Oxigenoterapia domiciliar prolongada em crianças e adolescentes: uma análise do uso clínico e de custos de um programa assistencial

Objectives: To describe the clinical and laboratory characteristics of patients on long-term home oxygen therapy followed up by the home care program of Hospital das Clinicas, School of Medicine, Universidade de São Paulo, during a period of 8 years, and to compare groups with and without secondary pulmonary hypertension. To estimate the cost of the program using oxygen concentrators versus oxygen cylinders provided by the hospital.Methods: A descriptive, retrospective cohort study of patients on long-term home oxygen therapy followed up from 2002 to 2009 at the Unit of Pulmonology, Children's Institute, Hospital das Clinicas, School of Medicine, Universidade de São Paulo.Results: We studied 165 patients, of whom 53% were male, with the following medians: age at the beginning of oxygen therapy - 3.6 years; duration of oxygen therapy - 7 years; and survival time after beginning of oxygen therapy - 3.4 years. the main diagnoses were: cystic fibrosis (22%), bronchopulmonary dysplasia (19%), and bronchiolitis obliterans (15%). of the 33 patients who underwent spirometry, 70% had severe obstructive lung disease. Echocardiogram was performed in 134 patients; 51% of them had secondary pulmonary hypertension. There was a statistically significant association between pulmonary hypertension and need of higher oxygen flows (chi-square, p = 0.011), and pulmonary hypertension and longer duration of oxygen therapy (Logrank, p = 0.0001). There was no statistically significant difference between survival time after the beginning of oxygen therapy and pulmonary hypertension. the average monthly costs of the program were: US$7,392.93 for concentrators and US$ 16,630.92 for cylinders.Conclusions: Long-term home oxygen therapy was used to treat different chronic diseases, predominantly in infants and preschool children. There was a high frequency of pulmonary hypertension associated with longer periods of oxygen use and greater oxygen flow, without association with survival rate. the use of concentrators instead of cylinders may reduce costs significantly.Universidade Federal de São Paulo, Escola Paulista Med, São Paulo, BrazilUniv São Paulo, Fac Med, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, São Paulo, BrazilWeb of Scienc

Development and validation of a simple and rapid capillary zone electrophoresis method for determination of nnrti nevirapine in pharmaceutical formulations

A simple and fast capillary zone electrophoresis (CZE) method has been developed and validated for quantification of a non-nucleoside reverse transcriptase inhibitor (NNRTI) nevirapine, in pharmaceuticals. The analysis was optimized using 10 mmol L-1 sodium phosphate buffer pH 2.5, +25 kV applied voltage, hydrodynamic injection 0.5 psi for 5 s and direct UV detection at 200 µm. Diazepam (50.0 µg mL-1) was used as internal standard. Under these conditions, nevirapine was analyzed in approximately less than 2.5 min. The analytical curve presented a coefficient of correlation of 0.9994. Limits of detection and quantification were 1.4 µg mL-1 and 4.3 µg mL-1, respectively. Intra- and inter-day precision expressed as relative standard deviations were 1.4% and 1.3%, respectively and the mean recovery was 100.81%. The active pharmaceutical ingredient was subjected to hydrolysis (acid, basic and neutral) and oxidative stress conditions. No interference of degradation products and tablet excipients were observed. This method showed to be rapid, simple, precise, accurate and economical for determination of nevirapine in pharmaceuticals and it is suitable for routine quality control analysis since CE offers benefits in terms of quicker method development and significantly reduced operating costs.Um método simples e rápido por eletroforese capilar foi desenvolvido e validado para a quantificação do inibidor não nucleosídeo da transcritase reversa (NNRTI) nevirapina, em medicamentos. A análise foi otimizada utilizando tampão fosfato de sódio 10 mmol L-1, pH 2,5, voltagem aplicada de +25 kV, injeção hidrodinâmica a 0,5 psi por 5 s e detecção UV em 200 µm. Diazepam (50,0 µg mL-1) foi usado como padrão interno. Sob estas condições, nevirapina foi analisada em aproximadamente menos de 2,5 min. A curva analítica apresentou um coeficiente de correlação de 0,9994. Os limites de detecção e quantificação foram 1,4 µg mL-1 e 4,3 µg mL-1, respectivamente. Precisões intra e inter-dia expressas como desvio padrão relativo foram 1,4% e 1,3%, respectivamente e a recuperação média foi de 100,81%. O fármaco foi submetido a testes de hidrólises (ácida, básica e neutra) e a estresse oxidativo. Não foi observada interferência por parte dos produtos de degradação, nem dos excipients na análise da nevirapina. Este método mostrou ser rápido, simples, preciso, exato e econômico para a determinação de nevirapina em produtos farmacêuticos e é apropriado para o controle de qualidade em análise de rotina uma vez que a eletroforese capilar oferece benefícios em termos de desenvolvimento rápido dos métodos e custos muito reduzidos de operação.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Candida auris: a literature review

Background: Emerging pathogen Candida auris has been associated with nosocomial outbreaks demonstrating widespread antifungal resistance. This microorganism is associated with systemic infections with a high mortality rate, and studies that contribute to a better understanding of this agent are important. Objectives: The present article aimed to carry out bibliographic research on Candida auris. Therefore, a literature search was carried out between January 2018 and January 2022, applying the following: C. auris; Candida auris and Infection, in Portuguese, English and Spanish. This review considers the available literature on C. auris and highlights key unknowns, which will provide guidance for future work in this field. Results: The data collected in the present review allowed us to divide the theme into topics on Pathophysiology, Epidemiology/clinical and drug resistance mechanisms, so that the understanding of Candida auris can be better detailed and understood. Conclusion: The predilection of C. auris by the most vulnerable and immunosuppressed patients or with comorbidities and with the potential to cause invasive and bloodstream infections with a propensity to cause outbreaks and concerns regarding resistance to antifungal agents, the fungus Candida auris, is of increasing clinical relevance. The increase in the number of detected cases and the occurrence of strains with multiple drug resistance prove to be worrisome, and applied research is essential to contribute to the knowledge of this strain and effective therapy

On the Electronic Structure of a Recently Synthesized Graphene-like BCN Monolayer from bis-BN Cyclohexane: A DFT Study

Since the rising of graphene, boron nitride monolayers have been deeply studied due to their structural similarity with the former. A hexagonal graphene-like boron-carbon-nitrogen (h-BCN) monolayer was synthesized recently using bis-BN cyclohexane (B2N2C2H12) as a precursor molecule. Herein, we investigated the electronic and structural properties of this novel BCN material, in the presence of single-atom (boron, carbon, or nitrogen) vacancies, by employing density functional theory calculations. The stability of these vacancy-endowed structures is verified from cohesion energy calculations. Results showed that a carbon atom vacancy strongly distorts the lattice leading to breaking on its planarity and bond reconstructions. The single-atom vacancies induce the appearance of flat midgap states. A significant degree of charge localization takes place in the vicinity of these defects. It was observed a spontaneous magnetization only for the boron-vacancy case, with a magnetic dipole moment about 0.87 mu_B. Our calculations predicted a direct electronic bandgap value of about 1.14 eV, which is in good agreement with the experimental one. Importantly, this bandgap value is intermediate between gapless graphene and insulating h-BN.Comment: 9 pages, 4 figure

Työkaluna huonekuvaukset : Case: Ikaalisten Kylpylä

Opinnäytetyön tarkoituksena oli saada Ikaalisten Kylpylälle uudet, päivitetyt ja hyvin toimivat huonekuvaukset kaikista neljästä hotellista. Toimeksiantaja on Ikaalisten Kylpylä. Työn tutkimusongelmia olivat mitä kaikkea huonekuvauksista pitäisi löytyä, jotta ne palvelisivat mahdollisimman hyvin vastaanoton ja myyntipalvelun henkilökuntaa sekä erityisesti asiakkaita. Ongelmana oli myös mitä vanhoihin huonekuvauksiin tulisi lisätä ja miten parantaa niiden informatiivisuutta. Alkuperäiset huonekuvaukset ovat 1990-luvun alkupuolelta ja ne ovat paperilla kansioissa. Teoreettisena viitekehyksenä työssä on Komppulan & Boxbergin (2005)kerroksinen tuote eli hotellihuone kerroksisena tuotteena. Kerroksinen tuote muodostuu ydinpalvelusta sekä lisäarvoa tuottavista liitännäis- ja lisäpalveluista. Näitä ovat avustavat palvelut ja tukipalvelut. Aineistona olivat jo valmiina olevat huonekuvaukset ja omat päivitykseni niihin. Lomakehaastattelun vastauksia käytettiin myös aineistona tässä työssä. Tiedonkeruumenetelmä oli omien päivitettyjen tietojen koonti itse suunniteltuun huonekuvauslomakkeeseen, oma havainnointi sekä lomakehaastattelun tekeminen. Tutkimusmenetelmä oli kvalitatiivinen eli laadullinen. Empiirinen osa toteutettiin tekemällä kyselytutkimus Ikaalisten Kylpylän vastaanoton työntekijöille. Kymmenen seitsemästätoista vastaanotossa ja myyntipalvelussa työskentelevästä vastasi kyselyyn. Lomakehaastattelu oli puolistrukturoitu. Se sisälsi sekä avoimia kysymyksiä että monivalintakysymyksiä. Lomakehaastattelu oli muodoltaan informoitu kysely. Lomakkeet jaettiin vastaajille etukäteen ja heille kerrottiin mikä tutkimuksen tarkoitus on. Tutkimuksen tuloksena uudet päivitetyt huonekuvaukset tehtiin sähköiseen muotoon tietokoneille kaikkien helposti ulottuville. Huonekuvauksista tehtiin myös paperiset versiot. Tutkimus osoitti huonekuvaukset tarpeellisiksi ja hyödyllisiksi huoneiden lukumäärän ja erilaisuuden vuoksi. Johtopäätöksenä voidaan sanoa, että huonekuvaukset ovat hyödyllisiä ja ne tulivat tarpeeseen. Kehitysideoita tähän opinnäytetyöhön liittyen voisivat olla vielä tarkemmat huonekuvaukset.The purpose of this thesis was to update Ikaalinen Spa’s room descriptions. New and updated room descriptions were made of all Ikaalinen Spa’s four Hotels. The client of the study was Ikaalinen Spa. The aim of the study was to define the contents of room descriptions so that they, in the best possible way, serve both the personnel of the receptions and the sales as well as customers in particular. Additionally, the descriptions were to be improved and made more informative. Original room descriptions were made in early 1990’s and they are only in paper files. The theoretical framework was Komppula & Boxberg’s (2005) layered product. In this case it was a hotel room as a layered product. Layered product consists of nuclear service and additional and supplementary services which produce surplus value. These latter are supporting services and remedial services. The research material used in this thesis consists of the old room descriptions and gathered updates to them. The results from the interview study were also used as material in this thesis. New self-designed question forms were used in finding updated details. The material was also gathered through subjective observation and conducting the interview study by a questionnaire designed for that purpose. The research method was qualitative. The empirical part of the thesis was carried out by an interview study in the form of a questionnaire to Ikaalinen Spa’s employees who worked in the reception and sales service. Ten out of seventeen answered to the questionnaire. The interview form was semistructured with both open and closed questions. The interview study was by form an informed questioning. Questionnaires were delivered to respondents beforehand and the respondents were informed of the purpose of the study. As a result of this thesis new room descriptions were made into electronic form. They are now located on computers and in paper files in reception and sales service. The study showed that room descriptions are necessary and useful because of the number of rooms and differences between rooms. Development ideas in regard to this thesis could be more specific room descriptions

Production and characterization of protease from Penicillium aurantiogriseum URM 4622

Proteases with new properties are required due to their increasing industrial importance. In this work, the optimal fermentation conditions for the production of a protease from Penicillium aurantiogriseum dierchx (URM-4622) are presented together with partial characterization of the protease catalytic properties. The batch fermentation conditions that allow for the highest specific proteolytic activity are 26 ºC, pH 7.0, and 25 % saturation dissolved O2 concentration. The obtained protease is stable over a wide range of pH (5.8 to 9.5) and temperature (25 to 40 ºC) values. In the presence of Zn2+ a 26 % reduction in the enzyme proteolytic activity occurs and, in contrast, Mn2+ enhances its activity by 28.9 %. 96.2 % and 70.8 % of the protease activity are maintained after 90 min incubation in 5 and 10 % (v/v) H2O2 aqueous solutions, respectively. PMSF inhibition reveals that this enzyme is a serine protease. Protease is able to hydrolyze different proteins

Towards a genome-wide transcriptogram: the Saccharomyces cerevisiae case

A genome modular classification that associates cellular processes to modules could lead to a method to quantify the differences in gene expression levels in different cellular stages or conditions: the transcriptogram, a powerful tool for assessing cell performance, would be at hand. Here we present a computational method to order genes on a line that clusters strongly interacting genes, defining functional modules associated with gene ontology terms. The starting point is a list of genes and a matrix specifying their interactions, available at large gene interaction databases. Considering the Saccharomyces cerevisiae genome we produced a succession of plots of gene transcription levels for a fermentation process. These plots discriminate the fermentation stage the cell is going through and may be regarded as the first versions of a transcriptogram. This method is useful for extracting information from cell stimuli/responses experiments, and may be applied with diagnostic purposes to different organisms