Intensive care medicines and therapeutics

SCOPUS: no.j

Greener Alternatives to Selected Organic Oxidation Reactions

The study of green chemistry is dedicated to eliminating or reducing toxic waste. One route to accomplish this goal is to explore alternative reaction conditions and parameters resulting in the development of more benign synthetic routes and reagents. The primary focus of this research is to find optimal reaction conditions for the oxidation of a primary alcohol to an aldehyde. As a case study, the oxidation of benzyl alcohol to benzaldehyde, a common industrial process, was examined. Traditionally carried out using the Jones Reagent, commonly referred to as chromium (IV) oxide or chromium trioxide (CrO3) in sulphuric acid, a great deal of research went into utilizing less toxic reagents, such as MnO2 or KMnO4 supported on a clay base. This research has led to an improvement on these alternatives, using a lithium chloride (LiCl) catalyst in a montmorillonite K10 clay solid phase, together with the oxidizing agent hydrogen peroxide, as even greener alternatives to these traditional oxidizing agents. Experiments were carried out to determine the lifetime of this LiCl/clay system as compared to MnO2 and KMnO4, to investigate its ability to catalyze the oxidation of other aromatic alcohols (such as 4-methoxybenzyl alcohol and diphenylmethanol), and to further improve the system’s adherence to green chemistry principles. Green solvent alternatives were examined by replacing the toluene solvent with dimethylcarbonate (DMC), and reaction conditions were optimized to improve product yield. It was determined that the LiCl/H2O2 system was, in most cases, equally as effective at catalyzing the oxidation of benzyl alcohol to benzaldehyde. Although the catalyst and oxidizing agent eliminated the toxic waste generated from chromium reagents, it offered significant challenges in product isolation, because of an aqueous-organic phase separation.

Sistemas de avaliação de tecnologias de saúde: dispositivos médicos

As tecnologias de saúde, nomeadamente medicamentos, dispositivos médicos (DM), procedimentos médicos ou cirúrgicos, entre outros, têm ocupado uma posição de destaque no setor da saúde, e na vida dos seus utilizadores. A inovação e utilização de tecnologias de saúde, e consequente aumento das despesas fizeram emergir a necessidade de avaliação das tecnologias de saúde. Surge assim, a avaliação de tecnologias de saúde (ATS), que tem por objetivo abordar os impactos clínicos, económicos, organizacionais, sociais, legais e éticos de uma tecnologia de saúde, considerando o seu contexto médico específico, bem como as alternativas disponíveis. A ATS pretende que os processos sejam feitos de forma rigorosa, transparente, valorizando e garantindo a sustentabilidade do acesso aos cuidados em saúde. Seguindo a tendência europeia de implementação de políticas e modelos de ATS, Portugal criou o seu próprio sistema de avaliação de tecnologias. O Decreto-Lei nº 97/2015, de 1 de junho veio oficializar a criação do Sistema Nacional de Avaliação de Tecnologias de Saúde (SiNATS). O SiNATS vai permitir uma avaliação não só de medicamentos, mas também de DM e outras tecnologias tendo em consideração a avaliação técnica, terapêutica e económica das tecnologias de saúde com base em fatores sociais, políticos, éticos e a participação de entidades, como, a indústria, as instituições de ensino, as instituições de saúde, os investigadores, os profissionais de saúde, os doentes e as associações dos doentes. O SiNATS vai emitir recomendações e decisões sobre o uso das tecnologias de saúde e possibilitar o ganho em saúde e contribuir para a sustentabilidade do Serviço Nacional de Saúde (SNS). O SiNATS vem permitir a avaliação de DM. O sector dos DM é um sector caracterizado pela inovação, crescimento e também competitividade. A complexidade e especificidade deste sector devem por isso ser tidas em consideração aquando da sua análise. A implementação do SiNATS permitirá avaliar e reavaliar preços, comparticipações, recomendações, contratos ao longo do ciclo de vida de cada DM. No presente momento, ainda é difícil expor os processos através dos quais esta avaliação vai ser processada, uma vez que se aguarda a publicação de despachos e portarias referidos no Decreto-Lei nº 97/2015, de 1 de junho. Tendo em consideração a partilha de informação sobre políticas, métodos, procedimentos de ATS aplicada aos DM na Europa, foram analisados os casos de França e do Reino Unido com o objetivo de alargar o conhecimento acerca do que já é feito a nível Europeu e explorar se os mesmos poderiam ser adaptados à realidade portuguesa. Em França, a ATS está diretamente relacionada com a comparticipação de DM, já no Reino Unido, o National Institute and Centre of Excellence (NICE) tem a responsabilidade de avaliar os DM segundo procedimentos de ATS, mas não está diretamente relacionado com comparticipação. O NICE publica normas de orientação que auxiliam a decisão de aquisição ou não de um DM. Tendo em consideração a informação reunida e descrita, este trabalho também propõe um modelo hipotético sobre o sistema português de avaliação de DM. Este modelo aborda, ainda que não de forma exaustiva, os possíveis processos e procedimentos para a avaliação de DM. Este sistema caracteriza-se pela importância dada ao envolvimento dos stakeholders e partilha de informação com os mesmos, mas também na agilização dos processos, isto é, uma redução e simplificação dos processos de avaliação de DM. A reavaliação de DM durante a sua comercialização também ganha destaque, apontando que cada grupo genérico de dispositivos ou DM inovador dever ser reavaliado a cada cinco anos, ou sempre que informação emergente o justifique. Este modelo representa uma abordagem experimental sobre o futuro do SiNATS aplicado aos DM. A partilha de informação, os fóruns de discussão e o envolvimento da sociedade serão uma mais-valia para que a implementação do SiNATS aos DM seja feita de forma gradual e com a máxima transparência possível.

Alternatives aux méthodes de déglaçage utilisées au Québec et au Canada

L’objectif de cet essai est de recommander des solutions alternatives aux méthodes de déglaçage présentement utilisées au Québec et au Canada. Actuellement, les routes hivernales sont maintenues sécuritaires grâce à l’épandage de sels de voirie et d’abrasifs. Le chlorure de sodium et le chlorure de calcium sont les plus utilisés sur les routes, en partie en raison de leurs faibles coûts. Or, les impacts négatifs d’une libération massive d’ions chlorure dans l’environnement sont nombreux. La perturbation de l’équilibre osmotique du sol menant à un dérèglement végétal, l’augmentation de la salinité de l’eau nuisant aux organismes aquatiques vertébrés et l’érosion accélérée du sol n’en sont que quelques-unes. En prime, les répercussions économiques reliées à la corrosion des véhicules et des structures routières, telles que les ponts et viaducs, causées par l’épandage de sels de voirie sont importantes. Ainsi, l’utilisation de méthodes alternatives peut limiter les impacts engendrés par les sels de voirie. Les recommandations sont divisées en deux catégories. D’une part, des recommandations sont formulées en lien avec l’épandage de produits de remplacements aux sels de voirie. L’exploitation du potentiel de l’extrait de betterave est suggérée. L’entretien hivernal des ponts et viaducs à l’aide de produits non corrosifs tels que les acétates est proposé, tout comme le traitement des piles d’abrasifs avec un produit comportant un pourcentage d’extrait de maïs. D’autre part, des recommandations concernant l’optimisation des méthodes employées et les visions environnementales à adopter en entretien hivernal sont formulées. Elles consistent à augmenter le nombre de villes québécoises participantes à la Stratégie québécoise pour une gestion environnementale des sels de voirie et de villes canadiennes éligibles au Code de pratique pour la gestion des sels de voirie, de miser en premier lieu sur l’amélioration des méthodes d’entretien hivernal dans les zones vulnérables prioritaires, de prendre en compte le cycle de vie des composés alternatifs et enfin d’effectuer une réduction à la source des émissions de sels de voirie dans l’environnement. Enfin, puisqu’aucune solution idéale n’existe, la solution réside en l’amélioration des méthodes actuelles et l’utilisation d’une combinaison d’alternatives, chacune jouant un rôle dans une situation qui lui est propre pour atténuer des impacts causés par l’épandage de sels de voirie.

Polyporus squamosus (Huds.) Fr from different origins: chemical characterization, screening of the bioactive properties and specific antimicrobial effects against Pseudomonas aeruginosa

Wild mushrooms are mainly collected during the rainy season and valued as a nutritious food and sources of natural medicines and nutraceuticals. The aim of this study was to determine the chemical composition and bioactive properties (antioxidant, antimicrobial and cytotoxicity) of Polyporus squamosus from two different origins, Portugal and Serbia. The sample from Portugal showed higher contents of as protein (17.14 g/100 g), fat (2.69 g/100 g), ash (3.15 g/100 g) and carbohydrates (77.02 g/100 g); the same sample gave the highest antioxidant activity: highest reducing power, DPPH radical scavenging activity, and lipid peroxidation inhibition in both β-carotene/linoleate and TBARS assay. These results could be related to its higher content in total tocopherols (1968.65 μg/100 g) and phenolic compounds (1.29 mg/100 g). Both extracts exhibited antibacterial activity against all the tested organisms. The samples from Serbia gave higher overall antibacterial activity and showed excellent antibiofilm activity (88.30 %). Overall, P. squamosus methanolic extracts possessed antioxidant, antimicrobial, antibiofilm and anti-quorum sensing activity, and without toxicity for liver cells. This investigation highlights alternatives to be explored for the treatment of bacterial infections, in particular against Pseudomonas aeruginosa. This study provides important results for the chemical and bioactive properties, especially antimicrobial activity of the mushroom P. squamosus. Moreover, to the authors’ knowledge this is the first report on sugars, organic acids, and individual phenolic compounds in P. squamosus.

How much do patients in Blantyre, Malawi know about antibiotics and other prescription only medicines?

Introduction This qualitative and quantitative exploratory study was conducted to assess patients’/customers’ knowledge, beliefs and practices about antibiotics and other prescription only medication (POM) in 10 community pharmacies in Blantyre, Malawi. Method 5 out of 10 pharmacies were selected by simple random sampling and 54 participants attending the selected pharmacies were interviewed. Results The major antibiotic drugs frequently requested without a doctor’s prescription were Bactrim (Cotrimoxazole) and amoxicillin. Knowledge of these medicines was attributed to the patients’ previous medical conditions and doctor’s prescription. However this knowledge does not extend to understanding of proper therapeutic indications and dosage regimens for antibiotic therapy. The majority (30 out of 54 participants) did not know about the importance of completing a prescribed course of antibiotics. All 54 participants believed in the efficiancy of antibiotics. Conclusion Study participants had wide range of knowledge about antibiotics and other POM from hospital, but the majority had limited knowledge regarding clinical indications and correct dosage schedules.

Sensing parasites: proteomic and advanced bio-detection alternatives

[EN] Parasitic diseases have a great impact in human and animal health. The gold standard for the diagnosis of the majority of parasitic infections is still conventional microscopy, which presents important limitations in terms of sensitivity and specificity and commonly requires highly trained technicians. More accurate molecular-based diagnostic tools are needed for the implementation of early detection, effective treatments and massive screenings with high-throughput capacities. In this respect, sensitive and affordable devices could greatly impact on sustainable control programmes which exist against parasitic diseases, especially in low income settings. Proteomics and nanotechnology approaches are valuable tools for sensing pathogens and host alteration signatures within micro fluidic detection platforms. These new devices might provide novel solutions to fight parasitic diseases. Newly described specific parasite derived products with immune-modulatory properties have been postulated as the best candidates for the early and accurate detection of parasitic infections as well as for the blockage of parasite development. This review provides the most recent methodological and technological advances with great potential for biosensing parasites in their hosts, showing the newest opportunities offered by modern “-omics” and platforms for parasite detection and control.

Reporting pharmacy staff communication for OTC medicines encounters with simulated patients

Poster presented at the 44th ESCP Symposium on Clinical Pharmacy. Lisbon, 28-30 October 2015

Comparison of access to medicines between Klang Valley and East Coast of peninsular Malaysia for children living in poor households

Purpose: To compare access to medicines in children living in poor households (income of USD1/person/day) between urbanised Klang Valley and rural East Coast of Peninsular Malaysia. Methods: A semi-structured interview was conducted with caregivers to determine demographics, access to medicines, knowledge, attitude and practice of parents in obtaining medicines for children. Results: There was no significant difference socio-demographically between poor households in Klang Valley (N = 58) and East Coast (N = 40). The study found that access to medicine for children (N = 325) in the households was adequate, where all households that reported illness in the children over the last 1 month and the last 6 month periods, obtained medicines and 99 % of the children were fully immunized. Qualitative analysis showed that poor households face several barriers in accessing medicines for their children such as financial, transportation, physical and attitudinal. Conclusion: Access to medicines for children living in poor households in both areas were similar and adequate. However, barriers to access remain and further studies are required.

Assessment of the storage and disposal of medicines in some homes in Jos north local government area of Plateau State, Nigeria

Purpose: The purpose of this study was to assess the way medicines are stored and disposed in some households in Jos North Local Government Area (LGA) of Plateau State, Nigeria. Methods: A cross-sectional survey of 130 households in Jos was carried out using a questionnaire to ascertain practices associated with medicine storage and their disposal. Results: The results showed that 105 (80.8%) households had 635 medicines in their homes, 65.8% of which were unused medicines (3.2 unused medicines per household). Some households stored their medicines in bags/containers (76.2%) while others kept them in cup-boards/cabinets (21.96%), refrigerators (10.5%) or other places (3.3%). Methods for disposal of unused drugs varied among households with some disposing them in trash cans (70.5%) while other disposed them in toilets (19.0%) or burnt them (10.5%). Only 10.5% (n=11) of respondents knew how medicines were properly disposed. Conclusion: While most households store their medicines appropriately, majority of them adopt poor disposal methods for medicines they no longer need in their homes. Public health education on problem disposal of medicines is of the essence.

Power Study on Testing Epidemic Alternatives

Detecting change points in epidemic models has been studied by many scholars. Yao (1993) summarized five existing test statistics in the literature. Out of those test statistics, it was observed that the likelihood ratio statistic showed its standout power. However, all of the existing test statistics are based on an assumption that population variance is known, which is an unrealistic assumption in practice. To avoid assuming known population variance, a new test statistic for detecting epidemic models is studied in this thesis. The new test statistic is a parameter-free test statistic which is more powerful compared to the existing test statistics. Different sample sizes and lengths of epidemic durations are used for the power comparison purpose. Monte Carlo simulation is used to find the critical values of the new test statistic and to perform the power comparison. Based on the Monte Carlo simulation result, it can be concluded that the sample size and the length of the duration have some effect on the power of the tests. It can also be observed that the new test statistic studied in this thesis has higher power than the existing test statistics do in all of cases.

Préférences musicales alternatives et ajustement psychosocial à la fin de l’adolescence : une approche développementale semi-paramétrique

Essai doctoral présenté à la Faculté des études supérieures en vue de l'obtention du grade de Docteur en psychologie (D. Psy,), option clinique

Préférences musicales alternatives et ajustement psychosocial à la fin de l’adolescence : une approche développementale semi-paramétrique

Essai doctoral présenté à la Faculté des études supérieures en vue de l'obtention du grade de Docteur en psychologie (D. Psy,), option clinique

Vaccins à base de plante comme alternatives aux antibiotiques : évaluation du potentiel d'un extrait de tabac contenant rFaeGntd/dsc d’Escherichia coli entérotoxigénique (ETEC) à induire une réponse immunitaire chez le procelet sevré.

La diarrhée post-sevrage causée par Escherichia coli entérotoxigénique présentant le fimbriae F4 (ETEC F4+) cause actuellement des pertes économiques importantes dans l’industrie porcine canadienne. Afin de mieux contrôler cette maladie, et afin d’offrir une alternative à l’utilisation excessive d’antibiotiques, le projet décrit dans ce mémoire évalue la capacité de la sous-unité majeure du fimbriae F4, FaeG, à protéger les porcelets contre ETEC F4+. Trois phases animales ont été réalisées afin de tester séparément et de façon combinée l’effet de FaeG sous forme d’émulsion orale et sous forme d’injection intramusculaire (IM). Les analyses de dosages d’anticorps spécifiques et de proliférations lymphocytaires effectuées sur les échantillons recueillis à chaque phase animale permirent d’évaluer la réponse immunitaire mucosale et systémique. Les résultats finaux obtenus ont démontré un effet des injections IM sur l’activation de la production d’anticorps sanguins ainsi que sur la prolifération de cellules mononucléées sanguines (CMS). L’évaluation de l’expression de différents gènes dans les ganglions mésentériques et dans la muqueuse iléale a permis d’observer une modulation de l’expression de certains gènes (TLR4, NFκBIA, IFNg, CCL20, CXCL2, IL4 et IL17), mais également l’absence de modulation sur plusieurs gènes attendus. Au final, certains effets secondaires observés lors des immunisations de la dernière phase animale, tels que la diarrhée, la difficulté à respirer et la faiblesse, ont nécessité des analyses supplémentaires. Il a ainsi été déterminé que plusieurs porcelets ont subi une réaction de type anaphylactique aux immunisations reçues à la dernière phase animale, bien que la composante exacte causant cette réaction soit inconnue. En conclusion, bien qu’une réponse immunitaire puisse être déclenchée par FaeG, d’autres études seront nécessaires afin de développer un vaccin oral contre ETEC F4+

A complexity-based diagnostic on the democratic unity roundtable mud: problems and alternatives (2008-2016)

Este trabajo exploratorio estudia al movimiento político Mesa de la Unidad Democrática (MUD), creada con el fin de oponerse la Gobierno socialista existente en venezuela. La crítica que este documento realiza, parte desde el punto de vista de la Ciencia de la Complejidad. Algunos conceptos clave de sistemas complejos han sido utilizados para explicar el funcionamiento y organización de la MUD, esto con el objetivo de generar un diagnóstico integral de los problemas que enfrenta, y evidenciar las nuevas percepciones sobre comportamientos perjudiciales que el partido tiene actualmente. Con el enfoque de la complejidad se pretende ayudar a comprender mejor el contexto que enmarca al partido y, para, finalmente aportar una serie de soluciones a los problemas de cohesión que presen