Reduction in the Sulfur Content of Fossil Fuels by Cunninghamella elegans (UCP 0596) to Dibenzothiophene Compound

Biodesulfurization (BDS) is one of the most promising technologies used together with traditional hydrodesulfurization (HDS) to reduce the sulfur content of fossil fuels. In this research study, a strain of Cunninghamella elegans (UCP 596) was isolated from mangrove sediments to metabolize an organosulfur dibenzothiophene (DBT) compound in the concentrations of 0.5 and 1 mM and transform to DBT sulfone (DBT-5-dioxide), followed by dibenzothiophene 5,5-dioxide and 2-hydroxybiphenyl metabolites, thus suggesting the use of the “4S” metabolic pathway. The fungus also degraded the DBT completely in the first 24 h of growth on a 2.0 mM DBT concentration by angular deoxygenation, which suggests that a new second metabolic pathway was used. The DBT was consumed as the carbon source, and the sulfur was removed in the form of sulfite ion. A new product, benzoic acid, was formed at the end of the catabolism of DBT by C. elegans using an angular route

CUIDADOS DA EQUIPE MULTIPROFISSIONAL NA PREVENÇÃO DA DIABETES MELLITUS GESTACIONAL

INTRODUCTION: Gestational diabetes mellitus is a metabolic disease characterized by hyperglycemia, which can bring complications to the pregnant woman and the fetus, considering the possible risks, the care of the multidisciplinary team has great relevance in early screening during prenatal care. OBJECTIVE: To carry out a bibliographic survey on the care provided by the multiprofessional team in the prevention of diabetes mellitus during pregnancy. METHODOLOGY: This is an integrative literature review. It was based on data from the Latin American and Caribbean Literature on Health Sciences (LILACS) and Nursing Database (BDENF) via the Virtual Health Library (VHL). The following descriptors were used: "Gestational diabetes", "Multiprofessional team" and "Prevention", and the inclusion criteria were: full text, Portuguese, Spanish and English language, which portrayed the theme under study, published in the years 2012 to 2022, and as exclusion criteria: duplicate texts, incomplete and that did not focus on the exposed theme. RESULTS: The multiprofessional team should provide prevention through educational practices, highlight the risks to the binomial, should using screening strategies, clarify and guide pregnant women about the importance of care to be taken during pregnancy and the improvement of life habits regarding self-care. CONCLUSION: It is concluded that the multiprofessional team has great importance in the process of care and prevention of gestational diabetes mellitus, promoting knowledge about the disease and motivating a healthy pregnancy, improving the quality of life.  INTRODUCCIÓN: La diabetes mellitus gestacional es una enfermedad metabólica caracterizada por hiperglucemia, que puede traer complicaciones para las mujeres embarazadas y el feto, considerando los posibles riesgos, la atención del equipo multidisciplinario tiene gran relevancia en el cribado precoz durante la atención prenatal. OBJETIVO: Realizar una encuesta bibliográfica sobre la atención del equipo multidisciplinario en la prevención de la diabetes mellitus durante el embarazo. METODOLOGÍA: Se trata de una revisión integradora de la literatura. Se basó en datos de la Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) y la Base de Datos de Enfermería (BDENF) a través de la Biblioteca Virtual en Salud (BVS), que tuvo como pregunta principal: "¿Qué aborda la literatura sobre el cuidado del equipo multidisciplinario en la prevención de la diabetes mellitus gestacional?". Se utilizaron los siguientes descriptores: "Diabetes gestacional", "Equipo multidisciplinario" y "Prevención", como criterios de inclusión: texto completo, lengua portuguesa, español e inglés, que retrataron el tema en estudio, publicado en los años 2012 a 2022, y como criterios de exclusión: textos duplicados, incompletos y que no se centraron en el tema expuesto. RESULTADOS: El equipo multidisciplinario debe brindar prevención a través de prácticas educativas, resaltar los riesgos para la binomina, utilizar estrategias de tamizaje, aclarar y orientar a las mujeres embarazadas sobre la importancia de los cuidados a tomar durante el embarazo y la mejora de los hábitos de vida en relación al autocuidado. CONCLUSIÓN: Se concluye que el equipo multidisciplinario tiene gran importancia en el proceso.INTRODUÇÃO: A diabetes mellitus gestacional é uma doença metabólica caracterizada por hiperglicemia, que pode trazer complicações para a gestante e para o feto, considerando os possíveis riscos, o cuidado da equipe multiprofissional tem grande relevância no rastreamento precoce durante o pré-natal. OBJETIVO: Realizar um levantamento bibliográfico acerca do cuidado da equipe multiprofissional na prevenção da diabetes mellitus na gestação. METODOLOGIA: Trata-se de uma revisão integrativa da literatura. Baseou-se nos dados de Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Base de Dados de Enfermagem (BDENF) via Biblioteca Virtual em Saúde (BVS) que teve como questão norteadora: “O que a literatura aborda acerca do cuidado da equipe multiprofissional na prevenção da diabetes mellitus gestacional?”. Foram utilizados os descritores: “Diabetes gestacional”, “Equipe multiprofissional” e “Prevenção”, como critérios de inclusão foram considerados: texto completo, idioma português, espanhol e inglês, que retratassem a temática em estudo, publicados nos anos 2012 a 2022, e como critério de exclusão: textos duplicados, incompletos e que não focaram no tema exposto. RESULTADOS: A equipe multiprofissional deve proporcionar prevenção através de práticas educativas, ressaltar os riscos ao binômio, devem, utilizando estratégias de rastreamento, esclarecer e orientar as gestantes sobre a importância dos cuidados a serem tomados durante a gestação e a melhoria dos hábitos de vida em relação ao autocuidado. CONCLUSÃO: Conclui-se que a equipe multiprofissional tem grande importância no processo de cuidar e prevenir a diabetes mellitus gestacional, promovendo conhecimento sobre a doença e motivando uma gestação saudável, melhorando a qualidade de vida.INTRODUÇÃO: A diabetes mellitus gestacional é uma doença metabólica caracterizada por hiperglicemia, que pode trazer complicações para a gestante e para o feto, considerando os possíveis riscos, o cuidado da equipe multiprofissional tem grande relevância no rastreamento precoce durante o pré-natal. OBJETIVO: Realizar um levantamento bibliográfico acerca do cuidado da equipe multiprofissional na prevenção da diabetes mellitus na gestação. METODOLOGIA: Trata-se de uma revisão integrativa da literatura. Baseou-se nos dados de Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Base de Dados de Enfermagem (BDENF) via Biblioteca Virtual em Saúde (BVS) que teve como questão norteadora: “O que a literatura aborda acerca do cuidado da equipe multiprofissional na prevenção da diabetes mellitus gestacional?”. Foram utilizados os descritores: “Diabetes gestacional”, “Equipe multiprofissional” e “Prevenção”, como critérios de inclusão foram considerados: texto completo, idioma português, espanhol e inglês, que retratassem a temática em estudo, publicados nos anos 2012 a 2022, e como critério de exclusão: textos duplicados, incompletos e que não focaram no tema exposto. RESULTADOS: A equipe multiprofissional deve proporcionar prevenção através de práticas educativas, ressaltar os riscos ao binômio, devem, utilizando estratégias de rastreamento, esclarecer e orientar as gestantes sobre a importância dos cuidados a serem tomados durante a gestação e a melhoria dos hábitos de vida em relação ao autocuidado. CONCLUSÃO: Conclui-se que a equipe multiprofissional tem grande importância no processo de cuidar e prevenir a diabetes mellitus gestacional, promovendo conhecimento sobre a doença e motivando uma gestação saudável, melhorando a qualidade de vida

CUIDADOS DA EQUIPE MULTIPROFISSIONAL NA PREVENÇÃO DA DIABETES MELLITUS GESTACIONAL

INTRODUCTION: Gestational diabetes mellitus is a metabolic disease characterized by hyperglycemia, which can bring complications to the pregnant woman and the fetus, considering the possible risks, the care of the multidisciplinary team has great relevance in early screening during prenatal care. OBJECTIVE: To carry out a bibliographic survey on the care provided by the multiprofessional team in the prevention of diabetes mellitus during pregnancy. METHODOLOGY: This is an integrative literature review. It was based on data from the Latin American and Caribbean Literature on Health Sciences (LILACS) and Nursing Database (BDENF) via the Virtual Health Library (VHL). The following descriptors were used: "Gestational diabetes", "Multiprofessional team" and "Prevention", and the inclusion criteria were: full text, Portuguese, Spanish and English language, which portrayed the theme under study, published in the years 2012 to 2022, and as exclusion criteria: duplicate texts, incomplete and that did not focus on the exposed theme. RESULTS: The multiprofessional team should provide prevention through educational practices, highlight the risks to the binomial, should using screening strategies, clarify and guide pregnant women about the importance of care to be taken during pregnancy and the improvement of life habits regarding self-care. CONCLUSION: It is concluded that the multiprofessional team has great importance in the process of care and prevention of gestational diabetes mellitus, promoting knowledge about the disease and motivating a healthy pregnancy, improving the quality of life.  INTRODUCCIÓN: La diabetes mellitus gestacional es una enfermedad metabólica caracterizada por hiperglucemia, que puede traer complicaciones para las mujeres embarazadas y el feto, considerando los posibles riesgos, la atención del equipo multidisciplinario tiene gran relevancia en el cribado precoz durante la atención prenatal. OBJETIVO: Realizar una encuesta bibliográfica sobre la atención del equipo multidisciplinario en la prevención de la diabetes mellitus durante el embarazo. METODOLOGÍA: Se trata de una revisión integradora de la literatura. Se basó en datos de la Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) y la Base de Datos de Enfermería (BDENF) a través de la Biblioteca Virtual en Salud (BVS), que tuvo como pregunta principal: "¿Qué aborda la literatura sobre el cuidado del equipo multidisciplinario en la prevención de la diabetes mellitus gestacional?". Se utilizaron los siguientes descriptores: "Diabetes gestacional", "Equipo multidisciplinario" y "Prevención", como criterios de inclusión: texto completo, lengua portuguesa, español e inglés, que retrataron el tema en estudio, publicado en los años 2012 a 2022, y como criterios de exclusión: textos duplicados, incompletos y que no se centraron en el tema expuesto. RESULTADOS: El equipo multidisciplinario debe brindar prevención a través de prácticas educativas, resaltar los riesgos para la binomina, utilizar estrategias de tamizaje, aclarar y orientar a las mujeres embarazadas sobre la importancia de los cuidados a tomar durante el embarazo y la mejora de los hábitos de vida en relación al autocuidado. CONCLUSIÓN: Se concluye que el equipo multidisciplinario tiene gran importancia en el proceso.INTRODUÇÃO: A diabetes mellitus gestacional é uma doença metabólica caracterizada por hiperglicemia, que pode trazer complicações para a gestante e para o feto, considerando os possíveis riscos, o cuidado da equipe multiprofissional tem grande relevância no rastreamento precoce durante o pré-natal. OBJETIVO: Realizar um levantamento bibliográfico acerca do cuidado da equipe multiprofissional na prevenção da diabetes mellitus na gestação. METODOLOGIA: Trata-se de uma revisão integrativa da literatura. Baseou-se nos dados de Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Base de Dados de Enfermagem (BDENF) via Biblioteca Virtual em Saúde (BVS) que teve como questão norteadora: “O que a literatura aborda acerca do cuidado da equipe multiprofissional na prevenção da diabetes mellitus gestacional?”. Foram utilizados os descritores: “Diabetes gestacional”, “Equipe multiprofissional” e “Prevenção”, como critérios de inclusão foram considerados: texto completo, idioma português, espanhol e inglês, que retratassem a temática em estudo, publicados nos anos 2012 a 2022, e como critério de exclusão: textos duplicados, incompletos e que não focaram no tema exposto. RESULTADOS: A equipe multiprofissional deve proporcionar prevenção através de práticas educativas, ressaltar os riscos ao binômio, devem, utilizando estratégias de rastreamento, esclarecer e orientar as gestantes sobre a importância dos cuidados a serem tomados durante a gestação e a melhoria dos hábitos de vida em relação ao autocuidado. CONCLUSÃO: Conclui-se que a equipe multiprofissional tem grande importância no processo de cuidar e prevenir a diabetes mellitus gestacional, promovendo conhecimento sobre a doença e motivando uma gestação saudável, melhorando a qualidade de vida.INTRODUÇÃO: A diabetes mellitus gestacional é uma doença metabólica caracterizada por hiperglicemia, que pode trazer complicações para a gestante e para o feto, considerando os possíveis riscos, o cuidado da equipe multiprofissional tem grande relevância no rastreamento precoce durante o pré-natal. OBJETIVO: Realizar um levantamento bibliográfico acerca do cuidado da equipe multiprofissional na prevenção da diabetes mellitus na gestação. METODOLOGIA: Trata-se de uma revisão integrativa da literatura. Baseou-se nos dados de Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Base de Dados de Enfermagem (BDENF) via Biblioteca Virtual em Saúde (BVS) que teve como questão norteadora: “O que a literatura aborda acerca do cuidado da equipe multiprofissional na prevenção da diabetes mellitus gestacional?”. Foram utilizados os descritores: “Diabetes gestacional”, “Equipe multiprofissional” e “Prevenção”, como critérios de inclusão foram considerados: texto completo, idioma português, espanhol e inglês, que retratassem a temática em estudo, publicados nos anos 2012 a 2022, e como critério de exclusão: textos duplicados, incompletos e que não focaram no tema exposto. RESULTADOS: A equipe multiprofissional deve proporcionar prevenção através de práticas educativas, ressaltar os riscos ao binômio, devem, utilizando estratégias de rastreamento, esclarecer e orientar as gestantes sobre a importância dos cuidados a serem tomados durante a gestação e a melhoria dos hábitos de vida em relação ao autocuidado. CONCLUSÃO: Conclui-se que a equipe multiprofissional tem grande importância no processo de cuidar e prevenir a diabetes mellitus gestacional, promovendo conhecimento sobre a doença e motivando uma gestação saudável, melhorando a qualidade de vida

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Catálogo Taxonômico da Fauna do Brasil: setting the baseline knowledge on the animal diversity in Brazil

The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Evaluation of tetracaine anesthetic formulations in beta-cyclodextrin and hydroxypropyl-beta-cyclodextrin

Orientadores: Eneida de Paula, Leonardo Fernandes FracetoDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de BiologiaResumo: A dor desempenha um papel biológico muito importante como indicador da presença de um estímulo nocivo, que pode representar dano real ou potencial ao organismo; entretanto, não é interessante que essa sinalização persista além das necessidades fisiológicas a ponto de tornar-se um incomodo, podendo dificultar o desempenho das atividades normais, comprometer a qualidade de vida do indivíduo e impedir a realização de práticas cirúrgicas curativas. Os anestésicos locais são fármacos empregados para alívio da dor aguda ou crônica, pois bloqueiam a condução do estímulo nervoso em membranas neuronais. Dentre eles, está a Tetracaína (TTC) um amino-éster de grande utilidade na prática clínica, empregado em procedimentos que requerem anestesia tópica, como aqueles oftalmológicos que necessitam de intervenções na córnea. As limitações do uso clínico da TTC está relacionadas à sua baixa estabilidade química (hidrólise da ligação éster por esterases plasmáticas) e sua toxicidade sistêmica. Sistemas de liberação modificada de fármacos, que empregam carreadores como ciclodextrinas, constituem uma alternativa para aumentar o tempo de ação anestésica e diminuir a toxicidade. As ciclodextrinas são capazes de formar complexos de inclusão com diversos fármacos, alterando propriedades como a solubilidade aquosa, o que torna esses oligosacarídeos cíclicos promissores para este tipo de aplicação. Neste trabalho, estudamos a complexação da TTC com beta-ciclodextrina (?-CD) e hidroxipropil-beta-ciclodextrina (HP-?-CD) em pH fisiológico e sua influência na toxicidade celular e efeito antinociceptivo, induzidos por aquele anestésico, objetivando a preparação de novas formas farmacêuticas. Para caracterização dos complexos de inclusão TTC:?-CD e TTC:HP-?-CD foram empregados métodos espectroscópicos (Ressonância Magnética Nuclear, fluorescência, absorção UV/VIS), difração de raios-X e calorimetria diferencial de varredura. A partir das análises realizadas, encontrou-se que a estequiometria de complexação da TTC com ambas as ciclodextrinas é de 1:1. A constante de associação aparente da TTC, determinada por DOSY-NMR, é de 777 M-1 e 2243 M-1, para ?-CD e HP-?-CD respectivamente, indicando uma forte interação entre as moléculas de anestésico e das ciclodextrinas, em pH fisiológico. Os dados de proximidade espacial, determinados por RMN (1DROESY) revelaram interações entre os hidrogênios Hh e Hi, (que fazem parte do anel aromático da TTC) e hidrogênios da cavidade interna das ciclodextrinas, permitindo assim propor a geometria dos complexos de inclusão da TTC com ambas ciclodextrinas. Ensaios in vitro, em cultura de fibroblastos da linhagem 3T3, mostraram aumento na viabilidade celular após complexação da TTC com ?-CD e HP-?-CD, em relação à TTC em solução. Testes de atividade biológica, de bloqueio do nervo infraorbital em ratos, demonstraram aumento significativo do tempo de duração da anestesia nos animais tratados com os complexos TTC:?-CD e TTC:HP-?-CD (40 min e 40 min), em relação ao grupo tratado com 0,5% de TTC livre (30 min). Os resultados obtidos neste estudo demonstram a formação de complexos de inclusão com forte interação entre TTC e ?-CD e HP-?-CD; indicam ainda que a utilização destes complexos de inclusão é promissora como forma farmacêutica alternativa para este anestésico, devido ao aumento da duração da anestesia (pois os complexos apresentaram maior eficácia quando comparados à TTC livre nas mesmas doses), ou ainda a diminuição da toxicidade (atingindo a mesma eficácia da TTC livre, com menores concentrações de TTC complexada).Abstract: Pain plays an important biological role as a sign of the presence of a noxious stimulus, that denotes actual or potential damage to the body. However, it is not interesting this signal to persist beyond the physiological point, to become a nuisance that impairs the performance of normal activities, the quality of life or prevents the procedure of healing surgical practices. Local anesthetics are used for the relief of acute or chronic pain since they block the conduction of the painful stimulation in neuronal membranes. Among them is Tetracaine (TTC) an amino ester useful in clinical procedures requiring local anesthesia such as those ophthalmic ones with intervention in the cornea. The clinical use of TTC is limited by its low chemical stability (hydrolysis of the ester bond by plasma esterases) and systemic toxicity. The use of drug-delivery systems, in carriers such as cyclodextrins is a good approach to improve the duration of action and to diminish the toxicity of local anesthetics. Cyclodextrins are suitable for this type of application since these cyclic oligosaccharides are able to form inclusion complexes with several drugs improving their water solubility. Here we have studied the complexation of TTC with beta (?-CD) and hydroxypropyl-beta-cyclodextrin (HP-?-CD) and its influence in cell toxicity and antinociceptive effects induced by that anesthetic, aiming the development of new pharmaceutical forms. TTC and ?-CD or HP-?-CD inclusion complexes were characterized using spectrophotometric methods (Nuclear Magnetic Resonance, fluorescence, UV-VIS absorption), X-ray Diffraction and Differential Scanning Calorimetry. A 1:1 stoichiometry of complexation was found for both complexes. The association constant determined by DOSY was 777 M-1 and 2.243 M-1 for TTC complexation with ?-CD and HP-?-CD, respectively, indicating a strong association between the anesthetic and both cyclodextrins, at physiological pH. The nuclear overhauser NMR data (ROESY) had disclosed trough the space proximities between hydrogens Hh and Hi - at the aromatic ring of TTC - and hydrogens from the inner cavity of the cyclodextrins, allowing us to suggest the geometry of TTC:?-CD and TTC:HP-?-CD complex formation. In vitro culture tests on 3T3 fibroblasts cells revealed an increase in cell viability after TTC complexation with ?-CD and HP-?-CD, in comparison to the effect of free TTC. Biological activity was assessed in rats, through the infraorbital nerve blockade test. The results revealed a significant increase in the duration of anesthesia in animals treated with TTC:?-CD and TTC:HP-?-CD (40 min and 40 min), in comparison to a solution of 0.5% tetracaine (30 min). The results presented here demonstrate the formation of strong associated inclusion complexes between TTC and ?-CD and HP-?-CD. The in vivo results allow us to consider those complexes as promising pharmaceutical forms to increase the duration of anesthesia induced by tetracaine (since both complexes showed higher anesthetic potency when compared to free TTC at equivalent doses) or to diminish its toxicity (since the same activity can be achieved with lower concentrations of the complexed TTC formulations).MestradoBioquimicaMestre em Biologia Funcional e Molecula

Improvement Of Tetracaine Antinociceptive Effect By Inclusion In Cyclodextrins.

Local anesthetics (LA) are among the most important pharmacological compounds used to attenuate or eliminate pain. However, systemic toxicity is still a limitation for LA application, especially for ester-type drugs, such as tetracaine (TTC) that presents poor chemical stability (due to hydrolysis by plasma esterases). Several approaches have been used to improve LA pharmaceutical properties, including the employment of drug-delivery systems. Here we used beta-cyclodextrin (β-CD) or hydroxypropyl-beta-cyclodextrin (HP-β-CD) to develop two new TTC formulations (TTC:β-CD and TTC:HP-β-CD). The inclusion complexes formation, in a 1:1 stoichiometry, was confirmed by differential scanning calorimetry, X-ray diffraction, UV-VIS absorption and fluorescence. Nuclear magnetic resonance (DOSY experiments) revealed that TTC association with HP-β-CD is stronger (Ka=1200 mol/L(-1)) than with β-CD (Ka=845 mol/L(-1)). Moreover, nuclear Overhauser effect (NOE) experiments provided information on the topology of the complexes, where TTC aromatic ring is buried inside the CD hydrophobic cavity. In vitro tests with 3T3 fibroblast cells culture revealed that complexation decreased TTC cytotoxicity. In addition, the total analgesic effect of TTC, tested in rats through the infraorbital nerve test, was improved in 36% with TTC:β-CD and TTC:HP-β-CD. In conclusion, these formulations presented potential for future clinical use, by reducing the toxicity and increasing the antinociceptive effect of tetracaine.2085-9

Using active learning strategies during a quality improvement collaborative: exploring educational games to enhance learning among healthcare professionals

Background The Breakthrough Series model uses learning sessions (LS) to promote education, professional development and quality improvement (QI) in healthcare. Staff divergences regarding prior knowledge, previous experience, preferences and motivations make selecting which pedagogic strategies to use in LS a challenge.Aim We aimed to assess new active-learning strategies: two educational games, a card game and an escape room-type game, for training in healthcare-associated infection prevention.Methods This descriptive case study evaluated the performance of educational strategies during a Collaborative to reduce healthcare-associated infections in Brazilian intensive care units (ICUs). A post-intervention survey was voluntarily offered to all participants in LS activities.Results Seven regional 2-day LS were held between October and December 2022 (six for adult ICUs and one for paediatric/neonatal ICUs). Of 194 institutions participating in a nationwide QI initiative, 193 (99.4%) participated in these activities, totalling 850 healthcare professionals. From these, 641 participants responded to the survey (75.4%). The post-intervention survey showed that the participants responded positively to the educational activities.Conclusion The participants perceived the various pedagogical strategies positively, which shows the value of a broad and diverse educational approach, customised to local settings and including game-based activities, to enhance learning among healthcare professionals