Avaliação Da Assistência Oftalmológica Na Perspectiva Dos Usuários

The prevalence of need of, access to, and dissatisfaction with ophthalmic assistance was estimated among those who were assisted in such services in the last year; factors associated with dissatisfaction were identified. Complex probabilistic sample was used. A descriptive, bivariate, and multiple analysis with correction for design effect was conducted. Of 2.582 participants, 76% needed assistance and, of those, 82.5% possessed access to it. Among patients who received assistance in the last year, 13.1% were dissatisfied. Dissatisfaction was higher among older patients, those who went walking or cycling to the location of assistance, and those who described the following aspects as regular/bad/terrible: being received and treated with respect, the clarity with which the service provider explained things, and their autonomy to choose their provider of ophthalmic assistance. Most of them was in need of and possessed access to assistance. Dissatisfaction was low. Patient’s age, means of transport used to get to the local of the assistance, patient-professional relationship, and autonomy to choose are factors that interfere for the outcome of dissatisfaction. © 2016, Assocaicao Brasileira de Pos, Gradacao em Saude Coletiva. All rights reserved.19239040

Hydroxocobalamin Quantification In Human Plasma By High-performance Liquid Chromatography Coupled With Electrospray Tandem Mass Spectrometry In A Pharmacokinetic Study

A rapid, sensitive and specific method for quantifying hydroxocobalamin in human plasma using paracetamol as the internal standard (IS) is described. The analyte and the IS were extracted from plasma by liquid-liquid extraction using an organic solvent (ethanol 100%; -20°C). The extracts were analyzed by high performance liquid chromatography coupled with electrospray tandem mass spectrometry (HPLC-MS-MS). Chromatography was performed on Prevail C8 3 μm, analytical column (2.1×100 mm i.d.). The method had a chromatographic run time of 3.4 min and a linear calibration curve over the range 5-400 ng.mL -1 (r>0.9983). The limit of quantification was 5 ng.mL-1. The method was also validated without the use of the internal standard. The precision in the intra-batch validation with IS was 9.6%, 8.9%, 1.0% and 2.8% whereas without IS was 9.2%, 8.2%, 1.8% and 1.5% for 5, 15, 80 and 320 ng/mL, respectively. The accuracy in intra-batch validation with IS was 108.9%, 99.9%, 98.9% and 99.0% whereas without IS was 101.1%, 99.3%, 97.5% and 92.5% for 5, 15, 80 and 320 ng/mL, respectively. The precision in the inter-batch validation with IS was 9.4%, 6.9%, 4.6% and 5.5% whereas without IS was 10.9%, 6.4%, 5.0% and 6.2% for 5, 15, 80 and 320 ng/mL, respectively. The accuracy in inter-batch validation with IS was 101.9%, 104.1%, 103.2% and 99.7% whereas without IS was 94.4%, 101.2%, 101.6% and 96.0% for 5, 15, 80 and 320 ng/ mL, respectively. This HPLC-MS-MS procedure was used to assess the pharmacokinetics of cobalamin following intramuscular injection 5000 μg in healthy volunteers of both sexes (10 males and 10 females). The volunteers had the following clinical characteristics (according to gender and expressed as mean ± SD [range]): males: age: 32.40 ± 8.00 [23.00-46.00], height: 1.73 ± 0.07 m [1.62-1.85], body weight: 72.48 ± 10.22 [60.20-88.00]; females: age: 28.60 ± 9.54 [18.00-44.00], height: 1.60 ± 0.05 [1.54-1.70], body weight: 58.64 ± 6.09 [51.70-66.70]. The following pharmacokinetic parameters were obtained from the hydroxocobalamin plasma concentration vs. time curves: AUC last, T1/2, Tmax, Vd, Cl, C max and Clast. The pharmacokinetic parameters were 120 (± 25) ng.mL -1 for C max, 2044 (± 641) ng.hr.mL -1 for AUClast, 8 (± 3.2) ng.mL -1 for Clast, 38 (± 15.8) hr for T 1/2 and 2.5 (range 1-6) hr for Tmax. Female volunteers presented significant (p=0.0136) lower AUC (1706 ± 704) ng.hr.mL-1) and larger (p=0.0205) clearance (2.91 ± 1.41 L/hr), as compared to male 2383 ± 343 ng.hr.mL -1 and 1.76 ± 0.23 L/hr, respectively. These pharmacokinetic differences could explain the higher prevalence of vitamin B12 deficiency in female patients. The method described validated well without the use of the internal standard and this approach should be investigated in other HPLC-MS-MS methods. © 2013 Mendes GD, et al.528087Butler, C.C., Vidal-Alaball, J., Cannings-John, R., McCaddon, A., Hood, K., Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency: A systematic review of randomized controlled trials (2006) Fam Pract, 23, pp. 279-285Kuzminski, A.M., Del Giacco, E.J., Allen, R.H., Stabler, S.P., Lindenbaum, J., (1998) Blood, 92, p. 1191van Asselt, D.Z., Merkus, F.W., Russel, F.G., Hoefnagels, W.H., Nasal absorption of hydroxocobalamin in healthy elderly adults (1998) Br J Clin Pharmacol, 45, pp. 83-86Van den Berg, M.P., Merkus, P., Romeijn, S.G., Verhoef, J.C., Merkus, F.W., Hydroxocobalamin uptake into the cerebrospinal fluid after nasal and intravenous delivery in rats and humans (2003) J Drug Target, 11, pp. 325-331Merkus, P., Guchelaar, H.J., Bosch, D.A., Merkus, F.W., (2003) Neurology, 6, p. 1669Chen, J.H., Jiang, S.J., Determination of cobalamin in nutritive supplements and chlorella foods by capillary electrophoresis-inductively coupled plasma mass spectrometry (2008) J Agric Food Chem, 56, pp. 1210-1215Kelly, R.J., Gruner, T.M., Sykes, A.R., Development of a method for the separation of corrinoids in ovine tissues by HPLC (2005) Biomed Chromatogr, 19, pp. 329-333Rosin, H., Man, W.Y., Doyle, E., Bult, A., Beijnen, J.H., (2000) J Liq Chromatogr and Related Tech, 23, p. 329Wang, Y.H., Yan, F., Zhang, W.B., Ye, G., Zheng, Y.Y., (2009) Neurosci Bull, 25, p. 209Dubois, D., Dubois, E.F., (1916) Arch Intern Med, 17, p. 862Mendes, F.D., Chen, L.S., Borges, A., Babadópulos, T., Ilha, J.O., Ciprofibrate quantification in human plasma by high-performance liquid chromatography coupled with electrospray tandem mass spectrometry for pharmacokinetic studies (2011) J Chromatogr B Analyt Technol Biomed Life Sci, 879, pp. 2361-2368Uhl, W., Nolting, A., Gallemann, D., Hecht, S., Kovar, A., Changes in blood pressure after administration of hydroxocobalamin: Relationship to changes in plasma cobalamins-(III) concentrations in healthy volunteers (2008) Clin Toxicol, 46, pp. 551-559. , (Phila

Correlates of accelerometer-assessed physical activity in pregnancy—The 2015 Pelotas (Brazil) Birth Cohort Study

Objective methods to measure physical activity (PA) have become available and widely used given the high degree of precision to evaluate PA. However, few studies have used accelerometers to measure PA during pregnancy, especially in low- and middle-income countries. We assessed overall PA, moderate, vigorous, and moderate-to-vigorous physical activity (MVPA) objectively measured among pregnant women and their correlates in a population-based study. PA was assessed for seven consecutive days using a raw triaxial wrist-worn accelerometer in women interviewed around 16 and 24 weeks of gestation in the 2015 Pelotas (Brazil) Birth Cohort Study. The average acceleration, which expresses overall PA, was presented in milli-g (1 mg = 0.001 g), and average time (min/day) spent in MVPA (>100 mg) was also analyzed in 5- and 10-min bouts. Analyses were performed using linear regression. In total, 2317 women were included in the analyses. Overall PA was 27.6 mg. Pregnant women spent on average 14 min/day in MVPA and 0.4 min in vigorous PA. Time spent in MVPA and total PA were inversely associated with years in school and income, and were lower among women receiving advice to not exercise. MVPA was also inversely associated with age, lower among women living with a partner, and higher among non-white women. The study indicated low levels of PA among pregnant women. The identified correlates may provide a framework to better understand factors influencing PA during pregnancy and thus inform future interventions

Comparative analysis of the secretome and interactome of Trypanosoma cruzi and Trypanosoma rangeli reveals species specific immune response modulating proteins

Chagas disease, a zoonosis caused by the flagellate protozoan Trypanosoma cruzi, is a chronic and systemic parasitic infection that affects ~5–7 million people worldwide, mainly in Latin America. Chagas disease is an emerging public health problem due to the lack of vaccines and effective treatments. According to recent studies, several T. cruzi secreted proteins interact with the human host during cell invasion. Moreover, some comparative studies with T. rangeli, which is non-pathogenic in humans, have been performed to identify proteins directly involved in the pathogenesis of the disease. In this study, we present an integrated analysis of canonical putative secreted proteins (PSPs) from both species. Additionally, we propose an interactome with human host and gene family clusters, and a phylogenetic inference of a selected protein. In total, we identified 322 exclusively PSPs in T. cruzi and 202 in T. rangeli. Among the PSPs identified in T. cruzi, we found several trans-sialidases, mucins, MASPs, proteins with phospholipase 2 domains (PLA2-like), and proteins with Hsp70 domains (Hsp70-like) which have been previously characterized and demonstrated to be related to T. cruzi virulence. PSPs found in T. rangeli were related to protozoan metabolism, specifically carboxylases and phosphatases. Furthermore, we also identified PSPs that may interact with the human immune system, including heat shock and MASP proteins, but in a lower number compared to T. cruzi. Interestingly, we describe a hypothetical hybrid interactome of PSPs which reveals that T. cruzi secreted molecules may be down-regulating IL-17 whilst T. rangeli may enhance the production of IL-15. These results will pave the way for a better understanding of the pathophysiology of Chagas disease and may ultimately lead to the identification of molecular targets, such as key PSPs, that could be used to minimize the health outcomes of Chagas disease by modulating the immune response triggered by T. cruzi infection