Tretinoin peel: a critical view

The tretinoin peel, also known as retinoic acid peel, is a superficial peeling often performed in dermatological clinics in Brazil. The first study on this was published in 2001, by Cuce et al., as a treatment option for melasma. Since then, other studies have reported its applicability with reasonable methodology, although without a consistent scientific background and consensus. Topical tretinoin is used for the treatment of various dermatoses such as acne, melasma, scars, skin aging and nonmelanoma skin cancer. The identification of retinoids cellular receptors was reported in 1987, but a direct cause-effect relation has not been established. This article reviews studies evaluating the use of topical tretinoin as agent for superficial chemical peel. Most of them have shown benefits in the treatment of melasma and skin aging. A better quality methodology in the study design, considering indication and intervention is indispensable regarding concentration, vehicle and treatment regimen ( interval and number of applications). Additionally, more controlled and randomized studies comparing the treatment with tretinoin cream versus its use as a peeling agent, mainly for melasma and photoaging, are necessary.Univ Fed Sao Paulo UNIFESP, Unit Cosmiatry Surg & Oncol, Dept Dermatol, Paulista Med Sch, Sao Paulo, SP, BrazilUniv Fed Sao Paulo EPM UNIFESP, Paulista Med Sch, Dept Dermatol, Sao Paulo, SP, BrazilUniv Estadual Campinas Unicamp, Sch Pharmaceut Sci, Campinas, SP, BrazilUniv Fed Sao Paulo UNIFESP, Unit Cosmiatry Surg & Oncol, Dept Dermatol, Paulista Med Sch, Sao Paulo, SP, BrazilUniv Fed Sao Paulo EPM UNIFESP, Paulista Med Sch, Dept Dermatol, Sao Paulo, SP, BrazilWeb of Scienc

Antigenicity and Immunogenicity of Plasmodium vivax Merozoite Surface Protein-3

A recent clinical trial in African children demonstrated the potential utility of merozoite surface protein (MSP)-3 as a vaccine against Plasmodium falciparum malaria. the present study evaluated the use of Plasmodium vivax MSP-3 (PvMSP-3) as a target antigen in vaccine formulations against malaria caused by P. vivax. Recombinant proteins representing MSP-3 alpha and MSP-3 beta of P. vivax were expressed as soluble histidine-tagged bacterial fusions. Antigenicity during natural infection was evaluated by detecting specific antibodies using sera from individuals living in endemic areas of Brazil. A large proportion of infected individuals presented IgG antibodies to PvMSP-3 alpha (68.2%) and at least 1 recombinant protein representing PvMSP-3 beta (79.1%). in spite of the large responder frequency, reactivity to both antigens was significantly lower than was observed for the immunodominant epitope present on the 19-kDa C-terminal region of PvMSP-1. Immunogenicity of the recombinant proteins was studied in mice in the absence or presence of different adjuvant formulations. PvMSP-3 beta, but not PvMSP-3 alpha, induced a TLR4-independent humoral immune response in the absence of any adjuvant formulation. the immunogenicity of the recombinant antigens were also tested in formulations containing different adjuvants (Alum, Salmonella enterica flagellin, CpG, Quil A, TiterMax (R) and incomplete Freunds adjuvant) and combinations of two adjuvants (Alum plus flagellin, and CpG plus flagellin). Recombinant PvMSP-3 alpha and PvMSP-3 beta elicited higher antibody titers capable of recognizing P. vivax-infected erythrocytes harvested from malaria patients. Our results confirm that P. vivax MSP-3 antigens are immunogenic during natural infection, and the corresponding recombinant proteins may be useful in elucidating their vaccine potential.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)US National Institutes of Health, National Institute for Allergy and Infectious DiseasesSIgNHorizontal Programme on Infectious Diseases under the Agency for Science, Technology and Research (A*STAR, Singapore)Wellcome Trust of Great Britain, as part of the Oxford Tropical Medicine Research Programme of Wellcome Trust-Mahidol UniversityUniv São Paulo, Fac Ciencias Farmaceut, Dept Anal Clin & Toxicol, São Paulo, BrazilUniv Estadual Campinas, Dept Genet Evolucao & Bioagentes, Inst Biol, Campinas, SP, BrazilUniv São Paulo, Inst Ciencias Biomed, Dept Microbiol, BR-05508 São Paulo, BrazilNatl Univ Singapore, Yong Loo Lin Sch Med, Dept Microbiol, Singapore 117595, SingaporeAgcy Sci Technol & Res, Singapore Immunol Network, Biopolis, Singapore, SingaporeChurchill Hosp, Ctr Vaccinol & Trop Med, Oxford OX3 7LJ, EnglandMahidol Oxford Univ Trop Med Res Programme, Shoklo Malaria Res Unit, Mae Sot, ThailandEmory Univ, Emory Vaccine Ctr, Atlanta, GA 30322 USAEmory Univ, Yerkes Natl Primate Res Ctr, Atlanta, GA 30322 USAEmory Univ, Dept Med, Div Infect Dis, Atlanta, GA 30322 USACtr Dis Control & Prevent, Malaria Branch, Div Parasit Dis, Chamblee, GA USAUniversidade Federal de São Paulo, CTCMOL, Dept Microbiol Imunol & Parasitol, Escola Paulista Med, São Paulo, BrazilUniversidade Federal de São Paulo, CTCMOL, Dept Microbiol Imunol & Parasitol, Escola Paulista Med, São Paulo, BrazilFAPESP: 2010/09893-0US National Institutes of Health, National Institute for Allergy and Infectious Diseases: 1R01AI24710Web of Scienc

HPLC assay of lidocaine in in vitro dissolution test of the Poloxamer 407 gels

Apresenta-se método simples de cromatografia líquida de alta eficiência (CLAE) para análise da lidocaína em meio aquoso, após estudo de liberação in vitro. A lidocaína foi analisada usando-se coluna LichroCART RP-18 (5 mm, 125x4 mm), fase móvel constituída de acetonitrila: tampão fosfato de sódio 0,05 M, pH 6 (35:65), adicionada de 0,05% de dietilamina com fluxo de 1 mL/min. O tempo de retenção foi de 7,9 min. O comprimento de onda de análise utilizado foi de 210 nm. A linearidade do método foi de 1,25 a 25 µg/mL com coeficiente de variação intraensaio e inter-ensaio menor que 3,5 %. A metodologia desenvolvida e validada mostrou sensibilidade e especificidade para a realização dos estudos propostos, considerando-se que as amostras obtidas a partir dos estudos de liberação in vitro contêm concentrações muito baixas do fármaco, além de outras substâncias do meio de dissolução que podem interferir no doseamento. A quantificação do fármaco e dos interferentes pode não ser possível se for efetuada por outras metodologias analíticas convencionais. Assim, o método desenvolvido é de grande importância para a quantificação do fármaco nas alíquotas obtidas nos ensaios de liberação in vitro.A simple high performance liquid chromatography method to assay lidocaine hydrochloride in aqueous receiving media, following in vitro release, is presented. Lidocaine hydrochloride was analysed using a 5 mm LichroCART® RP-18 column (125 x 4 mm i.d.). The mobile phase was acetonitrile: 0.05 M sodium phosphate buffer, pH 6.0 (35:65) and 0.05% of diethylamine at a flow rate of 1 mL/min. The retention time was 7.9 min. Detection was carried out at 210 nm at room temperature (28 ºC). The method was found to be linear in the range 1.25 to 25 mg/mL, showing average intraassay and inter-assay coefficients of variation below 3.5%. The proposed method was validated for linearity, specificity, precision and accuracy and was shown to be useful for the analysis of lidocaine hydrochloride in in vitro release studies

Long-term follow-up of IPEX syndrome patients after different therapeutic strategies : an international multicenter retrospective study

Background: Immunodysregulation polyendocrinopathy enteropathy x-linked(IPEX) syndrome is a monogenic autoimmune disease caused by FOXP3 mutations. Because it is a rare disease, the natural history and response to treatments, including allogeneic hematopoietic stem cell transplantation (HSCT) and immunosuppression (IS), have not been thoroughly examined. Objective: This analysis sought to evaluate disease onset, progression, and long-term outcome of the 2 main treatments in long-term IPEX survivors. Methods: Clinical histories of 96 patients with a genetically proven IPEX syndrome were collected from 38 institutions worldwide and retrospectively analyzed. To investigate possible factors suitable to predict the outcome, an organ involvement (OI) scoring system was developed. Results: We confirm neonatal onset with enteropathy, type 1 diabetes, and eczema. In addition, we found less common manifestations in delayed onset patients or during disease evolution. There is no correlation between the site of mutation and the disease course or outcome, and the same genotype can present with variable phenotypes. HSCT patients (n = 58) had a median follow-up of 2.7 years (range, 1 week-15 years). Patients receiving chronic IS (n 5 34) had a median follow-up of 4 years (range, 2 months-25 years). The overall survival after HSCT was 73.2% (95% CI, 59.4-83.0) and after IS was 65.1% (95% CI, 62.8-95.8). The pretreatment OI score was the only significant predictor of overall survival after transplant (P = .035) but not under IS. Conclusions: Patients receiving chronic IS were hampered by disease recurrence or complications, impacting long-term.disease-free survival. When performed in patients with a low OI score, HSCT resulted in disease resolution with better quality of life, independent of age, donor source, or conditioning regimen

Ab initio atomistic description of temperature-induced phase changes: The cases of zirconia and Ti-Y-co-doped zirconia

Zirconium dioxide, or zirconia, is a common and useful ceramic with a wide range of applications, from fuel cells to odontology. Its phase diagram is simple and well understood, having a structure which is monoclinic at temperatures up to 1500 K, tetragonal up to 2700 K and cubic up to 3000 K. Zirconia is rarely used in its pure form, being typically doped with Y2O3, MgO or TiO2, and in this regime its phase diagram becomes much more complex. In this context, ab initio molecular dynamics (AIMD) can provide a detailed atomistic description of the phase diagram of this system, accurately describing its stable phases and transition regions. In this work, 3 mol-% Y2O3 (3YSZ) crystals doped with different Ti contents were studied at the density-functional level. For Ti contents varying from 0 to 30 at%, a global search algorithm was first used to explore the 0 K potential-energy surface and determine the most stable sites for the added Ti atoms. It was found that, at low Ti compositions XTi, small TiO2 clusters form, followed by TiO2 channels and infinite TiO2 planes at larger XTi values, and that the highest stability is achieved at 9% Ti. AIMD simulations within the isothermal-isobaric NPT ensemble were then performed to characterize the temperature-dependent phase changes as a function of the Ti content, where it was found that the Ti-doped structures presented considerably smaller volume changes near the phase-change critical temperatures. These findings suggest that YSZ materials doped with a small amount of Ti are both energetically and kinetically more stable than the undoped counterparts, in the ideal proportion of 3% TiO2 for every 1% Y2O3 doping.Fil: Negreiros Ribeiro, Fábio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Físico-química de Córdoba. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Instituto de Investigaciones en Físico-química de Córdoba; ArgentinaFil: Ribeiro Ricci Lazar, Dolores. Comissao Nacional de Energia Nuclear. Centro de Lasers e Aplicacoes. Instituto de Pesquisas Energéticas e Nucleares; BrasilFil: Ussui, Valter. Comissao Nacional de Energia Nuclear. Centro de Lasers e Aplicacoes. Instituto de Pesquisas Energéticas e Nucleares; BrasilFil: De Lima, Nelson Batista. Comissao Nacional de Energia Nuclear. Centro de Lasers e Aplicacoes. Instituto de Pesquisas Energéticas e Nucleares; BrasilFil: Marchi, Juliana. Universidad Federal do Abc; BrasilFil: Dalpian, Gustavo Martini. Universidad Federal do Abc; Brasi

AIDS NO IDOSO: PANORAMA SITUACIONAL E AMPLIFICAÇÃO DA QUALIDADE DO ATENDIMENTO DE ENFERMAGEM

A população idosa vem apresentando crescimento notável concomitantemente a Síndrome da Imunodeficiência Adquirida nessa faixa etária. Nesta perspectiva, este estudo visou discutir sobre a qualidade do atendimento de enfermagem e não adesão ao tratamento dos portadores do Vírus da Imunodeficiência Humana com 60 anos ou mais, baseado em uma revisão bibliográfica referente ao assunto viabilizando conhecimento a respeito das implicações do processo de enfermagem. Diante disso foi possível observar que o principal fator do diagnóstico tardio é o atendimento falho levando em consideração ideias pré-concebidas sobre a sexualidade do idoso, além disso foi observado que a não adesão ao tratamento deve-se a falta de orientação e atendimento individualizado. Desta forma é imprescindível que a sociedade reflita a respeito da sexualidade nessa faixa etária para a garantia de envelhecimento saudável.

Evolution of the functional independence of elderly patients from a home care service through the point of view of caregivers

O conhecimento do desempenho do idoso em suas atividades é de grande importância na assistência domiciliar, pois é o que norteia os profissionais e o cuidador no monitoramento dos cuidados prestados. O objetivo deste estudo foi avaliar a evolução da independência funcional de idosos inclusos em um programa de assistência domiciliária, sob a ótica do cuidador pela Medida de Independência Funcional (MIF), em dois momentos, com intervalo de um ano entre eles. Foi realizado estudo de seguimento, no qual os dados foram obtidos pelos prontuários de 22 pacientes, que continham a avaliação da MIF nos dois momentos estudados (outubro de 2003 e outubro de 2004). Foram excluídos os prontuários que apresentaram mudança de cuidador entre as avaliações, exclusão do programa e óbito. Realizou-se análise descritiva simples e para verificar as diferenças estatísticas o teste t-pareado e teste de Wilcoxon. A associação dos resultados da MIF com as variáveis de gênero, idade e comorbidades dos idosos foram analisadas por meio do test t - pareado e correlação de Pearson. A amostra caracterizou-se por uma maioria feminina, com idade avançada e múltiplas doenças associadas. Não foram encontradas diferenças significantes entre as avaliações, das médias da MIF motor, cognitivo e total, das medianas das seis áreas e das dezoito atividades da MIF. A manutenção na atividade expressão se associou com o gênero feminino, enquanto que a atividade interação social e a área cognição com o número de comorbidades. Observou-se manutenção da independência funcional dos pacientes no período estudado. Os resultados sugerem que no período de um ano os idosos foram capazes de manter ou retardar seu declínio funcional.The knowledge of the performance of the aged one in its activities have a major importance in the home care services, because it is the objective of professionals and caregivers during health care. The objective of this study was to evaluate the functional independence evolution of patients included under home care, through the caregiver’s point of view of the Functional Independence Measure (FIM) instrument, at two moments, with one year between them. A follow up study was designed. The data had been gotten in recorded case histories of 22 patients, who contained the evaluation of FIM at the two studied moments (October 2003 and October 2004). The recorded of the patients who presented changes of caregiver between the evaluations, exclusion of the program and death were excluded. Simple descriptive analyses were made and statistical differences were tested using Paired- T Test and Wilcoxon test. The association of the results of the MIF with gender, age and diseases of the patients had been analyzed by means of Paired- T Test and correlation of Pearson. The features of the sample were composed by a feminine majority, with advanced age and multiple associated illnesses. Statistically significant differences were not found between the evaluations by the perception of the caregiver, in the averages of the motor, cognitive and total FIM, of the medium of six dimensions and eighteen categories of the FIM. The maintenance in the expression activity was associated with the feminine sort, while that the social interaction activity and the cognition area correlated with the number of diseases. Maintenance of the functional capacity of the patients in the studied period was observed. The results suggest that the home care attendance was revealed as a capable modality to keep or to delay the functional decline from elderly

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good

Impacts of the Tropical Pacific/Indian Oceans on the Seasonal Cycle of the West African Monsoon

The current consensus is that drought has developed in the Sahel during the second half of the twentieth century as a result of remote effects of oceanic anomalies amplified by local land–atmosphere interactions. This paper focuses on the impacts of oceanic anomalies upon West African climate and specifically aims to identify those from SST anomalies in the Pacific/Indian Oceans during spring and summer seasons, when they were significant. Idealized sensitivity experiments are performed with four atmospheric general circulation models (AGCMs). The prescribed SST patterns used in the AGCMs are based on the leading mode of covariability between SST anomalies over the Pacific/Indian Oceans and summer rainfall over West Africa. The results show that such oceanic anomalies in the Pacific/Indian Ocean lead to a northward shift of an anomalous dry belt from the Gulf of Guinea to the Sahel as the season advances. In the Sahel, the magnitude of rainfall anomalies is comparable to that obtained by other authors using SST anomalies confined to the proximity of the Atlantic Ocean. The mechanism connecting the Pacific/Indian SST anomalies with West African rainfall has a strong seasonal cycle. In spring (May and June), anomalous subsidence develops over both the Maritime Continent and the equatorial Atlantic in response to the enhanced equatorial heating. Precipitation increases over continental West Africa in association with stronger zonal convergence of moisture. In addition, precipitation decreases over the Gulf of Guinea. During the monsoon peak (July and August), the SST anomalies move westward over the equatorial Pacific and the two regions where subsidence occurred earlier in the seasons merge over West Africa. The monsoon weakens and rainfall decreases over the Sahel, especially in August.Peer reviewe