Assessment and prediction of asthma and its severity in the pediatric community

Seventy four asthmatic children aged 7 to 11 years were examined along with controls matched by age and sex. Clinical and laboratory investigations preceded a 28-day follow-up where data about morning and evening peak expiratory flow rate (PEF), symptoms and treatment were recorded. The coefficient of variation of PEF was found to be an objective measurement of asthma severity that has statistically significant correlation with both symptoms (r s= .36) and treatment (r s= .60). Moreover, it separates mild and severe asthmatics, as confirmed by statistically significant differences (p= .008 or less) in symptoms, treatment, skin allergy and airways response to exercise. Skin allergy and airways responsiveness to exercise were found to be predictors of both disease and severity. By means of logistic regression analysis it was possible to establish the probabilities for both asthma and severe asthma when children presenting and not presenting these characteristics are compared. One single positive skin test represent a probability of 88% for the development of asthma and a probability of 70% for severe disease. A PEF reduction of 10% after an exercise test implies a probability of 73% for disease and a probability of 64% for severe disease. Increases in these variables imply geometrically increased risks and their presence together have a multiplicative effect in the final risk.

Febre purpúrica brasileira: resultados preliminares da investigação etiológica

Em várias regiões do interior do Estado de São Paulo, notificou-se a partir do final de 1984 a 1986, a ocorrência de doença até então desconhecida, com características clínicas, em muitos aspectos, semelhante à meningococcemia. Esta síndrome foi denominada Febre Purpúrica Brasileira (FPB). Em quinze dos casos com quadro clínico compatível com a síndrome, o Haemophilus aegyptius foi isolado a partir de culturas de sangue, de líquido cefalorraquidiano sanguinolento, de secreção conjuntival e orofaríngea. Analisa-se a importância deste achado, face à existência de somente um relato na literatura, de infecção sistêmica por bactérias desta espécie.

Production of metallo-β-lactamase among Pseudomonas aeruginosa strains isolated in the State of Sergipe, Brazil

INTRODUCTION: Acquired production of metallo-β-lactamases is an important mechanism of resistance in Pseudomonas aeruginosa. The objective of this study was to investigate the production of metallo-β-lactamase and the genetic diversity among ceftazidime-resistant P. aeruginosa isolates from State of Sergipe, Brazil. METHODS: Metallo-β-lactamase was investigated using the disk approximation test and polymerase chain reaction (PCR). Genetic diversity was evaluated by pulsed-field gel electrophoresis (PFGE). RESULTS: A total of 48 (51.6%) isolates were resistant to ceftazidime. Six (12.2%) of these were positive for metallo-β-lactamase production. Only two (4.1%) of the ceftazidime-resistant isolates carried the bla SPM-1 gene. CONCLUSIONS: Production of metallo-β-lactamases was not the main mechanism of resistance to ceftazidime and carbapenems among P. aeruginosa strains in Sergipe, Brazil.

Sons de Korotkoff: o improvável também ocorre

Poucas descobertas tiveram um impacto tão grande e tamanha relevância para a Medicina clínica como a medição não-invasiva da pressão arterial diastólica. Vários fisiologistas e clínicos talentosos estavam, sem sucesso, em busca de um método não-invasivo para determinar a pressão diastólica. No entanto, a quantificação da pressão arterial diastólica não foi conseguida por qualquer um desses pesquisadores clínicos ou fisiológicos, mas por uma figura improvável e inesperada: Nikolai Sergeevich Korotkoff (1874-1920), um jovem cirurgião do exército russo, trabalhando em condições precárias sob as dificuldades de diversas guerras. É fácil descartar o feito de Korotkoff como uma descoberta fortuita semelhante à de Alexander Fleming na descoberta da penicilina. No entanto, a recente teoria do cisne negro de Nassim N. Taleb pode servir para ilustrar sua descoberta de uma nova e, talvez, surpreendente, forma.

Multimedia materials for education, training, and advocacy in international health: experiences with the Schistosomiasis Control Initiative CD-ROM

We describe an innovative use of multimedia materials to support training and advocacy within a schistosomiasis control programme. The Schistosomiasis Control Initiative (SCI) at Imperial College London works with selected sub-Saharan African countries to develop schistosomiasis control programmes. Two elements of the SCI programme were supported by multimedia materials developed at the Wellcome Trust in collaboration with the SCI: (1) training of programme managers, district health officers, and those delivering practical elements of the programme; and (2) advocacy targeted at decision-makers and donors. Evaluation of the materials revealed high reported ratings for both user satisfaction and impact from use of the product. From this experience we draw out several general messages about development of multimedia materials and how these will play a growing future role in promoting training within international health.

Funciones termodinámicas relativas a la transferencia del ketoprófen desde el agua hasta algunos sistemas orgánicos

The thermodynamics of molal partitioning of ketoprofen (KTP) was studied in cyclohexane/buffer (CH/W), octanol/buffer (ROH/W), and dimyristoyl phosphatidylcholine (DMPC), dipalmitoyl phosphatidylcholine (DPPC), and egg lecithin (EGG/W) liposome systems. In all cases the partition coefficients (Kmo/w)were greater than unity; therefore the standard free energies of transfer were negative indicating affinity of KTP for organic media. The Kmo/w values were approximately seventy-fold higher in the ROH/W system compared with the CH/W system. On the other hand, the Kmo/w values were approximately ten or fifty-fold higher in the liposomes compared with the ROH/W system. In all cases, the standard enthalpies and entropies of transfer of KTP were positive indicating some degree of participation of the hydrophobic hydration on partitioning processes.

Desviaciones al modelo logarítmico-lineal en la solubilidad de ibuprofén y naproxén en mezclas cosolventes propilenoglicol-agua

The deviations observed in the solubility of ibuprofen (IBP) and naproxen (NAP) in propylene glycol (PG) + water (W) cosolvent mixtures with respect to the logarithmic-linear model proposed by Yalkowsky have been analyzed at 25.00 ± 0.05 ºC. Negative deviations were obtained in all cosolvent compositions for both drugs; they were greater for IBP. Another treatment, based on Gibbs free energy relationships, was also employed showing an apparent hydrophobicity chameleonic effect, because at low PG proportions NAP is more hydrophobic, whereas at high PG proportions IBP is more hydrophobic. The results are discussed in terms of solute-solvent and solvent-solvent interactions.

Entalpía de disolución de sulfacetamida sódica en agua: comparación entre la calorimetría isoperibólica de solución y el método de van't Hoff

The dissolution enthalpy (ΔH0soln) of sodium sulfacetamide in water was determined by means of isoperibolic solution calorimetry. It was found that ΔH0soln diminishes as the drug concentration increases. Otherwise, the calorimetric values obtained as a function of the drug concentration were significantly different than those predicted by the van't Hoff method. It was demonstrated that the later is not a fully reliable method for the determination of ΔH0soln values in the specific case of highly soluble sodium salts. The observed phenomenon could be explained by the presence of strong solute-solute interactions at high salt concentrations, in addition to solute-solvent and solvent-solvent interactions.

Método extendido de Hildebrand en la predicción de la solubilidad del ketoprofeno en mezclas cosolventes etanol + agua

Extended Hildebrand Solubility Approach (EHSA) developed by Martin et al. was applied to evaluate the solubility of ketoprofen (KTP) in ethanol + water cosolvent mixtures at 298.15 K. Calculated values of molar volume and solubility parameter for KTP were used. A good predictive capacity of EHSA was found by using a regular polynomial model in order five to correlate the W interaction parameter and the solubility parameters of cosolvent mixtures (δmix). Nevertheless, the deviations obtained in the estimated solubilities with respect to the experimental solubilities were on the same order like those obtained directly by means of an empiric regression of the logarithmic experimental solubilities as a function of δmix values.

Validación de un método analítico empleando cromatografía líquida de alta eficiencia para la determinación de ibuprofeno en medios biorrelevantes

An analytical method by liquid chromatography has been proposed and validated to study the apparent solubility of ibuprofen in biorelevant dissolution media. The main properties of the studied media were pH values of 5.0 and 6.5 and the presence or absence of some natural surfactant agents. The parameters evaluated were specificity, linearity, precision, accuracy, and detection and quantification limits, as well as the drug stability under the analysis conditions. The developed method was useful to determine the apparent solubility of this drug as a function of temperature and surfactants concentration to demonstrate the validity of the Biopharmaceutics Classification System.

Thermodynamic study of the solubility of sodium naproxen in some ethanol + water mixtures

By using the van't Hoff and Gibbs equations the apparent thermodynamic functions Gibbs energy, enthalpy, and entropy of solution for sodium naproxen in ethanol + water cosolvent mixtures, were evaluated from solubility data determined at temperatures from (278.15 to 308.15) K. The drug solubility was greatest in neat water and lowest in neat ethanol at all the temperatures studied. By means of non-linear enthalpy-entropy compensation analysis, it follows that the dissolution process of this drug in ethanol-rich mixtures is entropy-driven, whereas, in water-rich mixtures the process is enthalpy-driven.

Indomethacin solubility estimation in 1,4-dioxane + water mixtures by the extended hildebrand solubility approach

Extended Hildebrand Solubility Approach (EHSA) was successfully applied to evaluate the solubility of Indomethacin in 1,4-dioxane + water mixtures at 298.15 K. An acceptable correlation-performance of EHSA was found by using a regular polynomial model in order four of the W interaction parameter vs. solubility parameter of the mixtures (overall deviation was 8.9%). Although the mean deviation obtained was similar to that obtained directly by means of an empiric regression of the experimental solubility vs. mixtures solubility parameters, the advantages of EHSA are evident because it requires physicochemical properties easily available for drugs.

Thermodynamic study of the solubility of triclocarban in ethanol + propylene glycol mixtures

By using the van't Hoff and Gibbs equations the apparent thermodynamic functions Gibbs energy, enthalpy, and entropy of solution for triclocarban in ethanol + propylene glycol mixtures were evaluated from solubility data determined at temperatures from (293.15 to 313.15) K. The drug solubility was greatest in the mixture with 0.60 in mass fraction of ethanol and lowest in neat propylene glycol at almost all the temperatures studied. Non-linear enthalpy-entropy compensation is found indicating apparently different mechanisms of the solution process according to the mixtures composition.

Solution thermodynamics of methocarbamol in some ethanol + water mixtures

Apparent thermodynamic functions, Gibbs energy, enthalpy and entropy of solution and mixing, for methocarbamol in ethanol + water mixtures, were evaluated from solubility data determined at temperatures from 293.15 K to 313.15 K and from calorimetric values of drug fusion. The drug solubility was greatest in the mixtures with 0.70 or 0.80 mass fraction of ethanol and lowest in neat water across all temperatures studied. Non-linear enthalpy-entropy compensation was found for the dissolution processes. Accordingly, solution enthalpy drives the respective processes in almost all the solvent systems analyzed.