Resiliência e adesão ao tratamento em pacientes com lúpus eritematoso sistêmico

Universidade Federal do Rio Grande do Norte

Tratamento de fístulas enterocutâneas através de sistema a vácuo com alta pressão e dieta oral normal

Enterocutaneous fistulas are associated with prolonged hospital stay, high morbidity/mortality, and increase in hospital costs. This study aims to describe the use of a vacuum system and normal oral diet in dealing with this problem. Methods: Seventy-four consecutive patients with recent and defined external postoperative fistulas were analyzed. Abdominal imaging was used to exclude abscess and distal obstruction. The fistula tract was sealed with Foley catheter, connected to a negative pressure flask, changed daily for 5, 10 or 15 days, as necessary. Normal oral diet was permitted. Results: No patient died. Serum albumin and transferrin showed significantly higher levels at the end of treatment than at the beginning. The moderate and low-output fistulas had the best results (97% closed). Forty-eight (65%) fistulas closed after five days, 16(22%) after 10 days and 4(5%) after 15 days. Treatment failed in 6(8%) patients, who subsequently underwent surgery. Only one patient with low-output did not close her fistula. The cost of the treatment was US$ 41.75/day and it was considered cost effective. Conclusions: The vacuum system demonstrated good results in the treatment of fistulas. It included simplicity, low cost, short hospital stay, absence of skin breakdown, normal eating, good nutrition and activity patterns

Ensaio clínico duplo-cego controlado e randômico, comparando a eficácia da Clofazimina com a Cloroquina, no tratamento das lesões cutâneas do Lúpus Eritematoso Sistêmico

PURPOSE: To evaluate the capacity of clofazimine (CFZ) to control cutaneous activity of systemic lupus erythematosus (SLE), compared with chloroquine diphosphate (CDP). METHODS: A prospective, randomized, controlled, double blind clinical trial was carried out in thirty-three patients with SLE and cutaneous lesions (malar rash and/or discoid lupus and/or subacute cutaneous lupus), after approval by the respective Ethics Committee. Sixteen patients received clofazimine - 100mg/day (CFZ group) and 17 received chloroquine diphosphate - 250mg/day (CDP group), during six months. Both groups applied broad-spectrum sunscreens twice a day. The dose of prednisone was kept stable during the study. Cutaneous lesions were evaluated by 2 blinded observers and photographed at baseline and at months 1, 2, 4 and 6. RESULTS: Thirty-three patients began and 27 completed the 6 months of treatment. The groups were homogeneous and comparable in terms of demographic and clinical characteristics. Five CFZ-patients and one CDP-patients dropped out due to severe flare of disease requiring other treatment. At the end of the study, 12 CFZ-patients (75%) and 14 CDP-patients (82,4%) presented complete or near-complete remission of skin lesions; intention-to-treat analysis showed no significant difference in the response rates between groups. Side effects in both groups were frequent, but patients didn t have to discontinue the drugs. CONCLUSIONS: Clofazimine and chloroquine were effective in controlling cutaneous lesions in SLE patients

Desempenho de três linhagens de tilápia submetidas ao tratamento com 17-α-metiltestosterona em condições ambientais não controladas

Este estudo foi realizado para descrever o efeito da reversão sexual de linhagens de tilápia sobre as taxas de sobrevivência, o crescimento e o percentual de machos fenotípicos em condições ambientais variáveis. Foram utilizadas duas linhagens de Oreochromis niloticus (tilápia-do-nilo comum e tailandesa) e uma híbrida Oreochromis sp (vermelha), que receberam o hormônio masculinizante 17-α-metiltestosterona incorporado à ração (60 mg/kg) durante os primeiros 30 dias de vida. Aos 90 dias de idade, a taxa de sobrevivência da tilápia-do-nilo comum superou a da tilápia tailandesa em 39,00% e da tilápia vermelha em 22,70%, enquanto a taxa instantânea de crescimento foi similar nas linhagens comum e tailandesa e significativamente inferior na linhagem vermelha. O percentual de machos, de acordo com o exame de gônadas, decresceu na seguinte ordem: tilápia-do-nilo comum, tailandesa e vermelha. em situações de oscilação de temperatura, a linhagem comum tem maior desempenho produtivo, mas são necessários estudos para comprovação da pureza genética e análise do manejo reprodutivo de linhagens de tilápia.

Nanosistemas de penicilina G benzatina para tratamento profilático da febre reumática: estudo analítico

Investigations in the field of pharmaceutical analysis and quality control of medicines require analytical procedures with good perfomance characteristics. Calibration is one of the most important steps in chemical analysis, presenting direct relation to parameters such as linearity. This work consisted in the development of a new methodology to obtain calibration curves for drug analysis: the stationary cuvette one. It was compared to the currently used methodology, and possible sources of variation between them were evaluated. The results demonstrated that the proposed technique presented similar reproducibility compared to the traditional methodology. In addition to that, some advantages were observed, such as user-friendliness, cost-effectiveness, accuracy, precision and robustness. Therefore, the stationary cuvette methodology may be considered the best choice to obtain calibration curves for drug analyis by spectrophotometry

Extração e pré-tratamento químico de frutanos de Yacon, Polymnia sonchifolia

O processo de desintegração de tubérculos de yacon promove a incorporação de oxigênio que favorece a oxidação de compostos fenólicos e decorrente contaminação do extrato aquoso com cores e odores objetáveis que prejudicam a sua utilização. Este estudo buscou verificar uma metodologia simplificada de extração dos carboidratos presentes nos tubérculos de yacon e efetuar uma primeira remoção de resíduos e compostos originários das cores e odores indesejáveis, utilizando processos de coagulação e precipitação, aplicando tecnologias de baixo custo. Após a etapa de trituração e remoção dos restos celulares, o extrato teve seu pH aumentado para 9,5 e a temperatura para 90ºC, seguido de sedimentação. A remoção deste precipitado foi realizada por filtração em papel após a coagulação com diferentes concentrações de sulfato de alumínio comercial. Verificou-se que a melhor concentração de coagulante no extrato foi de 100ppm, removendo 90,6% dos compostos coloridos. O balanço de massa mostrou uma recuperação de 47,5% dos sólidos totais sendo que 35,6% estão na forma de carboidratos, verificado através da concentrção de carbono orgânico. O processo de pré-tratamento químico causou hidrólise nos oligofrutanos, detectado por um aumento na concentração de açúcares redutores totais, diretamente proporcional à concentração de sulfato de alumínio utilizado no tratamento de coagulação. Análises cromatográficas indicaram o perfil dos açúcares no hidrolisado e a extensão desta hidrólise que foi considerada pequena. A metodologia aplicada mostrou-se fácil, de baixo custo, eficiente e aplicável em agroindústrias nas zonas produtoras desta espécie de raiz tropical.

Avaliação dos teores de metais pesados no solo e na planta de cana-de-açúcar sob adubação com lodo de esgoto e vinhaça

The objective of this work was to evaluate Cd, Cr, Ni and Pb total contents in soil and sugar cane after four annual applications of sewage sludge and vinasse to supply all N and all K required by the crop. A field experiment was carried out on clayey Typic Haplustox. It was used a randomized block design with seven treatments and three replications. The treatments consisted in: (i) rate of sewage sludge to supply 100% of the N required by the crop; (ii) rate of sewage sludge to supply 200% of the N required; (iii) rate of vinasse to supply 100% of the K required; (iv) rate of vinasse to supply 200% of the K required; ( v) combination of the treatments ( i) and ( iii); ( vi) combination of the treatments ( ii) e ( iv); (vii) control ( mineral fertilization). The contents of Cd, Cr, Ni and Pb in sewage sludge reached maximum values of 1.58, 41.66, 35.17 and 45.25 mg kg(-1), respectively. These metals were not detected in vinasse. The residues were applied annually for four years. At the end of this period, sewage sludge and vinasse accumulated rates, that get up to 51 t ha(-1) and 762 m(3) ha(-1), respectively, did not cause alteration in Cd, Cr, Ni and Pb total contents in soil, up to 50 cm of depth, and in plant. Sewage sludge and vinasse application to supply N and K for sugar cane did not offer soil pollution risk by heavy metals.

Influência do tratamento com ácido lipoico sobre o metabolismo ósseo e perfil antioxidante de mulheres na perimenopausa

Bone is a dynamic tissue that is in constant process of remodeling in response to mechanical stress and hormonal changes. This study aimed to understand the relationship between the biochemical changes, which women in the menopausal transition are subject to, and how the use of an alternative therapy with lipoic acid (LA) could influence these changes. The study of double-blind, was carried out in perimenopausal women that underwent a three month treatment with 600 mg of AL compared with another group that received placebo during the same period. This study showed that women had a waist circunference and body mass index above the values recommended by WHO (WC ≥ 80 cm; BMI > 25kg/m2). Associated with this, these women had increased concentrations of total cholesterol and triglycerides, and borderline LDL (Total Cholesterol > 200mg/dL; Triglycerides > 150mg/dL; LDL >130mg/dL). These changes were not affected by treatment with AL. There were no shifts in liver profile (ALT, AST and GGT), kidney profile (urea, creatinine, total protein and albumin), mineral profile (Total Calcium, Ionized Calcium, Phosphorus and Magnesium) as well in bone markers (osteocalcin, Total Alkaline Phosphatase and Tartrate Resistant Acid Phosphatase) after treatment with LA. The results of the oxidative profile showed that treatment with LA decreased GPx activity (p < 0,01), while for the TBARS, GSH and SOD activity there were no differences. With regard to SOD, this enzyme will submit to be high in the placebo group after 3 months of study (p<0,05). The expression of RANKL mRNA was reduced (p < 0,05) and of RANK increased (p <0.001), after treatment with LA, while the expression of IL-6 and TNF-ɑ genes were no changed. We conclude that women already in the perimenopause stage have changes in lipid profile and body composition that could induce shifts in oxidative and bone metabolism. However, LA treatment has provided an effective effect in the oxidative and bone profile since the earliest markers such as GPx activity and mRNA expression of RANKL, respectively, were reduced associated with no change in SOD activity. These results suggest a beneficial and protective effect of LA, indicating it potential as an alternative treatment to help the to prevent the complications associated with estrogen deficiency

Avaliação da atividade antimicrobiana de sistemas emulsionados contendo óleos naturais para o tratamento de infecções cutâneas

Natural oils have shown a scientific importance due to its pharmacological activity and renewable character. The copaiba (Copaifera langsdorffii) and Bullfrog (Rana catesbeiana Shaw) oils are used in folk medicine particularly because the anti-inflammatory and antimicrobial activities. Emulsion could be eligible systems to improve the palatability and fragrance, enhance the pharmacological activities and reduce the toxicological effects of these oils. The aim of this work was to investigate the antimicrobial activity of emulsions based on copaiba (resin-oil and essential-oil) and bullfrog oils against fungi and bacteria which cause skin diseases. Firstly, the essential oil was extracted from copaiba oil-resin and the oils were characterized by gas chromatography coupled to a mass spectrometry (GC-MS). Secondly, emulsion systems were produced. A microbiological screening test with all products was performed followed (the minimum inhibitory concentration, the bioautography method and the antibiofilm determination). Staphylococcus aureus, S. epidermidis, Pseudomonas aeruginosa, Candida albicans, C. parapsilosis, C. glabrata, C. krusei and C. tropicalis American Type Culture Collection (ATCC) and clinical samples were used. The emulsions based on copaiba oil-resin and essential oil improved the antimicrobial activity of the pure oils, especially against Staphylococcus e Candida resistant to azoles. The bullfrog oil emulsion and the pure bullfrog oil showed a lower effect on the microorganisms when compared to the copaiba samples. All the emulsions showed a significant antibiofilm activity by inhibiting the cell adhesion. Thus, it may be concluded that emulsions based on copaiba and bullfrog oils are promising candidates to treatment of fungal and bacterial skin infections

Uso da fluoxetina no tratamento da tricotilomania felina

A tricotilomania ou alopecia psicogênica felina é uma dermatopatia de origem psicogênica, decorrente da lambedura compulsiva do pelame, realizada pelo gato em situações de estresse. Tal distúrbio decorre de alterações neuro-hormonais e pode associar-se à introdução de novos animais e/ou crianças no ambiente. Além de mudanças de manejo e atitude para com o animal, sugere-se o emprego de ansiolíticos no tratamento da doença. A fluoxetina foi utilizada no tratamento de cinco gatos domésticos com tricotilomania, apresentando inibição do comportamento de lambedura, com repilação após dois a três meses de terapia.

Linfoma canino: clínica, hematologia e tratamento com o protocolo de Madison-Wisconsin

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Alterações ecocardiográficas em cães sob tratamento prolongado com doxorrubicina

Avaliou-se a cardiotoxicidade da doxorrubicina utilizando-se sete cães adultos, clinicamente normais, que receberam 30mg/m² de cloridrato de doxorrubicina (Adriblastina®) por via intravenosa, a cada 21 dias, durante 168 dias (grupo A), perfazendo dose cumulativa total de 240mg/m². em outros sete cães (grupo B) administraram-se 5ml de solução salina 0,9% estéril por via intravenosa, seguindo-se o esquema de aplicação proposto anteriormente. Os animais foram avaliados, periodicamente, por meio de exames ecocardiográficos em modo-M e bidimensional. Verificou-se aumento (P<0,01) no diâmetro e volume do ventrículo esquerdo, inicialmente em sístole e, posteriormente, em diástole, hipocinesia do septo interventricular e da parede livre do ventrículo esquerdo, reduções de aproximadamente 65% nas frações de encurtamento e de ejeção, além de aumento da separação do septo do ponto E do folheto anterior da válvula mitral nos animais do grupo A. As alterações cardíacas decorrentes do tratamento crônico com doxorrubicina foram semelhantes àquelas descritas em cães com cardiomiopatia dilatada, e os índices ecocardiográficos puderam ser utilizados no acompanhamento e na prevenção da cardiotoxicidade pelo quimioterápico.

Eficácia da imunoterapia no tratamento de pitiose facial em equino

Background: Pythiosis in horses is a proliferative and ulcerative disease that primarily affects the skin and subcutaneous tissue of limbs, thoracic-abdominal region and head. This disease sometimes can also affect limb bones or cause tumoral masses in abdomen. Usually, the cutaneous cases are confused with habronemiasis. The disease is more common in marshy areas, places with formation of slow drainage ponds and aquatic vegetation under high temperatures. The aim of this study was to describe the development of facial lesions in a horse caused by pythiosis in Cuiaba, Mato Grosso, and, additionally to discuss relevant issues regarding the diagnosis, clinical course and response to immunotherapy treatment.Case: One five years old mare of unknown breed, created in property located in the Cerrado region, had a wound on its face difficult to be healed and non-responsive to several treatments based on ivermectin and organophosphate administrated by either topical or systemic via. The animal was assisted on the farm of origin by the veterinary team of the Clinical Medicine sector, of the Veterinary Hospital, Universidade Federal de Mato Grosso (HOVET-UFMT). on the occasion of the visit, which occurred 60 days after onset of signs, the animal showed a circular single large lesion, ulcerative with serous discharge on the right part of its face, between the eyes and nostrils. There were some necrotic foci with sinus, from which kunkers were extracted; a condition compatible with pythiosis. The diagnosis was confirmed by histology, ELISA and PCR.Discussion: Assuming pythiosis from data obtained from the survey and profile of the lesion (secretory aspect, emaciation and presence of sinus and kunkers), immunotherapy treatment was immediately applied. The advanced clinical aspects and the fact that early diagnosis and treatment are essentials to satisfactory therapeutic response were also taken into consideration for starting the treatment. The remission of signs was achieved after five subcutaneous applications with 14 days between each application. From the second application, it was observed clinical improvement and after 60 days of treatment there was almost complete remission of signs. The signs for a satisfactory response in the injury site followed the order of decreasing secretory aspect, decreasing borders, decrease the itching and bringing the edges together with the formation of a thin layer of crust on the surface. Pythiosis cases with lesions on the face and lower abdomen are commonly confused with habronemiasis by macroscopic and widespread similarity between technicians and attendants, and essential support to the diagnosis through laboratory tests, which in turn are still underutilized. In this case, the authors demonstrated the therapeutic efficacy of immunotherapy as an advantage, considering the possibility of applying it in cases of lesions in areas of difficult surgical access, treatment conditions in the field, with low cost and ease of application. Further studies approaching this alternative therapy are necessary, since side effects have been observed in some cases.

Remoção de matéria orgânica, de nutrientes e de coliformes no processo anaeróbio em dois estágios (reator compartimentado seguido de reator UASB) para o tratamento de águas residuárias de suinocultura

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Transition metal rates in latosol twice treated with sewage sludge

A reciclagem agrícola do lodo de esgoto tem provocado o acúmulo de metais pesados no solo e na água, podendo atingir níveis tóxicos e causar danos às plantas cultivadas, aos animais e ao homem, por meio da cadeia trófica. Neste intuito foi desenvolvido o presente experimento, em condições de campo, entre 2000 e 2002, onde foram avaliados os efeitos da aplicação de lodo de esgoto por dois anos, sobre a extração de metais de transição (essenciais e não) pelo extrator DTPA em um Latossolo Vermelho distrófico (LVd) de textura média. As concentrações dos elementos metálicos: Mn, Fe, Cd, Ni, Co, Pb e Cr não foram detectados pelo método da absorção atômica na solução obtida com o extrator DTPA. A aplicação de lodo de esgoto causou inicialmente pequena elevação no pH do solo, posteriormente a diminuição do mesmo, e manteve-se próximo ao original. Foi possível concluir que, com a aplicação consecutiva do lodo, os teores extraíveis de Fe e Mn nas amostras de solos aumentaram gradativamente nos dois anos agrícolas, com as doses do lodo de esgoto aplicado, época de amostragens, e foram superiores ao tratamento testemunha. O extrator apresentou capacidade restrita para avaliação da fitodisponibilidade dos metais pesados decorrentes das baixas concentrações nas amostras de solo.