Estudo das características e propriedades da permeação in vitro de micropartículas de CMC/quitosana como sitema de liberação cutânea para vitamina E

Micropartículas de carboximetilcelulose (CMC)/quitosana contendo vitamina E foram preparadas pelo método de coacervação complexa e seu uso potencial como um sistema de liberação tópico foi avaliado. Estudos da morfologia, da distribuição do tamanho de partículas, da eficiência de encapsulação, da estabilidade física e química e da liberação e permeação cutânea in vitro foram realizados. As análises por Microscopia Eletrônica de Varredura mostraram que as partículas são esféricas, possuem uma superfície homogênea e ausência de agregados, com diâmetros na faixa de 2,7 a 7,6 µm. A eficiência de encapsulação da vitamina E foi 81%. Os estudos de estabilidade química mostraram proteção da vitamina E encapsulada, sendo que a diferença em relação à quantidade de ativo remanescente na emulsão O/A foi de 8,1% e na A/O, de 10,8%, após armazenamento a 45 °C por um período de 60 dias. O ensaio de liberação in vitro mostrou que 48% da vitamina E encapsulada, quantificada por CLAE, foram liberadas em 24 horas de experimento. Nos estudos de retenção e permeação in vitro observou-se que a emulsão A/O proporcionou maior penetração da vitamina E tanto da forma livre como encapsulada.Os sistemas avaliados parecem ser promissores para veiculação de ativos em preparações de uso tópico.Carboxymethylcellulose (CMC)/chitosan microparticles containing vitamin E were prepared by a complex coacervation method and their potential use as a topical delivery system was evaluated. Morphology, particle size distribution, encapsulation yield, physical and chemical stability, in vitro release and permeation through skin were studied. The microparticles appeared to be spherical, with a homogeneous surface and were not aggregated. Mean diameters ranged from 2.7 to 7.6 µm and the encapsulation yield was 81%. Chemical stability studies indicated a protection of encapsulated vitamin E, of 8.1% for O/W and of 10.83% for W/O emulsions, following storage at 45 °C for 60 days. Forty-eight% of vitamin E, determined by HPLC, were released within 24 hours. In vitro permeation and retention studies showed a higher penetration rate of vitamin E in the free and encapsulated forms, from the W/O emulsion. The carriers studied seem to be promising systems for topical administration

Síntesi i estudi de nous reactius quirals de solvatació d'estructura antracènica : anàlisi de les interaccions associatives /

Descripció del recurs: el 21 setembre 2011S'han sintetitzat quatre alquil i aril (9 anthry1) carbinol (metil, fenil isopropil, terc-butil, i) que van revelar la rotació restringida al voltant de l'enllaç C9-C11. La seva energia lliure d'activació per a la rotació s'ha determinat, sent 11.0, 14.0, 21.7, i 9.8 kcal / mol, respectivament. Es descriuen l'aplicació mètodes de mesura del NOE i del temps de relaxació per a la determinació de l'energia d'activació per a la rotació de bons. El bon acord amb els valors obtinguts amb el mètode de la temperatura de coalescència confirma que l'enfocament basat NOE és una bona alternativa per a la determinació de les elevades barreres de rotació. Els càlculs de Mecànica Molecular (MM2) donen valors propers als experimentals. S'han preparat els carbamats homoquirals del 9-anthryl-terc-butylcarbinol i s'ha estudiat el seu equilibri conformacional. La configuració absoluta es va determinar mitjançant la comparació de les dades de RMN amb càlculs de MM. Els enantiòmers de l'alcohol es van obtenir després de la separació cromatogràfica dels derivats de carbamat i la seva hidròlisi. Els alcohols homoquirals van ser preparats per columna de cromatografia quiral directa. S'han detectat i o separat a temperatura ambient els confòrmers cisoid i transoid del 9,10 dipivaloylantracè i del 9,10-bis(1-imino-2,2-dimetilpropil)antracè. La transformació entre dues atropisómers va ser estudiada per RMN i modelat pels mètodes de MM. La difracció de raigs X es va realitzar per als derivats imino. El 9-antril-terc-butilcarbinol es va provar com a agent de solvatació quiral (CSA) en presència de formes racèmica de p-toluenesulfinate de mentil, 9-(1-amino-2,2- dimetilpropil)-9,19-dihydroantracè, àcid R-methoxyfenylacetic i 1-phenyl-1,2- ethanediol. Es formaren els complexes diastereòmers entre el reactiu quiral i cada enantiòmer d'aquests últims compostos. Un dels enantiòmers de 9-antril-tertbutylcarbinol va ser estudiat mitjançant NOE intermolecular i càlculs de dinàmica molecular. Es trobaren les principals diferencies termodinàmiques i estructurals.Se han preparado Cuatro alquil- y aril- (9-antril)carbinols (metil, isopropil, tert-butil, y fenil) y mostraron la rotación restringida del enlace de C9-Cll. Su energía libre de activación para la rotación ha sido determinada, siendo 11.0, 14.0, 21.7, y 9.8 kcal/mol, respectivamente. Hemos determinado la energía de activación para la rotación de enlace C9-C11 por la aplicación de medidas de NOE y de tiempo de relajación. El buen acuerdo con los valores obtenidos con el método de temperatura coalescencia confirma que el método basado en el NOE es una buena alternativa para la determinación de barreras de rotatorión altas. La Mecánica Molecular (MM2) da valores cercanos a los experimentales. Se ha preparado el carbamato homochiral de 9-antril-tert-butilcarbinol y se ha estudiado su equilibrio conformacional. La configuración absoluta fue determinada por la comparación de los datos NMR con cálculos de MM. Los enantiomers del alcohol fueron obtenidos después de la separación cromatográfica de los carbamatos y tres su hidrólisis. Los mismos alcoholes se obtuvieron a través de una columna HPLC quiral Se han detectado o separado, a temperatura ambiente, los confórmeros cisoide y transoide del 9,10 dipivaloylantraceno y del 9,10-bis(1-imino-2,2- dimetilpropil)antraceno. La transformación entre los dos atropoisómeros se estudió por RMN i se modeló por métodes de MM. La difracción de rayos X se realitzó con los derivados imino. Se ha probado el 9-anthryl-tert-butylcarbinol como agente solvatación chiral (CSA) en presencia de las formas de racemicas de p-toluenesulfinato de mentilo, 9-(1-amino-2,2- dimetilpropil) - 9,19-dihydroanthracene, ácido de R-methoxyphenylacetic y 1-phenyl- 1,2-ethanediol. Se formaron los complejos diastereoisómericos el reactivo quiral y cada enantiomer de estos últimos compuestos. Uno de los enantiomers de 9-anthryltertbutylcarbinol fue estudiado por medio de NOE intermolecular y cálculos de dinámica moleculares. Las diferencias termodinámicas y estructurales principales fueron encontradas.Four alkyl- and aryl-(9-anthry1)carbinols (methyl, isopropyl, tert-butyl, and phenyl) were synthesized and revealed restricted rotation about the C9-Cll bond. Their free energy of activation for rotation has been determined, being 11.0, 14.0, 21.7, and 9.8 kcal/mol, respectively. The application of NOE enhancement and relaxation time measurements for the determination of the activation energy for bond rotation is described. The good agreement with the values obtained with the coalescence temperature method bears out that the NOE based approach is a good alternative for the determination of high rotational barriers. Molecular Mechanics (MM2) calculations give values close to the experimental ones. The homochiral carbamates of 9-anthryl-tert-butylcarbinol were prepared and their conformational equilibrium was studied. The absolute configuration was determined by comparison of the NMR data with MM calculations. The enantiomers of the alcohol were obtained after chromatographic separation of carbamate derivatives and their hydrolysis. The same homochiral alcohols were prepared by direct chiral column chromatography Cisoid and transoid conformations of 9,10-dipivaloylanthracene and 9,10-bis(1-imino- 2,2-dimethylpropyl) anthracene were separated and detected for the former and isolated for the latter at room temperature. The transformation between two atropisomers was studied by NMR and modeled by MM methods. X-ray diffraction was performed for the imino derivatives. The 9-anthryl-tert-butylcarbinol was tested as a chiral solvating agent (CSA) in the presence of racemic forms of mentil-p-toluenesulfinate, 9-(1-amino-2,2- dimethylpropyl)-9,19-dihydroanthracene, R-methoxyphenylacetic acid and 1-phenyl- 1,2-ethanediol. Diastereomeric complexes were found to form between each enantiomer of these last two compounds. One of the enantiomers of 9-anthryltert-butylcarbinol was studied by means of intermolecular NOE and molecular dynamics calculations. Major thermodynamic and structural differences were found

O IMPACTO DAS QUESTÕES AMBIENTAIS NA SAÚDE

RESUMO:  As evidências de que a sociedade contemporânea vivencia uma intensa crise ambiental são cada vez mais contundentes. Observa-se o impacto de tais problemas ambientais, mas não necessariamente desenvolvem-se ações de minimização do impacto ambiental na saúde. Situações de poluição pela disposição inadequada de lixo provocam impactos ambientais negativos em diferentes ecossistemas da cidade como as margens e leito dos rios, margens de ruas e estradas, fundos de vale e lotes baldios. Este artigo busca problematizar a relação entre as questões ambientais e o campo da saúde, assim como refletir sobre o impacto ambiental oriundo do lixo, através da revisão de literatura

Describing Complexity in Palliative Home Care Through HexCom : A Cross-Sectional, Multicenter Study

Complexity has become a core issue in caring for patients with advanced disease and/or at the end-of-life. The Hexagon of Complexity (HexCom) is a complexity assessment model in the process of validation in health-care settings. Our objective is to use the instrument to describe differences in complexity across disease groups in specific home care for advanced disease and/or at the end-of-life patients, both in general and as relates to each domain and subdomain. Cross-sectional study of home care was conducted in Catalonia. The instrument includes 6 domains of needs (clinical, psychological/emotional, social/family, spiritual, ethical, and death-related), 4 domains of resources (intrapersonal, interpersonal, transpersonal, and practical), and 3 levels of complexity (High (H), Moderate (M), and Low (L)). Interdisciplinary home care teams assessed and agreed on the level of complexity for each patient. Forty-three teams participated (74.1% of those invited). A total of 832 patients were assessed, 61.4% of which were cancer patients. Moderate complexity was observed in 385 (47.0%) cases and high complexity in 347 (42.4%). The median complexity score was 51 for cancer patients and 23 for patients with dementia (p<0.001). We observed the highest level of complexity in the social/family domain. Patients/families most frequently used interpersonal resources (80.5%). This study sheds light on the high-intensity work of support teams, the importance of the social/family domain and planning the place of death, substantial differences in needs and resources across disease groups, and the importance of relationship wellbeing at the end-of-life

Unexpected online gambling disorder in late-life : a case report

Background: The lifetime prevalence of problem or Gambling disorder (GD) in the elderly (i.e., those over 60 years old) is reported to range from 0.01 to 10.9%. Research has identified several specific risk factors and vulnerabilities in the elderly. Since the late 1990s, an increase in online GD has been observed in the youth population, whereas casinos, slot machines, and bingo seem to be the activities of choice among the elderly. Interestingly, online GD has not been described in the elderly to date. Case Description: We report an 83-year-old man who started online casino gambling from the age of 80 years, leading to debts that exceeded €30,000. He underwent a full clinical and neuropsychological assessment, without any evidence of cognitive impairment or any associated neurodegenerative disease. However, he had risk factors for GD, including adjustment disorder, stressful life events, previous offline casino GD when 50 years old, and dysfunctional personality traits. The change to online GD may have been due to his isolation, movement difficulties, and his high level of education, which facilitated his access to the Internet. Care management focused on individual cognitive-behavioral therapy. Conclusion: The prevalence of online GD may be underestimated among the elderly, and may increase among isolated old people with movement difficulties and ready access to the Internet. However, late-life GD should be considered a diagnosis of elimination, requiring a full medical, psychiatric (including suicide risk), and cognitive assessment. Specific therapeutic approaches need to be proposed and developed

Unexpected online gambling disorder in late-life: a case report

Background: The lifetime prevalence of problem or Gambling disorder (GD) in the elderly (i.e., those over 60 years old) is reported to range from 0.01 to 10.9%. Research has identified several specific risk factors and vulnerabilities in the elderly. Since the late 1990s, an increase in online GD has been observed in the youth population, whereas casinos, slot machines, and bingo seem to be the activities of choice among the elderly. Interestingly, online GD has not been described in the elderly to date. Case Description: We report an 83-year-old man who started online casino gambling from the age of 80 years, leading to debts that exceeded 30,000. He underwent a full clinical and neuropsychological assessment, without any evidence of cognitive impairment or any associated neurodegenerative disease. However, he had risk factors for GD, including adjustment disorder, stressful life events, previous of line casino GD when 50 years old, and dysfunctional personality traits. The change to online GD may have been due to his isolation, movement difficulties, and his high level of education, which facilitated his access to the Internet. Care management focused on individual cognitive-behavioral therapy. Conclusion: The prevalence of online GD may be underestimated among the elderly, and may increase among isolated old people with movement difficulties and ready access to the Internet. However, late-life GD should be considered a diagnosis of elimination, requiring a full medical, psychiatric (including suicide risk), and cognitive assessment. Specific therapeutic approaches need to be proposed and developed

Clinical-epidemiological analysis of HIV positive patients hospitalized in a Burn Therapy Unit

Introduction: HIV infection and burns are common public health issues, especially in low- and middle-income countries. There is a paucity in the literature evaluating the epidemiology of burns hospitalization in HIV patients. This study aims to evaluate the clinical and epidemiological profile of HIV-positive patients hospitalized in a Burn Therapy Unit. Methods: A retrospective analysis of burn patients diagnosed with HIV was performed at the Therapy Unit of the State Hospital of Bauru between 2008 and 2018. Results: 2,364 medical records were reviewed, and 14 (0.6%) patients were diagnosed with HIV. The mean age was 43.1 years. Regarding gender, nine (64.3%) were male, and five (35.7%) were female. The most common mechanism was direct flame in 11 (78.7%) cases. The etiology was alcohol (42.9%) in six patients, in three explosions (21. 5%), and the others were gasoline, cigarettes and contact with exhaustion, all with one (7.1%) case. When the cause of these burns was evaluated, nine (64.3%) were due to accidents, either at work or home, two (14.3%) for attempted murder, one (7.1%) self-extermination, and two (14.3%) cases had no information. Regarding total burn surface area, five (37.5%) had burns of 0-10%, three (21.4%) 11-20% and five (35.7%) greater than 20%, and one was unknown. Four (28.6%) showed airway lesions. Two (14.3%) patients died. Conclusion: The prevalence of burned HIV-positive patients admitted to a specialized unit for this treatment is like the national one, with similar characteristics concerning age and gender

Assessing Face Validity of the HexCom Model for Capturing Complexity in Clinical Practice : a Delphi study

Funding: This research was funded by INSTITUT CATALÀ DE LA SALUT, grant number 7Z19/008.Capturing complexity is both a conceptual and a practical challenge in palliative care. The HexCom model has proved to be an instrument with strong reliability and to be valid for describing the needs and strengths of patients in home care. In order to explore whether it is also perceived to be helpful in enhancing coordinated and patient-centred care at a practical level, a methodological study was carried out to assess the face validity of the model. In particular, a Delphi method involving a group of 14 experts representing the full spectrum of healthcare professionals involved in palliative care was carried out. The results show that there is a high level of agreement, with a content validity index-item greater than 0.92 both with regard to the complexity model and the HexCom-Red, HexCom-Basic, and the HexCom-Clin instruments, and higher than 0.85 regarding the HexCom-Figure and the HexCom-Patient instruments. This consensus confirms that the HexCom model and the different instruments that are derived from it are valued as useful tools for a broad range of healthcare professional in coordinately capturing complexity in healthcare practice