Sertraline associated with gold nanoparticles reduce cellular toxicity and induce sex-specific responses in behavior and neuroinflammation biomarkers in a mouse model of anxiety.

This study aimed to evaluate the effects of sertraline associated with gold nanoparticles (AuNPs) in vitro cell viability and in vivo behavior and inflammatory biomarkers in a mouse model of anxiety. Sertraline associated with AuNPs were synthesized and characterized. For the in vitro study, NIH3T3 and HT-22 cells were treated with different doses of sertraline, AuNPs, and sertraline + AuNPs and their viability was evaluated using the MTT assay. For the in vivo study, pregnant Swiss mice were administered a single dose of lipopolysaccharide (LPS) on the ninth day of gestation. The female and male offspring were divided into five treatment groups on PND 60 and administered chronic treatment for 28 days. The animals were subjected to behavioral testing and were subsequently euthanized. Their brains were collected and analyzed for inflammatory biomarkers. Sertraline associated with AuNPs exhibited significant changes in surface characteristics and increased diameters. Different doses of sertraline + AuNPs showed higher cell viability in NIH3T3 and HT-22 cells compared with sertraline alone. The offspring of LPS-treated dams exhibited anxiety-like behavior and neuroinflammatory biomarker changes during adulthood, which were ameliorated via sertraline + AuNPs treatment. The treatment response was sex-dependent and brain region-specific. These results suggest that AuNPs, which demonstrate potential to bind to other molecules, low toxicity, and reduced inflammation, can be synergistically used with sertraline to improve drug efficacy and safety by decreasing neuroinflammation and sertraline toxicity.

Antibody-conjugated nanoparticles for therapeutic applications.

A great challenge to clinical development is the delivery of chemotherapeutic agents, known to cause severe toxic effects, directly to diseased sites which increase the therapeutic index whilst minimizing off-target side effects. Antibody-conjugated nanoparticles offer great opportunities to overcome these limitations in therapeutics. They combine the advantages given by the nanoparticles with the ability to bind to their target with high affinity and improve cell penetration given by the antibodies. This specialized vehicle, that can encapsulate several chemotherapeutic agents, can be engineered to possess the desirable properties, allowing overcoming the successive physiological conditions and to cross biological barriers and reach a specific tissue or cell. Moreover, antibody-conjugated nanoparticles have shown the ability to be internalized through receptor-mediated endocytosis and accumulate in cells without being recognized by the P-glycoprotein, one of the main mediators of multi-drug resistance, resulting in an increase in the intracellular concentration of drugs. Also, progress in antibody engineering has allowed the manipulation of the basic antibody structure for raising and tailoring specificity and functionality. This review explores recent developments on active drug targeting by nanoparticles functionalized with monoclonal antibodies (polymeric micelles, liposomes and polymeric nanoparticles) and summarizes the opportunities of these targeting strategies in the therapy of serious diseases (cancer, inflammatory diseases, infectious diseases, and thrombosis).

Serum oxytocin concentrations in elective caesarean delivery: a randomized comparison of three infusion regimens.

BACKGROUND: The aim of this study was to determine serum oxytocin concentrations following different regimens of prophylactic oxytocin administration in women undergoing elective caesarean delivery. METHODS: Thirty healthy pregnant patients were randomized, after clamping of the umbilical cord, to receive intravenous oxytocin in one of the following groups: G1 (n=9), 10 IU of oxytocin infused over 30 min (0.33 IU/min); G2 (n=11), 10 IU of oxytocin infused over 3 min and 45 s (2.67 IU/min); and G3 (n=10), 80 IU of oxytocin infused over 30 min (2.67 IU/min). Both patient and surgeon were blinded to allocation. Uterine tone was assessed by surgical palpation. Serum oxytocin concentration was determined by enzyme immunoassay before anaesthesia (T0) and at 5 (T5), 30 (T30) and 60 (T60) min after the start of oxytocin infusion. RESULTS: Serum oxytocin concentrations (mean±standard error, ng/mL) were not significantly different in the groups at T0 (0.06±0.02, 0.04±0.02 and 0.07±0.04, respectively, P=0.76), and T60 (0.65±0.26, 0.36±0.26 and 0.69±0.26, respectively, P=0.58). G3 showed higher concentrations than G1 at T5 (3.65±0.74 versus 0.71±0.27, P=0.01) and at T30 (6.19±1.19 versus 1.17±0.37, P<0.01), and were higher than G2 at T30 (6.19±1.19 versus 0.41±0.2, P<0.01). Haemodynamic data and uterine tone were considered satisfactory and similar in all groups. No additional uterotonic agents were needed. CONCLUSION: Serum oxytocin measurements made using enzyme immunoassay in healthy pregnant women undergoing elective caesarean delivery showed that administration of 80 IU oxytocin over 30 min resulted in higher serum oxytocin levels after 5 and 30 min than the two other regimens. The concentrations did not differ between groups at 60 min.

[Utility of gas chromatography for the identification of mycobacterial species]. / Utilidad de la cromatografia gaseosa para la identificación de micobacterias.

The human immunodeficiency virus (HIV) epidemic has altered the epidemiological profile of tuberculosis in both industrialized and developing countries. Serious diseases caused by mycobacteria other than Mycobacterium tuberculosis, mostly belonging to the M. avium-intracellulare complex (MAC), have become very common in association with severe immunosuppression. The increase in mycobacterial disease complexity has stimulated the development of more rapid and efficient methods for diagnosis. In the present study, we investigated and assessed the suitability of a gas-liquid chromatography technique for diagnosis of clinically important mycobacteria in Argentina. An identification scheme was developed from the results obtained in a previous study where we characterized the cellular fatty acids and the mycolic acid cleavage products from most frequent species in Argentina. Of 183 isolates tested, 69% were correctly identified to species level and 5% were incorrectly classified. If we only take into account the isolates that could be identified, 93% were correctly identified. Although all of the isolates of M. tuberculosis were correctly identified, four isolates of MAC incorrectly matched by M. tuberculosis. Gas chromatography provides a rapid technique of highly predictive value for mycobacteria identification; it could be used in reference laboratories as a rapid presumptive identification until the biochemical tests are completed.

[Anna Justina Ferreira Nery: framework in the history of Brazilian nursing]. / Anna Justina Ferreira Nery: um marco na história da enfermagem brasileira.

The object of this study is Anna Neri (1814-1880), an anonymous woman who participated in the Paraguay War (1865-1870). This is a social-historical biographical study guided by the principles of the New History. The objective of this research is to characterize and raise relevant aspects of Anna Neri's life. It is known that this woman left her domestic life to play an important role in the public space. Her motivation was genuinely affectionate, and she didn't expect to be called a nurse. Anna Neri met the requirements that would raise the social and moral status of the XXth century nursing workers, and became a symbol of Brazilian nursing.

Portable devices used to detect endotracheal intubation during emergency situations: a review.

OBJECTIVES: To review the operational characteristics of commercial devices used to detect endotracheal intubation; and to identify an ideal device for detecting endotracheal intubation in emergency situations, especially in the prehospital setting during cardiac arrest. DATA SOURCES: Relevant articles from the medical literature are referenced. STUDY SELECTION: The authors identified the need for understanding the basic operation principles of portable devices used to detect endotracheal intubation and to correctly use them in unpredictable clinical situations. DATA EXTRACTION: Data from published literature. DATA SYNTHESIS: Recently, a number of new portable devices have been marketed for detecting endotracheal intubation, each having advantages and disadvantages, especially when used during emergency situations. The devices are classified based on their principle of operation. Some rely on CO2 detection (STATCAP, Easy Cap, and Pedi-Cap), others utilize the transmission of light (Trachlight, SURCH-LITE), one operates based on reflection of sound energy (SCOTI), and some depend on aspiration of air (TubeChek and TubeChek-B). A brief description of each device and its operational characteristics are reviewed. A comparative analysis among the devices is made based on size, portability, cost, ease of operation, need for calibration or regular maintenance, reliability for patients with and without cardiac arrest, and the possibility of use for adult and pediatric patients. False-negative and false-positive results for each device are also discussed. False-negative results mean that although the endotracheal tube is in the trachea, the device indicates it is not. False-positive results mean that although the endotracheal tube is in the esophagus, the device indicates it is in the trachea. CONCLUSIONS: Although no clinical comparative study of commercial devices to detect endotracheal intubation exists, the syringe device (TubeChek) has most of the characteristics necessary for a device to be considered ideal in emergency situations in the prehospital setting. It is simple, inexpensive, easy to handle and operate, disposable, does not require maintenance, gives reliable results for patients with and without cardiac arrest, and can be used for almost all age groups. The device may yield false-negative results, most commonly in the presence of copious secretions and in cases of accidental endobronchial intubation. Regardless of the device used, clinical judgment and direct visualization of the endotracheal tube in the trachea are required to unequivocally confirm proper endotracheal tube placement.

Epidural pressures and spread of 2% lidocaine in the epidural space: influence of volume and speed of injection of the local anesthetic solution.

BACKGROUND AND OBJECTIVES: The impact of epidural pressures on the spread of epidural block is controversial. This study examined the effect of volume and speed of injection of local anesthetics on epidural pressures and the spread of anesthesia. METHODS: Twenty women undergoing epidural anesthesia received a test dose of 3 mL of 2% lidocaine with epinephrine 1:200,000 over 6 seconds and subsequently the main dose of 15 mL of the solution over 30 seconds (group I) or 3 minutes (group II). Variables studied included epidural pressures and the extent and duration of thermal and sensory block. RESULTS: Peak epidural pressure following the main dose was significantly higher in group I as compared to group II. All other epidural pressures and the extent and duration of sensory and thermal block were similar in both groups. The peak epidural pressure in group II and the pressures obtained at 3 minutes after the main dose in both groups were inversely correlated with the extent of the thermal block and directly correlated with its regression time. CONCLUSIONS: The peak epidural pressures correlated with the speed of injection of the lidocaine solution and not with its volume, whereas the remaining epidural pressures correlated with its volume and not with the speed of injection. The extent and duration of the thermal block exhibited a more consistent correlation (inverse and direct, respectively) with the epidural pressures than those of the sensory block.

Small doses of intrathecal morphine combined with systemic diclofenac for postoperative pain control after cesarean delivery.

UNLABELLED: Postoperative pain control after cesarean delivery under spinal anesthesia is effectively obtained with morphine 0.1-0.3 mg intrathecally, although there may be dose-dependent side effects. We evaluated the quality of analgesia and the incidence of side effects with smaller doses of intrathecal morphine combined with intramuscular (i.m.) diclofenac. One hundred-twenty pregnant patients were allocated into six groups, which received the following treatments: Groups 1, 3, and 5 received 0.1, 0.05, and 0.025 mg of intrathecal morphine, respectively, plus 75 mg of i.m. diclofenac every 8 h; Groups 2, 4, and 6 received 0.1, 0.05, and 0.025 mg of intrathecal morphine, respectively, plus i.m. diclofenac on demand. Spinal anesthesia was performed with 15 mg of 0.5% hyperbaric bupivacaine. Pain scores and side effects were evaluated hourly for the first 24 h. Groups 1 and 2 had lower pain scores than Groups 3, 4, 5, and 6. However, only patients in Groups 2, 4, and 6 requested additional analgesics. Severe pruritus was more frequent in Groups 1 and 2. No patient experienced respiratory depression. We conclude that there is no advantage in using doses larger than 0.025 mg of intrathecal morphine if they are combined with systemic diclofenac. IMPLICATIONS: A multimodal approach to pain control may provide good quality analgesia while reducing drug-related side effects. In this study, a very small dose of intrathecal morphine, in association with intramuscular diclofenac, proved effective for controlling pain after cesarean delivery, with a low incidence of morphine-induced pruritus.

Traumas oculares causados por agressoes em 70 pacientes. / Ocular traumas caused by personal attack in 70 patients

Num estudo realizado em 307 pacientes com traumatismos oculares, internados no servico de oftalmologia do Hospital Municipal Souza Aguiar no periodo de 15 meses, foram registrados 70 casos de agressoes. O agente causal mais frequente do trauma ocular foi a pedrada seguida do projetil da arma de fogo (PAF), ocasionando graves ferimentos perfurantes de globo ocular. O estudo das causas que levam a agressao implica numa profunda analise do comportamento humano e social, nao sendo esse o nosso proposito. Consideracoes sobre alguns aspectos estatisticos sao aqui abordados visando possiveis medidas preventivas, que possam contribuir para diminuir as agressoes ou os seus efeitos