Capsaicin cyclodextrin complex enhances mepivacaine targeting and improves local anesthesia in inflamed tissues

Acidic environments, such as in inflamed tissues, favor the charged form of local anesthetics LA . Hence, these drugs show less cell permeation and diminished potency. Since the analgesic capsaicin CAP triggers opening of the TRPV1 receptor pore, its combination with LAs could result in better uptake and improved anesthesia. We tested the above hypothesis and report here for the first time the analgesia effect of a two drug combination LA and CAP on an inflamed tissue. First, CAP solubility increased up to 20 times with hydroxypropyl beta cyclodextrin HP amp; 946; CD , as shown by the phase solubility study. The resulting complex HP amp; 946; CD CAP showed 1 1 stoichiometry and high association constant, according to phase solubility diagrams and isothermal titration calorimetry data. The inclusion complex formation was also confirmed and characterized by differential scanning calorimetry DSC , X ray diffraction, and 1H NMR. The freeze dried complex showed physicochemical stability for at least 12 months. To test in vivo performance, we used a pain model based on mouse paw edema. Results showed that 2 mepivacaine injection failed to anesthetize mice inflamed paw, but its combination with complexed CAP resulted in pain control up to 45 min. These promising results encourages deeper research of CAP as an adjuvant for anesthesia in inflamed tissues and cyclodextrin as a solubilizing agent for targeting molecules in drug deliver

Iron deficiency anaemia in adolescent athletes of the Vila Olímpica Fonndation of Manaus - AM

Considering the dearth of information with regard to the nutritional state of young athletes, were identified the prevalence of iron deficiency anaemia and its association with nutritional indicators of adolescent athletes participating in the Sport Initiation Program of the Vila Olímpica Foundation in Manaus -AM. A sample was made up of 194 voluntary adolescent male athletes classified as beginners, who participated in several different sports. Data collected was by verification of anthropometric measures (body weight, height, and skinfold thicknesses of triceps and subscapular skinfold), hemoglobin dosage utilizing a portable hemoglobinometer, HemoCue direct calorimetric method, and socioeconomic instrument. In the diagnosis of the nutritional states, we used Height-for-age- and Body Mass Index for the age indicators, adjusted cut-off points proposed by the WHO. The results showed that 9.4 % of the adolescents suffered from malnutrition, 8.2% overweight, and 4.6 obesity. The prevalence of iron deficiency anaemia found in the samples was 41.7%, with predominance in the lowest socioeconomic class. Although the prevalence of anaemia was high, the nutritional state of the adolescents did not influence these results, considering that the majority looked healthy. In view of these findings, we suggest that effective means be taken for nutritional education to minimize and/or control iron deficiency anaemia.Considerando a escassez de informações quanto ao estado nutricional de atletas jovens, identificou-se a prevalência de anemia ferropriva e sua associação com indicadores nutricionais de atletas adolescentes participantes do Programa de Iniciação Esportiva da Fundação Vila Olímpica de Manaus-AM. A amostra foi constituída por 194 atletas adolescentes do gênero masculino, voluntários, praticantes de diferentes modalidades esportivas classificados como iniciantes. A coleta dos dados foi realizada mediante verificação de medidas antropométricas (peso corporal, estatura e espessuras das dobras cutâneas tricipital e subescapular), dosagem de hemoglobina utilizando o hemoglobinômetro portátil (Sistema Hemocue) e instrumento socioeconômico. No diagnóstico do estado nutricional foram utilizados os indicadores Estatura para a Idade (E/I) e Índice de Massa Corporal para a idade (IMC/I), assumindo pontos de corte propostos pela OMS. Os resultados mostraram que 9,4% dos adolescentes apresentaram desnutrição, 8,2% sobrepeso e 4,6% obesidade. A prevalência de anemia ferropriva encontrada na amostra foi de 41,7%, com predominância na classe socioeconômica mais baixa. Embora a prevalência de anemia tenha sido elevada, o estado nutricional dos adolescentes não influenciou sobre este resultado, considerando que a maioria dos adolescentes apresentou-se eutrófica. Diante do exposto, sugere-se a adoção de medidas efetivas de intervenção e de educação nutricional visando à minimização e/ou o controle da anemia ferropriva

Doença do enxerto contra hospedeiro pós-transfusional-guia para irradiação gama de hemocomponentes Transfusion-associated graft-versus-host disease-guideline on gamma irradiation of blood components

A doença enxerto contra hospedeiro transfusional (DECHT) é síndrome rara e geralmente fatal. É caracterizada por febre, eritema cutâneo, náuseas, vômitos, diarréia, hepatite e pancitopenia. Pode ocorrer em pacientes com imunossupressão severa e em pacientes imunocompetentes após a transfusão de hemocomponente celular de doador homozigoto para proteínas HLA às quais o receptor é heterozigoto. O diagnóstico é feito pelo quadro clínico e exame histopatológico da pele. A gamaglobulina antitimocítica associada a altas doses de corticosteróides é a terapêutica mais empregada. O desconhecimento da síndrome, o retardo no diagnóstico, o curso rápido e a ausência de resposta ao tratamento estão relacionados à má evolução dos pacientes. A melhor forma de abordagem da DECHT é a prevenção através da irradiação gama dos hemocomponentes. A dose necessária para completa inativação dos linfócitos T é de 2500 cGy. A principal alteração decorrente da irradiação é o aumento da concentração de potassio nos concentrados de hemácias. Os filtros de leucócitos não previnem o desenvolvimento da DECHT e a irradiação não previne a aloimunizaçao e as reaçoes transfusionais. Apenas hemocomponentes celulares como sangue total, concentrado de hemácias, concentrado de plaquetas e concentrado de granulócitos, necessitam ser irradiados. Devem ser irradiados os hemocomponentes para transfusão entre familiares, transfusões HLA compatíveis, pacientes submetidos a transplante de medula óssea, portadores de doença de Hodgkin, pacientes tratados com análogos da purina, transfusões intra-útero, recém nascidos pré-termo e pacientes com síndrome de imunodeficiência congênita. É recomendável a irradiação de hemocomponentes destinados a pacientes com doenças neoplásicas quando submetidos a protocolos de quimioterapia agressivos.<br>Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare and usuailly fatal syndrome. Clinical manifestations are fever, maculopapular skin rash, nausea, vomiting, diarrhea, hepatitis and pancytopenia owing to bone marrow hypoplasia. lt can occur in recipients with severe immunossuppression and in immunocompetent recipients after transfusion of ceillular components from HLA homozygous donor to recipients heterozygous for that HLA haplotype. The diagnosis is made by clinical manifestation and skin biopsy. Antithymocyte globulin and high dose systemic corticosteroids are both the most used therapy. The back of knowledge about this syndrome, the rapid evolution and the absence of treatement response are related to patients bad evolution. Gamma irradiation of blood products has been the mainstay of TA-GVHD prevention. Dose of 2500 cGy is required to completly inactivate T cells. lrradiation damage red cells membrane and the red celis units can not be storage for long time after irradiation. High potassium levels is the mainly change in red cells units.White cell-reduction filters do not prevent TA-GVHD and gamma irradiation does not prevent alloimmunization or blood reactions. Oniy cellular components like whole blood, red cells, platelets and granulocytes need be irradiated. Ali blood components should be irradiated to: first or second-degree relatives, patients need HLA-matched platelets, recipients of allogeneic or autologous bone marrow transplantation, patients with Hodgkin's disease, patients treated with purine analogue drugs, intrauterine transfusions, pre-term infants and when congenítal immunodeficiency states is suspected. lt is recomended irrradiated blood to patients with neoplastic disease when they receive intensive chemoterapy