Pre-formulation and systematic evaluation of amino acid assisted permeability of insulin across in vitro buccal cell layers

The aim of this work was to investigate alternative safe and effective permeation enhancers for buccal peptide delivery. Basic amino acids improved insulin solubility in water while 200 and 400 µg/mL lysine significantly increased insulin solubility in HBSS. Permeability data showed a significant improvement in insulin permeation especially for 10 µg/mL of lysine (p < 0.05) and 10 µg/mL histidine (p < 0.001), 100 µg/mL of glutamic acid (p < 0.05) and 200 µg/mL of glutamic acid and aspartic acid (p < 0.001) without affecting cell integrity; in contrast to sodium deoxycholate which enhanced insulin permeability but was toxic to the cells. It was hypothesized that both amino acids and insulin were ionised at buccal cavity pH and able to form stable ion pairs which penetrated the cells as one entity; while possibly triggering amino acid nutrient transporters on cell surfaces. Evidence of these transport mechanisms was seen with reduction of insulin transport at suboptimal temperatures as well as with basal-to-apical vectoral transport, and confocal imaging of transcellular insulin transport. These results obtained for insulin is the first indication of a possible amino acid mediated transport of insulin via formation of insulin-amino acid neutral complexes by the ion pairing mechanism.

Giardia trophozoites in dog hookworm, Ancylostoma caninum: accident or hyperparasitism?

During the course of transmission electron microscopic studies of adult Ancylostoma caninum removed from a dog, several Giardia trophozoites were found in sections of the buccal cavity, oesophagus and intestine of several hookworms. Although the protozoa appeared viable, this unusual finding probably represents accidental uptake by, rather than an established infection of, the hookworm. It is feasible, however, that the trophozoites might have survived and even multiplied in this aberrant site. (C) 2001 Elsevier Science B.V. All rights reserved.

Intervenção educativa junto de um grupo de enfermeiros de um serviço de medicina : impacto na prática da terapêutica inalatória

RESUMO: O presente estudo, enquadra-se, no domínio do exercício profissional dos enfermeiros e na formação em serviço destes profissionais e teve por objectivo avaliar, num grupo de enfermeiros de um serviço de medicina, o impacto de uma intervenção educativa na melhoria dos procedimentos a executar na prática da terapêutica inalatória. A amostra do estudo (amostra por conveniência) foi constituída por oito enfermeiros do serviço de medicina do Hospital Curry Cabral (idades compreendidas entre os 24 a 43 anos de idade), sem anterior formação específica na área da terapêutica inalatória, mas com experiencia profissional prévia com doentes respiratórios. O estudo decorreu em dois momentos de avaliação: avaliação 0 (antes da intervenção educativa) e avaliação 1 (após a intervenção educativa). Entre estes dois momentos, foi ministrada, a todos os enfermeiros, uma acção de formação sobre terapêutica inalatória, com componente teórico-prática. Antes e depois da intervenção educativa foram aplicados dois instrumentos: para avaliação dos conhecimentos teóricos, construi-se e aplicou-se, um questionário de auto-avaliação de conhecimentos sobre terapêutica inalatória ao grupo dos enfermeiros, e para avaliação dos conhecimentos práticos e execução de procedimentos, uma grelha de observação da demonstração da técnica de inalação com três dispositivos inalatórios: MDI, MDI com câmara expansora ACE e DPI turbohaler®. Os resultados do estudo mostraram que o grupo dos enfermeiros da nossa amostra detinha já alguns conhecimentos de carácter teórico, de âmbito geral, sobre a terapêutica inalatória, mas conhecimentos pouco sólidos, nomeadamente no que concerne aos fármacos utilizados por via inalatória. Verificou-se, ainda, um deficiente domínio de conteúdos de carácter mais específico e prático sobre terapêutica inalatória, por exemplo a importância de determinados procedimentos - agitação do inalador, tempo de pausa entre cada inalação, cuidados de manutenção da câmara expansora, higienização da cavidade bucal após a inalação dos corticosteróides. Quanto à observação da técnica de inalação, o grupo dos enfermeiros revelou algumas lacunas, quer relativamente à técnica de inalação com MDI, quer do MDI com câmara expansora, observando-se a execução de passos incorrectos e mesmo omissão de passos por parte dos enfermeiros, antes da intervenção educativa.Não nos foi possível realizar a observação da técnica de inalação com dispositivo de pó seco turbohaler®, dado que nenhum dos enfermeiros da nossa amostra se sentiu capaz de manusear de forma correcta este dispositivo, antes e após a formação. Em termos globais, achamos que a formação dada sobre terapêutica inalatória, mostrou melhorar os conhecimentos teóricos e práticos dos enfermeiros neste âmbito. Esta melhoria ficou claramente demonstrada no aumento do número de respostas correctas dadas pelos enfermeiros no questionário efectuado, após a formação. Do mesmo modo, após a formação, registou-se uma melhoria considerável dos conhecimentos específicos e práticos, no que concerne à importância de determinados procedimentos na prática da terapêutica inalatória - agitação do inalador, tempo de pausa entre cada inalação, cuidados de manutenção da câmara expansora, higienização da cavidade bucal após a inalação dos corticosteróides - observando-se, um maior número de respostas correctas assinaladas no questionário. Em contrapartida, os conhecimentos sobre fármacos administrados por via inalatória, ficaram um pouco aquém das expectativas, pois o número de respostas correctas dadas pelos enfermeiros após a formação não foi significativo. Poderemos mesmo dizer que, a acção de formação com maior grau de especificidade sobre fármacos não se revelou eficaz e gerou até alguma ―confusão‖ neste grupo de enfermeiros, parecendo que os conhecimentos anteriores sobre fármacos por via inalatória não estariam consolidados antes da formação. De igual modo, após a formação, registou-se no grupo dos enfermeiros do estudo uma melhoria na performance da técnica de inalação com o MDI e MDI com a câmara expansora. Os enfermeiros do estudo, não só corrigiram os passos ou itens de avaliação da técnica inalatória, anteriormente executados incorrectamente, mas também, mostraram um melhor conhecimento dos passos ou itens de avaliação da técnica de inalação, com menor número de passos ou itens de avaliação omissos, após a formação. Em contrapartida, a acção de formação, no que diz respeito ao dispositivo de pó seco turbohaler®, não cumpriu o seu objectivo, dado que nenhum dos enfermeiros da amostra foi capaz de demonstrar a técnica de inalação com este dispositivo, antes e após a formação. Poderemos dizer que, não sendo um dispositivo da sua prática clínica, os enfermeiros não sentiram necessidade de adquirir estes conhecimentos. Em síntese, podemos concluir que na sua globalidade, a formação dada (com informação actualizada sobre as orientações mais adequadas neste domínio) e o treino formal dos enfermeiros neste âmbito, foi bastante proveitoso, uma vez que, mostrou melhorar os conhecimentos teóricos e práticos na prática da terapêutica inalatória do grupo de enfermeiros doserviço de medicina. Realça-se, no entanto, a importância de uma formação adequada, sentida como útil pelos enfermeiros, faseada, ligada à prática dos profissionais e alternando com momentos de exercício profissional. Os conhecimentos e os procedimentos dos enfermeiros deverão ainda ser monitorizados e avaliados ao longo do tempo, para a detecção de eventuais desvios que a rotina pode introduzir e para levantamento de novas necessidades de formação.-------------------ABSTRACT: This study fits in the domain of in-service training of professional nurses. It was aimed to assess the impact of an educational intervention and the consequent improvement of the practice of inhalation therapy in a group of nurses from a medical service The study sample (convenience sample) was consituted by eight nurses from the medical service, Hospital Curry Cabral (aged 24-43 years) without previous special training in the field of inhalation therapy, but with prior experience with patients with respiratory diseases. The study ran in two moments of evaluation: evaluation 0 (before the educational intervention) and evaluation 1 (post-intervention). Between these two moments, a training program about therapeutic inhalation was administered to all nurses, with a double component of theory and practice. Before and after the educational intervention two evaluation tools were applied: for the assessment of theoretical knowledge, the nurses had to fill a self-assessment questionnaire and in order to evaluate their knowledge related to procedural skills as well as their performance, they were observed (and their behaviour recorded on a check-list) during a demonstration of three inhalation techniques with devices: metered dose inhaler, metered dose inhaler with a spacer device ACE® and device turbohaler® The study results showed that the group of nurses in our sample had already some knowledge of theoretical nature (general scope of the inhalation therapy) but little solid knowledge, particularly in regard to drugs used in inhalation. In fact, a relatively weaker knowledge was registerd in what concerns specific and practical knowledge about inhalation therapy, for example, the importance of certain procedures - shaking the inhaler, pause between each inhalation, maintenance care of spacer device, mouth cavity hygiene after inhalation of corticosteroids. As for the observation of the inhaler technique, it was found that the group of nurses had a poor inhalation technique, in what concerns inhalation technique with MDI or MDI with spacer device, with a performance with several incorrect steps, or even omission of steps by nurses before the educational intervention. Finally, as the observation technique of the dry powder device turbohaler ®, we were unable to analyze the observation concerning this device, since none of the nurses in our sample, wast able to handlle it correctly, before and after training.In general terms, we found that the training given on inhalation therapy had a positive impact either in the theorical or the pratical knowledge on inhalation therapy (higher number of correct answers after training). Similarly, after training, there was the considerable improvement of specific and practical skills, namely the importance of certain procedures in the practice of inhalation therapy - shaking the inhaler, pause time between each inhalation, maintenance care of spacer device, sanitizing the buccal cavity after inhalation of corticosteroids. In contrast, knowledge about drugs administered by inhalation, were slightly below expectations, showing a lower number of correct answers given by the nurses after training. The training seemed to be a factor of "confusion" for this group of nurses, whose prior knowledge in this domais was not probably very solid to begin with. After training, the group of nurses in the study improved the performance of inhalation technique with MDI and MDI with spacer device. They not only correcty performed the steps or itens for the assessment of inhalation technique, previously performed incorrectly, but also showed a better understanding of the steps or itens for assessing the inhalation technique, with fewer steps missing (after training). In contrast, training with regard to the device turbohaler ® dry powder, was also below expectations, given that none of the nurses in the sample was able to demonstrate inhaler technique with this device before and after training. This was probably due to the fact that, the nurses did not feel the need to acquire this knowledge and the related practice. In summary, we can say that, overall, the training (with updated information on the appropriate policies in this field) showed an improvement in knowledge and performance in the practice of inhalation therapy. It is however crucial to underline the importance of in-service adequate training programmes, perceived as useful by the nurses, developped in different phases, linked to the nurses’ practice and combining with professional practices. The nurses’ knowledge and skills should also be further monitorized and evaluated in order to detect deviations introduced by the rotinization of procedures and to identify new training needs.

Nueva especie de Cephalobium (Rhabditida, Diplogasteridae) parasito de ninfas de Gryllodes Laplatae (Orthoptera, Gryllidae) en la Argentina

Cephalobium bidentatum sp. nov., parasitizing nymphs of Gryllodes laplatae Sauss (Orthoptera, Gryllidae) from Argentina, is described and illustrated. It is distinguished from other members of the genus Cephalobium COBB, 1920, by having the buccal cavity very sclerotized with two hook-shaped teeth, vagina short and muscular, male has two spicules with hook-shaped tips, and by the distribution pattern of the postanal papillae: one pair under the anus, three pairs between the anus and the tail, and two pairs at the base of the tail appendage.

Sôbre o Phlebotomus Brasiliensis Costa Lima, 1932 (Diptera, Psychodidae)

In 1939, Mangabeira obtained, under laboratory conditions, the development of eggs of Phlebotomus brasiliensis Costa Lima, 1932, collected at Lassance (typical locality), Minas Gerais, Brasil. He then studied the female and immature stages of this Phlebotomus. The results of these observations plus some more recent data on the male, geographical distribution and bionomics are presented. Morphologically it is closest to Phlebotomus runoides. However, the male Phlebotomus brasiliensis differs from all other Phlebotomus because of its very long spicules, similar to those of Brumptomyia. The female differs by its longer ducts, and by possessing only four horizontal teeth in the buccal cavity, whereas P. runoides has approximately 12 teeth. The pupae of P. brasiliensis is characterized by its two pre-alar setae, which are very simple and small and by the abdominal setae, which are not planted on a protruding tubercle. The fourth stage larvae main characteristics are very thin antennae, inserted on a protruding tuberculum, and slightly brush-like hind frontal setae. P. brasiliensis is here reported, for the first time, for the State of Bahia (Cachoeira, Pojuca and Salvador). The species has almost always been found in armadillo burrows. In the State of Bahia it is more frequent during the dry season. Under laboratory conditions, the female lays about 53 eggs.

Anatomy and histology of Embolyntha batesi MacLahlan, 1877 (Embiidina)

The Embioptera are rather generalized insects whose internal anatomy is simple and not subject to great modifications. For this reason these insects form an ideal group for elementary anatomical and histological studies (fig. 2). The digestive tract is a long, simple tube without convolutions or diverticulae from the buccal cavity to the rectum. The buccal structures are of the chewing type. The oesophagus and ingluvia are differentiated only by slight dilation of their walls. In nymphs and females the proventriculus is very distinct due to folds which flatten as the structure becomes packed with food. The enteron is the largest in such forms and in both sexes limited caudally by the Malpighian tubules. The proctodeus has six large rectal papillae. The nervous system is complete with only the fifth abdominal segment lacking a ganglion in the metathorax includes the ganglion of the first abdominal segment. The brain exhibits very clear structure in histological sections. The tracheal system includes two pairs of thoracic spiracles and eight abdominal pairs. Only th metathoracic spiracle has an air expiration function; all others serve for inspiration. Various structures in the spiracles protect the atrium. The circulatory system includes a long, simple dorsal vessel which extends forward from the ninth abdominal segment into the cranium. It opens anteriorly near the circumoesophageal connectives. The dorsal vessel has a pair of ostia and valves corresponding to each abdominal and thoracic segment. It lacks the diverticulae or folds commonly found in more highly evolved insects. The excretory system is represented by Malphighian tubules, pericardial cells, and fat-body. The number and disposition of Malpighian tubules is variable within the order. The pericardial cells are localized around the entire dorsal vessel up to the opening of the aorta in the head. The fat-bodies form compact layers in the dorsal and ventral regions of the body. In males they are more developed in the abdominal region. The mandibles, maxillae, and salivary glands are of a simple type with very few cytological modifications. Only the salivary glands which extend into the mesothoracic region show appreciable specialization. The reproductive system is bi-sixual and shows considerable sexual dimorphism. Males have five pair of testes with a metameric disposition, two distinct ducts, two epidymis, and the ejaculatory organs. The accessory glands vary in number and size and open in the anterior portion of the ejaculatory duct. The female reproductive organs are of the panoistic type. The system includes five pairs of ovarioles, two long paired oviducts a small, unpaired oviduct and the spermatheca which opens in the vagina. Reproduction usually involves a union of male and female gametes, and eggs are usually laid in clusters attached to a substrate.

Halipegus dubius Klein, 1905 (Trematoda, Hemiuridae): a redescription, with notes on the working of the ovarian complex

A redescription of Halipegus dubius Klein, 1905, of Brazilian frogs Leptodactylus pentadactylus and L. ocellatus, is presented. The parasite was found exclusively in the buccal cavity, in number varying from 1 (in most instances) to 3, and exceptionally 25 (one instance). Morphological data were based on 40 whole-mounted specimens and 4 serially sectioned ones. Larval development takes place in planorbid snails (Biomphalaria glabrata and B. tenagophila) and in an undetermined species of cyclops. Working of the ovarian complex was followed by microscopical observation of life specimens. Constrating with the similarity of the four American species of Halipegus currently recognized as valid, they can be easily separated by the characters of their cercariae.

Binema bonaerensis n. sp. (Oxyurida: Thelastomatidae) parasite of Neocurtilla claraziana saussure (Orthoptera: Gryllotalpidae) in Argentina

The nematode Binema bonaerensis n. sp. (Oxyurida: Thelastomatidae) is described from the intestine of the mole cricket of Neocurtilla claraziana Saussure (Orthoptera: Gryllotalpidae) from Buenos Aires Province, Argentina. It is distinguished mainly by having a conical tail; three sclerotized arches in the buccal cavity; an excretory pore inmediately posterior to the base of the esophagus and the presence of five pairs of male genital papillae with one pair preanal and four pairs postanal.

Cephalobellus lobulata n. sp. (Oxyurida:Thelastomatidae) a parasite of Neocurtilla claraziana Saussure (Orthoptera: Gryllotalpidae) from Argentina

Cephalobellus lobulata n. sp. (Oxyurida: Thelastomatidae) a parasite of the mole cricket Neocurtilla claraziana Saussure (Orthoptera: Gryllotalpidae) found in Argentina is described and illustrated. It is characterized by a short buccal cavity armed with three teeth, a striated cuticle with the first annule wide with four lobes and the second annule divided in twelve lobes. The male have three pairs of preanal papillae and two pairs of postanal papillae.

Cardiovascular changes under normoxic and hypoxic conditions in the air-breathing teleost Synbranchus marmoratus: importance of the venous system

Synbranchus marmoratus is a facultative air-breathing fish, which uses its buccal cavity as well as its gills for air-breathing. S. marmoratus shows a very pronounced tachycardia when it surfaces to air-breathe. An elevation of heart rate decreases cardiac filling time and therefore may cause a decline in stroke volume (VS), but this can be compensated for by an increase in venous tone to maintain stroke volume. Thus, the study on S. marmoratus was undertaken to investigate how stroke volume and venous function are affected during air-breathing. To this end we measured cardiac output (Q), heart rate (fH), central venous blood pressure (PCV), mean circulatory filling pressure (MCFP), and dorsal aortic blood pressures (PDA) in S. marmoratus. Measurements were performed in aerated water (P-O2 > 130 mmHg), when the fish alternated between gill ventilation and prolonged periods of apnoeas, as well as during hypoxia (P-O2 <= 50 mmHg), when the fish changed from gill ventilation to air-breathing. Q increased significantly during gill ventilation compared to apnoea in aerated water through a significant increase in both fH and VS. PCV and MCFP also increased significantly. During hypoxia, when the animals surface to ventilate air, we found a marked rise in fH, PCV, MCFP, Q and VS, whereas PDA decreased significantly. Simultaneous increases in PCV and MCFP in aerated, as well as in hypoxic water, suggests that the venous system plays an important regulatory role for cardiac filling and VS in this species. In addition, we investigated adrenergic regulation of the venous system through bolus infusions of adrenergic agonists (adrenaline, phenylephrine and isoproterenol; 2 mu g kg(-1)). Adrenaline and phenylephrine caused a marked rise in PCV and MCFP, whereas isoproterenol led to a marked decrease in PCV, and tended to decrease MCFP. Thus, it is evident that stimulation of both alpha- and beta-adrenoreceptors affects venous tone in S. marmoratus.

Species diversity of yeast in oral colonization of insulin-treated diabetes mellitus patients

The aim of this study was to investigate oral yeast colonization, antifungal susceptibility and strain diversity in insulin-dependent diabetes mellitus patients (175), as well as to evaluate the influence of dental prostheses. Oral rinse samples were cultured on selective media, in order to isolate, count and identify the yeasts recovered. More than half of the diabetic subjects (53%) carried significant amounts of Candida cells in the buccal cavity and these organisms were recovered at higher densities in diabetics wearing dentures. A total of 93 yeast strains were isolated from these patients, including: Candida spp. (n = 89); Pichia (n = 02); Trichosporon (n = 1), and Geotrichum (n = 1). C. albicans represented 56% of these strains, non-albicans Candida 39.8%, and other genera of yeast 4.3%. C. albicans was prevalent, followed by C. parapsilosis, C. tropicalis, C. glabrata, C. krusei, C. rugosa and C. guilliermondii. Agar disk-diffusion tests of the susceptibility of non-albicans Candida and other genera of yeast to fluconazole showed resistance in 21.9%, mainly in C. rugosa (100%), C. glabrata (57%) and C. krusei (50%). Local oral factors, such as the presence of dentures, in association with diabetes, seemed to have the effect of increasing the amount and variety of Candida species in the oral cavities, mainly those with lower drug susceptibilities.

Effects of temperature and hypercapnia on ventilation and breathing pattern in the lizard Uromastyx aegyptius microlepis

In most reptiles, the ventilatory response to hypercapnia consists of large increases in tidal volume (V-T), whereas the effects on breathing frequency (f(R)) are more variable. The increased V-T seems to arise from direct inhibition of pulmonary stretch receptors. Most reptiles also exhibit a transitory increase in ventilation upon removal of CO2 and this post-hypercapnic hyperpnea may consist of changes in both V-T and f(R). While it is well established that increased body temperature augments the ventilatory response to hypercapnia, the effects of temperature on the post-hypercapnic hyperpnea is less described. In the present study, we characterise the ventilatory response of the agamid lizard Uromastyx aegyptius to hypercapnia and upon the return to air at 25 and 35 degreesC. At both temperatures, hypercapnia caused large increases in V-T and small reductions in f(R), that were most pronounced at the higher temperature. The post-hypercapnic hyperpnea, which mainly consisted of increased fR, was numerically larger at 35 compared to 25 degreesC. However, when expressed as a proportion of the levels of ventilation reached during steady-state hypercapnia, the post-hypercapnic hyperpnea was largest at 25 degreesC. Some individuals exhibited buccal pumping where each expiratory thoracic breath was followed by numerous small forced inhalations caused by contractions of the buccal cavity. This breathing pattern was most pronounced during severe hypercapnia and particularly evident during the post-hypercapnic hyperpnea. (C) 2002 Published by Elsevier B.V.

Hypercarbic cardiorespiratory reflexes in the facultative air-breathing fish jeju (Hoplerythrinus unitaeniatus): the role of branchial CO2 chemoreceptors

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

Oral microbiota of Brazilian captive snakes

The present work aimed to determine the oral microbiotic composition of snakes from Sao Jose do Rio Preto city, São Paulo State, Brazil. Ten snake species, comprising the families Boidae, Colubridae, Elapidae and Viperidae, were submitted to microbiological examination of their oral cavity, which indicated positivity for all buccal samples. Gram-negative bacilli, gram-negative cocci bacilli, gram-positive bacilli and gram-positive cocci were isolated from the snakes. Among isolated bacterium species, the occurrence of coagulase-negative staphylococci in the buccal cavity of Crotalus durissus (Viperiade), Eunectes murinus (Boidae), Mastigodryas bifossatus (Colubridae) and Bacillus subtilis, common to oral cavity of Bothrops alternatus (Viperidae) and Phalotris mertensi (Colubridae), was detected. It was observed higher diversity of isolated bacteria from the oral cavity of Micrurus frontalis (Elapidae) and Philodryas nattereri (Colubridae), as well as the prevalence of gram-positive baccillus and gram-positive cocci. The composition of the oral microbiota of the studied snakes, with or without inoculating fangs, is diverse and also related to the formation of abscesses at the bite site in the victims of the ophidian accidents, and to pathogenic processes in the snakes that host these microorganisms.