Oral aspirin for treating venous leg ulcers

Background Venous leg ulcers (VLUs) or varicose ulcers are the final stage of chronic venous insufficiency (CVI), and are the most common type of leg ulcer. The development of VLUs on ankles and lower legs can occur spontaneously or after minor trauma. The ulcers are often painful and exudative, healing is often protracted and recurrence is common. This cycle of healing and recurrence has a considerable impact on the health and quality of life of individuals, and healthcare and socioeconomic costs. VLUs are a common and costly problem worldwideprevalence is estimated to be between 1.65% to 1.74% in the western world and is more common in adults aged 65 years and older. The main treatment for a VLU is a firm compression bandage. Compression assists by reducing venous hypertension, enhancing venous return and reducing peripheral oedema. However, studies show that it only has moderate effects on healing, with up to 50% of VLUs unhealed after two years of compression. Non-adherence may be the principal cause of these poor results, but presence of inflammation in people with CVI may be another factor, so a treatment that suppresses inflammation (healing ulcers more quickly) and reduces the frequency of ulcer recurrence (thereby prolonging time between recurrent episodes) would be an invaluable intervention to complement compression treatments. Oral aspirin may have a significant impact on VLU clinical practice worldwide. Evidence for the effectiveness of aspirin on ulcer healing and recurrence in high quality RCTs is currently lacking. Objectives To assess the benefits and harms of oral aspirin on the healing and recurrence of venous leg ulcers. Search methods In May 2015 we searched: The Cochrane Wounds Specialised RegisterThe Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library)Ovid MEDLINEOvid MEDLINE (In-Process & Other Non-Indexed Citations)Ovid EMBASE and EBSCO CINAHL. Additional searches were made in trial registers and reference lists of relevant publications for published or ongoing trials. There were no language or publication date restrictions. Selection criteria We included randomised controlled trials (RCTs) that compared oral aspirin with placebo or no drug intervention (in the presence or absence of compression therapy) for treating people with venous leg ulcers. Our main outcomes were time to complete ulcer healing, rate of change in the area of the ulcer, proportion of ulcers healed in the trial period, major bleeding, pain, mortality, adverse events and ulcer recurrence (time for recurrence and proportion of recurrence). Data collection and analysis Two review authors independently selected studies for inclusion, extracted data, assessed the risk of bias of each included trial and assessed overall quality of evidence for the main outcomes in the 'Summary of findings' table. Main results The electronic search located 62 studies. We included two RCTs of oral aspirin (300 mg/daily) given in addition to compression compared with compression and placebo, or compression alone. To date, the impact of aspirin on VLUs has been examined by only two randomised clinical trials, both with a small number of participants. The first RCT was conducted in the United Kingdom (n=20) and reported that daily administration of aspirin (300mg) in addition to compression bandages increased both the rate of healing, and the number of participants healed when compared to placebo in addition to compression bandaging over a four month period. Thirty-eight per cent of the participants given aspirin reported complete healing compared with 0% in the placebo group. Improvement (assessed by reduction in wound size) occurred in 52% of the participants taking aspirin compared with 26% in those taking placebo). The study identified potential benefits of taking aspirin as an adjunct to compression but the sample size was small, and neither the mechanism by which aspirin improved healing nor its effects on recurrence were investigated. In 2012 an RCT in Spain (n=51) compared daily administration of aspirin (300mg) in addition to compression bandages with compression alone over a five month period. There was little difference in complete healing rates between groups (21/28 aspirin and 17/23 compression bandages alone) but the average time to healing was shorter (12 weeks in the treated group vs 22 weeks in the compression only group) and the average time for recurrence was longer in the aspirin group (39 days: [SD 6.0] compared with 16.3 days [SD 7.5] in the compression only group). Although this trial provides some limited data about the potential use of aspirin therapy, the sample size (only 20 patients) was too small for us to draw meaningful conclusions. In addition, patients were only followed up for 4 months and no information on placebo was reported. Authors' conclusions Low quality evidence from two trials indicate that there is currently insufficient evidence for us to draw definitive conclusions about the benefits and harms of oral aspirin on the healing and recurrence of venous leg ulcers. We downgraded the evidence to low quality due to potential selection bias and imprecision due to the small sample size. The small number of participants may have a hidden real benefit, or an increase in harm. Due to the lack of reliable evidence, we are unable to draw conclusions about the benefits and harms of oral daily aspirin as an adjunct to compression in VLU healing or recurrence. Further high quality studies are needed in this area.Evidence Based Actions Department From Marilia Medical School - FAMEMA, BrazilFAPESP-Fundacao de Amparo a Pesquisa do Estado de Sao Paulo, BrazilNational Institute for Health ResearchEvidence Based Health Actions Department and Thoracic Surgery Department, Marilia Medical School, Marilia, BrazilDepartment of Medicine, Federal University of São Paulo, São Paulo, BrazilDepartment of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, AustraliaDepartment of Medicine, Federal University of São Paulo, São Paulo, BrazilWeb of Scienc

Modelagem matemática da secagem de bagaço de laranja associado ao método convectivo e radiação infravermelha

Sem informaçãoMathematical modeling enables dimensioning of dryers, optimization of drying conditions and the evaluation of process performance. The aim of this research was to describe the behavior of orange bagasse drying using Page's and Fick's second law models, and to assess activation energy (using Arrhenius equation), moisture content, water activity and bulk density of product at the end of the process. The drying experimental assays were performed in 2011 with convective air temperature between 36 and 64 degrees C and infrared radiation application time in the range from 23 to 277 s in accordance with the experimental central composite rotatable design. Analysis of variance and F-test were applied to results. At the end of the drying process, moisture content was about 0.09 to 0.87 db and water activity was between 0.25 and 0.87. Bulk density did not vary under studied conditions. Empirical Page's model demonstrated better representation of experimental data than the Fick's model for spheres. Activation energy values were about 18.491; 14.975 and 11.421 kJ mol(-1) for infrared application times of 60; 150 e 244 s, respectively.Mathematical modeling enables dimensioning of dryers, optimization of drying conditions and the evaluation of process performance. The aim of this research was to describe the behavior of orange bagasse drying using Page's and Fick's second law models, an191211781184Sem informaçãoSem informaçãosem informaçãoA modelagem matemática permite o dimensionamento de secadores, otimização das condições de secagem e avaliação do desempenho do processo. O objetivo deste trabalho foi descrever o comportamento da secagem de bagaço de laranja utilizando-se os modelos de

Peripheral lymphocyte subpopulations in prostate cancer - data from an animal model

Introduction: Prostate cancer (PCa) is one of the most common cancers among men worldwide. The presence of immune cells in human cancer raises a fundamental question in oncology. The interaction between immune system and PCa is an important field for translational research. This work aimed to characterize the peripheral lymphocyte subpopulations in a PCa animal model. Methods: Twenty-five male Wistar Unilever rats (Rattus norvegicus) with twelve weeks of age were randomly divided into two groups: Control (n=10) and Induced (n=15). All procedures were approved by the Portuguese Competent Authority (DGAV no. 021326). Prostate lesions were induced through the administration of flutamide (50 mg/kg, TCI Chemicals, USA), testosterone propionate (100 mg/kg, TCI Chemicals, USA) and N-methyl-N-nitrosourea (30 mg/kg, Sigma Chemical Co., Spain), and crystalline testosterone implants. Animals were humanely sacrificed at 61 weeks of age. Peripheral blood of all animals was collected by intracardiac puncture and transferred into tubes containing EDTA salt as an anticoagulant for flow cytometry analysis. The following conjugated monoclonal antibodies were used: cyCD3-BV421, CD3-FITC, CD25-APC, CD45-BV510, CD127-PE, CD161-FITC, CD4-PE/Cy7, CD45RA-APC/Cy7, OX-82-PE and CD8a-PerCP. The flow cytometry immunophenotyping was performed in a BD FACSCantoTM II cytometer (BD Biosciences, USA) and data were analysed with InfinicytTM, flow cytometry software 1.7 version. Statistical analysis was performed using SPSS 25. The differences were considered statistically significant at p<0.05. Results: Although differences did not reach the level of statistical significance, the populations of CD3+ and CD4+ lymphocytes were higher in control group when compared with induced group (p>0.05). Similarly, CD8+ lymphocyte population was higher in control group than in induced group (9.56±0.74 vs 6.38±0.32) (p<0.05). Inversely, the population of regulatory T cells (TRegs) (2.99±0.46 vs 4.630±0.35), the TRegs/CD8 ratio (0.35±0.09 vs 0.45±0.08) and the TRegs/Natural Killer ratio (0.52±0.05 vs 1.03±0.13) were higher in induced group when compared with control one (p<0.05). Conclusion: The population of Tregs increased in induced animals, while the population of NK decreased in these animals, which is in accordance with data previously published by other authors reporting the increase of Tregs and decrease of NK cells in animals with cancer. The characterization of these immune system subpopulation can be important for other studies such as preclinical cancer models

The challenges with Glässer’s disease in technified pig production

The swine upper respiratory tract is early colonised by Haemophilus parasuis, a bacteria which causes Glässer´s disease under favorable conditions. Glässer’s disease is a septicemic infectious disease characterised by causing polyserositis. The prevention of Glässer disease still represents a big challenge for the production chain, since the mechanism of systemic infection in pigs and virulence factors that prevent phagocytosis are not yet well understood. Even in swine herds with high sanitary standard, itis the main cause of mortality that has led to productive and economic losses in the pig industry worldwide. Although the H. parasuis genome sequence has been completed already, diagnosis is still difficult due to the existence of non-virulent strains and the early colonisation of the upper respiratory tract of healthy swines. This review aims to provide up-to-date information about the etiology, epidemiology, pathogenesis, clinical signs, gross and microscopic lesions, diagnosis, treatment and control of Glässer’s disease.&nbsp

Infraspecific variability in the essential oil composition of Lychnophora ericoides

Variations in the composition of the leaf essential oils of wild Lychnophora ericoides, with and without scent, which were grown in three sampling sites, were examined by GC-MS. Results were submitted to principal component and cluster analysis which allowed for two groups of essential oils to be distinguished with regard to scent: cluster I with specimens exhibiting an aromatic scent and containing a high percentage of &#945;-bisabolol (34 ± 23%) and o-cymene (8.4 ± 6.9%); cluster II with specimens without any scent and characterised by a high percentage of caryophyllene oxide (11 ± 9%) and &#948;-elemene (5.7 ± 6.9%). The two types of oil coexist in all the populations under study, although patterns of aromatic samples deriving from Caldas Novas' State Park reveal chemical differences in relation to the samples from Brasília's National Park and Santo Antônio do Descoberto. Such chemical variations clearly suggest, apart from a geographical influence, genetic differences between individuals in the populations. The high content of &#945;-bisabolol supports the folk medicinal use of arnica as anti-inflammatory

Does Meditation Alter Brain Responses to Negative Stimuli? A Systematic Review

Background: Despite several attempts to review and explain how meditation alters the brain and facilitates emotion regulation, the extent to which meditation and emotion regulation strategies share the same neural mechanisms remains unclear.Objective: We aim to understand the influence of meditation on the neural processing of negative emotional stimuli in participants who underwent meditation interventions (naive meditators) and long-term meditators.Methodology: A systematic review was conducted using standardized search operators that included the presence of terms related to emotion, meditation and neuro-imaging techniques in PsycInfo, PubMed, Scopus, and Web of Science databases.Results: Searches identified 882 papers, of which 11 were eligible for inclusion. Results showed a predominance of greater prefrontal/frontal activity related to meditation, which might indicate the increased recruitment of cognitive/attentional control resources in naïve and long-term meditators. This increased frontal activity was also observed when participants were asked to simply react to negative stimuli. Findings from emotion-related areas were scarce but suggested increased insular activity in meditators, potentially indicating that meditation might be associated with greater bodily awareness.Conclusions: Meditation practice prompts regulatory mechanisms when participants face aversive stimuli, even without an explicit request. Moreover, some studies reported increased insular activity in meditators, consistent with the hypothesis that meditation helps foster an interoceptive awareness of bodily and emotional states

THE CONSTRUCTION OF MENTAL HEALTH ASSISTANCE AT TWO FAMILY HEALTH UNITS IN CUIABÁ-MATO GROSSO STATE/BRAZIL

El Programa Salud de la Familia (PSF) y la Reforma psiquiátrica prevén un cambio de modelo de atención quees la superación de prácticas médico-curativas. Examinar la dinámica de atención a la salud mental en dos unidades de PSFde Cuiabá, MT fue el objetivo de esta investigación, de foque cualitativo. El análisis de contenido fue identificado en trescategorías: la territorialidad, los recursos y la relación de servicios; proceso de trabajo de los equipos; red de atención dela salud mental; los resultados muestran la dificuldad de acceso, la precariedad de la infraestructura y vínculo frágil de lasunidades con la comunidad. Hubo demanda de los trastornos mentales en los dos, pero solamente en una la organizacióndel trabajo articulava la promoción de la salud mental en la comunidad. La red de referencia en salud mental fue desarticuladade las unidades estudiadas. Hay necesidades de iversiones técnico-asistenciales y políticas para consolidar la atención delos titulares de molestias mentales en el PSF.The Family Health Program and the Psychiatric Reform foresee a change in the caring model, surpassing themedical curing practices. This research study, with a qualitative approach, objectified to analyze mental health caringdynamics at two units of the Family Health Program in Cuiabá, Mato Grosso State/Brazil. Content analysis identified threecategories: unit coverage area, resources and services link; teams’ work process and mental health care network. Theresults evidenced access difficulties, a precarious infra-structure and fragile bonds between the units and the community.There was a caring demand of mental disorders in the two units, however in only one of them work organization articulatedmental health promotion within the community. The reference mental health network proved to be disarticulated in thoseunits. There is a need of investments in technical assistance and policies to consolidate mental health care in the FamilyHealth Program.O Programa Saúde da Família e a Reforma Psiquiátrica prevêem a mudança de modelo assistencial superandopráticas médico-curativas. Analisar a dinâmica assistencial à saúde mental em duas unidades do Programa Saúde daFamília-PSF de Cuiabá-MT foi o objetivo desta pesquisa de abordagem qualitativa. A análise de conteúdo identificou trêscategorias: territorialidade, recursos e vínculo dos serviços; processo de trabalho das equipes; rede assistencial em saúdemental. Os resultados mostram a dificuldade de acesso, infra-estrutura precária e vínculo frágil das unidades com acomunidade. Havia demanda de transtornos mentais nas duas unidades, porém somente em uma houve uma aproximaçãodo trabalho articulado à promoção da saúde mental na comunidade. A rede de referência em saúde mental destas unidadesse mostrou desarticulada. Há necessidade de investimentos técnico-assistenciais e políticos para consolidar a atençãoaos portadores de transtornos mentais no PSF

FIRE EFECT ON THE SEASONAL FOREST STRUCTURE IN THE CERRADO BIOME

There are few studies on the effects of fire on the seasonal semideciduous forest of the Cerrado region. This study aimed to assess the effect of fire on Semideciduous forest fragments located in the Altamiro Moura Pacheco State Park (AMPSP). The study area is located in the central state of Goiás. A total of 10 plots (50 x 20 m; 1,000 m2) were drawn in the remaining forests seeking to portray two areas: area which underwent forest fire (burned area; B) and unburned area (unburned; UB). A total of 771 individuals with DBH (≥ 5 cm) were identified. A total of 303 individuals were recorded in the burned area (B), comprising 28 families, 41 genera and 47 species, while the unburned area (UB) had 468 individuals comprising 25 families, 43 genera and 50 species. The species Anadenanthera colubrina (Vell.) Brenan, Emmotum nitens (Benth.), Zanthoxylum rhoifolium Lam, Tapirira guianensis Aubl., Myracrodruon urundeuva Allemão and Luehea candicans Mart. had the highest Importance Value Index (IVI) values and occur in both areas. The percentage of dead trees differed between the areas, where the burned area had a mortality of 12.69% and the unburned area of 7.29% in regards to the number of individuals. Density per plot was the only parameter that differed between the areas, where the burned area (B) had the lowest values. The fire affected all diameter classes, demonstrating the fragility of this vegetation type in regards to fire. The fire had a greater effect on trees in the smaller diameter classes, reducing the frequency of individuals in the burned area and changing height distribution, which may have favored the establishment of lianas and invasive species.

Biosorbents in the Metallic Ions Determination

This chapter provides an overview and discusses analytical strategies for metallic ions determination using solid phase extraction. Solid phase extraction (SPE) is a much-used technique for extraction and/or concentration of complex samples, so that the analytes present in low concentration were detected mainly using chromatographic methods. However, in recent years, this technique has been widely used in the development of methodologies for metallic ions determination in the deferential samples. This technique shows simplicity and rapidity comparing with other conventional techniques, liquid–liquid extraction, cloud point extraction and others. Solid phase extraction procedures become even more interesting when commercial adsorbents are exchanged for others with higher adsorptive capacity, selectivity, flexibility, economy and low environmental impacts. For this purpose, some inorganic, organic and several natural adsorbents are used. New approaches to obtain adsorbent materials from natural sources such as fungi, bacteria, industrial residues and composting materials have received attention. These materials have been used in the development of analytical methods with varied proposals, such as preconcentration or speciation of metal ions