Subacute toxicology studies on the aqueous fraction of the ethanol extract of the leaves of Cissampelos sympodialis Eichl. (Menispermaceae) in dogs

Cissampelos sympodialis Eichl. (Menispermaceae) has been investigated about its botanical, chemical, pharmacological and toxicological aspects in our laboratory. Previous acute toxicology studies demonstrated that in dogs as well as in Wistar rats, 5 g/kg, p.o., and 2 g/kg, i.p. of the aqueous fraction of the ethanol extract of the leaves of Cissampelos sympodialis (AFL), induced a significant increase in the phosphatase alkaline and gama glutamil tranferase (GGT) levels, that were completely reversed in 15 days after interruption of AFL treatment. The aim of the present work was to investigate the subacute toxicology effects induced by AFL in dogs. We used the methods proposed by Portaria 116/96 of the Secretaria Nacional de Vigilância Sanitária, which regulates studies of toxicity for phytomedicines in Brazil. Daily administration (p.o.) of AFL, 45 mg/kg/day (5 times the dose used by human beings), during 4 weeks, was devoid of any effect on haematological (haemogram and platelets) and on blood biochemical parametes. In conclusion, the present study, using dogs, demonstrated that AFL, in a popularly used dose, by human beings, was devoid of any toxicological effect

Avaliação da anemia em crianças da cidade de Campina Grande, Paraíba, Brasil Evaluation of anemia in children from the city of Campina Grande, Paraíba, Brazil

A anemia é uma condição definida como a redução da concentração de hemoglobina circulante a um valor inferior ao considerado pela Organização Mundial da Saúde em13 g/dl, 12 g/dl e 11 g/dl para homens, mulheres e crianças, respectivamente. É considerada a principal consequência da deficiência de ferro - um nutriente que atua principalmente na síntese das células vermelhas do sangue e no transporte de oxigênio para as demais células do corpo. Este trabalho, realizado nos meses de março e abril de 2007, teve como objetivo avaliar as alterações hematológicas e os níveis de ferro sérico em crianças de 6 a 59 meses de idade na cidade de Campina Grande-PB. A prevalência de anemia observada foi de 31,73%, e, dentre as crianças anêmicas, 91% apresentaram quadro de anemia leve (Hb < 11,0 e > 9,0 g/dl). A faixa etária predominante em que se observou a menor concentração de hemoglobina foi de 6 a 12 meses (10,26 ± 1,27 g/dl). Considerando-se os vários parâmetros do hemograma para avaliar a etiologia ferropriva entre os anêmicos, o RDW (amplitude de distribuição dos eritrócitos) foi o que mais apresentou especificidade no diagnóstico laboratorial da anemia por deficiência de ferro. Dessa forma, a investigação laboratorial é essencial para o diagnóstico precoce e para o acompanhamento terapêutico eficiente da anemia ferropriva em crianças.<br>Anemia is a condition that is defined as a concentration of circulating hemoglobin at a level lower than that considered adequate by the World Health Organization (13 g/dL, 12 g/dL and 11 g/dL for men, women and children, respectively). It is considered the main consequence of iron deficiency - a nutrient that mainly acts in the synthesis of red blood cells and in the transportation of oxygen to other cells of the body. This study, which was performed in March and April 2007, aimed at evaluating hematologic alterations and serum iron levels in 6 to 59-month-old children in the city of Campina Grande. The prevalence of anemia was 31.73% and among the anemic patients, 91% had mild anemia (Hb < 11.0 and > 9.0 g/dL). The lowest concentration of hemoglobin was predominantly observed in the 6 to 12-month age group. Considering different parameters of the hemogram in order to evaluate the etiology of iron deficiency among anemic patients, the RDW (Red Cell Distribution Width) showed the greatest sensitivity in laboratory diagnoses of iron deficiency anemia. Therefore, laboratory investigation is essential for early diagnosis and efficient therapy of iron deficiency anemia in children

Chemical Composition and Antileishmanial Activity from Fractions of Piper cabralanum C.D.C. (Piperaceae)

Submitted by Gilvan Almeida ([email protected]) on 2016-08-29T19:06:30Z No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 20.pdf: 242014 bytes, checksum: 72d0145bce4dff62c809fa48671a4777 (MD5)Approved for entry into archive by Michelle Lanzellote ([email protected]) on 2016-09-12T17:49:23Z (GMT) No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 20.pdf: 242014 bytes, checksum: 72d0145bce4dff62c809fa48671a4777 (MD5)Made available in DSpace on 2016-09-12T17:49:34Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 20.pdf: 242014 bytes, checksum: 72d0145bce4dff62c809fa48671a4777 (MD5) Previous issue date: 2010-03Fundação Oswaldo Cruz. Instituto de Tecnologia em Fármacos. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Tecnologia em Fármacos. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto de Tecnologia em Fármacos. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Bioquímica de Tripanosomatídeos. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Bioquímica de Tripanosomatídeos. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Bioquímica de Tripanosomatídeos. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Bioquímica de Tripanosomatídeos. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Centro de Ciências da Saúde. Núcleo de Pesquisas de Produtos Naturais. Rio de Janeiro, RJ, Brasil.Folhas de Piper cabralanum C.DC. foram coletadas no Município de Teresópolis/RJ, em área particular próxima ao Parque Nacional da Serra dos Órgãos. O material vegetal foi seco em estufa a 40oC e, em seguida, submetido a extração com metanol por maceração estática. O extrato metanólico foi concentrado e particionado em solventes de diferentes polaridades, rendendo frações solúveis em n-hexano, diclorometano, acetato de etila e n-butanol. O extrato metanólico bruto e suas partições foram testadas em promastigotas de Leishmania amazonensis. Somente o extrato metanólico bruto e sua partição em n-hexano (PCA-Hex) mostraram boa atividade contra L. amazonensis (CE50 de 30 μg/ml e 25 μg/ml, respectivamente. Essa partição foi submetida à purificação por cromatografia em coluna com gel de sílica e posterior análise por cromatografia com fase gasosa acoplada à espectrometria de massas, o que possibilitou a caracterização de hidrocarbonetos, sesquiterpenos, esqualeno e uma mistura de esteróides (campesterol, estigmasterol e b-sitosterol).Leaves from Piper cabralanum C.DC. were collected in the city of Teresópolis / RJ, in particular site near the National Park of Serra dos Órgãos. The plant material was dried and then subjected to extraction with methanol by static maceration. The obtained methanol extract was concentrated and subjected to liquid-liquid partition with solvents of different polarities, yielding fractions soluble in n-hexane, dichloromethane, ethyl acetate and n-butanol. The crude methanol extract and its partitions were tested in promastigotes of Leishmania amazonensis. Only the crude methanol extract and its partition obtained with n-hexane (PCA-Hex) showed high activity against promastigotes (IC50 value = 30 µg/ml and 25 µg/ml, respectively). This partition was subjected to purification by column chromatography with silica gel, and the resulting non-polar fractions were analyzed by gas chromatography coupled to mass spectrometry, which allowed the characterization of hydrocarbons, sesquiterpenes, squalene and a mixture of steroids (campesterol, stigmasterol and b-sitosterol)

Beneficial effects of colchicine for moderate to severe COVID-19: a randomised, double-blinded, placebo-controlled clinical trial

Objective To evaluate whether the addition of colchicine to standard treatment for COVID-19 results in better outcomes.Design We present the results of a randomised, double-blinded, placebo-controlled clinical trial of colchicine for the treatment of moderate to severe COVID-19, with 75 patients allocated 1:1 from 11 April to 30 August 2020. Colchicine regimen was 0.5 mg thrice daily for 5 days, then 0.5 mg twice daily for 5 days. The primary endpoints were the need for supplemental oxygen, time of hospitalisation, need for admission and length of stay in intensive care unit and death rate.Results Seventy-two patients (36 for placebo and 36 for colchicine) completed the study. Median (and IQR) time of need for supplemental oxygen was 4.0 (2.0–6.0) days for the colchicine group and 6.5 (4.0–9.0) days for the placebo group (p&lt;0.001). Median (IQR) time of hospitalisation was 7.0 (5.0–9.0) days for the colchicine group and 9.0 (7.0–12.0) days for the placebo group (p=0.003). At day 2, 67% versus 86% of patients maintained the need for supplemental oxygen, while at day 7, the values were 9% versus 42%, in the colchicine and the placebo groups, respectively (log rank; p=0.001). Two patients died, both in placebo group. Diarrhoea was more frequent in the colchicine group (p=0.26).Conclusion Colchicine reduced the length of both, supplemental oxygen therapy and hospitalisation. The drug was safe and well tolerated. Once death was an uncommon event, it is not possible to ensure that colchicine reduced mortality of COVID-19.Trial registration number RBR-8jyhxh

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)