles and joints of the limbs of paraplegic patients. The feedback signal, related to the knee joint angle, can be obtained by using an electrogoniometer. However, the use of accelerometers can help the measurements due the facility of adhering these devices to the skin. Accelerometers are also very suitable for these applications due their small dimensions and weight. In this paper a new method for designing a control system that can vary the knee joint angle using Functional Electrical Stimulation (FES) is presented, as well as a simulation with parameters values available in the literature. The nonlinear control system was represented by a Takagi-Sugeno fuzzy model and the feedback signals were obtained by using accelerometers. The design method considered all plant nonlinearities and was efficient and reliable to control the leg position of a paraplegic patient with the angle of the knee ranging from 0° to 30°, considering electric stimulation at the quadriceps muscle. The proposed method is viable and offers a new alternative for designing control systems of the knee joint angle using more comfortable sensors for the patients.

H ∞ state feedback control of discrete-time Markov jump linear systems through linear matrix inequalities

This paper addresses the H ∞ state-feedback control design problem of discretetime Markov jump linear systems. First, under the assumption that the Markov parameter is measured, the main contribution is on the LMI characterization of all linear feedback controllers such that the closed loop output remains bounded by a given norm level. This results allows the robust controller design to deal with convex bounded parameter uncertainty, probability uncertainty and cluster availability of the Markov mode. For partly unknown transition probabilities, the proposed design problem is proved to be less conservative than one available in the current literature. An example is solved for illustration and comparisons. © 2011 IFAC.

Níveis de fertirrigação na avaliação das características morfofisiológicas em mudas de pimenta malagueta

O presente trabalho teve o objetivo de avaliar as características morfofisiológicas de mudas de pimenta malagueta (Capsicum frutescens) sob diferentes níveis de fertirrigação, utilizando-se fertilizante líquido 10-10-10 (N-P-K). O experimento foi realizado na Faculdade de Ciências Agrárias da Universidade Federal da Grande Dourados. O delineamento experimental foi em blocos casualizados (DBC), com seis doses de fertilizante líquido (0; 2,5; 5,0; 10,0; 20,0 e 40 mL L-1) diluídos na água de irrigação e quatro repetições. As mudas foram produzidas em viveiro telado, em bandejas de 128 células preenchidas com substrato. Realizou-se uma fertirrigação, aos 15 dias após a semeadura ( DAS). Avaliou-se, aos 30 dias após a semeadura, o número de folhas, o comprimento da parte aérea e da raiz, a massa fresca e seca da parte aérea e da raiz, a área foliar e o teor de clorofila. A dose de 25 mL L-1 do fertilizante líquido 10-10-10, aplicada via fertirrigação, é recomendada para a produção de mudas de pimenta malagueta, embora tenha havido aumento da massa seca de raízes e parte aérea em dose maior.

Macrophage migration inhibitory factor in the nucleus of solitary tract decreases blood pressure in SHRs

Aims The macrophage migration inhibitory factor (MIF) is an intracellular inhibitor of the central nervous system actions of angiotensin II on blood pressure. Considering that angiotensin II actions at the nucleus of the solitary tract are important for the maintenance of hypertension in spontaneously hypertensive rats (SHRs), we tested if increased MIF expression in the nucleus of the solitary tract of SHR alters the baseline high blood pressure in these rats.Methods and resultsEight-week-old SHRs or normotensive rats were microinjected with the vector AAV2-CBA-MIF into the nucleus of the solitary tract, resulting in MIF expression predominantly in neurons. Rats also underwent recordings of the mean arterial blood pressure (MAP) and heart rate (via telemetry devices implanted in the abdominal aorta), cardiac- and baroreflex function. Injections of AAV2-CBA-MIF into the nucleus of the solitary tract of SHRs produced significant decreases in the MAP, ranging from 10 to 20 mmHg, compared with age-matched SHRs that had received identical microinjections of the control vector AAV2-CBA-eGFP. This lowered MAP in SHRs was maintained through the end of the experiment at 31 days, and was associated with an improvement in baroreflex function to values observed in normotensive rats. In contrast to SHRs, similar increased MIF expression in the nucleus of the solitary tract of normotensive rats produced no changes in baseline MAP and baroreflex function.ConclusionThese results indicate that an increased expression of MIF within the nucleus of the solitary tract neurons of SHRs lowers blood pressure and restores baroreflex function. © 2012 Published on behalf of the European Society of Cardiology. All rights reserved.

Photodynamic inactivation of planktonic cultures and biofilms of Candida albicans mediated by aluminum-chloride-phthalocyanine entrapped in nanoemulsions

New drug delivery systems, such as nanoemulsions (NE), have been developed to allow the use of hydrophobic drugs on the antimicrobial photodynamic therapy. This study evaluated the photodynamic potential of aluminum-chloride- phthalocyanine (ClAlPc) entrapped in cationic and anionic NE to inactivate Candida albicans planktonic cultures and biofilm compared with free ClAlPc. Fungal suspensions were treated with different delivery systems containing ClAlPc and light emitting diode. For planktonic suspensions, colonies were counted and cell metabolism was evaluated by XTT assay. Flow cytometry evaluated cell membrane damage. For biofilms, the metabolic activity was evaluated by XTT and ClAlPc distribution through biofilms was analyzed by confocal laser scanning microscopy (CLSM). Fungal viability was dependent on the delivery system, superficial charge and light dose. Free ClAlPc caused photokilling of the yeast when combined with 100 J cm-2. Cationic NE-ClAlPc reduced significantly both colony counts and cell metabolism (P < 0.05). In addition, cationic NE-ClAlPc and free ClAlPc caused significant damage to the cell membrane (P < 0.05). For the biofilms, cationic NE-ClAlPc reduced cell metabolism by 70%. Anionic NE-ClAlPc did not present antifungal activity. CLSM showed different accumulation on biofilms between the delivery systems. Although NE system showed a lower activity for planktonic culture, cationic NE-ClAlPc showed better results for Candida biofilms. Candida albicans biofilm overview after 30 min of contact with free ClAlPc. This study presents the photodynamic potential of aluminum-chloride-phthalocyanine (ClAlPc) entrapped in cationic and anionic nanoemulsions (NE) to inactivate C. albicans planktonic cultures and biofilm comparing with free ClAlPc. The photodynamic effect was dependent on the delivery system, superficial charge and light dose. Cationic NE-ClAlPc and free ClAlPc caused significant reduction in colony counts, cell metabolism and damage to the cell membrane (P < 0.05). However, only the free ClAlPc was able to cause photokilling of the yeast. The anionic NE-ClAlPc did not present antifungal activity. Although NE system showed a lower activity for planktonic culture, cationic NE-ClAlPc showed better results for Candida biofilms. © 2012 Wiley Periodicals, Inc. Photochemistry and Photobiology © 2012 The American Society of Photobiology.

Blends of cross-linked high amylose starch/pectin loaded with diclofenac

Polymers blends represent an important approach to obtain materials with modulated properties to reach different and desired properties in designing drug delivery systems in order to fulfill therapeutic needs. The aim of this work was to evaluate the influence of drug loading and polymer ratio on the physicochemical properties of microparticles of cross-linked high amylose starch-pectin blends loaded with diclofenac for further application in controlled drug delivery systems. Thermal analysis and X-ray diffractograms evidenced the occurrence of drug-polymer interactions and the former pointed also to an increase in thermal stability due to drug loading. The rheological properties demonstrated that drug loading resulted in formation of weaker gels while the increase of pectin ratio contributes to origin stronger structures. © 2012 Elsevier Ltd.

Microbiological control of moisturizing mask formulation added of hibiscus flowers, assai palm, black mulberry and papaw glycolic extracts

The microbiological control of moisturizing mask formulation added of hibiscus flowers, assai palm, black mulberry and papaw glycolic extracts, determining the number of viable microorganisms and possible presence of pathogenic. The moisturizing mask formulation was composed of zinc oxide (5. 0%) and moisturizing cream constituted of triceteareth-4 phosphate (and) cetyl alcohol (and) stearyl alcohol (and) sodium cetearyl sulfate (and) oleth-10 (qs 50g). To this formulation was added hibiscus flowers glycolic extract (2. 5%), assai palm glycolic extract (1. 5%), black mulberry glycolic extract (1. 5%) and papaw glycolic extract (2. 0%). The formulation was stored in aseptically clean recipients, away from humidity and light, in fresh and airy places. The results of the microbiological analysis on the counting of aerobic mesophilic microorganisms (bacteria and fungi), of the above mentioned formulation, revealed a bioburden < 10 CFU/mL in all samples. Such data indicate adequate microbiological quality of the tested products, according to official recommendations. Furthermore, it was not detected the presence of pathogenic microorganisms, assuring the harmlessness of the formulation. The results lead us to conclude that the formulation and raw materials analyzed did not present microbial contamination, evidenced for estimating the number of viable microorganisms (<10 UFC/g) and for researching pathogens.

Nasal administration of liquid crystal precursor mucoadhesive vehicle as an alternative antiretroviral therapy

The purpose of this study was to develop a mucoadhesive stimuli-sensitive drug delivery system for nasal administration of zidovudine (AZT). The system was prepared by formulating a low viscosity precursor of a liquid crystal phase, taking advantage of its lyotropic phase behavior. Flow rheology measurements showed that the formulation composed of PPG-5-CETETH-20, oleic acid and water (55, 30, 15% w/w), denominated P, has Newtonian flow behavior. Polarized light microscopy (PLM) revealed that formulation P is isotropic, whereas its 1:1 (w/w) dilution with artificial nasal mucus (ANM) changed the system to an anisotropic lamellar phase (PD). Oscillatory frequency sweep analysis showed that PD has a high storage modulus (G′) at nasal temperatures. Measurement of the mucoadhesive force against excised porcine nasal mucosa or a mucin disk proved that the transition to the lamellar phase tripled the work of mucoadhesion. Ex vivo permeation studies across porcine nasal mucosa exhibited an 18-fold rise in the permeability of AZT from the formulation. The Weibull mathematical model suggested that the AZT is released by Fickian diffusion mechanisms. Hence, the physicochemical characterization, combined with ex vivo studies, revealed that the PPG-5-CETETH-20, oleic acid, and water formulation could form a mucoadhesive matrix in contact with nasal mucus that promoted nasal absorption of the AZT. For an in vivo assessment, the plasma concentrations of AZT in rats were determined by HPLC method following intravenous and intranasal administration of AZT-loaded P formulation (PA) and AZT solution, respectively, at a dose of 8 mg/kg. The intranasal administration of PA resulted in a fast absorption process (Tmax = 6.7 min). Therefore, a liquid crystal precursor formulation administered by the nasal route might represent a promising novel tool for the systemic delivery of AZT and other antiretroviral drugs. In the present study, the uptake of AZT absorption in the nasal mucosa was demonstrated, providing new foundations for clinical trials in patients with AIDS. © 2012 Elsevier B.V. All rights reserved.

Immunomodulatory effects of low dose chemotherapy and perspectives of its combination with immunotherapy

Given that cancer is one of the main causes of death worldwide, many efforts have been directed toward discovering new treatments and approaches to cure or control this group of diseases. Chemotherapy is the main treatment for cancer; however, a conventional schedule based on maximum tolerated dose (MTD) shows several side effects and frequently allows the development of drug resistance. On the other side, low dose chemotherapy involves antiangiogenic and immunomodulatory processes that help host to fight against tumor cells, with lower grade of side effects. In this review, we present evidence that metronomic chemotherapy, based on the frequent administration of low or intermediate doses of chemotherapeutics, can be better than or as efficient as MTD. Finally, we present some data indicating that noncytotoxic concentrations of antineoplastic agents are able to both up-regulate the immune system and increase the susceptibility of tumor cells to cytotoxic T lymphocytes. Taken together, data from the literature provides us with sufficient evidence that low concentrations of selected chemotherapeutic agents, rather than conventional high doses, should be evaluated in combination with immunotherapy. Copyright © 2012 UICC.

Variação genética em progênies de jacaranda cuspidifolia mart. Utilizando o delineamento sistemático tipo leque

Knowledge of genetic variation in native tree species has helped direct strategies of genetic ex situ conservation, based on provenances and progenies tests. These tests use fixed spacing, not allowing evaluating the behavior of different progenies under this management variable. One way to evaluate simultaneously the genetic variation and different spacing in a small planting area is to use a systematic design. The aim of this study was to estimate the genetic variation and to evaluate its performance in Jacaranda cuspidifolia under different spacing. We used a progeny test in a systematic fan design, arranged in a system of 30 concentric rays, with one progeny per ray, randomly, at angles of 12°. The plants were arranged in rays in geometric progression of ratio 1.21, corresponding to nine for plant spacing: 1,95 m2; 2,86 m2; 4,18 m2; 6,12 m2; 8,96 m2; 13,12 m2; 19,21 m2; 28,13 m2; e 41,19 m 2 installed in Selvíria/MS. The traits height, height diameter of 30 cm to soil (DA3) and survival were evaluated at 12 and 24 months of age. Estimates of genetic parameters and spacing were evaluated using the procedure REML/BLUP (restricted maximum likelihood / best linear unbiased prediction). The progenies showed genetic variation, showing that the sample strategy to ex situ conservation was efficient. The species showed good adaptability inthe field and the best performance in treating five, equivalent to a 3 × 3 m spacing, with 8,96 m2;/plant for all traits. The fan systematic design permitted to evaluate in a small area the silvicultural behavior of J. Cuspidifolia plants in spacing varying from 2 to 42 m2/plant (5.000 to 238 trees/ha); which could hardly be evaluat by the traditional designs.

Photodynamic inactivation of biofilm: Taking a lightly colored approach to stubborn infection

Microbial biofilms are responsible for a variety of microbial infections in different parts of the body, such as urinary tract infections, catheter infections, middle-ear infections, gingivitis, caries, periodontitis, orthopedic implants, and so on. The microbial biofilm cells have properties and gene expression patterns distinct from planktonic cells, including phenotypic variations in enzymic activity, cell wall composition and surface structure, which increase the resistance to antibiotics and other antimicrobial treatments. There is consequently an urgent need for new approaches to attack biofilm-associated microorganisms, and antimicrobial photodynamic therapy (aPDT) may be a promising candidate. aPDT involves the combination of a nontoxic dye and low-intensity visible light which, in the presence of oxygen, produces cytotoxic reactive oxygen species. It has been demonstrated that many biofilms are susceptible to aPDT, particularly in dental disease. This review will focus on aspects of aPDT that are designed to increase efficiency against biofilms modalities to enhance penetration of photosensitizer into biofilm, and a combination of aPDT with biofilm-disrupting agents. © 2013 Informa UK Ltd.

Comparação de técnicas de redes de Petri na descrição de um pipeline

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Ciprofloxacino encapsulado em lipossomas revestidos com ácido poli láctico co-glicólico ou veiculado em gel de copolímero de bloco Pluronic R F127

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)