Multicomponent complex formation between vinpocetine, cyclodextrins, tartaric acid and water-soluble polymers monitored by NMR and solubility studies

This work deals with multicomponent complex formation of vinpocetine (VP) with [beta]-cyclodextrin ([beta]CD), sulfobutyl ether [beta]-cyclodextrin (SBE[beta]CD) and tartaric acid (TA), in the presence or absence of water-soluble polymers, in aqueous solution. Complexation was monitored by phase-solubility and proton nuclear magnetic resonance (1H NMR) studies. TA demonstrated a synergistic effect on VP solubility, and in the complexation efficiency of [beta]CD and SBE[beta]CD. Additionally, water-soluble polymers increased even more the complexation efficiency of the CDs that was reflected by a 2.1-2.5 increase on KC values for VP-CD-TA-polymer multicomponent complexes. SBE[beta]CD was more effective in VP solubilization, as KC values of VP-SBE[beta]CD-TA multicomponent complexes were notably higher than in corresponding [beta]CD complexes. The large chemical shift displacements from protons located in the interior of the hydrophobic CD cavities (i.e., H-3 and H-5) coupled with significant chemical shift displacements of VP aromatic protons suggested that this moiety was included in the cavity of both [beta]CD and SBE[beta]CD. Two-dimensional rotating frame nuclear Overhauser effect spectroscopy (ROESY) experiments were carried out in order to obtain information about the multicomponent complex geometry in solution. Inspection of ROESY spectra allowed the establishment of spatial proximities between all aromatic protons of VP and the internal protons of the CDs, confirming that the aromatic moiety of VP is included in CD cavities being deeply inserted in SBE[beta]CD multicomponent complexes, since additional interactions with the sulfobutyl side chains were evidenced.http://www.sciencedirect.com/science/article/B6T25-4DT2KX7-1/1/a543ba03bff16fe4ef579956893c94b

Who are the patients with tuberculosis who are diagnosed in emergency facilities? An analysis of treatment outcomes in the state of São Paulo, Brazil.

OBJECTIVE: Early tuberculosis diagnosis and treatment are determinants of better outcomes and effective disease control. Although tuberculosis should ideally be managed in a primary care setting, a proportion of patients are diagnosed in emergency facilities (EFs). We sought to describe patient characteristics by place of tuberculosis diagnosis and determine whether the place of diagnosis is associated with treatment outcomes. A secondary objective was to determine whether municipal indicators are associated with the probability of tuberculosis diagnosis in EFs. METHODS: We analyzed data from the São Paulo State Tuberculosis Control Program database for the period between January of 2010 and December of 2013. Newly diagnosed patients over 15 years of age with pulmonary, extrapulmonary, or disseminated tuberculosis were included in the study. Multiple logistic regression models adjusted for potential confounders were used in order to evaluate the association between place of diagnosis and treatment outcomes. RESULTS: Of a total of 50,295 patients, 12,696 (25%) were found to have been diagnosed in EFs. In comparison with the patients who had been diagnosed in an outpatient setting, those who had been diagnosed in EFs were younger and more socially vulnerable. Patients diagnosed in EFs were more likely to have unsuccessful treatment outcomes (adjusted OR: 1.54; 95% CI: 1.42-1.66), including loss to follow-up and death. At the municipal level, the probability of tuberculosis diagnosis in EFs was associated with low primary care coverage, inequality, and social vulnerability. In some municipalities, more than 50% of the tuberculosis cases were diagnosed in EFs. CONCLUSIONS: In the state of São Paulo, one in every four tuberculosis patients is diagnosed in EFs, a diagnosis of tuberculosis in EFs being associated with poor treatment outcomes. At the municipal level, an EF diagnosis of tuberculosis is associated with structural and socioeconomic indicators, indicating areas for improvement

Spontaneous cytokine production in children according to biological characteristics and environmental exposures.

BACKGROUND: Environmental factors are likely to have profound effects on the development of host immune responses, with serious implications for infectious diseases and inflammatory disorders such as asthma. OBJECTIVE: This study was designed to investigate the effects of environmental exposures on the cytokine profile of children. METHODS: The study involved measurement of T helper (Th) 1 (interferon-gamma), 2 [interleukin (IL)-5 and IL-13], and the regulatory cytokine IL-10 in unstimulated peripheral blood leukocytes from 1,376 children 4-11 years of age living in a poor urban area of the tropics. We also assessed the impact of environmental exposures in addition to biological characteristics recorded at the time of blood collection and earlier in childhood (0-3 years before blood collection). RESULTS: The proportion of children producing IL-10 was greater among those without access to drinking water [p < 0.05, chi-square test, odds ratio (OR) = 1.67]. The proportion of children producing IL-5 and IL-10 (OR = 10.76) was significantly greater in households that had never had a sewage system (p < 0.05, trend test). CONCLUSIONS: These data provide evidence for the profound effects of environmental exposures in early life as well as immune homeostasis in later childhood. Decreased hygiene (lack of access to clean drinking water and sanitation) in the first 3 years of life is associated with higher spontaneous IL-10 production up to 8 years later in life

Non-Timber Forest Products (NTFP) in the Brazilian Amazon and Cerrado biomes: multi scale governance for Implementing enhanced socio-biodiversity chains

Non-Timber Forest Products (NTFP), contribute to the livelihoods of over 6 million people in Amazon and over 4 million people in the Cerrado biomes. Here we explored data on the socio-ecology of extractivist landscapes at the biome scale in Amazonia and Cerrado in Brazil. We found that there are market chains for 45 and 58 NTFPs in Brazilian Amazon and Cerrado, respectively. Although there is a vast repertoire of empirical data for characterizing sociobiodiversity in Brazil this body of literature is mostly case-study driven, focusing on a very limited number of products and using different methodological approaches. Therefore, although there is a robust research legacy meaningful comparisons are very challenging. So far we have a fragmented view of vegetal extractivist dynamics at the biome scale. Our work contributes to upscale from the socioecology of individual NTFP to the biome scale encompassing a variety of products and its associated livelihoods

Cutaneous phaeohyphomycosis caused by Exophiala xenobiotica : a case report

We report a case of phaeohyphomycosis that affected the leg of a 45-year-old Brazilian man, car mechanic and renal transplanted. The direct mycological examination evidenced dematiaceous septated hyphae. The pathogenic fungal species was identified as Exophiala xenobiotica. Antifungal activity in vitro revealed terbinafine as the best antifungal. For treatment, it was chosen surgical excision of the entire lesion and used systemic itraconazole. Phaeohyphomycosis caused by Exophiala xenobiotica is extremely rare and is closely related to transplant patients

Fast and efficient microfluidic cell filter for isolation of circulating tumor cells from unprocessed whole blood of colorectal cancer patients

Liquid biopsy offers unique opportunities for low invasive diagnosis, real-time patient monitoring and treatment selection. The phenotypic and molecular profile of circulating tumor cells (CTCs) can provide key information about the biology of tumor cells, contributing to personalized therapy. CTC isolation is still challenging, mainly due to their heterogeneity and rarity. To overcome this limitation, a microfluidic chip for label-free isolation of CTCs from peripheral blood was developed. This device, the CROSS chip, captures CTCs based on their size and deformability with an efficiency of 70%. Using 2 chips, 7.5 ml of whole blood are processed in 47 minutes with high purity, as compared to similar technologies and assessed by in situ immunofluorescence. The CROSS chip performance was compared to the CellSearch system in a set of metastatic colorectal cancer patients, resulting in higher capture of DAPI+/CK+/CD45- CTCs in all individuals tested. Importantly, CTC enumeration by CROSS chip enabled stratification of patients with different prognosis. Lastly, cells isolated in the CROSS chip were lysed and further subjected to molecular characterization by droplet digital PCR, which revealed a mutation in the APC gene for most patient samples analyzed, confirming their colorectal origin and the versatility of the technology for downstream applications

Toxocara Seropositivity, Atopy and Wheezing in Children Living in Poor Neighbourhoods in Urban Latin American

Background Toxocara canis and T. cati are parasites of dogs and cats, respectively, that infect humans and cause human toxocariasis. Infection may cause asthma-like symptoms but is often asymptomatic and is associated with a marked eosinophilia. Previous epidemiological studies indicate that T. canis infection may be associated with the development of atopy and asthma. Objectives To investigate possible associations between Toxocara spp. seropositivity and atopy and childhood wheezing in a population of children living in non-affluent areas of a large Latin American city. Methods The study was conducted in the city of Salvador, Brazil. Data on wheezing symptoms were collected by questionnaire, and atopy was measured by the presence of aeroallergen-specific IgE (sIgE). Skin prick test (SPT), total IgE and peripheral eosinophilia were measured. Toxocara seropositivity was determined by the presence of anti-Toxocara IgG antibodies, and intestinal helminth infections were determined by stool microscopy. Findings Children aged 4 to 11 years were studied, of whom 47% were seropositive for anti-Toxocara IgG; eosinophilia >4% occurred in 74.2% and >10% in 25.4%; 59.6% had elevated levels of total IgE; 36.8% had sIgE≥0.70 kU/L and 30.4% had SPT for at least one aeroallergen; 22.4% had current wheezing symptoms. Anti-Toxocara IgG was positively associated with elevated eosinophils counts, total IgE and the presence of specific IgE to aeroallergens but was inversely associated with skin prick test reactivity. Conclusion The prevalence of Toxocara seropositivity was high in the studied population of children living in conditions of poverty in urban Brazil. Toxocara infection, although associated with total IgE, sIgE and eosinophilia, may prevent the development of skin hypersensitivity to aeroallergens, possibly through increased polyclonal IgE and the induction of a modified Th2 immune reaction

Antifungal drug susceptibility profile of Pichia anomala isolates from patients presenting with nosocomial fungemia

In vitro susceptibility of 58 isolates of Pichia anomala to five antifungal drugs using two broth microdilution methods (CLSI and EUCAST) was analyzed. Low susceptibility to itraconazole was observed. Fluconazole, voriconazole, amphotericin B, and caspofungin showed good antifungal activity, although relatively high drug concentrations were necessary to inhibit the isolates.Inst Adolfo Lutz Registro, São Paulo, BrazilUniversidade Federal de São Paulo, Div Infect Dis, São Paulo, BrazilUniv Estadual Campinas, Fac Med Sci, Div Infect Dis, Campinas, SP, BrazilUniv Catolica Argentina, Fac Med, Buenos Aires, DF, ArgentinaUniv São Paulo, Hosp Clin, Lab Clin Micorbiol, São Paulo, BrazilUniv São Paulo, Hosp Clin, Hosp Infect Control Dept, LIM 54, São Paulo, BrazilHosp Sirio Libanes, São Paulo, BrazilUniv Fed Rio de Janeiro, Dept Internal Med, Rio de Janeiro, BrazilUniv São Paulo, Hosp Clin, Dept Infect Dis, São Paulo, BrazilUniversidade Federal de São Paulo, Div Infect Dis, São Paulo, BrazilWeb of Scienc

Estudo analítico dos casos de Meningite no estado do Rio de Janeiro de 2011 a 2021: Analytical study of Meningitis cases in the state of Rio de Janeiro from 2011 to 2021

Introdução: A inflamação dos revestimentos protetores do cérebro e da medula espinhal causa uma doença chamada meningite que, em geral, são causadas por infecções virais, bacterianas, micobacterianas e fúngicas. A meningite bacteriana, em todo o mundo, continua sendo uma das principais causas de morbimortalidade, causando anualmente mais de 303.000 mortes e 2.628.000 anos vividos com incapacidade. Objetivo: O objetivo deste estudo consiste em analisar os casos de meningite no estado do Rio de Janeiro em relação aos aspectos epidemiológicos da doença a fim de estabelecer vínculo entre a etiologia e promoção de saúde Metodologia: Este artigo refere-se a um estudo transversal, realizado no período de julho de 2022 a outubro de 2022. Foi efetuada uma busca bibliográfica para selecionar trabalhos relacionados ao tema em questão nas bases de dados SciELO, PubMed e Medline. As palavras-chave utilizadas foram “meningite” e “epidemiologia da meningite” nos idiomas português e inglês. A base de dados “DATASUS” também foi utilizada para a coleta de dados estatísticos. Desenvolvimento e Conclusão: No período estudado, no estado do Rio de Janeiro, foi possível constatar que a meningite atingiu em maior proporção a população em idade adulta-jovem e também crianças entre 1 e 9 anos de idade. A meningite viral foi a etiologia mais incidente seguida pela bacteriana. Com relação aos sorogrupos de meningite causada por N. meningitidis, os tipos C e B foram os mais encontrados. A taxa de letalidade pela doença no município ficou na média de valores encontrada em todo território nacional. &nbsp

Trajetórias assistenciais de pessoas com doença renal crônica: desafios para a Atenção Básica

Introduction: Chronic Kidney Disease (CKD) is considered a Public Health problem, susceptible to prevention and diagnosis in Primary Care. Diabetes Mellitus (DM) and Hypertension (HTN) are the main causes of CKD, which implies the importance of its management in the Health Care Network (HCN). Objective: To evaluate the assistancial pathways adopted by people with CKD in HCN from the perspective of users and their families. Methodology: Qualitative research that used semi-structured interviews that aimed people with CKD due to DM and/or HTN and their families. Content analysis was performed in thematic mode. Results: 11 users and 11 family members were interviewed, and three assistancial pathways were identified: Did not seek Basic Health Units (BHU); Went to BHU but did not receive the diagnosis; Were diagnosed at BHU and then referred to specialists. Users and family members did not linked Primary Care as a place of care of CKD, it being restricted to Specialized Care.Introdução: A Doença Renal Crônica (DRC) é considerada um problema de Saúde Pública, passível de prevenção e diagnóstico na Atenção Básica. Diabetes Mellitus e Hipertensão Arterial (HAS) são as principais causas de DRC, o que implica a importância do seu manejo na Rede de Atenção à Saúde (RAS). Objetivo: Avaliar trajetórias assistenciais percorridas por pessoas com DRC na RAS sob a ótica de usuários e familiares. Metodologia: Pesquisa qualitativa, que utilizou entrevistas semiestruturadas com pessoas portadoras de DRC por DM e/ou HAS e seus familiares. Realizada Análise de Conteúdo na modalidade temática. Resultados: Foram entrevistados 11 usuários e 11 familiares, e identificadas três trajetórias assistenciais: Não procurou a UBS; Procurou a UBS, mas não recebeu o diagnóstico; recebeu diagnóstico na UBS e foi encaminhado para especialistas. Usuários e familiares não perceberam a Atenção Básica como lugar de cuidado para a DRC