Atualização das evidências da morinda citrifolia (NONI) na prática clínica / Updating the evidence of morinda citrifolia (NONI) in clinical practice

Baseado no dito popular de que os pacientes em uso da Morinda citrifolia (Noni) não apresentavam redução do peso ponderal durante o tratamento com quimioterápicos foi proposto uma revisão na literatura a respeito dos efeitos biológicos dessa planta sobre a possível redução do catabolismo celular durante a terapia oncológica. A busca ativa em diversas bases de dados proporcionou um enriquecimento no acervo bibliográfico do trabalho no que diz respeito ao conteúdo físico-químico, biológico e medicinal do uso da Morinda citrifolia. Além do seu uso antitumoral, também foram descritos efeitos antibacteriano, antioxidante, antifúngica, anti-helmíntica, analgésica, anti-inflamatória, hipotensora e imune estimulante. Objetivou-se analisar e sumarizar as atualizações das evidências da Morinda Citrifolia (Noni) na prática clínica. A metodologia utilizada foi pela coleta de dados relevantes ao tema e aos parâmetros pré-estabelecidos com embasamento em artigos do tipo revisão nos últimos 20 anos coletados nas bases de dados PUBMED, SCIELO, BVS, COCHRANE LIBRARY e MEDLINE. Assim o objetivos foram descritos a partir de  diversos efeitos medicinais da planta, seu benefício planta é por meio da folha, fruto ou raiz quando se realiza o processo de maceração e/ou decocção com atividade antibacteriana, antiviral, antifúngica, antitumoral, anti-helmíntica, analgésica, anti-inflamatória, hipotensora e imune estimulante (Pimentel et al., 2015). No Brasil, sua utilização é comum e facilitada pelo clima, com condições favoráveis para seu plantio e cultura, e pelas crenças populares no substrato natural como um tratamento adjuvante para conter o avanço do câncer. A literatura atual aborda diferentes efeitos e ações que esta possui sobre os sistemas do corpo humano, sendo uma planta muito utilizada no âmbito da medicina fitoterápica e pela população em geral por meio do senso comum. A partir da revisão dos dados e da análise das evidências foi possível observar um efeito fitoterápico do Noni não só antitumoral como também, uma planta que é capaz de exercer efeitos anti-inflamatórios, imunomoduladores, anti-helmínticos, antioxidante, antifúngica e hipotensora. Além disso, é importante ressaltar o aspecto social do uso desse herbáceo pois, diversas gerações e culturas possuem a medicina fitoterápico, em específico o uso do Noni como a cura ou tratamento adjuvante para diversas moléstias

Multistrain models predict sequential multidrug treatment strategies to result in less antimicrobial resistance than combination treatment

Background Combination treatment is increasingly used to fight infections caused by bacteria resistant to two or more antimicrobials. While multiple studies have evaluated treatment strategies to minimize the emergence of resistant strains for single antimicrobial treatment, fewer studies have considered combination treatments. The current study modeled bacterial growth in the intestine of pigs after intramuscular combination treatment (i.e. using two antibiotics simultaneously) and sequential treatments (i.e. alternating between two antibiotics) in order to identify the factors that favor the sensitive fraction of the commensal flora. Growth parameters for competing bacterial strains were estimated from the combined in vitro pharmacodynamic effect of two antimicrobials using the relationship between concentration and net bacterial growth rate. Predictions of in vivo bacterial growth were generated by a mathematical model of the competitive growth of multiple strains of Escherichia coli. Results Simulation studies showed that sequential use of tetracycline and ampicillin reduced the level of double resistance, when compared to the combination treatment. The effect of the cycling frequency (how frequently antibiotics are alternated in a sequential treatment) of the two drugs was dependent upon the order in which the two drugs were used. Conclusion Sequential treatment was more effective in preventing the growth of resistant strains when compared to the combination treatment. The cycling frequency did not play a role in suppressing the growth of resistant strains, but the specific order of the two antimicrobials did. Predictions made from the study could be used to redesign multidrug treatment strategies not only for intramuscular treatment in pigs, but also for other dosing routes

Pharmacodynamic modelling of in vitro activity of tetracycline against a representative, naturally occurring population of porcine Escherichia coli

Background The complex relationship between drug concentrations and bacterial growth rates require not only the minimum inhibitory concentration but also other parameters to capture the dynamic nature of the relationship. To analyse this relationship between tetracycline concentration and growth of Escherichia coli representative of those found in the Danish pig population, we compared the growth of 50 randomly selected strains. The observed net growth rates were used to describe the in vitro pharmacodynamic relationship between drug concentration and net growth rate based on E max model with three parameters: maximum net growth rate (α max ); concentration for a half-maximal response (E max ); and the Hill coefficient (γ). Results The net growth rate in the absence of antibiotic did not differ between susceptible and resistant isolates (P = 0.97). The net growth rate decreased with increasing tetracycline concentrations, and this decline was greater in susceptible strains than resistant strains. The lag phase, defined as the time needed for the strain to reach an OD 600 value of 0.01, increased exponentially with increasing tetracycline concentration. The pharmacodynamic parameters confirmed that the αmax between susceptible and resistant strains in the absence of a drug was not different. EC 50 increased linearly with MIC on a log–log scale, and γ was different between susceptible and resistant strains. Conclusions The in vitro model parameters described the inhibition effect of tetracycline on E. coli when strains were exposed to a wide range of tetracycline concentrations. These parameters, along with in vivo pharmacokinetic data, may be useful in mathematical models to predict in vivo competitive growth of many different strains and for development of optimal dosing regimens for preventing selection of resistance

Pharmacokinetic-pharmacodynamic model to evaluate intramuscular tetracycline treatment protocols to prevent antimicrobial resistance in pigs

High instances of antimicrobial resistance are linked to both routine and excessive antimicrobial use, but excessive or inappropriate use represents an unnecessary risk. The competitive growth advantages of resistant bacteria may be amplified by the strain dynamics; in particular, the extent to which resistant strains outcompete susceptible strains under antimicrobial pressure may depend not only on the antimicrobial treatment strategies but also on the epidemiological parameters, such as the composition of the bacterial strains in a pig. This study evaluated how variation in the dosing protocol for intramuscular administration of tetracycline and the composition of bacterial strains in a pig affect the level of resistance in the intestine of a pig. Predictions were generated by a mathematical model of competitive growth of Escherichia coli strains in pigs under specified plasma concentration profiles of tetracycline. All dosing regimens result in a clear growth advantage for resistant strains. Short treatment duration was found to be preferable, since it allowed less time for resistant strains to outcompete the susceptible ones. Dosing frequency appeared to be ineffective at reducing the resistance levels. The number of competing strains had no apparent effect on the resistance level during treatment, but possession of fewer strains reduced the time to reach equilibrium after the end of treatment. To sum up, epidemiological parameters may have more profound influence on growth dynamics than dosing regimens and should be considered when designing improved treatment protocols

Modeling the growth dynamics of multiple Escherichia coli strains in the pig intestine following intramuscular ampicillin treatment

Background: This study evaluated how dosing regimen for intramuscularly-administered ampicillin, composition of Escherichia coli strains with regard to ampicillin susceptibility, and excretion of bacteria from the intestine affected the level of resistance among Escherichia coli strains in the intestine of nursery pigs. It also examined the dynamics of the composition of bacterial strains during and after the treatment. The growth responses of strains to ampicillin concentrations were determined using in vitro growth curves. Using these results as input data, growth predictions were generated using a mathematical model to simulate the competitive growth of E. coli strains in a pig intestine under specified plasma concentration profiles of ampicillin. Results: In vitro growth results demonstrated that the resistant strains did not carry a fitness cost for their resistance, and that the most susceptible strains were more affected by increasing concentrations of antibiotics that the rest of the strains. The modeling revealed that short treatment duration resulted in lower levels of resistance and that dosing frequency did not substantially influence the growth of resistant strains. Resistance levels were found to be sensitive to the number of competing strains, and this effect was enhanced by longer duration of treatment. High excretion of bacteria from the intestine favored resistant strains over sensitive strains, but at the same time it resulted in a faster return to pre-treatment levels after the treatment ended. When the duration of high excretion was set to be limited to the treatment time (i.e. the treatment was assumed to result in a cure of diarrhea) resistant strains required longer time to reach the previous level. Conclusion: No fitness cost was found to be associated with ampicillin resistance in E. coli. Besides dosing factors, epidemiological factors (such as number of competing strains and bacterial excretion) influenced resistance development and need to be considered further in relation to optimal treatment strategies. The modeling approach used in the study is generic, and could be used for prediction of the effect of treatment with other drugs and other administration routes for effect on resistance development in the intestine of pigs

Laser Chemical Elemental Analysis: From Total to Images

This book chapter focuses on laser ablation employed in elemental analysis and discusses the fundamentals and instrumentation of the laser-induced breakdown spectroscopy (LIBS) and laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) techniques. The analytical performance of such techniques, challenges related to calibration, and strategies to improve sensitivity are discussed. In addition, the processes involved in data acquisition and imaging for acquiring the elemental spatial distribution are highlighted, and some representative examples in environmental, biological, medical, and forensic researches are presented

Novas perspectivas no tratamento farmacológico da doença de huntington / New perspectives in pharmacological treatment of huntington's disease

A doença de Huntington (DH) teve sua primeira publicação científica em abril de 1872, por George Huntington. Desde então, avanços científicos permitiram desvendar melhor essa moléstia que acomete 5 a cada 100.000 indivíduos e gera perdas neurológicas. O objetivo do atual estudo é elucidar a atualização no tratamento farmacológico dessa patologia