Risk Factors for Cardiovascular Disease, Metabolic Syndrome and Sleepiness in Truck Drivers

Abstract Background: Truck driver sleepiness is a primary cause of vehicle accidents. Several causes are associated with sleepiness in truck drivers. Obesity and metabolic syndrome (MetS) are associated with sleep disorders and with primary risk factors for cardiovascular diseases (CVD). We analyzed the relationship between these conditions and prevalence of sleepiness in truck drivers. Methods: We analyzed the major risk factors for CVD, anthropometric data and sleep disorders in 2228 male truck drivers from 148 road stops made by the Federal Highway Police from 2006 to 2011. Alcohol consumption, illicit drugs and overtime working hours were also analyzed. Sleepiness was assessed using the Epworth Sleepiness Scale. Results: Mean age was 43.1 ± 10.8 years. From 2006 to 2011, an increase in neck (p = 0.011) and abdominal circumference (p < 0.001), total cholesterol (p < 0.001), triglyceride plasma levels (p = 0.014), and sleepiness was observed (p < 0.001). In addition, a reduction in hypertension (39.6% to 25.9%, p < 0.001), alcohol consumption (32% to 23%, p = 0.033) and overtime hours (52.2% to 42.8%, p < 0.001) was found. Linear regression analysis showed that sleepiness correlated closely with body mass index (β = 0.19, Raj2 = 0.659, p = 0.031), abdominal circumference (β = 0.24, Raj2 = 0.826, p = 0.021), hypertension (β = -0.62, Raj2 = 0.901, p = 0.002), and triglycerides (β = 0.34, Raj2 = 0.936, p = 0.022). Linear multiple regression indicated that hypertension (p = 0.008) and abdominal circumference (p = 0.025) are independent variables for sleepiness. Conclusions: Increased prevalence of sleepiness was associated with major components of the MetS.

Tratamento eclético da lepra: 20 anos de experiência

The author gives the clinical records of 20 patients, 14 of which were treated during 17 months, and the rest much less. The method used for treatment was the ecclectical — preferred by the A. since many years —, in which he associates electricity with minor surgery, chaulmestrol (pure or with 0.5 p. c. iodine or 4 p. c. creosote) and other auxilliary curative agents. The chaulmoogra derivatives were used daily as nostrils tamponage (2 p.c. mentholated or thymolated ester), periodically by injections inside the enlarged lymph nodes and nerve abscesses, and twice weekly by subcutaneous infiltrations (MUIR method) 5 c.c. each, and chaulmoogra soap tablets per os. The galvanocauterisation session was once per week, on active leprotic lesions, followed by painting with 30 p. c. trichloracetic acid solution. All 20 patients were bacilliferous before treatment, and became stronger positive after some months treatment. At the end 14 negativated and 6 remained positive and sometimes bacilli being very scanty. 16 out of 20 gave interesting serological reactions, viz.: Wassermann, Stern, Kahn. Rubino, Witebsky and Gaté (Formol-gel) positive in 5; Stern, Rubino. Witebsky and Gaté positive and Wassermann and Kahn negative in 2; Stern. Kahn, Witebsky and Gaté positive and Wassermann anticomplementary in 1; Wassermann. Stern, Kahn, Rubino and Gaté negative in 1. in the beginning, and a few months later Stern. Witebsky and Gaté becoming positive; Stern. Rubino. Witebsky and Gaté positive and anticomplementary W. in 1; Stern, Witebsky and Gaté positive and Wassermann. Kahn and Rubino negative in 1; Witebsky and Gaté positive and Wassermann, Stern, Kahn and Rubino negative in 1; Witebsky 3 times anticomplemantary and strongly positive Gaté in 1; Wassermann and Gaté positive in 1; Stern and Rubino positive in 1 and Stern test negative in one. In 7 cases high Formol-gel were associated with a high sedimentation index. Many cases had very high S.I. being a false measure of the severity of the disease; others remained very high notwithstanding the great improvement of the disease. All patients with more than 12 months treatment became practically symptom free. Lepra reaction amongst them was rare and always started by embolic rash, being controlled by destruction of such skin lesions by galvanocauterisation. In a few cases the lepromata infiltrated with "Subintrol" (a 3 p. c. special chaulmoogra soap prepared by Dr. ASTROGILDO MACHADO) were completely destroyd and never relapsed. In October 1946 Dr. ERNEST MUIR saw here a few cases treated by the author's method and suggested the combination of Diasone with galvanocauterisation which is being done now with satifactory results. The second part of this paper, reporting many leprosy cases treated by the so-called ecclectical method, which are symptom free and negativated since five to ten years, will be published as soon as the sulfone-therapy be summarised in some reliable scientific report to be compared with.

Prevalence of hepatitis B and C virus markers among malaria-exposed gold miners in Brazilian Amazon

Hepatitis B and C virus markers were assessed during a survey on malaria in gold mine camps in southern Brazilian Amazon in order to identify risk factors associated to these viral diseases. The study comprised 520 subjects, most of them were gold miners. Missing subjects totaled 49 (8.6%). Among these 520, 82.9% had HBV markers and 7.1% were HBsAg positive. Previous hospitalization, surgery, sexually transmitted diseases and incarceration were quite common among surveyed people, but there is no association between total HBV markers and these factors. On other hand, HBsAg was independently associated to history of sexually transmitted diseases and history of surgery after adjustment. The most frequent HBsAg subtypes identified, adw2 (59%), predominates in populations of Northeast Brazil. The most surveyed people were immigrants coming from that area suggesting that immigrants carried HBV themselves to the study area. Immunoblot (RIBA) confirmed-anti-HCV were found in 2.1%. The only variable associated to anti-HCV in multivariate analysis was illicit intravenous drug. Lack of HCV infection in subjects with such a high HBV markers prevalence reinforces the opinion that HCV is transmitted by restricted routes when compared to HBV. Furthermore, gold miners in Amazon may be considered as a risk group for HBV infection, but not for HCV.

Development of a Bacillus sphaericus tablet formulation and its evaluation as a larvicide in the biological control of Culex quinquefasciatus

This study aimed to analyze the final fermentation culture of Bacillus sphaericus 2362, standardize it and develop an active tablet formulation for use in urban mosquito breeding sites. It was performed in three phases: analysis and standardization of a B. sphaericus fermented culture; physical, chemical, and biological analysis of the active powder (solubility, residual humidity, particle size, resting angle, flowing off time, compacted density, and biological activity against Culex quinquefasciatus larvae); and the development of fast-disintegrating tablets. Five formulations with differing compositions were developed and a UV protector was added to the selected formulation. The formulation products with or without UV protector, as well as the active powder caused 100% larval mortality from 1 day to 2 months after a single treatment under simulated field conditions. These results show that the UV protector does not affect the initial larvicide activity of B. sphaericus, nor its persistence over a period of two months.

Using a single tablet daily to treat latent tuberculosis infection in Brazil: bioequivalence of two different isoniazid formulations (300 mg and 100 mg) demonstrated by a sensitive and rapid high-performance liquid chromatography-tandem mass spectrometry method in a randomised, crossover study

The recommended treatment for latent tuberculosis (TB) infection in adults is a daily dose of isoniazid (INH) 300 mg for six months. In Brazil, INH was formulated as 100 mg tablets. The treatment duration and the high pill burden compromised patient adherence to the treatment. The Brazilian National Programme for Tuberculosis requested a new 300 mg INH formulation. The aim of our study was to compare the bioavailability of the new INH 300 mg formulation and three 100 mg tablets of the reference formulation. We conducted a randomised, single dose, open label, two-phase crossover bioequivalence study in 28 healthy human volunteers. The 90% confidence interval for the INH maximum concentration of drug observed in plasma and area under the plasma concentration vs. time curve from time zero to the last measurable concentration “time t” was 89.61-115.92 and 94.82-119.44, respectively. The main limitation of our study was that neither adherence nor the safety profile of multiple doses was evaluated. To determine the level of INH in human plasma, we developed and validated a sensitive, simple and rapid high-performance liquid chromatography-tandem mass spectrometry method. Our results showed that the new formulation was bioequivalent to the 100 mg reference product. This finding supports the use of a single 300 mg tablet daily strategy to treat latent TB. This new formulation may increase patients’ adherence to the treatment and quality of life.

O impacto das novas mídias para os anunciantes brasileiros

O surgimento das tecnologias digitais permitiu o desenvolvimento de meios de contato inéditos entre empresas e consumidores, as chamadas novas mídias. Capazes de reconfigurar indústrias como a fonográfica e a do cinema, as novas mídias têm também impacto considerável na indústria da publicidade. O subsídio cruzado entre anunciantes, veículos de massa e consumidores, consolidado ao longo do século XX, se vê fragilizado com a popularização de aparelhos como Digital Video Recorders (DVRs), tablets, consoles de videogames e telefones celulares, dispositivos que transferem aos consumidores o poder de regular sua exposição à publicidade. Nesse novo ambiente, mídias tradicionais e novas mídias competem pela preferência de consumidores e pela verba dos anunciantes. Apesar da necessidade dos anunciantes de aferir e rentabilizar campanhas publicitárias, verificou-se que o investimento em veículos tradicionais vem crescendo, enquanto a audiência entregue diminui. Num panorama de mudanças, no presente estudo procura-se identificar que fatores influenciam o processo de compra de mídias por parte dos anunciantes, observando a percepção deles sobre mídias emergentes e tradicionais, seus benefícios e desafios. Para tanto, foi realizada uma pesquisa exploratória, utilizando uma abordagem qualitativa. Entre junho e julho de 2009, foram realizadas entrevistas em profundidade com os profissionais responsáveis pelas campanhas publicitárias de 15 empresas anunciantes de grande porte, atuantes em diversas indústrias. Ao analisar os dados colhidos em campo à luz da literatura estudada sobre o tema, a pesquisa identificou três fatores com forte influência sobre a definição do mix de mídias dos entrevistados: o uso de métricas inadequadas às mídias emergentes, a dependência dos anunciantes com as agências de publicidade e os veículos de massa e os próprios processos internos dos anunciantes.

Origin of samples of Cannabis sativa through insect fragments associated with compacted hemp drug in South America

Origin of samples of Cannabis sativa through insect fragments associated with compacted hemp drug in South America. Insects associated with a seizure of Cannabis sativa L. may indicate the origin of the illicit drug. Nevertheless, no work regarding this subject has been previously published for South America. In the present investigation, seven kilograms of vegetal material (C. sativa) were inspected for insect fragments. Three species were identified and used to test the origin of the seizure of cannabis plant material: Euschistus heros (Fabricius, 1794), Thyanta perditor (Fabricius, 1794) (Heteroptera, Pentatomidae), and Cephalotes pusillus (Klug, 1824) (Hymenoptera, Formicidae). These insect species restricted the geographic origin of the drug to the Neotropical region, and their distribution patterns showed an overlap of the State of Mato Grosso (Brazil), Argentina, and Paraguay. Based on this information, two of the three major C. sativa growing areas in South America were excluded: (1) the Colombian territory and (2) northeastern Brazil.

Determinação direta de molibdênio em comprimidos polivitamínicos por voltametria em meio não aquoso

Adsorptive stripping voltammetry carried out in a homogeneous ternary solvent composed of N,N-dimethylformamide, water and ethanol, with alpha-benzoinoxime (alphaBO) as the complexing agent for Mo(VI) and a 0.5 mol L-1 acetic acid - sodium acetate buffer as supporting electrolyte was successfully used for the determination of molybdenum in polyvitamin-polymineral tablets. Tablet samples were analyzed and the results were compared with those obtained both by graphite furnace atomic absorption and by recovery tests, with good correlations, indicating that this may be considered as an alternative procedure for routine determination of Mo(VI) in pharmaceutical samples.

Determinação de lamivudina, estavudina e nevirapina, em comprimidos, por cromatografia líquida de alta eficiência

A high performance liquid chromatography method was developed to quantify lamivudine, stavudine and nevirapine combined in tablets. The separation was carried out in less than 10 min using a phosphate buffer of pH 3.0 and acetonitrile (75:25, v/v) as mobile phase, a LiChrospher ODS column and UV detection at 266 nm. The method was linear over the range of 15-135 µg/mL (lamivudine), 4-36 µg/mL (stavudine) and 20-180 µg/mL (nevirapine). The accuracy ranged from 98.56 to 102.04% and intra-day and inter-day precision was less than 1% for the three drugs. The method showed robustness, remaining unaffected by deliberate variations in relevant parameters.

Determinação espectrofotométrica simultânea de paracetamol e ibuprofeno em formulações farmacêuticas usando calibração multivariada

A simple method was proposed for determination of paracetamol and ibuprofen in tablets, based on UV measurements and partial least squares. The procedure was performed at pH 10.5, in the concentration ranges 3.00-15.00 µg ml-1 (paracetamol) and 2.40-12.00 µg ml-1 (ibuprofen). The model was able to predict paracetamol and ibuprofen in synthetic mixtures with root mean squares errors of prediction of 0.12 and 0.17 µg ml-1, respectively. Figures of merit (sensitivity, limit of detection and precision) were also estimated. The results achieved for the determination of these drugs in pharmaceutical formulations were in agreement with label claims and verified by HPLC.

Desenvolvimento de método analítico por CLAE em comprimidos de Benznidazol para a Doença de Chagas

The analytical method of high performance liquid chromatography (HPLC) for the assay of benznidazole in tablets was developed and validated following the requirements of regulatory agencies. The method used as mobile phase acetonitrile:wather 1:1, a C18 column of 12.5 cm length x 4 mm id, 5 mm particles and lambda=316 nm. The statistical analysis of the results demonstrated that the method satisfies all parameters so as to be considered a safe and efficient analytical alternative of low cost for laboratory routine.

Validação de método por cromatografia líquida de alta eficiência para determinação da lamivudina e zidovudina em comprimidos

An HPLC method was validated to assay lamivudine and zidovudine combined in tablets. The chromatographic separation was carried out using methanol and acetate buffer pH 6.5 (50:50 v/v) and a RP-18 column, as mobile and stationary phase, respectively. The UV detection was at 270 nm. The method was linear in the range of 24 - 36 µg/mL (lamivudine) and 48 - 72 µg/mL (zidovudine). The recovery (accuracy) ranged from 101.35% to 103.04% and the precision (repeatability and intermediate precision) was less than 2%. The method can be also applied to the quantification of these drugs in the dissolution test of tablets containing both drugs.

Determination of cocaine in brazilian paper currency by capillary gas chromatography/mass spectrometry

The presence of illicit drugs such as cocaine and marijuana in US paper currency is very well demonstrated. However, there is no published study describing the presence of cocaine and/or other illicit drugs in Brazilian paper currency. In this study, Brazilian banknotes were collected from nine cities, extracted and analyzed by capillary gas chromatography/mass spectrometry, in order to investigate the presence of cocaine. Bills were extracted with deionized water followed by ethyl acetate. Results showed that 93% of the bills presented cocaine in a concentration range of 2.38-275.10 µg/bill.

Determinação de 3,4-metilenodioximetanfetamina (MDMA) em comprimidos de Ecstasy por cromatografia líquida de alta eficiência com detecção por fluorescência (CLAE-DF)

This paper describes the development and validation of simple and selective analytical method for determination of 3.4-methylenedioxymethamphetamine (MDMA) in Ecstasy tablets, using high performance liquid chromatography with fluorescence detection. Analysis was performed in a reversed phase column (LiChrospher 100 C18, 150 x 4.6 mm, 5 µm), isocratic elution with phosphate buffer 25 mmol/L pH 3.0 and acetonitrile (95:5, v/v). The method presents adequate linearity, selectivity, precision and accuracy. MDMA concentration in analyzed tablets showed a remarkable variability (from 8.5 to 59.5 mg/tablet) although the tablet weights were uniform, indicating poor manufacturing control thus imposing additional health risks to the users.

Extração e purificação de fármacos anti-inflamatórios não esteroidais ciclo-oxigenase-2 seletivos

Celecoxib (CB) and lumiracoxib (LM) are potent COX-2 inhibitors widely marketed for the treatment of rheumatoid arthritis and osteoarthritis. Nevertheless, it is difficult to obtain because it are protected under patents. The aim of this work was to develop an extraction method of drugs, CB and LM, in order to obtain the drug with a purity degree appropriated for use in research projects. The developed method showed to be effective of both drugs, becoming interesting due to its low cost, easy and speed of execution, application to different dosage forms (capsules and tablets) and drugs with different physicochemical properties.