Interchangeability among therapeutic equivalents of lamotrigine: evaluation of quality of life

Epilepsia é o distúrbio neurológico grave mais comum no mundo todo. Aproximadamente 70% dos pacientes com epilepsia têm suas crises controladas com tratamento clínico e farmacológico. Esta pesquisa avaliou a possível interferência da intercambialidade entre equivalentes terapêuticos da lamotrigina na condição clínica e na qualidade de vida dos pacientes com epilepsia refratária. O estudo foi dividido em três períodos de 42 dias e em cada período foi dispensado um equivalente terapêutico, aleatoriamente (dois similares - formulação A e B e o medicamento de referência - formulação C). A dose média de lamotrigina foi de 5,5 mg/kg/dia. A ocorrência de efeitos colaterais tende a ser mais decisiva para a redução da qualidade de vida em epilepsia refratária em relação às variações no número de crises ou alterações nas concentrações plasmáticas. Os resultados demonstram que, independentemente do medicamento prescrito, a intercambialidade entre equivalentes terapêuticos pode interferir no sucesso do controle da epilepsia.Epilepsy is the most common serious neurological disorder worldwide. Approximately 70% of patients with epilepsy have their seizures controlled by clinical and pharmacological treatment. This research evaluated the possible influence of interchangeability among therapeutic equivalents of LTG on the clinical condition and quality of life of refractory epileptic patients. The study was divided into three periods of 42 days, and an equivalent therapeutic LTG randomly dispensed for each period (two similars - formulations A and B, and the reference product - formulation C). The mean dose of LTG was 5.5 mg/kg/day. The presence of side effects tends to have a greater deleterious effect on quality of life of refractory epileptics compared to variations in number of seizures or changes in plasma concentrations. The results showed that independently of the drug prescribed, interchangeability among therapeutic equivalents can negatively impact epilepsy control

Synthesizing the problems and obstacles of productive capital in Latin America: a discussion based on Orlando Caputo’s Marxist Theory of Dependency

O objetivo deste trabalho foi revisar os problemas e desafios do capital produtivo na América Latina (AL). O intuito foi atualizar o debate à luz do capitalismo contemporâneo, discutindo seus achados com a perspectiva histórica da industrialização dependente, pela Teoria Marxista da Dependência, de Orlando Caputo. Para tanto, foi realizada uma revisão tendo como fonte nove periódicos científicos especializados, que foram metodologicamente sistematizados e cujo conteúdo foi sintetizado em temáticas consideradas relevantes. Foram elas: ‘Dependência e os mecanismos de transferência de valor’; ‘Origem e dinâmica constitutiva do capital produtivo nas economias dependentes’; e os próprios ‘Problemas e obstáculos do capital produtivo nas economias dependentes’. Ao final, discutiram-se esses conteúdos com a perspectiva da relação do capital produtivo e financeiro nas economias dependentes na visão de Caputo. Por fim, concluiu-se que a perspectiva de Caputo ainda é incipiente na compreensão do processo de (des)industrialização vivenciado na AL ainda hoje.The objective of this work was to review the problems and challenges of productive capital in Latin American economies. The aim was to update the debate in the light of contemporary capitalism, discussing its findings with the historical perspective of dependent industrialization by Orlando Caputo’s Marxist Theory of Dependence. To this end, a review was carried out using nine specialized scientific journals as source, which were methodologically systematized and whose content was synthesized in topics considered relevant. They were: ‘Dependency and value transfer mechanisms’; ‘Origin and constitutive dynamics of productive capital in dependent economies’ and the ‘Problems and obstacles of productive capital in dependent economies’. At the end, these contents were discussed with the perspective of the relationship between productive and financial capital in dependent economies in Caputo’s view. Finally, it was concluded that Caputo’s perspective is still incipient in the understanding of the (de)industrialization process experienced in LA even today

“Vaza, Falsiane!”: iniciativa de letramento midiático contra notícias falsas em redes sociais

The proliferation of false information on online social networks created a scenario of mistrust regarding information sources. Concerns over the threat of fake news has become a breeding ground for collective demands for proposals to combat misinformation. This research is based on studies of social responses to fake news to evaluate the proliferation of fact checking sites, threats of legal control and technical alterations in social network algorithms, contrasting these strategies with the potential of initiatives based on media literacy. Based on the research-action methodology, this paper presents a panorama of media education proposals existing in different platforms (video channels, multimedia pages, face-to-face workshops, massive open online courses), comparing their possibilities of interactivity, participation and public engagement. As a result, it was identified a lack of free, asynchronous, massive, multimedia, interactive, accessible, attractive and potentially viral online media literacy courses. In response to the gaps in this field, the papers develops a new mechanism for combating misinformation using the principles of media literacy, but occupying the same space of proliferation of false news – social networks – and using its specific formats to fight fake news in its environment. Developed as a result of this research, the course “Vaza, Falsiane!” reached 200 thousand visitors in two years, and its contents impacted more than 10 million through Facebook.A proliferação de informações falsas em redes sociais online criou um cenário de desconfiança em relação às fontes informativas. A preocupação em relação à ameaça de notícias falsas se tornou um terreno fértil para demandas coletivas por propostas para combater a desinformação. Esta pesquisa avalia a proliferação de sites de checagem de fatos, ameaças de controle legal e alterações técnicas em algoritmos de redes sociais, contrastando essas estratégias com o potencial de iniciativas baseadas na educomunicação. Para isso, foi analisado um panorama de propostas de educação midiática já existentes em diferentes plataformas (canais de vídeo, páginas multimídia, oficinas presenciais, curso online aberto e massivo [MOOC, da sigla em inglês “Massive Open Online Course”] sincrônico ou não), comparado suas possibilidades de empoderamento por meio da interatividade, participação e engajamento do público. Em resposta às lacunas nesse campo, foi desenvolvido um novo mecanismo de combate à desinformação usando dos princípios da educomunicação, mas ocupando o mesmo espaço de proliferação das notícias falsas – as redes sociais – e usando seus formatos específicos para lutar contra as fake news em seu próprio ambiente

Biological and immunological studies of five Brazilian rabies virus isolates

Aspects of biological behavior of Brazilian rabies virus isolated from canine, bovine, equine, vampire and insectivorous bats were studied in mice. The oral infection occurred in mice fed with infected brain of insectivours bat (8.82%), canine (8.57%) and equine (3.03%). The mean period of incubation to all the isolates was 6 days after mice intracerebral inoculation, however, symptoms were variable, since hyperexcitability (canine sample), progressive paralysis of lower limbs and prolonged clinical course until death (equine sample), and mice without clinical signs before death (insectivorous bat). By immunohistochemistry IFN was detected in brains of mice inoculated with bovine and insectivorous bat samples, TNF and iNOS were detected in brains of those inoculated with insectivorous bat, bovine and canine samples, and positive GFAP astrocytes were found in all five samples. Two commercial inactivated rabies vaccines, one imported (vaccine 1) and another manufactured in Brazil (vaccine 2) were compared to evaluate their efficacy to protect against experimental rabies infection in mice, through the NIH and the CDC potency tests, using these street isolates as challenge virus. There was no statistical significant difference between the efficaccy of both vaccines, when comparing the same potency test and challenge virus strain suggesting no need to produce specific vaccines with street isolates.Estudou-se em camundongos aspectos do comportamento biológico de amostras brasileiras de virus rábico isoladas de cão, bovino, eqüino, morcegos hematófago e insetívoro. Observou-se transmissão oral em camundongos alimentados com cérebros infectados de morcego insetívoro (8,82%), cão (8,57%) e eqüino (3,03%). O período de incubação médio para todas as amostras foi de 6 dias após a inoculação intracerebral, com sintomas variando, desde hiperexitabilidade (amostra canina), paralisia progressiva principalmente de membros posteriores e maior duração do curso clínico até a morte (eqüino) e morte repentina, sem sintomas aparentes (morcego insetívoro). Pela imunoistoquímica detectou-se produção de IFN nos cérebros dos camundongos inoculados com amostra de bovino e morcego insetívoro, TNF e iNOS nos animais infectados com amostra de cão, bovino e morcego insetívoro e reação astrocitária com aumento da expressão de GFAP em todas as cinco amostras. A eficácia de 2 vacinas comerciais inativadas, uma nacional e outra importada, para a proteção contra a infecção experimental em camundongos foi avaliada através dos testes NIH e CDC, usando as amostras de campo para o desafio. Não houve diferença significativa entre o desempenho das vacinas, quando comparadas para um mesmo teste de potência e amostra de desafio sugerindo que não há necessidade de se produzir vacinas com amostras isoladas de campo

Influence of the clinical profile of patients with refractory epilepsy on lamotrigine plasma concentration

The purpose of this work was to evaluate the influence of the clinical profile on lamotrigine (LTG) plasma concentrations from patients with refractory epileptic seizures. In this cross-sectional study, therapeutic monitoring of LTG, and questionnaires with 75 patients with refractory epileptic seizures of a Hospital in Ribeirão Preto-SP-Brazil were performed. The multiple linear regression model was used to verify association between the LTG plasma concentrations and the independent variables. Covariance analysis was used to compare the mean LTG plasma concentration among the co-medication groups. The LTG plasma concentration was associated both with the LTG dosage (mg/kg/day) (p=0.0096) and with the use of first generation antiepileptic drugs (AED) (p<0.01), being carbamazepine (CBZ) and phenytoin (PHT), the AEDs showing the most prominent influence in reducing LTG plasma concentrations. Adverse events, adherence to the pharmacological treatment, and epileptic seizures frequency, did not show significant correlation with LTG plasma concentration values. The conclusion is that LTG plasma concentration is significantly influenced by the LTG dosage and by the concomitant use of a first generation AED

Stir bar-sorptive extraction, solid phase extraction and liquid-liquid extraction for levetiracetam determination in human plasma: comparing recovery rates

Levetiracetam (LEV), an antiepileptic drug (AED) with favorable pharmacokinetic profile, is increasingly being used in clinical practice, although information on its metabolism and disposition are still being generated. Therefore a simple, robust and fast liquid-liquid extraction (LLE) followed by high-performance liquid chromatography method is described that could be used for both pharmacokinetic and therapeutic drug monitoring (TDM) purposes. Moreover, recovery rates of LEV in plasma were compared among LLE, stir bar-sorptive extraction (SBSE), and solid-phase extraction (SPE). Solvent extraction with dichloromethane yielded a plasma residue free from usual interferences such as commonly co-prescribed AEDs, and recoveries around 90% (LLE), 60% (SPE) and 10% (SBSE). Separation was obtained using reverse phase Select B column with ultraviolet detection (235 nm). Mobile phase consisted of methanol:sodium acetate buffer 0.125 M pH 4.4 (20:80, v/v). The method was linear over a range of 2.8-220.0 µg mL-1. The intra- and inter-assay precision and accuracy were studied at three concentrations; relative standard deviation was less than 10%. The limit of quantification was 2.8 µg mL-1. This robust method was successfully applied to analyze plasma samples from patients with epilepsy and therefore might be used for pharmacokinetic and TDM purposes.</p