IN VITRO AND IN VIVO REMOVAL OF ORAL ANTIDIABETIC AGENTS (METFORMIN) USING ACTIVATED CARBONS

Diabetes is the most worldwide common chronic disease, according the International Diabetes Federation [1], more than 32 million citizens living in the European Union have diabetes, representing nearly 10% of the population, to which we should add equal number of people suffering from impaired glucose tolerance. Diabetes prevalence is growing at alarming rate worldwide, being of particular relevance the type 2 diabetes. Nowadays 285 million people worldwide live with diabetes and it is expected that this numbers will increase by 20% until 2030 due to obesity and the ageing of the population [1]. This growth leads to an increasing consumption of drugs such as oral antidiabetics. Metformin is one of the active principles most commonly used for this purpose being among the pharmaceuticals with the highest production numbers worldwide to treat type 2 diabetes because is cheap, has high level of tolerance and when used in the prescribed dosage is very secure with minimal side effects. However, in case of overdose of metformin upon a ingestion of more than 10 times the prescribed dosage, accidentally or on propose, lactic acidosis and low blood pressure can occur. Overdoses with metformin are relatively uncommon, but may have serious consequences, if medical attention is not given on time, it may lead to coma and ultimately death Because of its spread use another problem must be taken into consideration, which needs to be addressed, the occurrence of metformin residues in sewage and surface waters due to improper discharge of the non-used tablets to regular garbage [2]. This situation is becoming a serious problem of environmental pollution and public health. This paper reports the use of activated carbon produced from biomass for the removal of metformin in 2 different settings. On one hand, from aqueous solutions and, in another hand, from simulated biological fluids (gastric and intestinal) conjugated with in vivo testing

Aspectos técnicos da cultura da amora-preta.

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Grande potencial.

Embora ainda pouco conhecido, o mirtilo é uma fruta muito apreciada no exterior, com crescimento de consumo de cerca de 20% ao ano. No Brasil, representa uma oportunidade de diversificação devido a seu elevado valor agregado.Número especial. Contém orientações gerais de como produzir mirtilo

Bloodless open heart surgery: simple and safe

OBJECTIVES: The use of blood or blood products is routine in cardiac surgery, but is associated with various complications. Aware of this, we have always tried to avoid the use of blood products whenever possible. In this study we sought to evaluate the results of this policy. METHODS: The records of 1505 adult patients who underwent coronary (732) or valve (773) surgery under cardiopulmonary bypass (CPB) in 2002 and 2003 were reviewed retrospectively. Of these, 1058 were male (70.3%) and the mean age was 62.1+/-11.4 years. Mean weight was 68.5+/-10.2 kg and body surface area was 1.7+/-0.2 m2, corresponding to a blood volume of 4119.9+/-593.6 ml. Preoperative hematocrit (Hct) was 40.6+/-4.2% and the prothrombin index was 87.0+/-17.4%. A bloodless prime of the bypass circuit was used for all patients with Hct > or =36%. The prime volume was reduced to the minimum possible. Plasma was used when coagulation was deficient. All blood remaining in the CPB circuit was reinfused at the end of the procedure, either in the operating room or in the ICU. Shed mediastinal blood was retransfused in the first 6 hours in the ICU. RESULTS: Operative mortality was 0.7% for coronary and 0.5% for valve patients. Blood or blood products were not used in 77.3% of the patients (88.7% of coronary and 66.5% of valve patients). Blood and/or plasma was initially added to the prime in 18.2% of cases and during CPB in 11%. Hct was 28.9+/-4.0% after initiation and 28.8+/-3.9% after discontinuation of CPB. The number of units (300 cc) of blood used was 0.25.57 per patient (1.09+/-0.73 per patient transfused). The number of units (300 cc) of plasma used was 0.24+/-0.72. Reoperation for bleeding was required in 2.4% of the patients. CONCLUSIONS: This blood-sparing policy is simple, effective and safe, resulting in low mortality and morbidity rates. More than three quarters of the patients did not require blood or blood products. Additional measures are possible to further decrease the use of blood products

The Creation of Defects with Core Condensation

Defects in superfluid 3He, high-Tc superconductors, QCD colour superfluids and cosmic vortons can possess (anti)ferromagnetic cores, and their generalisations. In each case there is a second order parameter whose value is zero in the bulk which does not vanish in the core. We examine the production of defects in the simplest 1+1 dimensional scalar theory in which a second order parameter can take non-zero values in a defect core. We study in detail the effects of core condensation on the defect production mechanism.Comment: 9 pages, 7 figures, small corrections, 2 references added, final version to be published in PR

Cardiac transplantation: five years' activity

OBJECTIVE: To analyze the initial five years experience of the new heart transplant program of Coimbra University Hospitals. METHODS: Between November 2003 aid December 2008, 132 patients were transplanted, with a mean age of 52.0 years (range 3-71 years), of whom 98 were male (74%). Half of the patients had dilated cardiomyopathy and 33% ischemic cardiomyopathy. The mean age of donors was 31.7 years and 102 were male (77%). Donor hearts were harvested at a distance in 62% of cases. There was a gender mismatch between donor and recipient (F:M) in 19% of cases and ABO blood type disparity (not identical but compatible) in 11%. In all cases we used the technique of total transplantation with bicaval anastomosis, modified in this center. Mean ischemia time was 88.9 +/- 32.2 minutes. All patients received induction therapy with basiliximab and methylprednisolone. RESULTS: Six patients (4.5%) died within 30 days or during hospitalization, due to graft failure in four and hyperacute rejection in two. Two patients required prolonged ventilation, ten (8%) required inotropic support for more than 48 hours, and four required pacemaker implantation. Mean hospital stay was 15.6 +/- 15.2 days (median 13 days). Ninety percent of patients (116/129) were maintained on triple immunosuppressive therapy, including cyclosporine, the remainder receiving tacrolimus. In 23 patients it was necessary to change the immunosuppressive regimen due to renal and/or tumoral complications, or humoral rejection. All patients are followed regularly in the Surgical Center. Thirteen patients (10%) died late of cancer (6 patients), infection (4 patients), and pancreatitis, pulmonary hypertension and suicide (one patient each). Twenty-two patients (17%) had 25 episodes of cellular rejection (> or = 2R), with clinical consequences in only one case, and five had humoral rejection (3.9%). No patients died of late rejection, but there is evidence of mild graft vascular disease in one. Actuarial survival (Kaplan-Meier) at one and five years was 90% and 82%, respectively. CONCLUSION: In this initial series of five years we obtained results equivalent to or bette than those in centers with wider and longer experience, aided by self-correction arising from our own experience. This program has increased the rate of cardiac transplantation in Portugal to above the European average

c-Src inhibition improves cardiovascular function but not remodeling or fibrosis in Ang II-induced hypertension

c-Src plays an important role in angiotensin II (Ang II) signaling. Whether this member of the Src family kinases is involved in the development of Ang II–induced hypertension and associated cardiovascular damage in vivo remains unknown. Here, we studied Ang II–infused (400 ng/kg/min) mice in which c-Src was partially deleted (c-Src+/−) and in wild-type (WT, c-Src+/+) mice treated with a c-Src inhibitor (CGP077675; 25 mg/kg/d). Ang II increased blood pressure and induced endothelial dysfunction in WT mice, responses that were ameliorated in c-Src+/− and CGP077675-treated mice. Vascular wall thickness and cross-sectional area were similarly increased by Ang II in WT and c-Src+/− mice. CGP077675 further increased cross-sectional area in hypertensive mice. Cardiac dysfunction (ejection fraction and fractional shortening) in Ang II–infused WT mice was normalized in c-Src+/− mice. Increased oxidative stress (plasma thiobarbituric acid–reactive substances, hydrogen peroxide, and vascular superoxide generation) in Ang II–infused WT mice was attenuated in c-Src–deficient and CGP077675-treated mice. Hyperactivation of vascular c-Src, ERK1/2 (extracellular signal–regulated kinase 1/2), and JNK (c-Jun N-terminal kinase) in hypertensive mice was normalized in CGP077675-treated and c-Src+/− mice. Vascular fibronectin was increased by Ang II in all groups and further augmented by CGP077675. Cardiac fibrosis and inflammation induced by Ang II were amplified in c-Src+/− and CGP-treated mice. Our data indicate that although c-Src downregulation attenuates development of hypertension, improves endothelial and cardiac function, reduces oxidative stress, and normalizes vascular signaling, it has little beneficial effect on fibrosis. These findings suggest a divergent role for c-Src in Ang II–dependent hypertension, where c-Src may be more important in regulating redox-sensitive cardiac and vascular function than fibrosis and remodeling

How to break access control in a controlled manner

The Electronic Medical Record (EMR) integrates heterogeneous information within a Healthcare Institution stressing the need for security and access control. The Biostatistics and Medical Informatics Department from Porto Faculty of Medicine has recently implemented a Virtual EMR (VEMR) in order to integrate patient information and clinical reports within a university hospital. With more than 500 medical doctors using the system on a daily basis, an access control policy and model were implemented. However, the healthcare environment has unanticipated situations (i.e. emergency situations) where access to information is essential. Most traditional policies do not allow for overriding. A policy that allows for Break-The-Glass (BTG) was implemented in order to override access control whilst providing for non-repudiation mechanisms for its usage. The policy was easily integrated within the model confirming its modularity and the fact that user intervention in defining security procedures is crucial to its successful implementation and use

Embedded Topological Defects in Hot Electroweak Theory: a Lattice Study

We study the properties of Nambu monopoles and Z-vortices in the 3D lattice SU(2) Higgs theory which represents the Standard Model at high temperature. We show that the densities of the Nambu monopoles and the Z-vortices are O(1) in the symmetric phase and generically small in the Higgs phase. Near to the critical Higgs mass and in the vicinity of the phase transition the densities are no more negligible in the broken phase. The percolation probability of the Z-vortex lines is found as a new disorder parameter for this phase transition. We conclude that the transition to the symmetric phase is accompanied by Z-vortex condensation. Simulations comparing elementary and extended vortices and monopoles at different \beta_G values, aiming to show that the density of vortices and monopoles of fixed physical size might have a well-defined continuum limit, gives encouraging but so far inconclusive results.Comment: 13 pages, LaTeX, 8 figures, epsf.sty needed; revision: minor changes and reference adde