Long-Term Anticoagulant Therapy of Patients with Venous Thromboembolism. What Are the Practices?

Current guidelines of antithrombotic therapy suggest early initiation of vitamin K antagonists (VKA) in non-cancer patients with venous thromboembolism (VTE), and long-term therapy with low-molecular weight heparin (LMWH) for those with cancer. We used data from RIETE (international registry of patients with VTE) to report the use of long-term anticoagulant therapy over time and to identify predictors of anticoagulant choice (regarding international guidelines) in patients with- and without cancer. Among 35,280 patients without cancer, 82% received long-term VKA (but 17% started after the first week). Among 4,378 patients with cancer, 66% received long term LMWH as monotherapy. In patients without cancer, recent bleeding (odds ratio [OR] 2.70, 95% CI 2.26-3.23), age >70 years (OR 1.15, 95% CI 1.06-1.24), immobility (OR 2.06, 95% CI 1.93-2.19), renal insufficiency (OR 2.42, 95% CI 2.15-2.71) and anemia (OR 1.75, 95% CI 1.65-1.87) predicted poor adherence to guidelines. In those with cancer, anemia (OR 1.83, 95% CI 1.64-2.06), immobility (OR 1.51, 95% CI 1.30-1.76) and metastases (OR 3.22, 95% CI 2.87-3.61) predicted long-term LMWH therapy. In conclusion, we report practices of VTE therapy in real life and found that a significant proportion of patients did not receive the recommended treatment. The perceived increased risk for bleeding has an impact on anticoagulant treatment decision.

Fondaparinux in the initial and long-term treatment of venous thromboembolism.

BACKGROUND: Even in the absence of evidence on its long-term efficacy and safety, a number of patients with venous thromboembolism (VTE) receive long-term therapy with fondaparinux alone in everyday practice. METHODS: We used the Registro Informatizado de Enfermedad Tromboembólica (RIETE) registry to compare the rate of VTE recurrences and major bleeding at 10 and 90 days in patients with and without cancer. For long-term therapy, fondaparinux was compared with vitamin K antagonists (VKA) in patients without cancer and with low-molecular-weight heparin (LMWH) in those with cancer. RESULTS: Of 47,378 patients recruited, 46,513 were initially treated with heparin, 865 with fondaparinux. Then, 263 patients (78 with cancer) were treated for at least 3 months with fondaparinux. After propensity-score matching, there were no differences between patients receiving initial therapy with heparin or fondaparinux. Among patients with cancer, there were no differences between fondaparinux and LMWH. Among patients without cancer, the long-term use of fondaparinux was associated with an increased risk of major bleeding (3.24 % vs. 0.95 %, p<0.05). CONCLUSIONS: An unexpected high rate of major bleeding was observed in non-cancer patients treated with long-term fondaparinux. Our small sample does not allow to derive relevant conclusions on the use of fondaparinux in cancer patients.

Determinação de Ácidos Carboxílicos na Atmosfera Urbana de São Paulo: uma abordagem analítica e ambiental

In this work, analytical strategies are evaluated in order to measure accurately the ambient levels of atmospheric organic acids. Environmental considerations about the determination of low molecular weight mono- and di-carboxylic acids from urban areas of São Paulo are described.

Caracterização de quitosana por Cromatografia de Permeação em Gel - Influência do método de preparação e do solvente

In this work, samples of chitosan obtained in different conditions were characterized by molecular weight distribution, using Gel Permeation Chromatography (GPC), in two different solvents. It was observed that the increase in the number of deacetylation steps promotes a increase in the degree of deacetylation followed by a decrease in the average of molecular weight and polydispersion. The GPC curves obtained for chitosan samples in the two solvents used (CH3COOH 0.30 mol/dm³ - CH3CONa 0.20 mol/dm³ and CH3COOH 0.10 mol/dm³ - NaCl 0.20 mol/dm³) showed small difference in elution volume, but significant changes in the average molecular weight (Mn and Mw) and polydispersion that, in agree with the values of Huggins constant, present evidences of chitosan aggregates formation in the second solvent.

Origem e implicações dos ácidos carboxílicos na atmosfera

A general overview about the ambient levels of low molecular weight carboxylic acids and their possible emission sources, as well as the implication of them in the atmosphere is presented. Carboxylic acids are considered to be one of the dominant classes of organic compounds found in the atmosphere in a variety of phases, such as in rainwater, snow and ice, on aerosol particles and gas phase. They may be originated from biogenic and anthropogenic direct emissions and by photochemical reaction in situ. Emission sources and formation mechanisms of organic acids in the atmosphere are discussed.

Formação de multicamadas de polissacarídeos e proteína

In this work the formation of multilayers composed by carboxymethylcellulose (CMC), chitosane and bovine serum albumin (BSA) was studied by ellipsometry. First, the adsorption behavior of carboxymethylcellulose onto amino-terminated surfaces was investigated as a function of molecular weight and average degree of substitution of CMC. The influence of these parameters on the adsorbed amount of CMC onto amino-terminated substrates was absent. However, the interaction of CMC covered surfaces with chitosane and BSA was favored when the average degree of substitution of CMC was increased. The adsorption of BSA onto the polysaccharide systems was studied as a function of pH. At the isoelectric point of BSA a maximum in the adsorbed amount was found.

Sideróforos: uma resposta dos microorganismos

Siderophores (from the Greek: "iron carriers") are defined as relatively low molecular weight, ferric ion specific chelating agents elaborated by microorganisms growing under low iron stress. The role of these compounds is to scavenge iron from the environment and to make this essential chemical element available to the microbial cell. The present paper is a brief presentation of siderophore coordination chemistry with emphasis on those aspects relevant to the transportation of iron (III) complexes across biological membranes. Finally, the role of siderophores in infection and their clinical potential as iron scavenging molecules are reviewed.

Caracterização e estabilidade físico-química de sistemas poliméricos nanoparticulados para administração de fármacos

Polymeric nanoparticle systems such as nanocapsules and nanospheres present potential applications for the administration of therapeutic molecules. The physico-chemical characteristics of nanoparticle suspensions are important pre-requisites of the success of any dosage form development. The purpose of this review is to present the state of the art regarding the physico-chemical characterization of these drug carriers, in terms of the particle size distribution, the morphology, the polymer molecular weight, the surface charge, the drug content and the in vitro drug release profiles. Part of the review is devoted to the description of the techniques to improve the stability of colloidal systems.

Proteínas tirosina fosfatases: propriedades e funções biológicas

Protein phosphorylation-dephosphorylation catalyzed by the opposing and dynamic action of protein kinases and phosphatases probably, is the most crucial chemical reaction taking place in living organisms. Protein phosphatases are classified according to their substrate specificity and sensitivity to inhibitory or activator agents, into two families of protein phosphatases: serine/threonine phosphatases and tyrosine phosphatases (PTPs). PTPs can be divided into 3 groups: tyrosine specific phosphatases, dual and low molecular weight phosphatases. The role of tyrosine phosphorylation in mitogenic signaling is well documented, and one would predict that vanadate, pervanadate and other oxidant agents (protein tyrosine phosphatase inhibitors) may act as a growth stimulator.

Polimerização 1,4-cis de butadieno com sistemas catalíticos Ziegler-Natta à base de neodímio

Nowadays the catalyst systems based on neodymium are the ones most used in the high cis polybutadiene production. These systems contain a neodymium compound (catalyst), an alkylaluminium compound (cocatalyst) and a halogen compound (halogenating agent). The microstructure, molecular weight characteristics and the reaction activity are influenced by the nature and concentration of catalyst system components. Those characteristics are also affected by the polymerization conditions. This paper presents a brief review on 1,4-cis-butadiene polymerization on neodymium catalysts.

Emprego de catalisadores à base de níquel para homo- e copolimerização de estireno

This review deals with the homo- and copolymerization of styrene with nickel catalysts. The catalytic activity, polymer stereoregularity, polymer molecular weight and polydispersity are dependent upon nickel ligands and reaction parameters. Catalysts supported on silica, treated with methylaluminoxane (MAO), have shown higher stereospecificity and activity compared to homogeneous ones. The influence of these parameters is discussed focusing on the elucidation of some aspects of the polymerization mechanism.

Determinação eletroquímica da capacidade antioxidante para avaliação do exercício físico

Physical training can adapt or cause injury to skeletal muscles implicating metabolic alterations, which can be detected by biochemical analysis. Apparently the increase in the production of reactive oxygen species (ROS) is involved in both processes. Enzymatic and low molecular weight antioxidants (LMWA) minimize ROS's deleterious action through redox reactions. Cyclic voltammetry (CV) has been suggested as a tool to quantify the antioxidant capacity conferred by LMWA. The use of CV to evaluate the modulation of the antioxidant capacity conferred by LMWA in response to physical exercise is discussed here.

Antioxidant and antiviral properties of Pseudopiptadenia contorta (Leguminosae) and of quebracho (Schinopsis sp.) extracts

Proanthocyanidins from P. contorta leaves and from a commercial quebracho extract were isolated and characterized. Flavonoids, catechins and gallic acid were also identified in the extracts of P. contorta. Compounds were evaluated for their antioxidant properties and for their antiviral activity against an acyclovir-resistant herpes simplex virus type 1 strain. The low molecular weight phenolic derivatives and the proanthocyanidins from P. contorta showed the highest antioxidant activity. Purified proanthocyanidins from both P. contorta and quebracho showed the same maximum non toxic concentrations (25 µg/mL), with 82.2% and 100% of virus inhibition, respectively.

The effect of lignin as a natural adhesive on the physico-mechanical properties of Vitis vinifera fiberboards

Lignin was used as a natural adhesive to manufacture Vitis vinifera fiberboards. The fiberboards were produced at laboratory scale by adding powdered lignin to material that had previously been steam-exploded under optimized pretreatment and pressing conditions. The kraft lignin used was washed several times with an acidic solution to eliminate any contaminants and low molecular weight compounds. This research studied the effects of amounts of lignin ranging from 5% to 20% on the properties of Vitis vinifera fiberboards. The fiberboard properties evaluated were density, water resistance in terms of thickness swelling, water absorption, and the mechanical properties in terms of modulus of rupture, modulus of elasticity, and internal bond. Results showed that fiberboards made from Vitis vinifera without lignin addition had weaker mechanical properties. However, the fiberboards obtained using acid-washed kraft lignin as a natural adhesive had good mechanical and water resistance properties that fully satisfied the relevant standard specifications

Decoloración de alginato de sodio extraído de las algas pardas marinas del género Sargassum con el uso de peróxido de hidrógeno

Hydrogen peroxide bleaching of sodium alginate from seaweeds oh the Sargassum genus was studied. The influence of H2O2 concentration (percentage of H2O2 on a dry weight alginate basis, w/w) and NaOH/H2O2 ratio (% NaOH/% H2O2, both referred to a dry weight alginate basis, w/w) on the molecular weight, color removal and content of Fe3+ ions of bleached alginate samples was investigated by UV and IR spectroscopies, colorimetric determination of Fe3+ ions and vapor pressure osmometry. Higher yield, purity and molecular weight of alginate were obtained using 3% (or less) of hydrogen peroxide and a NaOH/H2O2 ratio of 1.2 for bleaching.