Preterm birth versus neonatal pain challenges for organizations and health teams

A incidência do parto pré-termo tem aumentado em todo o mundo, desafios de sobrevivência dos recémnascidos prematuros de muito baixo peso têm colocado a inovação e a evolução tecnológica acima de outros fatores críticos a eles inerentes: a hipersensibilidade sensorial e a imaturidade neurológica para a manifestar. Estudos realizados em diferentes países e Unidades de Cuidados Intensivos Neonatais têm revelado o elevado número de procedimentos dolorosos a que diariamente estes recém-nascidos são submetidos e confirmado o seu insuficiente tratamento. A dor continuada e prolongada tem reflexos imediatos (alterações cardiovasculares, hormonais e metabólicas) no prematuro, e posteriormente na infância e idade adulta (hiperatividade, deficit de atenção, transtornos de ansiedade e stress. Apesar de ser possível avaliar e tratar a dor no recém nascido, existe um hiato entre o conhecimento cientifico e a pratica clinica. Conquistou-se nas últimas décadas a valorização e o reconhecimento pelos profissionais de saúde, da dor neonatal, não sendo estes suficientes para a sua prevenção, avaliação e tratamento. Conhecer os fatores que incrementam a gestão da dor neonatal e identificar as estratégias que possam contribuir para melhorar as práticas de cuidados é o objetivo deste trabalho. Para tal realizou-se uma revisão sistemática, que considera os mais importantes artigos científicos publicados sobre este tema, no últimos 5 anos, possibilitando assim a análise do quão importante esta questão está a ser considerada pela comunidade científica. A qualidade parece emergir da estreita colaboração e decisões partilhadas entre profissionais de saúde. Programas personalizados como o NIDCAP®, Newborn Individualized Developmental Care and Assessment Program, têm-se revelado vantajosos na redução do número de procedimentos dolorosos. Recomenda-se a adoção de guidelines | protocolos de prevenção e tratamento, com auditorias e estudos de acompanhamento que caraterizem a sua eficácia. Mudar culturas organizacionais é considerada a chave para a eficácia da gestão da dor neonatal e diminuição de morbilidades, sendo o fator social um importante impulsionador para a aplicabilidade de medidas individuais importantes para a sua prevenção, avaliação e tratamento

Acute kidney injury biomarkers: renal angina and the need for a renal troponin I

Acute kidney injury (AKI) in hospitalized patients is independently associated with increased morbidity and mortality in pediatric and adult populations. Continued reliance on serum creatinine and urine output to diagnose AKI has resulted in our inability to provide successful therapeutic and supportive interventions to prevent and mitigate AKI and its effects. Research efforts over the last decade have focused on the discovery and validation of novel urinary biomarkers to detect AKI prior to a change in kidney function and to aid in the differential diagnosis of AKI. The aim of this article is to review the AKI biomarker literature with a focus on the context in which they should serve to add to the clinical context facing physicians caring for patients with, or at-risk for, AKI. The optimal and appropriate utilization of AKI biomarkers will only be realized by understanding their characteristics and placing reasonable expectations on their performance in the clinical arena

Evaluation of the oxidative stability of Chipotle chili (Capsicum annuum L.) oleoresins in avocado oil

Capsicum annuum L. (Chipotle chili) is a natural source of bioactive metabolites with antioxidant properties. The objective of this research was to obtain and characterize the oxidative stability under storage of Chipotle chili oleoresins extracted with cold-pressed avocado oil. The most efficient conditions obtained to extract carotenoids and phenolic compounds were at 1:3 ratio (chipotle chili: avocado oil; w:v) at room temperature in darkness during 48 h. At the end of the harshest conditions (45 °C, 30 days), the extracts were stable to lipid oxidation with a final Totox value of 27.34, a carotenoid preservation of 85.6%, antioxidant activity retention of 80.66% and a color change (ΔE) of 1.783. The kinetic constants obtained were higher for peroxide formation than for carotenoid degradation. The oleoresins obtained could be considered an economic and sustainable alternative to extract carotenoids with good oxidation stability that could be used in foodstuffs

Simultaneous determination of natural and synthetic steroid estrogens and their conjugates in aqueous matrices by liquid chromatography / mass spectrometry

An analytical method for the simultaneous determination of nine free and conjugated steroid estrogens was developed with application to environmental aqueous matrices. Solid phase extraction (SPE) was employed for isolation and concentration, with detection by liquid chromatography/mass spectrometry (LC/MS) using electrospray ionisation (ESI) in the negative mode. Method recoveries for various aqueous matrices (wastewater, lake and drinking water) were determined, recoveries proving to be sample dependent. When spiked at 50 ng/l concentrations in sewage influent, recoveries ranged from 62-89 % with relative standard deviations (RSD) < 8.1 %. In comparison, drinking water spiked at the same concentrations had recoveries between 82-100 % with an RSD < 5%. Ion suppression is a known phenomenon when using ESI; hence its impact on method recovery was elucidated for raw sewage. Both ion suppression from matrix interferences and the extraction procedure has bearing on the overall method recovery. Analysis of municipal raw sewage identified several of the analytes of interest at ng/l concentrations, estriol (E3) being the most abundant. Only one conjugate, estrone 3-sulphate (E1-3S) was observe

The transcriptional repressor protein NsrR senses nitric oxide directly via a [2Fe-2S] cluster

The regulatory protein NsrR, a member of the Rrf2 family of transcription repressors, is specifically dedicated to sensing nitric oxide (NO) in a variety of pathogenic and non-pathogenic bacteria. It has been proposed that NO directly modulates NsrR activity by interacting with a predicted [Fe-S] cluster in the NsrR protein, but no experimental evidence has been published to support this hypothesis. Here we report the purification of NsrR from the obligate aerobe Streptomyces coelicolor. We demonstrate using UV-visible, near UV CD and EPR spectroscopy that the protein contains an NO-sensitive [2Fe-2S] cluster when purified from E. coli. Upon exposure of NsrR to NO, the cluster is nitrosylated, which results in the loss of DNA binding activity as detected by bandshift assays. Removal of the [2Fe-2S] cluster to generate apo-NsrR also resulted in loss of DNA binding activity. This is the first demonstration that NsrR contains an NO-sensitive [2Fe-2S] cluster that is required for DNA binding activity

An optically stimulated superconducting-like phase in K3C60 far above equilibrium Tc

The control of non-equilibrium phenomena in complex solids is an important research frontier, encompassing new effects like light induced superconductivity. Here, we show that coherent optical excitation of molecular vibrations in the organic conductor K3C60 can induce a non-equilibrium state with the optical properties of a superconductor. A transient gap in the real part of the optical conductivity and a low-frequency divergence of the imaginary part are measured for base temperatures far above equilibrium Tc=20 K. These findings underscore the role of coherent light fields in inducing emergent order.Comment: 40 pages, 23 figure

Synergistic Inhibition of Endothelial Cell Proliferation, Tube Formation, and Sprouting by Cyclosporin A and Itraconazole

Pathological angiogenesis contributes to a number of diseases including cancer and macular degeneration. Although angiogenesis inhibitors are available in the clinic, their efficacy against most cancers is modest due in part to the existence of alternative and compensatory signaling pathways. Given that angiogenesis is dependent on multiple growth factors and a broad signaling network in vivo, we sought to explore the potential of multidrug cocktails for angiogenesis inhibition. We have screened 741 clinical drug combinations for the synergistic inhibition of endothelial cell proliferation. We focused specifically on existing clinical drugs since the re-purposing of clinical drugs allows for a more rapid and cost effective transition to clinical studies when compared to new drug entities. Our screen identified cyclosporin A (CsA), an immunosuppressant, and itraconazole, an antifungal drug, as a synergistic pair of inhibitors of endothelial cell proliferation. In combination, the IC50 dose of each drug is reduced by 3 to 9 fold. We also tested the ability of the combination to inhibit endothelial cell tube formation and sprouting, which are dependent on two essential processes in angiogenesis, endothelial cell migration and differentiation. We found that CsA and itraconazole synergistically inhibit tube network size and sprout formation. Lastly, we tested the combination on human foreskin fibroblast viability as well as Jurkat T cell and HeLa cell proliferation, and found that endothelial cells are selectively targeted. Thus, it is possible to combine existing clinical drugs to synergistically inhibit in vitro models of angiogenesis. This strategy may be useful in pursuing the next generation of antiangiogenesis therapy