Nanosystems, Drug Molecule Functionalization and Intranasal Delivery: An Update on the Most Promising Strategies for Increasing the Therapeutic Efficacy of Antidepressant and Anxiolytic Drugs.

Depression and anxiety are high incidence and debilitating psychiatric disorders, usually treated by antidepressant or anxiolytic drug administration, respectively. Nevertheless, treatment is usually given through the oral route, but the low permeability of the blood-brain barrier reduces the amount of drug that will be able to reach it, thus consequently reducing the therapeutic efficacy. Which is why it is imperative to find new solutions to make these treatments more effective, safer, and faster. To overcome this obstacle, three main strategies have been used to improve brain drug targeting: the intranasal route of administration, which allows the drug to be directly transported to the brain by neuronal pathways, bypassing the blood-brain barrier and avoiding the hepatic and gastrointestinal metabolism; the use of nanosystems for drug encapsulation, including polymeric and lipidic nanoparticles, nanometric emulsions, and nanogels; and drug molecule functionalization by ligand attachment, such as peptides and polymers. Pharmacokinetic and pharmacodynamic in vivo studies' results have shown that intranasal administration can be more efficient in brain targeting than other administration routes, and that the use of nanoformulations and drug functionalization can be quite advantageous in increasing brain-drug bioavailability. These strategies could be the key to future improved therapies for depressive and anxiety disorders.

Follow-up loss in smoking cessation consultation: can we predict and prevent it?

BACKGROUND: Cigarette smoking has a considerable health and economic burden in modern society, with increased risk of morbidity and mortality. Therefore, smoking cessation policies and medical treatments are essential. However, cessation rates are low and the abandonment of the consultation is common. The identification of characteristics that may predict adherence will help defining the best treatment strategy. This study aimed to identify predictors of follow-up loss in smoking cessation consultation. METHODS: We made a retrospective observational study, including a cohort of patients who started smoking cessation consultation (April-December 2018). Clinical data from consultations was collected and analyzed with IBM SPSS Statistics (SPSS, RRID:SCR_002865). RESULTS: A total of 175 patients was selected (41.1% female), with a mean age of 53±12 years. Eighty-five patients (48.6%) were discharged for abandonment. They had a median pack-year unit 38±36 (P=0.011), Fagerström and Richmond scores of 5±2 and 7±2, respectively. There was an association between women (P<0.001), younger age (P<0.001), depression/anxiety (P=0.023), lower smoking load (P=0.019), starting the treatment in the first appointment (P=0.004) and the abandonment of the consultation. In binary logistic regression, younger age (less than 50 years) (OR =4.39; 95% CI: 1.99-9.70), starting the treatment in the first appointment (OR =3.04; 95% CI: 1.44-6.42) and depression/anxiety (OR =2.30; 95% CI: 1.08-4.88) remained independent predictors of loss in follow-up. CONCLUSIONS: Women, younger age, depression/anxiety, lower smoking load and starting treatment in the first appointment are predictors of follow-up loss, so, these patients may benefit from more frequent evaluations and intensive cognitive approach. This study also raises awareness about the adequate timing to start pharmacological support for smoking cessation.

Influence of the chemical structure on mobility of PCB congeners in female and male sardine (Sardina pilchardus) from Portuguese coast.

Concentrations of 30 polychlorinated biphenyl congeners (CBs) were determined in muscle, liver and gonad tissues of female and male sardines (Sardina pilchardus) collected in February-May 2000 and September-January 2001 from purse seine vessels operating around Peniche, Portugal. The determined CBs were aggregated in four groups (I, II, III and IV), according to similarities of their chemical structures. Muscle and liver of males contained significantly higher concentrations of groups I and II than females during the final period of spawning (February-April). A less contrast was observed for the groups III and IV. This seasonal fluctuation associated with the spawning indicates that female sardines regulate the excess of CBs sequestrated during fatten period. On the contrary, levels of groups I and II were higher in males than in females indicating slower mobility of these compounds as lipids were consumed during the final period of spawning. The deficient regulation of those CBs in muscle of male sardines can not be attributed to selective transfer to gonads and subsequent excretion. Although the full explanation was not found for the different mobility of PCBs with the gender, the results provide evidence of slower elimination of group I and II congeners in male sardines.

[Treatment of latent tuberculosis infection: update of guidelines, 2006]. / Tratamento da tuberculose latente: revisão das normas, 2006.

The Tuberculosis Working Group of the Portuguese Society of Pulmonology, feeling the need to develop guidelines for the diagnosis and treatment of latent tuberculosis infection, compiled a set of recommendations, in view to standardize procedures on this area. This document was prepared in collaboration with the Portuguese Societies of Internal Medicine, Pediatrics and Infectious Diseases, A review and update of guidelines for tracing and treatment of latent tuberculosis infection was made, concerning immunocompetent children and adults, as well as immunocompromised children and adults due to HIV infection. It is understood that these guidelines are to be used as general recommendations, and they should not replace the individual analysis of each case.

[Pulmonary arteriovenous malformations - association with hereditary hemorrhagic telangiectasia. Clinical cases and family screening]. / Malformações arteriovenosas pulmonares - Associação a telangiectasia hemorrágica hereditária. Casos clínicos e rastreio familiar.

Pulmonary arteriovenous malformations are a rare disorder associated to hereditary hemorrhagic telangiectasia in over 50 % of the cases. Clinical presentation, diagnostic work-up, therapeutic options and prognosis are reviewed by the authors. Pulmonary arteriovenous malformations are known to have considerable morbidity and mortality, their treatment being advisable as well as their screening among family members, especially if the index case is diagnosed with both pulmonary arteriovenous malformations and hereditary hemorrhagic telangiectasia. To this moment prospective studies establishing the best diagnostic work-up for the patients and their families are lacking. The authors report two pulmonary arteriovenous malformations cases in a family with hereditary hemorrhagic telangiectasia. Patient's diagnosis led to family screening which resulted in the identification of pulmonary arteriovenous malformations in two family members and pulmonary disease exclusion in four patients previously known to have hereditary hemorrhagic telangiectasia.

[Endobronchial granular cell tumor - what approach to take]. / Tumor de células granulares endobrônquico - Como abordamos?

Granular cell tumor is a mesenchymal neoplasm almost always benign, with tendency to recurrence. Although it is more frequent in in the head and neck it has been described in almost all areas of the body. Its occurrence in the lung is extremely rare. The authors describe two cases of endobronchial granular cell tumours, discuss the particularities of this pathology as well as the treatment options, with particular attention to the use of endobronchial excision and criotherapy.

Sugar bislactones by one-step oxidative dimerisation with pyridinium chlorochromate versus regioselective oxidation of vicinal diols.

Synthesis of 10-membered bislactones by PCC oxidation of methyl 2,6-di-O-pivaloyl-alpha-D-glucopyranoside and methyl 4,6-O-benzylidene-alpha-D-glucopyranoside is described, with emphasis on their structure elucidation using the information gained by combination of NMR spectroscopic techniques with X-ray diffraction data. In alternative, the use of PCC and PCC adsorbed on silica gel or alumina for the regioselective oxidation of vicinal diols in sugars is also reported. Both bislactones showed antifungal activity against Candida albicans, and were slightly active against the bacteria Bacillus subtilis. The bislactone presenting pivaloyl protecting groups also promoted some growth inhibition of Staphylococcus aureus.

Treatment of pulmonary actinomycosis with levofloxacin.

Actinomycosis is a chronic suppurative bacterial infection characterized by multiple abscesses, fistulous pathways, and fibrosis involving the face, neck, chest, and abdomen. It is caused by an anaerobic Gram-positive saprophytic bacterium (Actinomyces). Primary actinomycosis of the lung is a rare disease that probably results from aspiration of oropharyngeal secretions. It can present as a chronic respiratory disease. The treatment of choice is antibiotic therapy with penicillin. The authors report the case of a 55-year-old female diagnosed with pulmonary actinomycosis and successfully treated with levofloxacin.

Organochlorine bioaccumulation and biomarkers levels in culture and wild white seabream (Diplodus sargus).

Persistent organic pollutants (POPs), which can accumulate in the adipose fish tissues, can enter the human food chain through the consumption of fish, and cause risk to health. The use of chemical analysis, and biochemical and cellular responses is a way to detect the impact of pollutants in aquatic systems. The purpose of this study was to investigate the levels of organochlorine compounds (polychlorinated biphenyls - PCB and p,p'-dichlorodiphenyltrichloroethane and its metabolites - tDDT) in, wild and cultivated, white seabream (Diplodus sargus), and also its biological effects that were evaluated by assessing the activity of biotransformation enzymes and genotoxic effects. To achieve that we have sampled five different size classes (I - 13 g, II - 64 g, III - 143 g, IV - 315 g and V - 441 g) of white seabream from a local aquaculture, and also a group of wild fish (375g) in order to compare accumulation and responses between cultured and wild fish. White seabream, cultured and wild, presented low levels of organochlorine content, both in liver and in muscle. Wild white seabream, in comparison to cultured ones at the marketable size, showed lower organochlorine accumulation. Biotransformation enzymes showed negative correlations with organochlorine levels in liver. Micronucleous numbers revealed that wild white seabream are not so exposed to genotoxic compounds as cultured ones.

Tratamento da actinomicose pulmonar com levofloxacina / Treatment of pulmonary actinomycosis with levofloxacin

A actinomicose é uma infecção bacteriana supurativa crônica caracterizada por múltiplos abcessos, trajetos fistulosos e fibrose envolvendo a face, o pescoço, o tórax e o abdômen. É causada por uma bactéria anaeróbia, Gram-positiva e saprófita (Actinomyces). A actinomicose pulmonar primária é uma doença rara que resulta provavelmente da aspiração de secreções da orofaringe. Pode apresentar-se como uma doença respiratória crônica. O tratamento de escolha é a antibioticoterapia com penicilina. Os autores apresentam o caso clínico de uma mulher de 55 anos com diagnóstico de actinomicose pulmonar tratada com sucesso com levofloxacina.

Actinomycosis is a chronic suppurative bacterial infection characterized by multiple abscesses, fistulous pathways, and fibrosis involving the face, neck, chest, and abdomen. It is caused by an anaerobic Gram-positive saprophytic bacterium (Actinomyces). Primary actinomycosis of the lung is a rare disease that probably results from aspiration of oropharyngeal secretions. It can present as a chronic respiratory disease. The treatment of choice is antibiotic therapy with penicillin. The authors report the case of a 55-year-old female diagnosed with pulmonary actinomycosis and successfully treated with levofloxacin.