A cocaína e suas manifestações orofaciais

A cocaína é uma droga com ação estimulante no sistema nervoso central, extraída e refinada a partir da planta de coca (Erythroxylum coca). É característica por induzir o consumidor a um estado de hipervigilância reduzindo ao mesmo tempo, o cansaço e a fadiga. Este pó branco, cristalino, de sabor amargo, possui também um efeito anestésico local e vasoconstritor. As formas de apresentação mais comuns da droga são o cloridrato de cocaína e a cocaína crack. Esta droga destaca-se por ser o estimulante mais consumido na Europa com cerca de 3,4 milhões de consumidores estimados no ano de 2014. A prevalência do consumo desta droga em Portugal aumentou 0,3% de 2001, para 2012 na população geral (15-64 anos). Os estudos mais recentes em populações escolares (entre 2010 e 2011) evidenciaram, de um modo geral, o aumento da prevalência de consumo nesta população. Os efeitos adversos resultantes, tanto a nível físico como psíquico, são vários, sendo as manifestações orofaciais as que mais interferem na Qualidade de vida do toxicómano. As manifestações mais frequentes são as perfurações do septo nasal e palatino, bruxismo, gengivite, erosão dentária, xerostomia, cárie, lesões brancas atípicas e cefaleias em salva, tendo o Médico Dentista um papel importante no diagnóstico e tratamento destas lesões. A legislação, ao nível Europeu, sobre drogas procura uma uniformização das medidas aplicadas nos países membros, baseando-se no equilíbrio entre as sanções e o tratamento. Apesar das convenções das Nações Unidas sobre drogas limitarem o consumo de estupefacientes e substâncias psicotrópicas exclusivamente para fins médicos e científicos, cabe aos países signatários a liberdade de decisão das políticas a adoptar em matérias de infrações penais como a posse e o consumo ilegal.

Procoagulant state after raloxifene therapy in postmenopausal women

AZEVEDO, George Dantas de et al. Procoagulant state after raloxifene therapy in postmenopausal women. Fertility and Sterility, Estados Unidos, v.84, n.6, p.1680-1684, 2005

Raloxifene therapy does not affect uterine blood flow in postmenopausal women: a transvaginal Doppler study

AZEVEDO, George Dantas de et al. Raloxifene therapy does not affect uterine blood flow in postmenopausal women: a transvaginal Doppler study. Maturitas, Amsterdam, v.47, n.3, p.195-200, 2004

Produção de quitosana a partir de resíduos de camarão: análise do processo e da operação de secagem

A quitina é encontrada principalmente nos exoesqueletos de crustáceos, insetos e na parede celular de fungos. O biopolímero quitosana é obtido através da hidrólise alcalina da quitina. A despolimerização da quitosana é realizada para se obter um produto com valores baixos de massa molecular. O uso da quitosana em diversas áreas é diretamente relacionada com a massa molecular e o grau de desacetilação do polímero. Os objetivos deste trabalho foram o estudo da cinética de secagem de quitina em camada delgada utilizando um modelo difusivo, considerando a resistência externa à transferência de massa; a determinação do comportamento da massa molecular média viscosimétrica da quitosana, durante a secagem convectiva, em camada delgada; a otimização das etapas de desacetilação e despolimerização da quitosana. A quitina foi obtida de resíduos de camarão. Os experimentos da secagem de quitina e da quitosana foram em secador de bandejas, a 60°C, sendo que para a quitina foram utilizadas duas velocidades do ar de 0,5 e 1,5 m/s. A estimativa da viscosidade intrínseca foi através da equação de Huggins e a massa molecular da quitosana foi calculada pela equação de Mark-Houwink-Sakurada. As otimizações da reação de desacetilação e despolimerização foram realizadas utilizando a metodologia da superfície de resposta. Para a reação de desacetilação foram variados o tempo e a temperatura. Para a reação de despolimerização foram analisados a concentração de ácido clorídrico, a temperatura e o tempo de reação. O modelo difusivo com difusividade efetiva variável, utilizado para analisar a secagem de quitina, apresentou concordância com os dados experimentais, onde foi observado o efeito da resistência externa à transferência de massa, quando utilizada a menor velocidade do ar. A condição ótima da reação de desacetilação para massa molecular foi observada na temperatura de 130°C em 90 min, e correspondeu a massa molecular de 150 kDa e um grau de desacetilação de 90%. A operação de secagem da quitosana causou um aumento na massa molecular média viscosimétrica de 27% e este aumento foi linear com o tempo e a umidade do polímero, apresentando duas regiões. As condições da reação de despolimerização para alcançar 50 kDa foram à temperatura de reação de 65°C, concentração de ácido clorídrico de 35% v/v. Nestas condições a cinética de despolimerização foi de pseudo-primeira ordem, apresentando duas fases.

Effects of feeding carnitine and ractopamine on rainbow trout (Oncorhynchus mykiss, Walbaum 1972)

L-carnitine is required for the transfer of long-chain fatty acids from the cytosol to the mitochondrial matrix for 13-oxidation of them and ractopamine, beta adrenergic agonists, have potential stimulating lipolysis and altering rates of protein degradation and synthesis. Present study was carried out to improve lipid body oxidation and protein-sparing action of fish through addition of L-carnitine and ractopamine to diet of rainbow trout, Oncorhynchus mykiss, Walbaum 1972. An eight-week feeding trial was carried out to evaluate the effects of supplementation of tree levels of L-carnitine tartrate (0, 1 and 2 g/kg) and two levels of ractopamine hydrochloride (0 and 10 ppm) on growth performance, fillet muscle fatty acid compositions and blood biochemical parameters in 288 juvenile rainbow trout (130 g) at 3X2 factorial experimental design. Ractopamine and 1 g/kg carnitine improved the specific growth rate, feed conversion ratio, protein efficiency ratio and weight gain at the end of experiment. The protein and lipid contents of fillet muscle were affected by the inclusion of 10 mg/kg ractopamine in the diet, increasing crude protein and reducing crude fat (P<0.05) of fish fillet muscle. The highest protein and lowest fat contents of fish fillet were observed in diet that contains 2 g/kg carnitine plus ractopamine. Ractopamine and carnitine increased levels of albumin, total protein and globulin in fish blood serum, but carnitine increased triacylglycerol and cholesterol. Fatty acids compositions of fish fillet were also affected by ractopamine and carnitine. All fatty acids except for eicosapentaenoic acid and docosahexaenoic acid, were increased by dietary supplementation of ractopamine. Total saturated fatty acids were not affected by carnitine. Supplementation (P>0.05). However, total n-3 poly unsaturated fatty acids were reduced by carnitine supplementation. A significant interaction was observed between ractopamine and carnitine supplementation regarding the saturated (P<0.01) and n-3 poly unsaturated fatty acid (P<0.001) of fish fillet. This study shows that supplementation of 1 g/kg carnitine and 10 ppm ractopamine could improve performance of juvenile rainbow trout and their combination in diet results in protein increment, fat reduction and change in profile of fatty acids in fillet muscle.

Safe lipid nanocapsule-based gel technology to target lymph nodes and combat mediastinal metastases from an orthotopic non-small-cell lung cancer model in SCID-CB17 mice

International audience

Vinculação do Adulto e Sistema Comportamental de Prestação de Cuidados em Toxicodependentes integrados em Comunidade Terapêutica e em Programa de Metadona

Dissertação de Mestrado apresentada no Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Clínica

Therapeutic effects of ciprofloxacin/bushenhuazhuo combination on chronic prostatitis

Purpose: To evaluate the clinical effect of bushenhuazhuo (a Chinese traditional medicine) in combination with ciprofloxacin (an orthodox medicine) in chronic prostatitis (CP) therapy. Methods: A total of 160 patients who suffered from CP and received treatment in the People’s Hospital of Zhengzhou between April 2012 and June 2014 were selected and divided randomly into treatment and control groups, with 80 patients in each group. Control group was given 0.25 g ciprofloxacin hydrochloride tablets twice a day for 4 weeks. In addition to ciprofloxacin administration, patients in the treatment group also received a dose of bushenhuazhuo preparation twice daily for 4 weeks. Clinical outcomes, quality of life as well as lecithin body and white blood cell (WBC) count in expressed prostatic secretions (EPS-WBC) were evaluated. Results: Cure rates in the treatment and control groups were 90 and 72.50 %, respectively; this difference was significant (p < 0.05). Scores for National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), WBC, and lecithin bodies in the treatment group (8.20 ± 2.20 points, 4.50 ± 1.20 points, and 28.10 ± 2.10 points, respectively) were higher (p < 0.05) than for the control group (12.20 ± 2.20, 6.30 ± 2.20, and 23.30 ± 2.90 points, respectively). The levels of interferon (IFN)-γ and tumour necrosis factor (TNF)-α in the treatment group (26.20 ± 3.30 and 33.80 ± 5.40 mg/L, respectively) were lower than those in the control group (37.70 ± 3.90 and 48.40 ± 3.70 mg/L, respectively), whereas the level of interleukin (IL)-10 in the treatment group (292.60 ± 23.70 mg/L) was higher (p < 0.05) than that in control group (235.80 ± 25.90 mg/L). Conclusion: Ciprofloxacin combined with the Chinese traditional medicine, bushenhuazhuo preparation, demonstrates a marked therapeutic effect in CP. Its mechanism of action may be related to decreased levels of IFN-γ and TNF-α and increased IL-10.

One-pot synthesis of aminated multi-walled carbon nanotube using thiol-ene click chemistry for improvement of epoxy nanocomposites properties

A non-oxidative method based on thiol-ene click chemistry for functionalization of multi-walled carbon nanotube (CNT) was performed in order to improve the interfacial interactions between epoxy matrix and CNT. In this way, the CNT was aminated using 2-aminoethanethiol hydrochloride radicals thermally produced by a peroxide radical initiator. The aminated CNT (CNT-NH2) was characterized by FTIR, TGA, and solubility evaluations, confirming that thiol radicals are successfully grafted onto the CNT surface with a proper yield. Various percentages of pure CNT (p-CNT) and CNT-NH2 were then incorporated into epoxy matrix to evaluate the effect of the functionalization of CNT on thermal, mechanical, and morphological properties. The nanocomposites were characterized by DMA, tensile testing, and TGA. Results showed that glass transition temperature, tensile properties and thermal stability of epoxy nanocomposites containing CNT-NH2 improves significantly compared to those containing unmodified CNT. These results prove the role of amino-functionalization in improving the interfacial adhesion between epoxy and CNT, which was further confirmed by morphological observations of fracture surfaces of the nanocomposites.

A novel and facile approach to fabricate a conductive and biomimetic fibrous platform with sub-micron and micron features

The demands of multifunctional scaffolds have exceeded the passive biocompatible properties previously considered sufficient for tissue engineering. Herein, a novel and facile method used to fabricate a core-shell structure consisting of a conducting fiber core and an electrospun fiber shell is presented. This multifunctional structure simultaneously provides the high conductivity of conducting polymers as well as the enhanced interactions between cells and the sub-micron topographical environments provided by highly aligned cytocompatible electrospun fibers. Unlimited lengths of PEDOT:PSS-Chitosan-PLGA fibers loaded with an antibiotic drug, ciprofloxacin hydrochloride, were produced using this method. The fibers provide modulated drug release with excellent mechanical properties, electrochemical performance and cytocompatibility, which hold great promise for the application of conductive electrospun scaffolds in regenerative medicine.

Effect of adjunctive raloxifene therapy on severity of refractory schizophrenia in women: a randomized clinical trial

IMPORTANCE: A substantial proportion of women with schizophrenia experience debilitating treatment-refractory symptoms. The efficacy of estrogen in modulating brain function in schizophrenia has to be balanced against excess exposure of peripheral tissue. Raloxifene hydrochloride is a selective estrogen receptor modulator (mixed estrogen agonist/antagonist) with potential psychoprotective effects and fewer estrogenic adverse effects. OBJECTIVE: To determine whether adjunctive raloxifene therapy reduces illness severity in women with refractory schizophrenia. DESIGN, SETTING, AND PARTICIPANTS: This 12-week, double-blind, placebo-controlled, randomized clinical trial with fortnightly assessments was performed at an urban tertiary referral center and a regional center from January 1, 2006, to December 31, 2014. Participants included 56 women with schizophrenia or schizoaffective disorder and marked symptom severity despite substantial and stable antipsychotic doses. Data were analyzed using intention to treat as the basis. INTERVENTIONS: Adjunctive raloxifene hydrochloride, 120 mg/d, or placebo for 12 weeks. MAIN OUTCOMES AND MEASURES: The primary outcome was the change in the Positive and Negative Syndrome Scale (PANSS) total score. Clinical response (defined as a ≥20% decrease in PANSS total score from baseline) and change in PANSS subscale scores, mood, cognition, reproductive hormone levels, and adverse events were also assessed. RESULTS: Of the 56 participants (mean [SD] age, 53 [7.7] years; age range, 40-70 years; mean [SD] duration of psychotic illness, 24 [11] years), 26 were randomized to raloxifene and 30 were randomized to placebo. Raloxifene produced a greater reduction in the PANSS total score relative to placebo (β = -6.37; 95% CI, -11.64 to -1.10; P = .02) and resulted in an increased probability of a clinical response (hazard ratio, 5.79; 95% CI, 1.46 to 22.97; P = .01). A significant reduction was found in the PANSS general symptom scores for the raloxifene compared with the placebo (β = -3.72; 95% CI, -6.83 to -0.61; P = .02) groups. For patients who completed the full 12-week trial, there was not a statistically significant treatment effect on PANSS positive symptom scores (β for change in raloxifene vs placebo, -1.92; 95% CI, -3.83 to 0.00; P = .05). Change in mood, cognition, and reproductive hormone levels and the rate of adverse events did not differ between groups. CONCLUSIONS AND RELEVANCE: Raloxifene hydrochloride, 120 mg/d, reduces illness severity and increases the probability of a clinical response in women with refractory schizophrenia. This large trial of raloxifene in this patient population offers a promising, well-tolerated agent that has potential application in clinical practice. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00361543.

Incidencia de síndrome de abstinencia secundario a opioides y/o benzodiacepinas en dos unidades de cuidados intensivos pediátricos

• Introducción: El síndrome de abstinencia (SA) es el conjunto de síntomas y signos que se producen al suspender bruscamente la administración de un fármaco una vez se haya establecido dependencia física. • Objetivos: Caracterizar los pacientes que presentan SA secundario a opiodes (OP) y/o benzodiacepinas(BZ) durante la hospitalización en las unidades de cuidados intensivos pediátricos de la Clínica Infantil Colsubsidio (CIC) y Hospital del Niño de Panamá (HDN) del 1 de abril al 30 de septiembre del 2016. • Materiales y métodos: se realizó un estudio descriptivo, longitudinal, prospectivo. Incluimos 189 pacientes en la CIC y 144 pacientes en el HDN. Se utilizó la escala SOPHIA para el diagnóstico de SA, las escalas COMFORT para evaluar la sedación en pacientes ventilados no relajados y la escala FLACC para evaluar la analgesia. Se utilizó software StataV12® para el análisis estadístico. • Resultados: se reportó una incidencia global de SA de 6.1/100 días personas. La incidencia acumulada de SA fue de 56.08% y 29.86% para la CIC y el HDN respectivamente. En la CIC el 69.81% de los pacientes que requirieron infusión de OP y BZ desarrollaron SA. Se reportó una dosis acumulada de fentanyl de 530.34 ± 276.49 mcg/kg. Con respecto al HDN, de los pacientes que recibieron opioides y benzodiacepinas el 53.49 % desarrollaron SA. • Conclusión: El SA secundario a opioides y/o benzodiacepinas es frecuente en nuestras unidades con una incidencia variable, es mayor la presentación del SA al usar ambos fármacos, mayores dosis acumuladas y más días de infusión continua.