Gastroenterite aguda por Campylobacter spp. no Serviço de Urgência Pediátrica de um hospital de nível II

Introduction: Campylobacter spp. is the main cause of pediatric acute bacterial gastroenteritis (ABG) in the European Union, with greater incidence in children under five years old. Most patients present complete recovery within days of infection, with no associated comorbidities. Antibiotic therapy should be reserved for severe cases. Objectives: The aim of this study was to investigate the epidemiology, symptoms, treatment, and complications of Campylobacter spp. infection in pediatric patients with ABG. Material and methods: Case-by-case review of the clinical records of patients evaluated in the Pediatric Emergency Department of a level II hospital with a diagnosis of ABG and Campylobacter spp. isolated from stool samples over a five-year period (2013-2017). Results: Of the 1990 stool tests performed, 637 (32%) were positive for the presence of bacteria. Campylobacter spp. was identified in the samples of 459 patients (72%). Eighteen patients were excluded for insufficient data, making up a final sample of 441 patients, with a mean age of three years old. Clinically, patients presented with aqueous diarrhea (59.6%), bloody diarrhea (43.8%), bloody and mucus diarrhea (15.4%), mucus diarrhea (3.9%), vomiting (36.3%), abdominal pain (24.3%), fever (63%), seizures (0.9%), and rash (0.2%). Eighty-nine patients were hospitalized. Eleven patients received antibiotic therapy. Discussion: This study represents the largest national case-by-case review of ABG by Campylobacter spp. in the pediatric population. Campylobacter was the main bacteria identified, mostly associated with self-limited disease. Conclusion: A judicious use of stool tests allows etiological identification in ABG. The growing number of cases of ABG by Campylobacter spp. reinforces the need for better hygiene procedures.info:eu-repo/semantics/publishedVersio

Characterizing the mechanism of quetiapine distribution in lipid-core nanocapsules pseudo-phases using a validated LC/UV method

Quetiapine is an atypical antipsychotic used to treat schizophrenia. However, despite great interest for its chronic therapeutic use, quetiapine has some important side effects such as weight gain induction. The development of a quetiapine nanocarrier can potentially target the drug into central nervous system, resulting in a reduction of systemic side effects and improved patient treatment. In the present work, a simple liquid chromatography/ultraviolet detection (LC/UV) analytical method was developed and validated for quantification of total quetiapine content in lipid core nanocapsules as well as for determination of incorporation efficiency. An algorithm proposed by Oliveira et al. (2012) was applied to characterize the distribution of quetiapine in the pseudo-phases of the nanocarrier, leading to a better understanding of the quetiapine nanoparticles produced. The analytical methodology developed was specific, linear in the range of 0.5 to 100 µg mL−1 (r2 > 0,99), and accurate and precise (R.S.D < ±5%). The absolute recovery of quetiapine from the nanoparticles was approximately 98% with an incorporation efficiency of approximately 96%. The results indicated that quetiapine was present in a type III distribution according to the algorithm, and was mainly located in the core of the nanoparticle because of its logD in the formulation pH (6.86 ± 0.4)

Analysis of in vivo absorption of didanosine tablets in male adult dogs by HPLC

AbstractDidanosine is an effective antiviral drug in untreated and antiretroviral therapy-experienced patients with Human Immunodeficiency Virus (HIV). An automated system using on-line solid extraction and High Performance Liquid Chromatography (HPLC) with ultraviolet (UV) detection was developed and validated for pharmacokinetic analysis of didanosine in dog plasma. Modifications were introduced on a previous methodology for simultaneous analysis of antiretroviral drugs in human plasma. Extraction was carried out on C18 cartridges, with high extraction yield as stationary phase, whereas mobile phase consisted of a mixture of 0.02 M potassium phosphate buffer, acetonitrile (KH2PO4: acetonitrile: 96:4, v/v) and 0.5% (w/v) of heptane sulphonic acid. The pH was adjusted to 6.5 with triethylamine. All samples and standard solutions were chromatographed at 28°C. For an isocratic run, the flux was 1.0mL/min, detection was at 250nm and injected volume was 20μL. The method was selective and linear for concentrations between 50 and 5000ng/mL. Drug stability data ranged from 96% to 98%, and limit of quantification was 25ng/mL. Extraction yield was up to 95%. Drug stability in dog plasma was kept frozen at −20°C for one month after three freeze–thaw cycles, and for 24h after processing in the auto sampler. Assay was successfully applied to measure didanosine concentrations in plasma dogs

Clinical and laboratory parameters as predictors of long-term outcome according to the etiology of underlying chronic liver disease in patients who underwent liver transplantation for hepatocellular carcinoma treatment

OBJECTIVES: This study aimed to analyze clinical and laboratory parameters and their association with longterm outcomes in patients who underwent liver transplantation for hepatocellular carcinoma treatment, according to the etiology of the underlying chronic liver disease, in order to identify predictors of response to this therapeutic modality. METHODS: Demographic, clinical, and laboratory data from a cohort of 134 patients who underwent orthotopic liver transplantation for hepatocellular carcinoma treatment at a referral center in Brazil were retrospectively selected and compared according to the etiologic group of the underlying chronic liver disease. Events, defined as tumor recurrence or death from any cause, and event-free survival were also analyzed, and multivariate analysis was performed. RESULTS: The etiologies comprised hepatitis C and B virus infection, alcohol abuse, and cryptogenic disorder. Although liver transplantation was performed outside the Milan criteria in 33.3% of the subjects, according to pathologic examination of the explanted liver, the Model for End-Stage Liver Disease score was low (o22) in most patients (70.6%) and recurrence was identified in only 10 (7.9%) patients. Events occurred in 37 patients (28.5%), and the median event-free survival was 75 months (range, 24-116 months). No difference among etiologic groups was found in the parameters analyzed, which were not independently associated with outcome. CONCLUSION: Clinical and laboratory characteristics according to etiologic groups were not different, which might have led to comparable long-term outcomes among these patient groups and failure to identify predictors that could aid in better selection of subjects for liver transplantation in the management of this cancer

Rehabilitation of a complex industrial wastewater containing heavy metals and organic solvents using low cost permeable bio-barriers from lab-scale to pilot-scale

This work addresses the treatment of a complex industrial effluent containing high concentrations of metals and spiked with two organic solvents (diethylketone DEK, and methyl ethyl ketone - MEK) using an eco-friendly approach. The treatment system herein proposed consists of a bio-barrier that combines the adsorption capacity of sepiolite with the properties of a Streptococcus equisimilis biofilm with proven ability in the degradation and bioremoval of a wide range of pollutants. Results from the open-systems experiments conducted with raw sepiolite exposed to a binary mixture of DEK and MEK revealed the preference of the sorbent towards DEK. The results from the biodegradation experiments also revealed the preference of S. equisimilis to degrade/bioremove DEK over MEK independently of their initial concentration (100 mg/L to 3200 mg/L). Bioremoval percentages higher than 95 % were reached for all the concentrations of DEK tested. The lab-scale experiments conducted in open-system with sepiolite and sepiolite covered with biofilm, and the pilot-scale experiment conducted in closed-loop, revealed similar performances on the rehabilitation of an industrial effluent containing heavy metals and additionally spiked with DEK and MEK. Regarding the selectivity towards the different pollutants, Cu was preferentially removed over Cr and Ni, and DEK over MEK. The presence of the biofilm allowed an improvement on the removal of heavy metals, particularly Cr, besides preventing the leaching of Al, Fe, and Mg from the sepiolite structure, an extremely important advantage in comparison to the system without biofilm. EDS analyses performed in sepiolite samples revealed the presence of several metals (Cr, Cu and Ni), proving thus the occurrence of sorption processes by sepiolite and by sepiolite covered by biofilm. The breakthrough data obtained in the open-systems were properly described by the Dose Response and the Yoon and Nelson mathematical models. More research work needs to be performed with complex industrial effluents aiming the optimization of the treatment systems to be applied in real context scenarios.This study was supported by the Portuguese Foundation for Science and Technology (FCT) under the scope of the research project PTDC/ AAG-TEC/5269/2014, the strategic funding of UID/BIO/04469/2020 unit and BioTecNorte operation (NORTE-01-0145-FEDER-000004) funded by the European Regional Development Fund under the scope of Norte2020 - Programa Operacional Regional do Norte, Portugal. A. Lago and V. Rocha, thank FCT for the concession of their PhD grants (SFRH/ BD/132271/2017 and SFRH/BD/141073/2018).info:eu-repo/semantics/publishedVersio

Incidentes relacionados à limpeza de artigos para a saúde que comprometem a segurança do paciente

The aim was to identify evidence in the literature of the main incidents/adverse events reported due to inadequate processing of health articles. This is an integrative literature review, which used the PRISMA guidelines, and was carried out in the databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL) and International Literature in Health Sciences (MEDLINE/PubMed). From the PubMed database, 42 articles were identified, CINAHL 48 articles were identified, totaling 90 articles. Twenty-six articles from PubMed and 42 from CINAHL were selected for reading, resulting in a total of 68 articles. Among these, 18 PubMed and 35 CINAHL were excluded. Being elected 17 articles, which are part of this review. This study presents data that the Material and Sterilization Center (CME) acts through the implementation of good practices and evidence for recommendations or contraindications for the use of materials used in health services, a function that helps in the process of guaranteeing the quality of care and which is also related to the development of new tools. It is noticed that the MSC plays an important role when it comes to patient safety, a factor that is directly related to the improvement or not of their health status.Objetivou-se identificar na literatura evidências dos principais incidentes/eventos adversos notificados devido ao processamento inadequado dos artigos para a saúde. Trata-se de uma revisão integrativa de literatura, que utilizou as diretrizes PRISMA, e foi realizada nas bases de dados: Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Literatura Internacional em Ciências da Saúde (MEDLINE/PubMed). Da base de dados PubMed foram identificados 42 artigos, CINAHL foram identificados 48 artigos, totalizando 90 artigos. Foram selecionados para leitura 26 artigos da PubMed e 42 da CINAHL sendo selecionados um total de 68 artigos. Dentre estes foram excluídos 18 PubMed e 35 da CINAHL. Sendo eleitos 17 artigos, os quais fazem parte desta revisão. Este estudo apresenta dados de que a Central de Material e Esterilização (CME) atua através da implementação de boas práticas e evidências para recomendações ou contraindicação de uso dos materiais utilizados em serviços de saúde, função que auxilia no processo de garantia da qualidade da atenção e que também tem relação com o desenvolvimento de novas ferramentas. Percebe-se que a CME desempenha uma importância de destaque quando se trata de segurança do paciente, fator que está diretamente relacionado com a melhoria ou não do estado de saúde deles

Antiproliferative Organic Salts Derived from Betulinic Acid: Disclosure of an Ionic Liquid Selective Against Lung and Liver Cancer Cells

In the last few years, we have been witnessing an increasing interest in ionic liquids (ILs) and organic salts, given their potential applications in biological and pharmaceutical sciences. We report the synthesis and in vitro evaluation of novel organic salts combining betulinate, known for its anticancer properties, with antimalarial drugs, primaquine, chloroquine, and mepacrine, and also with the trihexyltetradecylphosphonium ([P6,6,6,14]) cation. The salts were screened for their in vitro activity against tumor lines HepG2 (liver), MG63 (osteosarcoma), T47D (breast), A459 (lung), and RKO (colon), and also on normal human fibroblasts. All betulinates prepared displayed antiproliferative properties, with the trihexyltetradecylphosphonium betulinate standing out for its higher selectivity. This unprecedented disclosure of a betulinic acid (BA)-derived IL with selective antitumor activity constitutes a relevant first step toward development of novel anticancer therapies based on BA-derived IL.info:eu-repo/semantics/publishedVersio