Tuberculosis chemotherapy: current drug delivery approaches

Tuberculosis is a leading killer of young adults worldwide and the global scourge of multi-drug resistant tuberculosis is reaching epidemic proportions. It is endemic in most developing countries and resurgent in developed and developing countries with high rates of human immunodeficiency virus infection. This article reviews the current situation in terms of drug delivery approaches for tuberculosis chemotherapy. A number of novel implant-, microparticulate-, and various other carrier-based drug delivery systems incorporating the principal anti-tuberculosis agents have been fabricated that either target the site of tuberculosis infection or reduce the dosing frequency with the aim of improving patient outcomes. These developments in drug delivery represent attractive options with significant merit, however, there is a requisite to manufacture an oral system, which directly addresses issues of unacceptable rifampicin bioavailability in fixed-dose combinations. This is fostered by the need to deliver medications to patients more efficiently and with fewer side effects, especially in developing countries. The fabrication of a polymeric once-daily oral multiparticulate fixed-dose combination of the principal anti-tuberculosis drugs, which attains segregated delivery of rifampicin and isoniazid for improved rifampicin bioavailability, could be a step in the right direction in addressing issues of treatment failure due to patient non-compliance

A experiência do Programa Universidade Aberta e suas contribuições para a transformação social The Open University Program experience and its contributions to social transformation

Este artigo faz uma reflexão sobre o Programa Universidade Aberta, que vem se desenvolvendo há doze anos no Departamento de Saneamento e Saúde, da Escola Nacional de Saúde Pública/Fiocruz. O Programa se traduz como um movimento de discussão sobre as raízes da desigualdade social, buscando caminhos para minorá-la, com a sustentação do diálogo entre meio acadêmico e comunidades desfavorecidas socialmente. Utilizando-se da educação para a cidadania como instrumento de sensibilização e mobilização comunitária, incentivou a participação-cidadã, garantindo-lhes condições necessárias para ações pró-ativas na conquista e melhoria de serviços básicos e essenciais à manutenção da saúde e dignidade da vida. Os resultados obtidos pelo Universidade Aberta, na minimização dos problemas socioambientais do Complexo de Manguinhos, destacaram a sua metodologia de pesquisa orientada para a resolução de problemas - a pesquisa-ação. Sensibilizou, ainda, a direção da Escola Nacional de Saúde Pública Sérgio Arouca, constituindo-se um Programa oficial da Escola, representante do compromisso social da academia para com a sociedade. O artigo tem como objetivo fazer um relato analítico do Universidade Aberta, destacando sua trajetória, a metodologia adotada, seus principais resultados e avaliação.<br>This paper is a reflection on the Open University Program that has been developed for twelve years in the Sanitation and Health Department of the Public Health National School/ Fiocruz. The Program is translated as a discussion movement concerning the roots of social inequality, looking for ways to diminish it, through the dialogue between the academic board and the poor local communities. Since its beginning, the Program has motivated the processes of community participation, playing an important role in improving life quality and environment for many poor communities. Using education as an instrument of promoting citizenship and community mobilization, it has empowered the communities neglected by government attention, to take proactive actions to maintain their health and dignity. The well-known results obtained by the Open University Program in Manguinhos, have highlighted its methodology - the research-action -, calling the attention of different public and private institutions and NGOs. It has also sensitized the direction of the Public Health National School in order to change it into an official Program of the school, representing its social commitment to the society. This paper is an analytic report of the Open University, highlighting its path, adopted methodology, main results and evaluation

Monetary models of exchange rates and sweep programs

Numerous studies find that monetary models of exchange rates cannot beat a random walk model. Such a finding, however, is not surprising given that such models are built upon money demand functions and traditional money demand functions appear to have broken down in many developed countries. In this article, we investigate whether using a more stable underlying money demand function results in improvements in forecasts of monetary models of exchange rates. More specifically, we use a sweep-adjusted measure of US monetary aggregate M1 which has been shown to have a more stable money demand function than the official M1 measure. The results suggest that the monetary models of exchange rates contain information about future movements of exchange rates, but the success of such models depends on the stability of money demand functions and the specifications of the models.

Motor repertoire is age-inadequate in infants with cystic fibrosis

Background General movements (GMs) in infants occur as fidgety movements (FMs) between postterm 9 and 20 weeks. We aimed to evaluate FMs and motor repertoire in infants with cystic fibrosis (CF) and their relation with clinical findings. Methods Demographic and clinical characteristics were recorded. FMs and motor repertoire were analyzed from a 5-min video recording of each infant. Videos were rated based on the Prechtl General Movement Assessment and motor optimality score (MOS) was calculated. Results The analysis included 18 infants with CF and 20 healthy infants at postterm age of 3-5 months. MOS was significantly lower in the infants with CF compared to controls (p < 0.05). Fifty percent of the infants with CF had abnormal or absent/sporadic FMs. MOS was negatively associated with hospitalization duration (r = -0.378,p = 0.036); and positively associated with vitamin A level in CF infants (r = 0.665,p = 0.026). Conclusions Infants with genetically anticipated severe CF phenotype tended to have lower MOS. MOS may be used in addition to genetic testing to predict disease severity in infants with CF. Infants with CF, absent/sporadic FMs, and lower MOS could be considered for planning specific age-adequate early intervention programs. Impac