Consenso de imunização para crianças e adolescentes com doenças reumatológicas

Crianças e adolescentes com doenças reumatológicas apresentam maior prevalência de doenças infecciosas quando comparados com a população em geral, em decorrência de atividade da doença, possível deficiência imunológica secundária à própria doença, ou uso de terapia imunossupressora. A vacinação é uma medida eficaz para a redução da morbidade e mortalidade nesses pacientes. O objetivo deste artigo foi realizar um consenso de eficácia e segurança das vacinas em crianças e adolescentes com doenças reumatológicas infantis baseadas em níveis de evidência científica. Imunização passiva para os pacientes e orientações para as pessoas que convivem com doentes imunodeprimidos também foram incluídas. Os 32 pediatras reumatologistas membros do Departamento de Reumatologia da Sociedade de Pediatria de São Paulo (SPSP) e/ou da Comissão de Reumatologia Pediátrica da Sociedade Brasileira de Reumatologia elaboraram o consenso, sendo que alguns desses profissionais estão envolvidos em pesquisas e publicações científicas nesta área. A pesquisa dos termos eficácia e/ou segurança das diferentes vacinas em crianças e adolescentes com doenças reumatológicas foi realizada nas bases de Medline e Scielo, de 1966 até março de 2009, incluindo revisões, estudos controlados e relatos de casos. O grau de recomendação e o nível científico de evidências dos estudos foram classificados em quatro níveis para cada vacina. de um modo geral, as vacinas inativadas e de componentes são seguras nos pacientes com doenças reumatológicas, mesmo em uso de terapias imunossupressoras. Entretanto, vacinas com agentes vivos atenuados são, em geral, contraindicadas para os pacientes imunossuprimidos.

Estudos hematológico e hormonal de frangos de corte tratados com contaminantes do milho: Crotalaria spectabilis e Senna occidentalis

Crotalaria spectabilis (crotalária) e a Senna occidentalis (fedegoso) podem crescer em plantações de milho e, durante a colheita, este cereal pode ser contaminado com as sementes dessas plantas, que apresenta toxicidade para os animais. O objetivo deste estudo foi investigar os parâmetros morfométricos dos eritrócitos, as variáveis hematológicas e a concentração plasmática hormonal dos frangos de corte tratados com ração de dois níveis de energia, que foi adicionada de 0,1% e 0,5% de sementes de Crotalaria spectabilis e Senna occidentalis, respectivamente. Cento e oitenta frangos de corte foram divididos em seis grupos, de acordo com uma análise fatorial 3 x 2 (controle, crotalária e fedegoso como tratamentos principais e dois níveis de energia, 2.900 e 3.200 kcal ME/kg de ração). Os resultados deste experimento mostraram que o efeito tóxico da crotalária determinou uma redução no número de hemácias, no valor do hematócrito e do VCM, não influenciando os parâmetros morfométricos avaliados. A semente de crotalária induziu, também, aumento na incidência de ascite, em função de sua toxicidade hepática. Já a semente de fedegoso não mostrou toxicidade suficiente para induzir ascite nos frangos.

Estudos de expressão gênica utilizando-se microarrays: delineamento, análise, e aplicações na pesquisa zootécnica

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Utilização do colágeno cromatado como indicador em estudos de digestão com caprinos

The objective of this research was to study the feasibility of utilizing chromated collagen as an external indicator of digestibility by comparing it to acid insoluble ash (AIA) and indigestible acid detergent fiber (IADF) as internal markers, and to the total collection method. Six castrated Alpine breed kid goats with an average weight of 33,4 kg were used. They were housed in metabolism cages. Feeding was based on 60 g/kg PV 0,75 of a pelleted ration per animal, supplied daily in two meals (7 am and 4 pm). The experimental design was completely randomized with four treatments and six replications. The results permitted the conclusion that the chromated collagen was the best of the indicators studied, and therefore, is one more indicator which can be used. The AIA and IADF were less efficient and underestimated the digestibility of the feed.

Estudos hídricos com substratos vegetais para cultivo de orquídeas epífitas

Different growing media were compared as to water adsorption and water loss, at Jaboticabal, SP, Brazil, through a three-year period. The objective was to recommend substrates other than tree fern fiber for cultivation of epiphytic orchids. Two treatments of each substrate were used in each sampling: materials stored in laboratory (without use) and materials exposed to conditions of orchid cultivation under laths (used). Generally, the substrates without use adsorbed less water than used substrates. When materials without use were compared, the tree fern fiber retained initially the greatest quantity of water and the blocks of pressed coconut bark, the smallest. However, these blocks gained a great capacity of water adsorption after being used. Charcoal added to the growing media did not cause significant alterations in the studied characteristics. In terms of water relations, the best growing media to substitute the tree fern fiber were composed by blocks of pressed coconut bark or by mixtures of this material with charcoal or Eucalyptus grandis bark. Bark of E grandis alone or in mixture with charcoal did not give good results.

Eficácia e segurança do uso inalatório da adrenalina-L na laringite pós-intubação utilizada em associação com a dexametasona

Objective: to assess the efficacy and safety of the use of nebulized L-epinephrine associated with dexamethasone in post-intubation laryngitis. Method: we carried out a prospective, randomized, double-blind, placebo controlled study with two cohorts of patients with postintubation laryngitis graded 3 to 6 by Downes and Raphaely score and during two years. Our population was divided into two groups: A and B; both groups received intravenous dexamethasone and nebulized saline with (group B) and without (group A) L-epinephrine. The efficacy was assessed by Downes and Raphaely's score. The side effects of epinephrine were evaluated according to occurrence of arrhythmia, to increased blood pressure, and to average heart rate of group B in comparison to group A. Results: twenty-two patients were included in group A (average score = 4.8) and 19 in group B (average score = 5.2). During treatment, 3 patients in group A presented a score of 8 and were reintubated. This group also showed higher clinical scores than group B during the first two hours of the protocol; these results were not statistically significant. No side effects were observed due to epinephrine. The gasometric parameters were adequate in both groups, but better in the control group. Conclusions: we did not observe increased efficacy for the treatment of post-intubation laryngitis when nebulized L-epinephrine was used simultaneously with intravenous dexamethasone. Some indicators, however, did present a favorable trend when combined therapy was used and should be submitted to further evaluation.

Utilização de índices de estabilidade transitória para a avaliação de segurança dinâmica

Indices that report how much a contingency is stable or unstable in an electrical power system have been the object of several studies in the last decades. In some approaches, indices are obtained from time-domain simulation; others explore the calculation of the stability margin from the so-called direct methods, or even by neural networks.The goal is always to obtain a fast and reliable way of analysing large disturbance that might occur on the power systems. A fast classification in stable and unstable, as a function of transient stability is crucial for a dynamic security analysis. All good propositions as how to analyse contingencies must present some important features: classification of contingencies; precision and reliability; and efficiency computation. Indices obtained from time-domain simulations have been used to classify the contingencies as stable or unstable. These indices are based on the concepts of coherence, transient energy conversion between kinetic energy and potential energy, and three dot products of state variable. The classification of the contingencies using the indices individually is not reliable, since the performance of these indices varies with each simulated condition. However, collapsing these indices into a single one can improve the analysis significantly. In this paper, it is presented the results of an approach to filter the contingencies, by a simple classification of them into stable, unstable or marginal. This classification is performed from the composite indices obtained from step by step simulation with a time period of the clearing time plus 0.5 second. The contingencies originally classified as stable or unstable do not require this extra simulation. The methodology requires an initial effort to obtain the values of the intervals for classification, and the weights. This is performed once for each power system and can be used in different operating conditions and for different contingencies. No misplaced classification o- - ccurred in any of the tests, i.e., we detected no stable case classified as unstable or otherwise. The methodology is thus well fitted for it allows for a rapid conclusion about the stability of th system, for the majority of the contingencies (Stable or Unstable Cases). The tests, results and discussions are presented using two power systems: (1) the IEEE17 system, composed of 17 generators, 162 buses and 284 transmission lines; and (2) a South Brazilian system configuration, with 10 generators, 45 buses and 71 lines.

Estudos sobre liberação controlada e vetorização de drogas através de lipossomas

The text highlights the state of research related with the application of liposomes in the control of drug delivery and drug target to infectious diseases. Liposomes have several pharmaceutical applications and this manuscript is primarily focused on the potential of this colloidal system as an antibiotic carrier system and of administration through several accesses via to organism. Numerous case studies in which liposomes have successfully been used to improve pharmacological drug effect are presented. Mechanisms involved in drug delivery, application possibilities, research and development and efforts to reach these objectives are discussed. © Copyright Moreira Jr. Editora. Todos os direitos reservados.

Eficácia e segurança da atorvastatina no tratamento de pacientes com hipercolesterolemia primária

Introduction: Hypercholesterolemia is an important risk factor for cardiovascular disease, the first cause of death and third reason for hospital admissions in Brazil. The reduction of serum cholesterol levels reduces morbidity and mortality from cardiovascular disease. The present study evaluated the efficacy and safety of atorvastatin in the treatment of Brazilian patients with primary hypercholesterolemia (types IIA and IIB dyslipidemias). Patients and methods: After a 4-week wash-out period, 152 patients were treated with atorvastatin at the initial dose of 10 mg/day. According to treatment efficacy within the first 8 weeks this dose could be increased to 20 mg/day. Treatment lasted for a total of 16 weeks, and its efficacy was evaluated by the reduction of serum levels of LDL-cholesterol, total cholesterol, HDL-cholesterol, and triglycerides, as well as by the propotion of patients that achieved the target levels recommended by the National Cholesterol Education Program - Adult Treatment Panel II (NCEP ATP II) Results: The analysis of efficacy was conducted in 145 patients. Atorvastatin led to significant reductions in the levels of LDL-cholesterol after 8 and 16 weeks of treatment (P<0.001 for both comparisons). The relative reduction of such levels was 38% (P<0.001 after 8 and 16 weeks). Atorvastatin also led to significant reductions of total cholesterol and triglycerides. At the end of the study, 81% of patients achieved the target LDL-cholesterol levels recommended by NCEP ATP II. Treatment was well tolerated, and was interrupted due to creatine phosphokinase elevation in only one patient. Conclusion: Atorvastatina is efficacious and safe in the treatment of patients with primary hypercholesteromia. © Copyright Moreira Jr. Editora. Todos os direitos reservados.

Estudos ecológicos em taxocenoses helmínticas de Chaunus ictericus (Spix, 1824) e C. schneideri (Werner, 1894) (Anura: Bufonidae) simpátricos, capturados no distrito de São Cristóvão, Município de Três Barras, Santa Catarina.

Fifty eight Chaunus ictericus and 42 C. schneideri specimens were collected on São Cristóvão district, Três Barras, SC for helminthological studies. Fourteen helminth species were diagnosed, from which only five species were found on both hosts. Chaunus ictericus showed higher values of species richness (2,8448+/-1,1516) and diversity (H = 1,374), with mild dominance (1-D = 0,642, J = 0,5528), in comparison with C. schneideri (0,6428+/-1,007; H = 1,165; 1-D = 0,5822 e J = 0,5985). Also, descriptors of helminthic infection were superior in the former host. Little number of shared species between the analyzed toad species suggests parasitic host-specificity.

Caracterização de biotérios, legislação e padrões de biossegurança

The use of laboratory animals in conjunction with research on the human organism provides a basis for on understanding of several important physiological and pathological processes. Besides, the results of experimental studies enable technical and safety improvements to be made in surgical techniques used in the medical clinic. As living biological material is involved, we should guarantee its physical well-being, taking into account microbiological contamination and the genetics, nutrition and correct manipulation of the animals, in order to avoid incorrect conclusions from the experiments or unnecessarily large numbers of animals being used. In parallel with the concerns and legislation on the use of laboratory animals, there is also a growing preoccupation with the welfare and safety of those who handle the laboratory animals, since they run the risk of acquiring occupational diseases through contact with zoonotic pathogens or developing allergies. Prevention requires the application of modern technological advances in the design of the animal house and in the work routines. Unfortunately, few establishments in Brazil possess staff with adequate training and a basic infrastructure of research that includes the laboratory animal breeding centers, equivalent to those existing ones in the United States and Europe.

Farmacovigilância no Brasil: A relação entre polimorfismo de fármacos, efetividade e segurança dos medicamentos

In spite of the stated Brazilian policy on medicines that their quality, effectiveness and safety should be ensured at reasonable cost, hospitals in the ANVISA Surveillance Network have been receiving notifications of technical complaints, adverse reactions and suspected therapeutic ineffectiveness (STI) of medicines. The purpose of this study was to identify the medicines notified for suspicion of therapeutic ineffectiveness, at a university hospital participating in the national Surveillance Network, and to investigate the existence of polymorphs of any of the drugs involved, by examining the literature. There were 31 notifications of STI in a period of 18 months, concerning 11 different drugs, all of which were 'similar' drugs (neither original nor licensed by originator); five of these could contain polymorphs, according to the literature. However, this does not mean that the other drugs could not contain some unknown polymorphs, more studies being needed on polymorphism, especially in the cases of reported therapeutic ineffectiveness. Therefore, tests of polymorphism should be made part of the routine quality control of the raw materials during the development of medicines and in the studies of pharmaceutical equivalence to 'reference' medicines (innovative brands). The stability test should also involve a study of polymorphism, in order to confirm the solid state stability of the drug. All these measures will assure the effectiveness of medicines, since the reproducibility in the quality of pharmaceutical products could be monitored, as well as the equivalence of each production batch with the batch selected to determine the bioequivalence with the reference brand.

Ensaios biológicos para avaliação de segurança de produtos cosméticos

Despite efforts to the contrary, some cosmetic products can cause undesirable side effects in the users. These may often be due to individual factors or inappropriate use of the product. Thus, biological assays to assess the safety of a new cosmetic must precede its being placed on the market. Historically, these tests have always been carried out in vivo, in animals, since such tests can be used to evaluate many of the potential risks, such as irritation, allergy or systemic effects; but, recently, some research centers have been adopting in vitro alternatives, in order to replace the animal tests. This review emphasizes the need to employ biological assays to test the safety of cosmetic products, and reviews the main in vivo and in vitro tests used, focusing on the need to develop and use alternatives to the in vivo assays of product safety, so as to offer the consumers the maximum safety with the least possible risk, while ensuring the best conditions of use of the product.

Investimento e reformas no Brasil: industria e infra-estructura nos anos 1990

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Padronização dos critérios de seleção em estudos sobre medicações nasais

Clinical studies on nasal topical medications require the standardization of nasosinusal normality in order to establish control groups through a specific evaluation of the upper airways. Aim: to standardize the evaluation of candidates for control groups in clinical studies on nasal topical medications. Material and Methods: healthy male volunteers of 18 to 50 years of age, asymptomatic from the nasosinusal standpoint were subjected to a sequential and excluding assessment made up of clinical evaluation, immediate hypersensitivity skin test, saccharin test, flexible nasofibroscopy and nasal cytology. Study design: Crosssectional contemporary cohort. Results: Of the 33 people originally enrolled, 14 (42.4%) were excluded for clinical reasons. Of the 19 remaining, 2 (10.5%) had atopy diagnosed in the skin test and were excluded. 17 were tested with saccharin and presented normal mucociliary clearance. Evaluation by nasal endoscopy showed abnormality in 2 cases (11.8%) and these were excluded. The remaining 15 were submitted to nasal cytology, which proved normal, representing 45.5% of those initially included. Conclusion: The proposed protocol for sequential and excluding evaluation was effective in defining candidates for the establishment of control groups in clinical studies on nasal topical medications. © Revista Brasileira de Otorrinolaringologia. All Rights reserved.