Elevated neopterin levels in non-allergic asthma

Neopterin is synthesized by human monocyte-derived macrophages upon stimulation with interferon-gamma (IFN-gamma). Measurement of neopterin concentration is useful to monitor cell-mediated (Th1-type) immune activation. In this study, we aimed to analyze the behaviour of neopterin in long lasting asthma considering its role as a marker of the Th1 environment and to establish the distinction between patients belonging either to the allergic or the non-allergic population, particularly in the elderly where asthma is often under diagnosed. Therefore we evaluated allergic parameters such as skin prick tests, IgE and hemogram (eosinophils count), and we compared our findings with neopterin values found in an age-matched control population. A group of individuals older than 65 was selected. It included 64 asthmatic patients (mean age 72+/-5 years) and 41 healthy individuals (mean age 79+/-7 years). In our study population, 42 patients presented positive skin tests, mainly to house dust mites. All patients were clinically stable and presented an average percentage of predicted forced expiratory volume in the first second (FEV1) of 73.6+/-25.3 and predicted median expiratory flow percentage (MEF50) of 38.8+/-26.7. Blood cell counts showed statistically different mean values of eosinophils between allergic and non-allergic controls (5.42+/-4.7% versus 2.8+/-2.8%; p2.1ng/ml) presented lower mean IgE values (IgE</=336.58IU) than those with lower neopterin values (</=2.1ng/ml) who presented mean IgE values of 402.70IU. Our initial findings may lead to a better understanding of the immunoinflammatory pathways in asthma. Further studies will probably show that serum neopterin could became a useful marker for asthma classification including in elderly patients with long lasting disease

Metodologia de avaliação dos impactos ambientais de inovações tecnológicas agroindustriais, com base no ciclo de vida.

O paradigma do desenvolvimento sustentável, para ser aplicável, requer o desenvolvimento e a adoção de tecnologias comprometidas com o bem-estar socioeconômico e com a conservação ambiental. Nesse contexto, torna-se importante a utilização de instrumentos que avaliem a contribuição de uma tecnologia para a sustentabilidade, com a avaliação dos seus impactos ambientais. Este trabalho tem como objetivo propor um sistema de avaliação de impactos de inovações agroindustriais, baseado no conceito de ciclo de vida. O sistema avalia o impacto de uma inovação agroindustrial em comparação a outra tecnologia preexistente, ao longo das etapas de produção, consumo e pós-consumo, considerando-se a vulnerabilidade ambiental dos locais onde as unidades produtivas, de consumo e descarte estão inseridas

OFF-LABEL USE OF ANTIBACTERIALS IN A CONTEXT OF ANTIMICROBIAL RESISTANCE THREAT

Objective: The objective of the study was to describe the off-label use of antibacterial in prescriptions for hospitalized adult patients as per the Brazilian drug regulatory agency, namely, the National Health Surveillance Agency (ANVISA). Methods: This is a cross-sectional study with prescriptions for inpatients in a teaching hospital. Data collection and analysis were based on the checklist of the Medicine Prescription, Use and Administration Protocol of the Ministry of Health, where the off-label use is classified as per information of ANVISA’s Electronic Bulletin. Descriptive analyses were performed, and the method of logistic regression was used to evaluate the association between the off-label use of antibacterial and the explanatory variables age, gender, hospitalization clinic, and medical specialty. Results: About one-third of the antibacterial was prescribed for off-label use, and the frequency of administration was the primary use outside standards established in the products’ licenses (87.3%), and dose (7.4%) and the administration route was next. The third-generation cephalosporin was the most consumed class in this regimen (69.5%). In some cases, the off-label use was not supported by scientific evidence. The off-label use was positively associated with the variables gender (odds ratio [OR] = 2.48; confidence interval [CI] = 1.23–4.92) and the prescribing clinic (OR = 4.94; CI = 2.61–8.96). Conclusion: Off-label use is a frequent practice in the studied environment, and in the face of a dramatic scenario of increased antibacterial resistance, it is imperative to adopt measures for the standardization of records and the rational use of this class of drugs

Substance P in Long-Lasting Asthma: Immunoinflammatory pathways

Background: Substance P (SP) was described at the beginning of the 20th Century, and its biological action was recognized to have implications in neurogenic inflammation and constriction of smooth muscles. The changes associated with inflammatory chronicity can compromise organ function reversibility. The role of neuromechanisms in the pathology of the disease has been investigated in order to achieve better diagnosis and therapeutic approaches. The stimulation of human cells, such as macrophages and polymorphonuclear cells by SP leads to their activation and to the release of reactive oxygen species (ROS) by these cells. Consequently, a continuous inflammatory disability is observed, mainly if a decrease in antioxidant defence occurs. SP is a substrate for dipeptidyl peptidase IV (DPPIV), which is a multifunctional molecule with enzymatic and proinflammatory activities. CD26 is considered an activation T cell marker. The aim of the present study was to analyse if serum SP values in long-lasting asthma patients were related to lung function parameters. It was also decided to analyze the relationship of SP with superoxide dismutase (SOD) and total antioxidant activity in serum (TAS), as well as its association to CD26/DPPIV values considering their immunological and inflammatory properties. Methods/Data base: A group of individuals older than 65 years, including 64 asthmatic patients (mean age 72±5 years) and 41 healthy individuals (mean age 79±7years) was selected. Both subgroups were submitted to clinical observation, to skin prick tests (SPT) and to SP, TAS, SOD, and DPPIV determinations. T cell CD26 typing was also performed. Lung function tests were done on all patients. Results: Among the patients studied, 42 had positive skin tests, mainly to house dust mites. Asthmatic patients showed a significant increase in SP values (116.2±138.9 vs 39.5±17.9 pg/ml) when compared to controls and a significant decrease in TAS levels (.85±.13 vs .91±.10 mM) and in SOD levels (588.1±156.l vs 822.9±179.5 U/gHb). All patients were clinically stable and presented an average percentage of predict forced expiratory volume in the first second (FEV1) of 73.6±25.3 and median expiratory flow percentage of predict (MEF50) of 38.8±26.7. DPPIV values were significantly increased in asthmatics compared to controls (69.7±15.2 vs 58.6±14.3 U/L). The CD26 expression was only slightly increased in asthmatic patients (41.9±10.2 vs 39.4±11.4). Conclusion: These results confirm the role of SP in asthma and give a contribution for a better knowledge of the immunoinflammatory pathway associated with this chronic disorder. A final goal for these studies would be to achieve a better therapeutic approach in order to improve the outcome of asthmatic patients

Métodos de avaliação do desempenho ambiental de inovações tecnológicas agroindustriais.

A avaliação de desempenho ambiental (ADA) de inovações é uma ferramenta importante na busca do desenvolvimento sustentável. No presente trabalho, analisam-se métodos de ADA de inovações tecnológicas agroindustriais, discutindo-se aspectos relacionados a seus escopos, estruturas conceituais e operacionais, bem como seus potenciais para apoio ao processo de inovação tecnológica. Equipes de pesquisa e desenvolvimento podem se beneficiar deste estudo quando da escolha de métodos de avaliação ambiental de inovações agroindustriais

Substance P in Bronchial Asthma: Role in oxidant stress and in cell activation

The substance P (SP) was described in the beginning of the XXth Century, and its biological actions was recognized to have implications in neurogenic inflammation and constriction of smooth muscles. The bronchial asthma prevalence has been increasing in all developed countries. The changes associated to inflammatory chronicity can compromise the organ function reversibility. The role of neuromechanisms in the pathology of the disease has been investigated considering the hypotheses that better therapeutic approaches can be achieved. The stimulation of human cells by SP leads to their activation and to reactive oxygen species (ROS) release. Consequently a persisting inflammatory disability is observed, mainly if a decrease in the anti-oxidant defence occurs. SP is a substrate for dipeptidyl peptidase IV (DPPIV), which is a multifunctional molecule with enzymatic and proinflammatory activities. CD26 was identified as the membrane DPPIV and is considered as an activation T cell marker, as well as CD25. The aim of the present study was therefore to analyse if serum SP values in long-term asthma patients, were associated to lung function parameters, considering the role of SP in neurogenic inflammation and in bronchoconstriction. It was also proposed to analyse the relationship of SP with superoxide dismutase (SOD) and total anti-oxidation activity in serum (TAS), considering the ROS production during the inflammatory process, as well as its association to CD26 and CD25 values and their immunologic and inflammatory properties. A group of individuals older than 65 years including 64 asthmatic patients (mean age 72.4±5.1 years) and 41 healthy individuals (mean age 79.2±7.0 years) was selected. Both subgroups were submitted to clinical observation, to skin prick tests and to SP, TAS and SOD. T cell CD26 and CD25 typing was also performed. Lung function tests were done to all patients. Among patients studied, 42 presented positive skin tests, mainly to house dust mites. Asthmatic patients presented significant increased values of SP (116.2±138.9 vs 39.5±17.9 pg/ml) when compared to controls and a significant decrease of TAS (.85±.13 vs .91±.10 mM) and SOD (588.1±156.l vs 822.9±179.5 U/gHb). All patients have clinical stability and presented forced expiratory volume in one second (FEV1) values of 73.6±25.3 l/s and peak expiratory flow (PEF50) of 38.8±26.7l. The CD25 expression was significantly increased in disease (14.3±5.9 vs 22.4±7.8) while CD26 was only slightly increased (41.9±10.2 vs 39.4±11.4). These results confirm the role of SP in the respiratory pathology studied and give a contribution for a better knowledge of the network of immunoinflammatory pathway, associated to this chronic disorder. A final goal for these studies would be a better diagnostic and therapeutic approach in this pathology

Sobrevivência de pacientes adultos com Aids em hospital de referência no Nordeste brasileiro

OBJECTIVE: To evaluate the influence of sociodemographic, clinical, and epidemiological factors in AIDS patients survival in a reference hospital. METHODS: A sample of 502 adult AIDS patients out of 1,494 AIDS cases registered in a hospital in Fortaleza, Brazil, was investigated between 1986 and 1998. Sixteen cases were excluded due to death at the moment of the AIDS diagnosis and 486 were analyzed in the study. Socioeconomic and clinical epidemiological were the variables studied. Statistical analysis was conducted using the Kaplan-Meier survival analysis and the Cox proportional hazards model. RESULTS: Three hundred and sixty two out of the 486 patients studied took at least one antiretroviral drug and their survival was ten times longer than those who did not take any drug (746 and 79 days, respectively, pOBJETIVO: Avaliar, em um hospital de referência, a influência de fatores sociodemográficos e clínico-epidemiológicos na sobrevivência de pacientes com Aids. MÉTODOS:Foi estudada uma amostra de 486 adultos com Aids atendidos em hospital de referência no Ceará, entre 1986 e 1998. Foram avaliadas as variáveis socioeconômicas e clínico-epidemiológicas. A análise foi realizada pelo método Kaplan-Meier e por regressão de Cox. RESULTADOS: Dos 486 pacientes estudados, 362 utilizaram pelo menos uma droga anti-retroviral e tiveram sobrevida dez vezes maior que os que não a utilizaram (746 e 79 dias, respectivamente;

Análise da vulnerabilidade ambiental.

Revisão sobre o tema vulnerabilidade; Métodos de avaliação da vulnerabilidade ambiental de Bacias Hidrográficas às pressões oriundas de atividades agroindustriais (Vulneragri); Aplicação no método Vuneragri.bitstream/item/33965/1/DO10002.pd

Método de avaliação do desempenho ambiental de inovações tecnológicas agroindustriais: Ambitec - ciclo de vida.

Estrutura conceitual; Particularidades da etapa de produção da matéria-prima; Detalhamento do método Ambitec-Ciclo de Vida; Planejamento da Avaliação; Definição da função, da unidade funcional, do produto ou processo substituto utilizado na comparação e do fluxo de referência; Escolha das unidades em cada etapa da avaliação; Identificação das bacias hidrográficas onde cada unidade se localiza; Análise da Vulnerabilidade Ambiental de bacias hidrográficas; Normalização dos indicadores de vulnerabilidade ambiental; Agregação dos indicadores em critérios de Vulnerabilidade Ambiental; Agregação dos critérios no Índice de Vulnerabilidade Ambiental (IVA) da bacia; Avaliação de Desempenho Ambiental em uma etapa do ciclo de vida de um produto ou na etapa de uso de um processo; Ajuste dos valores dos indicadores de Desempenho Ambiental pela unidade funcional; Normalização dos indicadores de desempenho ambiental em uma etapa; Ponderação de indicadores pelo (IVA) da bacia; Agregação dos indicadores de uma etapa em critérios de desempenho ambiental; Agregação de critérios de uma etapa em princípios de desempenho ambiental; Agregação dos critérios no Índice de Desempenho Ambiental (IDA) de uma etapa; Avaliação final do desempenho ambiental de um produto; Agregação dos valores dos indicadores de cada etapa em indicadores finais; Normalização do indicador final de desempenho ambiental; Ponderação do indicador final pela vulnerabilidade ambiental média; Agregação dos indicadores finais normalizados em critérios de desempenho ambiental; Agregação dos critérios em princípios de desempenho ambiental; Agregação dos critérios no IDA; Estudo de caso: substrato de coco verde (SCV); Planejamento da avaliação; Análise de vulnerabilidade; Avaliação de desempenho ambiental.bitstream/CNPAT-2010/12001/1/Doc-121.pd