Potenciais interações medicamentosas responsáveis por internações hospitalares

As interações medicamentosas (IM) são consideradas um problema de saúde pública, pois podem causar resultados negativos à saúde dos usuários de medicamentos. Portanto o referido trabalho teve como objetivos: estimar a prevalência de internações hospitalares relacionadas a Potenciais IM (PIM); identificar os sinais e sintomas, e os fatores de risco para a hospitalização relacionados à PIM. Metodologia: Realizou-se estudo transversal na clínica geral de um hospital privado do interior de São Paulo (Brasil), em maio de 2006, com pacientes acima de 18 anos, com tempo de hospitalização superior a 24horas, sendo os mesmos entrevistados sobre os sintomas/motivos de internação e os medicamentos que haviam utilizado previamente à hospitalização. Calculou-se Odds-ratiopara identificar fatores de risco, sendo encontrado os seguintes resultados: 168 pacientes utilizando mais de um medicamento, dos quais 57 apresentaram PIM, sendo que em 17(10,1%), os sinais e sintomas da PIM possivelmente foram a causa da hospitalização. A maioria das manifestações clínicas das PIM foram sintomas cardiovasculares (44,3%), gastrintestinais (17,2%) e musculoesqueléticos (13,8%) e 10% das PIM foram consideradas potencialmente perigosas. Não foram detectados fatores de risco relacionados ao gênero, idade, uso de medicamentos de estreita faixa terapêutica para hospitalização por PIM. A polimedicação foi fator de risco para ocorrência de PIM (p < 0,0001) opostamente ao aumento da idade que revelou ser um fator de proteção (p=0,02). Conclusão: Se faz necessário seguimento farmacoterapêutico de pacientes que utilizam fármacos de estreita faixa terapêutica, pois estas substâncias estão frequentemente envolvidas em IM perigosas. Palavras-chave: Problema relacionado ao medicamento. Resultado negativo associado ao medicamento. Erros de medicação. Interações de medicamentos.

Obtenção e caracterização de filmes finos de Bi3NbO7 pelo método dos precursores poliméricos

Pós-graduação em Engenharia Mecânica - FEG

Scaling properties and universality in a ratchet system

Critical exponents that describe a transition from unlimited to limited diffusion for a ratchet system are obtained analytically and numerically. The system is described by a two dimensional nonlinear mapping with three relevant control parameters. Two of them control the non-linearity while the third one controls the intensity of the dissipation. Chaotic attractors appear in the phase space due to the dissipation and considering large non-linearity are characterised by the use of Lyapunov exponents. The critical exponents are used to overlap different curves of average momentum (dynamical variable) onto a single plot confirming a scale invariance. The formalism used is general and the procedure can be extended to different systems.

Incorporação de novas tecnologias no setor sucroalcooleiro: produção de hidrogênio e aumento da oferta de eletricidade

This work studies the incorporation of new technologies in the sugarcane sector. Are considered the ethanol steam reforming and the gasification of sugarcane bagasse(by-product) processes associated with combined cycle systems (Gas Turbine + Steam Turbine), aggregating hydrogen production and increased electricity supply in the sector, respectively. To verify the technical feasibility of the incorporation processes was performed a thermodynamic analysis, considering data from a typical Brazilian Sugar Cane Industry. In another step the economic viability study of the hydrogen production process was made, with consideration on hydrated and anhydrous ethanol steam reform, comparing the cost of hydrogen production. Also considered studies of economic engineering of the gasification process and the generation of electricity associated. As conclusions, it follows that the ethanol steam reforming is a great alternative for hydrogen production, presenting production cost relatively low, especially when is considered the steam reforming of hydrated ethanol. For the gasification process associated with combined cycle, can be observed an increase of 8.56 times of the electricity production in the sugar cane industry, indicating a positive annual saving when the sales price of the supply electricity is greater than 0.070 US$/kWh. Finally it can be concluded that the incorporation of these new processes allow greater profitability and operational flexibility of Brazilian sugarcane mills

Marginal adaptation of Class V restorations with current generation dentin-bonding agents: effect of different dentin surface treatments.

This study sought to assess the use of chlorhexidine with several excipients as a dentin surface treatment and its effect on marginal adaptation of class V restorations with current-generation dentin bonding agents. A total of 120 human third molars were selected and allocated into 12 groups, with standardized buccal class V restorations randomly divided into preconditioned dentin rinsed with: water; water + chlorhexidine; ethanol; or ethanol + chlorhexidine. After rinsing of dentin (previously conditioned with 35% phosphoric acid) with the test solutions, the Adper single bond 2, prime and bond 2.1, and Excite bonding systems were applied randomly. Restorations were performed with FiltekTM Z350 XT composite resin. The resulting specimens were subjected to thermal and mechanical load cycling. Quantitative analysis of marginal adaptation was performed on epoxy replicas by means of scanning electron microscopy. Results were assessed by means of the Kruskal-Wallis test (percentages of continuous margins) and Wilcoxon test (differences between percentages of continuous margins before and after thermal cycling and mechanical loading), at a significance level of p < 0.05. Outcomes in the chlorhexidine-treated groups were not superior to those obtained with other treatments.

Simulação numérica do escoamento em difusores radiais com discos frontais fixos e móveis

Pós-graduação em Engenharia Mecânica - FEIS

Avaliação da cinetica bacteriana na biolixiviação de calcopirita

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

The nature of Ru-NO bonds in ruthenium tetraazamacrocycle nitrosyl complexes-a computational study

Ruthenium complexes including nitrosyl or nitrite complexes are particularly interesting because they can not only scavenge but also release nitric oxide in a controlled manner, regulating the NO-level in vivo. The judicious choice of ligands attached to the [RuNO] core has been shown to be a suitable strategy to modulate NO reactivity in these complexes. In order to understand the influence of different equatorial ligands on the electronic structure of the Ru-NO chemical bonding, and thus on the reactivity of the coordinated NO, we propose an investigation of the nature of the Ru-NO chemical bond by means of energy decomposition analysis (EDA), considering tetraamine and tetraazamacrocycles as equatorial ligands, prior to and after the reduction of the {RuNO}(6) moiety by one electron. This investigation provides a deep insight into the Ru-NO bonding situation, which is fundamental in designing new ruthenium nitrosyl complexes with potential biological applications.

Comparison of physical properties of two exogenous surfactants: new parameter.

The pulmonary surfactant has essential physical properties for normal lung function. The most important property is the surface tension. In this work, it was evaluated the surface tension of two commercial exogenous surfactants used in surfactant replacement therapy, poractant alfa (Curosurf, Chiesi Farmaceuticals, Italy) and beractant (Survanta, Abbott Laboratories, USA) using new parameters. A Langmuir film balance (Minitrough, KSV Instruments, Finland) was used to measure surface tension of poractant alfa and beractant samples. For both samples, we prepared a solution of 1 mg/m dissolved in chloroform (100π`), which was applied over a subphase of milli-Q water (175 ml) in the chamber of the balance. The chamber has two moving barriers that can change its surface area between a maximal value of 112.5 cm 2 , and a minimal value of 22.5 cm 2, defining a balance cycle. Each surfactant had its surface tension evaluated during 20 balance cycles for three times. Four quantities were calculated from the experiment: Minimum Surface Tension (MTS), defined as the surface tension at minimal surface area during the first cycle; Mean Work Cycle (MWC), defined as the mean hysteresis area of the measured surface tension curve of the last 16 balance cycles; Critical Active Surface Area in Compression (CASAC) or in Expansion (CASAE), defined as the maximal chamber area where the surfactant is active on the surface in compression or expansion. The t-test was applied to verify for statistical significance of the results. Comproved with the MST is the same reported in literature, the differences between MWC, CASAC, and CASAE were statistically significant (p<0.001). The MWC, CASAC and CASAE were higher for poractant alfa than for beractant. A higher MWC for poractant alfa means higher elastic recoil of the lung in comparison with beractant. Using a different methodology, our results showed that poractant alfa is probably more effective in a surfactant replacement therapy than beractant due the use of poractant alfa in relation to the use of beractant in preterm infants with Respiratory Distress Syndrome (RDS).

Optimised polyolefin branch quantification by 13 C NMR spectroscopy

Quantitative branch determination in polyolefins by solid- and melt-state 13C NMR has been investigated. Both methods were optimised toward sensitivity per unit time. While solid-state NMR was shown to give quick albeit only qualitative results, melt-state NMR allowed highly time efficient accurate branch quantification. Comparison of spectra obtained using spectrometers operating at 300, 500 and 700 MHz 1H Larmor frequency, with 4 and 7~mm MAS probeheads, showed that the best sensitivity was achieved at 500 MHz using a 7 mm 13C-1H optimised high temperature probehead. For materials available in large quantities, static melt-state NMR, using large diameter detection coils and high coil filling at 300 MHz, was shown to produce comparable results to melt-state MAS measurements in less time. While the use of J-coupling mediated polarisation transfer techniques was shown to be possible, direct polarisation via single-pulse excitation proved to be more suitable for branch quantification in the melt-state. Artificial line broadening, introduced by FID truncation, was able to be reduced by the use of π pulse-train heteronuclear dipolar decoupling. This decoupling method, when combined with an extended duty-cycle, allowed for significant improvement in resolution. Standard setup, processing and analysis techniques were developed to minimise systematic errors contributing to the measured branch contents. The final optimised melt-state MAS NMR method was shown to allow time efficient quantification of comonomer content and distribution in both polyethylene- and polypropylene-co-α-olefins. The sensitivity of the technique was demonstrated by quantifying branch concentrations of 8 branches per 100,000 CH2 for an industrial ‘linear’ polyethylene in only 13 hours. Even lower degrees of 3–8 long-chain branches per 100,000 carbons were able to be estimated in just 24 hours for a series of γ-irradiated polypropylene homopolymers.

First principle study of ions in water and ionic liquids

Die beiden in dieser Arbeit betrachteten Systeme, wässrige Lösungen von Ionen und ionische Flüssigkeiten, zeigen vielfältige Eigenschaften und Anwendungsmöglichkeiten, im Gegensatz zu anderen Systemen. Man findet sie beinahe überall im normalen Leben (Wasser), oder ihre Bedeutung wächst (ioinische Flüssigkeiten). Der elektronische Anteil und der atomare Anteil wurden getrennt voneinander untersucht und im Zusammenhang analysiert. Mittels dieser Methode konnten die in dem jeweiligen System auftretenden Mechanismen genauer untersucht werden. Diese Methode wird "Multiscale Modeling" genannt, dabei werden die Untereinheiten eines Systems genauer betrachtet, wie in diesem Fall die elektronischen and atomaren Teilsystem. Die Ergebnisse, die aus den jeweiligen Betrachtungen hervorgehen, zeigen, dass, im Falle von hydratisierten Ionen die Wasser-Wasser Wechselwirkungen wesentlich stärker sind als die elektrostatischen Wechselwirkung zwischen Wasser und dem Ion. Anhand der Ergebnisse ergibt sich, dass normale nicht-polarisierbare Modelle ausreichen, um Ionen-Wasser Lösungen zu beschreiben. Im Falle der ionischen Flüssigkeiten betrachten wir die elektronische Ebene mittels sehr genauer post-Hartree-Fock Methoden und DFT, deren Ergebnisse dann mit denen auf molekularer Ebene (mithilfe von CPMD/klassischer MD) in Beziehung gesetzt werden. Die bisherigen Ergebnisse zeigen, dass die Wasserstoff-Brückenbindungen im Fall der ionischen Flüssigkeiten nicht vernachässigt werden können. Weiterhin hat diese Studie herausgefunden, dass die klassischen Kraftfelder die Elektrostatik (Dipol- und Quadrupolmomente) nicht genau genug beschreibt. Die Kombination des mikroskopischen Mechanismus und der molekularen Eigenschaften ist besonders sinnvoll um verschiedene Anhaltspunkte von Simualtionen (z.B. mit klassische Molekular-Dynamik) oder Experimenten zu liefern oder solche zu erklären.

Evaluation von Effektivität und Sicherheit der niederfrequenten, transkraniellen Ultraschalltherapie beim Schlaganfall

In den westlichen Ländern nimmt die Zahl der Schlaganfall-Patienten stetig zu und zählt mittlerweilernzu einer der häufigsten Todesursachen. Derzeit ist die Rekanalisationstherapie mit demrnFibrinolytikum rt-PA die einzig zugelassene Therapie. Die Rekanalisationsrate ist oftmals inkomplettrnund aufgrund von möglichen Blutungskomplikationen die Therapie nicht bei allen Patientenrnmöglich. Daher ist es wichtig, Alternativtherapieansätze (z.B. Ultraschallthrombolyse) zurnentwickeln. Blutgerinnsel können mit Hilfe von Ultraschall in Schwingung gebracht und sornlysiert oder die Wirkung von rt-PA verstärkt werden. Die vorliegende Arbeit hatte die Evaluationrnvon Bioeffekten von 60 kHz Ultraschall an gesundem und ischämischem Hirngewebe zum Ziel.rnNeben tierexperimentellen Methoden kamen auch molekular-biologische Techniken zur Anwendung.rnDie erste Studie beschäftigte sich mit der Wirkung von 60 kHz (Intensität: 0,2 W/cm2 undrnDuty Cycle 50%) auf ischämisches Hirngewebe (permanent ischämisch und nach Reperfusion).rnLediglich nach Reperfusion und Ultraschallbehandlung war das Läsionsvolumen signifikantrnerhöht, so dass von einer besonderen Vulnerabilität des Hirngewebes nach Reperfusionrnauszugehen ist (Penumbraschädigung). In der neurologischen Beurteilung der Tiere zeigte sichrnbei allen Tieren mit permanenter Okklusion und etwa einem Drittel der Tiere nach Reperfusionrnund Ultraschallbehandlung eine Hörminderung. In der anschließenden Studie wurde diernUltraschallintensität erniedrigt und der Duty Cycle variiert. In einer publizierten in vitro Studiernkonnte die zunehmende Lyserate mit steigendem Duty Cycle nachgewiesen werden. DiernAuswertung ergab eine Abhängigkeit des Läsionsvolumens von der Länge des Duty Cycles. Derrndritte Teil der Arbeit befasst sich mit der Wirkung von Ultraschall auf die Genexpression. Hierzurnwurden gesunde Ratten mit Ultraschall verschiedener Frequenzen (60 kHz, 488 kHz und 3 MHz)rntranskraniell behandelt und 4 h bzw. 24 h nach der Behandlung getötet. Proben von ischämischenrnTieren dienten als positive Kontrollen. Aufgrund von Literaturrecherchen wurden mehrerernKandidatengene ermittelt. Die Messung der Ischämieproben ergab eine weitgehende Übereinstimmungrnmit der Literatur. Die Messungen an den mit 60 kHz behandelten Proben ergabenrnkaum Anzeichen für eine differenzielle Genregulation. Die Frequenz von 488 kHz zeigte diernmeisten Regulationen, gefolgt von der Behandlung mit 3 MHz. Dieses Ergebnis lässt vermuten,rndass es sich bei den detektierten Veränderungen um protektive Mechanismen handelt, da diesernFrequenzen bislang im Tierversuch als nebenwirkungsarm beschrieben wurden. Die Auswertungrnvon 60 kHz-Proben mit Affymetrix Arrays ergab lediglich einige wenige differentiell regulierternGene. Die Array-Experimente konnten nicht durch qPCR-Messungen bestätigt werden.

Disabling c-Myc in childhood medulloblastoma and atypical teratoid/rhabdoid tumor cells by the potent G-quadruplex interactive agent S2T1-6OTD

We investigated here the effects of S2T1-6OTD, a novel telomestatin derivative that is synthesized to target G-quadruplex-forming DNA sequences, on a representative panel of human medulloblastoma (MB) and atypical teratoid/rhabdoid (AT/RT) childhood brain cancer cell lines. S2T1-6OTD proved to be a potent c-Myc inhibitor through its high-affinity physical interaction with the G-quadruplex structure in the c-Myc promoter. Treatment with S2T1-6OTD reduced the mRNA and protein expressions of c-Myc and hTERT, which is transcriptionally regulated by c-Myc, and decreased the activities of both genes. In remarkable contrast to control cells, short-term (72-hour) treatment with S2T1-6OTD resulted in a dose- and time-dependent antiproliferative effect in all MB and AT/RT brain tumor cell lines tested (IC(50), 0.25-0.39 micromol/L). Under conditions where inhibition of both proliferation and c-Myc activity was observed, S2T1-6OTD treatment decreased the protein expression of the cell cycle activator cyclin-dependent kinase 2 and induced cell cycle arrest. Long-term treatment (5 weeks) with nontoxic concentrations of S2T1-6OTD resulted in a time-dependent (mainly c-Myc-dependent) telomere shortening. This was accompanied by cell growth arrest starting on day 28 followed by cell senescence and induction of apoptosis on day 35 in all of the five cell lines investigated. On in vivo animal testing, S2T1-6OTD may well represent a novel therapeutic strategy for childhood brain tumors.

Enzyme engineering of aminotransferases for improved activity and thermostability

The production by biosynthesis of optically active amino acids and amines satisfies the pharmaceutical industry in its demand for chiral building blocks for the synthesis of various pharmaceuticals. Among several enzymatic methods that allow the synthesis of optically active aminoacids and amines, the use of minotransferase is a promising one due to its broad substrate specificity and no requirement for external cofactor regeneration. The synthesis of chiral compounds by aminotransferases can be done either by asymmetric synthesis starting from keto acids or ketones, and by kinetic resolution starting from racemic aminoacids or amines. The asymmetric synthesis of substituted (S)-aminotetralin, an active pharmaceutical ingredient (API), has shown to have two major factors that contribute to increasing the cost of production. These factors are the raw material cost of biocatalyst used to produce it and product loss during biocatalyst separation. To minimize the cost contribution of biocatalyst and to minimize the loss of product, two routes have been chosen in this research: 1. To engineer the aminotransferase biocatalyst to have greater specific activity, and 2. Improve the engineering of the process by immobilization of biocatalyst in calcium alginate and addition of cosolvents. An (S)-aminotransferase (Mutant CNB03-03) was immobilized, not as purified enzyme but as enzyme within spray dried cells, in calcium alginate beads and used to produce substituted (S)-aminotetralin at 50 °C and pH 7 in experiments where the immobilized biocatalyst was recycled. Initial rate of reaction for cycle 1 (6 hr duration) was determined to be 0.258 mM/min, for cycle 2 (20 hr duration) it decreased by ~50% compared to cycle 1, and for cycle 3 (20 hr duration) it decreased by ~90% compared to cycle 1 (immobilized preparation consisted of 50 mg of spray dried cells per gram of calcium alginate). Conversion to product for each cycle decreased as well, from 100% in cycle 1 (About 50 mM), 80% in cycle 2, and 30% after cycle 3. This mutant was determined to be deactivated at elevated temperatures during the reaction cycle and was not stable enough to allow multiple cycles in its immobilized form. A new mutant aminotransferase was isolated by applying error-prone polymerase chain reaction (PCR) on the gene coding for this enzyme and screening/selection: CNB04-01. This mutant showed a significant improvement in thermostability in comparison to CNB03-03. The new mutant was immobilized and tested under similar reaction conditions. Initial rate remained fairly constant (0.2 mM/min) over four cycles (each cycle with a duration of about 20 hours) with the mutant retaining almost 80% of initial rate in the fourth cycle. The final product concentrations after each cycle did not decrease during recycle experiments. Thermostability of CNB04-01 was much improved compared to CNB03-03. Under the same reaction conditions as stated above, the addition of co-solvents was studied in order to increase substituted tetralone solubility. Toluene and sodium dodecylsulfate (SDS) were used. SDS at 0.01% (w/v) allowed four recycles of the immobilized spray dried cells of CNB04-01, always reaching higher product concentration (80-85 mM) than the system with toluene at 3% (v/v) -70 mM-. The long term activity of immobilized CNB04-01 in a system with SDS 0.01% (w/v) at 50 °C, pH 7 was retained for three cycles (20 to 24 hours each one), reaching always final product concentration between 80-85 mM, but dropping precipitously in the fourth cycle to a final product concentration of 50 mM. Although significant improvement of immobilization on productivity and stability were observed using CNB04-01, another observation demonstrated the limitations of an immobilization strategy on reducing process costs. After analyzing the results of this experiment it was seen that a sudden drop occurred on final product concentration after the third recycle. This was due to product accumulation inside the immobilized preparation. In order to improve the economics of the process, research was focused on developing a free enzyme with an even higher activity, thus reducing raw material cost as well as improving biomass separation. A new enzyme was obtained (CNB05-01) using error-prone PCR and screening using as a template the gene derived from the previous improved enzyme. This mutant was determined to have 1.6 times the initial rate of CNB04-01 and had a higher temperature optimum (55°). This new enzyme would allow reducing enzyme loading in the reaction by five-fold compared to CNB03-03, when using it at concentration of one gram of spray dried cells per liter (completing the reaction after 20-24 hours). Also this mutant would allow reducing process time to 7-8 hours when used at a concentration of 5 grams of spray dried cells per liter compared to 24 hours for CNB03-03, assuming that the observations shown before are scalable. It could be possible to improve the economics of the process by either reducing enzyme concentration or reducing process time, since the production cost of the desired product is primarily a function of both enzyme concentration and process time.

"Deal of the day” platforms: what drives consumer loyalty?

Maintaining a loyal customer base is challenging for “Deal of the Day” (DoD) platforms. DoD providers market and sell deals on products and services, yet it is the merchants who ultimately deliver those to consumers. Low entry and switching costs drive competition in this market. However, research on the determinants of user loyalty in the DoD context is limited. This study uses Grounded Theory and Structural Equation Modeling to explore the phenomenon of DoD platform loyalty. Particularly, monetary benefits, signal-to-noise ratio, perceived risk, and service friendliness during a merchant encounter emerge as powerful determinants of loyalty in this novel context.