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1.
J Nat Prod ; 85(9): 2184-2191, 2022 09 23.
Artículo en Inglés | MEDLINE | ID: mdl-35998343

RESUMEN

Herein, the isolation of secondary metabolites from the aerial parts of Justicia aequilabris guided by HPLC-MSn and molecular networking analyses is reported. Twenty-two known compounds were dereplicated. Three new lignans (aequilabrines A-C (1-3)) and three known compounds (lariciresinol-4'-O-ß-glucose (4), roseoside (5), and allantoin (6)) were obtained. The anti-inflammatory activity of compounds 1-3 was evaluated in vitro by inhibiting the nitric oxide production (NO) and pro-inflammatory activity on the cytokine IL-1ß. Compounds 2 and 3 showed significant inhibitory activity against NO production, with IC50 values of 9.1 and 7.3 µM, respectively. The maximum inhibition of IL-1ß production was 23.5% (1), 27.3% (2), and 32.5% (3).


Asunto(s)
Antiinflamatorios , Género Justicia , Lignanos , Alantoína/química , Alantoína/aislamiento & purificación , Alantoína/farmacología , Antiinflamatorios/química , Antiinflamatorios/aislamiento & purificación , Antiinflamatorios/farmacología , Furanos/química , Furanos/aislamiento & purificación , Furanos/farmacología , Lignanos/química , Lignanos/aislamiento & purificación , Lignanos/farmacología , Estructura Molecular , Óxido Nítrico/antagonistas & inhibidores , Extractos Vegetales/química
2.
Artículo en Inglés | MEDLINE | ID: mdl-33727938

RESUMEN

Several secondary metabolites have been isolated from Zornia brasiliensis (Leguminosae), mainly flavonoids. These compounds are known for many pharmacological actions, such as antispasmodic and antidiarrheal. Therefore, we evaluated the antidiarrheal effect of the ethanolic extract obtained from Zornia brasiliensis aerial parts (ZB-EtOHAP), as well as its underlying mechanisms. Castor-oil-induced diarrhea, fluid accumulation, and intestinal transit (normal and castor oil induced) were performed to assess the antidiarrheal, antisecretory, and antipropulsive activities of the extract. The involvement of opioid and adrenergic pathways was also investigated. ZB-EtOHAP inhibited, in a dose-dependent manner, both total defecation frequency and the number of watery stools. The extract showed no effect on fluid accumulation or normal intestinal transit. On the other hand, when the animals were pretreated with castor oil, the extract decreased the distance traveled by the marker in the small intestine. Investigation of the involvement of opioid and adrenergic systems showed that the pharmacological potency of the extract did not change in the presence of naloxone, but it was reduced in the presence of yohimbine. The data indicate that Zornia brasiliensis has an antidiarrheal effect due to inhibition of the intestinal motility through adrenergic pathway activation.

3.
Lancet ; 396(10256): 959-967, 2020 10 03.
Artículo en Inglés | MEDLINE | ID: mdl-32896292

RESUMEN

BACKGROUND: The efficacy and safety of azithromycin in the treatment of COVID-19 remain uncertain. We assessed whether adding azithromycin to standard of care, which included hydroxychloroquine, would improve clinical outcomes of patients admitted to the hospital with severe COVID-19. METHODS: We did an open-label, randomised clinical trial at 57 centres in Brazil. We enrolled patients admitted to hospital with suspected or confirmed COVID-19 and at least one additional severity criteria as follows: use of oxygen supplementation of more than 4 L/min flow; use of high-flow nasal cannula; use of non-invasive mechanical ventilation; or use of invasive mechanical ventilation. Patients were randomly assigned (1:1) to azithromycin (500 mg via oral, nasogastric, or intravenous administration once daily for 10 days) plus standard of care or to standard of care without macrolides. All patients received hydroxychloroquine (400 mg twice daily for 10 days) because that was part of standard of care treatment in Brazil for patients with severe COVID-19. The primary outcome, assessed by an independent adjudication committee masked to treatment allocation, was clinical status at day 15 after randomisation, assessed by a six-point ordinal scale, with levels ranging from 1 to 6 and higher scores indicating a worse condition (with odds ratio [OR] greater than 1·00 favouring the control group). The primary outcome was assessed in all patients in the intention-to-treat (ITT) population who had severe acute respiratory syndrome coronavirus 2 infection confirmed by molecular or serological testing before randomisation (ie, modified ITT [mITT] population). Safety was assessed in all patients according to which treatment they received, regardless of original group assignment. This trial was registered at ClinicalTrials.gov, NCT04321278. FINDINGS: 447 patients were enrolled from March 28 to May 19, 2020. COVID-19 was confirmed in 397 patients who constituted the mITT population, of whom 214 were assigned to the azithromycin group and 183 to the control group. In the mITT population, the primary endpoint was not significantly different between the azithromycin and control groups (OR 1·36 [95% CI 0·94-1·97], p=0·11). Rates of adverse events, including clinically relevant ventricular arrhythmias, resuscitated cardiac arrest, acute kidney failure, and corrected QT interval prolongation, were not significantly different between groups. INTERPRETATION: In patients with severe COVID-19, adding azithromycin to standard of care treatment (which included hydroxychloroquine) did not improve clinical outcomes. Our findings do not support the routine use of azithromycin in combination with hydroxychloroquine in patients with severe COVID-19. FUNDING: COALITION COVID-19 Brazil and EMS.


Asunto(s)
Antivirales/uso terapéutico , Azitromicina/uso terapéutico , Infecciones por Coronavirus/tratamiento farmacológico , Hidroxicloroquina/uso terapéutico , Neumonía Viral/tratamiento farmacológico , Anciano , Antivirales/efectos adversos , Azitromicina/efectos adversos , Betacoronavirus , Brasil/epidemiología , COVID-19 , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/mortalidad , Quimioterapia Combinada , Femenino , Humanos , Hidroxicloroquina/efectos adversos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/mortalidad , Terapia Respiratoria , SARS-CoV-2 , Nivel de Atención , Resultado del Tratamiento
4.
N Engl J Med ; 383(21): 2041-2052, 2020 11 19.
Artículo en Inglés | MEDLINE | ID: mdl-32706953

RESUMEN

BACKGROUND: Hydroxychloroquine and azithromycin have been used to treat patients with coronavirus disease 2019 (Covid-19). However, evidence on the safety and efficacy of these therapies is limited. METHODS: We conducted a multicenter, randomized, open-label, three-group, controlled trial involving hospitalized patients with suspected or confirmed Covid-19 who were receiving either no supplemental oxygen or a maximum of 4 liters per minute of supplemental oxygen. Patients were randomly assigned in a 1:1:1 ratio to receive standard care, standard care plus hydroxychloroquine at a dose of 400 mg twice daily, or standard care plus hydroxychloroquine at a dose of 400 mg twice daily plus azithromycin at a dose of 500 mg once daily for 7 days. The primary outcome was clinical status at 15 days as assessed with the use of a seven-level ordinal scale (with levels ranging from one to seven and higher scores indicating a worse condition) in the modified intention-to-treat population (patients with a confirmed diagnosis of Covid-19). Safety was also assessed. RESULTS: A total of 667 patients underwent randomization; 504 patients had confirmed Covid-19 and were included in the modified intention-to-treat analysis. As compared with standard care, the proportional odds of having a higher score on the seven-point ordinal scale at 15 days was not affected by either hydroxychloroquine alone (odds ratio, 1.21; 95% confidence interval [CI], 0.69 to 2.11; P = 1.00) or hydroxychloroquine plus azithromycin (odds ratio, 0.99; 95% CI, 0.57 to 1.73; P = 1.00). Prolongation of the corrected QT interval and elevation of liver-enzyme levels were more frequent in patients receiving hydroxychloroquine, alone or with azithromycin, than in those who were not receiving either agent. CONCLUSIONS: Among patients hospitalized with mild-to-moderate Covid-19, the use of hydroxychloroquine, alone or with azithromycin, did not improve clinical status at 15 days as compared with standard care. (Funded by the Coalition Covid-19 Brazil and EMS Pharma; ClinicalTrials.gov number, NCT04322123.).


Asunto(s)
Antivirales/administración & dosificación , Azitromicina/administración & dosificación , Infecciones por Coronavirus/tratamiento farmacológico , Hidroxicloroquina/administración & dosificación , Neumonía Viral/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Antivirales/uso terapéutico , Azitromicina/uso terapéutico , Betacoronavirus , Brasil , COVID-19 , Quimioterapia Combinada , Femenino , Hospitalización , Humanos , Hidroxicloroquina/uso terapéutico , Masculino , Persona de Mediana Edad , Pandemias , Gravedad del Paciente , SARS-CoV-2 , Insuficiencia del Tratamiento , Tratamiento Farmacológico de COVID-19
5.
J Nat Prod ; 83(5): 1515-1523, 2020 05 22.
Artículo en Inglés | MEDLINE | ID: mdl-32364737

RESUMEN

Three new caryophyllane-type sesquiterpenoids, linariophyllenes A-C (1-3), two new hamamelitol derivatives, linaritols A (4) and B (5), two new chromones, linariosides A (6) and B (7), and three known chromones, cnidimol C (8), monnieriside A (9), and undulatoside A (10), were identified from the aerial parts of Evolvulus linarioides. The structures of these compounds were elucidated by NMR, MS, and IR data. The absolute configurations of compounds 1-5 and 7 were established via electronic circular dichroism data. The anti-inflammatory potential of compounds 1-5 and 7-10 was evaluated by determining their ability to inhibit the production of nitric oxide (NO) and proinflammatory cytokine IL-1ß by stimulated J774 macrophages. Compounds tested at noncytotoxic concentrations inhibited NO production by macrophages, exhibiting IC50 values between 17.8 and 66.2 µM, and inhibited IL-1ß production by stimulated macrophages by 72.7-96.2%.


Asunto(s)
Convolvulaceae/química , Componentes Aéreos de las Plantas/química , Animales , Antiinflamatorios no Esteroideos/farmacología , Línea Celular , Supervivencia Celular/efectos de los fármacos , Dicroismo Circular , Cromatografía de Gases y Espectrometría de Masas , Interleucina-1beta/antagonistas & inhibidores , Macrófagos/efectos de los fármacos , Macrófagos/metabolismo , Espectroscopía de Resonancia Magnética , Espectrometría de Masas , Ratones , Estructura Molecular , Óxido Nítrico/antagonistas & inhibidores , Extractos Vegetales/química , Espectrofotometría Infrarroja
6.
Epidemiol Infect ; 146(1): 100-106, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-29173239

RESUMEN

The purpose of the present study was to reconstruct the phylogeny of dengue virus serotype 4 (DENV-4) that was circulating in Espírito Santo state, Brazil, in 2013 and 2014, and to discuss the epidemiological implications associated with this evolutionary hypothesis. Partial envelope gene of eight DENV-4 samples from Espírito Santo state were sequenced and aligned with 72 worldwide DENV-4 reference sequences from GenBank. A phylogenetic tree was reconstructed through Bayesian Inference and the Time of the Most Recent Common Ancestor was estimated. The study detected the circulation of DENV-4 genotype II in Espírito Santo state, which was closely related to strains from the states of Mato Grosso collected in 2012 and of São Paulo sampled in 2015. This cluster emerged around 2011, approximately 4 years after the entry of the genotype II in Brazil through its northern states, possibly imported from Venezuela and Colombia. This is so far the first phylogenetic study of the DENV-4 circulating in Espírito Santo state and shows the importance of an internal route of dengue viral circulation in Brazil to the introduction of the virus into this state.


Asunto(s)
Virus del Dengue/clasificación , Virus del Dengue/genética , Filogenia , Brasil , Humanos , Análisis de Secuencia de ARN , Serogrupo
7.
EXCLI J ; 16: 14-24, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28337115

RESUMEN

Hyptis umbrosa (syn. Mesosphaerum sidifolium) (Lamiaceae Family) has been used to treat several conditions such as gastrointestinal disorders, skin infections, nasal congestion, fever and cramps. The objective of this study was to evaluate the chemical composition, analgesic and anti-inflammatory profiles of ethanol extract from leaves of Hyptis umbrosa (EEB). HPLC-DAD was used to determine the fingerprint chromatogram of the extract. Male Swiss mice were orally pretreated with EEB (100, 200 or 400 mg/kg; 60 min before initiating algesic stimulation) and antinociceptive activity was assessed using the acetic acid-induced writhing model, formalin test and hyperalgesia induced by glutamate or capsaicin. Also, peritonitis was induced by the intrathoracic injection of carrageenan to quantify the total number of leukocytes. The presence of phenolic compounds in the extract was confirmed using HPLC-DAD. The treatment with EEB, at all doses, produced a significant analgesic effect against acetic acid-induced antinociceptive activity. In the formalin test, only the 400-mg/kg-dose of EEB had a significant effect in the first phase. However, all doses tested were able to reverse nociception in the second phase. The effect of all doses of EEB also showed a significant antinociceptive effect in the glutamate and capsaicin tests and inhibited the carrageenan-induced leukocyte migration to the peritoneal cavity. The present study suggests that the EEB possesses peripheral analgesic action and showed potential in reducing the spreading of the inflammatory processes. Also, it seems to be related with vanilloid and glutamate receptors.

8.
Epidemiol Infect ; 145(1): 46-53, 2017 01.
Artículo en Inglés | MEDLINE | ID: mdl-27609661

RESUMEN

Dengue presents a wide clinical spectrum of signs and symptoms, with characteristics of the host potentially influencing the disease evolution. Therefore, the purpose of this study was to evaluate the influence of gender and age on dengue clinical outcomes in a recent outbreak situation in Brazil, applying a cross-sectional design and including 6703 dengue cases with laboratory confirmation, occurring in Vitória, Espírito Santo State, Brazil, between 2007 and 2013. Data were obtained from the Information System for Notifiable Diseases. Overall, 11·3% of the sample presented with severe dengue, which affected 13·0% of males, 10·0% of females, 8·8% of children, 12·5% of adolescents, 10·5% of adults and 15·5% of the elderly. Age was higher in the severe dengue group (P = 0·03). Severe dengue was associated with males and the elderly (P < 0·01); however, considering only severe cases, children presented haemorrhage and plasma leakage more frequently than older age groups. The results emphasize the importance of a differentiated protocol for management of dengue cases, taking into consideration host factors like age. These findings also suggest the elderly and children as priority groups for immunization in a future implementation of a vaccine.


Asunto(s)
Demografía , Dengue/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Adulto Joven
9.
Steroids ; 107: 74-86, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26742628

RESUMEN

The aim of this study was to identify the expression, cellular localization and regulation of classic estrogen receptors ERα and ERß, ER-α36 isoform and GPER in the androgen-independent prostate cancer cell line PC-3. In addition, we evaluated the relative contribution of these receptors to the activation of the ERK1/2 (extracellular signal-regulated protein kinases) signaling pathway. These four estrogen receptors were detected by Western blot assays and were shown by immunofluorescence assays to localize preferentially in extranuclear regions of PC-3 cells. In addition, treatment with 17ß-estradiol (E2) (1 µM) for 24 h led to down-regulation of the classic estrogen receptors, whereas E2 at physiological concentration (0.1 nM) for 24h tended to increase the levels of ERα and ERß. Furthermore, the ERα-selective agonist PPT selectively increased the expression of ERß and the ERß-selective agonist DPN increased ERα levels. None of these treatments affected expression of the ER-α36 isoform. The unusual cytoplasmic localization of the classic estrogen receptors in these cells differs from the nuclear localization in the majority of estrogen target cells and suggests that rapid signaling pathways may be preferentially activated. In fact, treatment with selective agonists of ERα, ERß and GPER induced ERK1/2 phosphorylation that was blocked by the respective antagonists. On the other hand, activation of ERK1/2 induced by E2 may involve additional mechanisms because it was not blocked by the three antagonists. Taken together, the results indicate that there is a crosstalk between ERα and ERß to regulate the expression of each other, and suggest the involvement of other receptors, such as ER-α36, in the rapid ERK1/2 activation by E2. The identification of new isoforms of ERs, regulation of the receptors and signaling pathways is important to develop new therapeutic strategies for the castration-resistant prostate cancer.


Asunto(s)
Estradiol/farmacología , Receptor alfa de Estrógeno/biosíntesis , Receptor beta de Estrógeno/biosíntesis , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Proteínas de Neoplasias/biosíntesis , Neoplasias de la Próstata/metabolismo , Línea Celular Tumoral , Receptor alfa de Estrógeno/genética , Receptor beta de Estrógeno/genética , Humanos , Sistema de Señalización de MAP Quinasas/efectos de los fármacos , Sistema de Señalización de MAP Quinasas/genética , Masculino , Proteínas de Neoplasias/genética , Neoplasias de la Próstata/genética
10.
Acta Odontol Latinoam ; 28(1): 72-8, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25950166

RESUMEN

The aim of this study was to evaluate the addition of 2-[3-(2HBenzotriazol- 2-yl)-4-hydroxyphenyl]ethyl methacrylate (BTAM) to an experimental adhesive resin. An experimental base adhesive resin was formulated with BisGMA, TEGDMA and HEMA, to which BTAM was added at 1, 2.5 and 5%, in weight. One group with no addition was used as control. The experimental adhesives were evaluated for antibacterial potential (against Streptococcus mutans), degree of conversion with FTIR, softening in solvent and microRaman interface analyses. Data were analyzed by Kruskal-Wallis, paired t test and ANOVA and Tukey, considering a 5% level of significance. The results showed antibacterial activity of 5% BTAM against S. mutans (p<0.05), however, no difference was found among BTAM groups (p> 0.05). The results of degree of conversion and softening of solvent showed no statistical difference between BTAM and control groups (p>0.05). The addition of 5% BTAM showed higher antibacterial activity than the negative control, and copolymerization with comonomer blend of adhesive resin and BTAM was detected at the dentin/ adhesive interface.


Asunto(s)
Metacrilatos/química , Adhesivos , Recubrimiento Dental Adhesivo , Recubrimientos Dentinarios , Humanos , Cementos de Resina
11.
Acta odontol. latinoam ; Acta odontol. latinoam;28(1): 72-78, Apr. 2015. ilus, graf, tab
Artículo en Inglés | LILACS | ID: biblio-949692

RESUMEN

The aim of this study was to evaluate the addition of 2-[3-(2HBenzotriazol- 2-yl)-4-hydroxyphenyl]ethyl methacrylate (BTAM) to an experimental adhesive resin. An experimental base adhesive resin was formulated with BisGMA, TEGDMA and HEMA, to which BTAM was added at 1, 2.5 and 5%, in weight. One group with no addition was used as control. The experimental adhesives were evaluated for antibacterial potential (against Streptococcus mutans), degree of conversion with FTIR, softening in solvent and microRaman interface analyses. Data were analyzed by Kruskal-Wallis, paired t test and ANOVA and Tukey, considering a 5% level of significance. The results showed antibacterial activity of 5% BTAM against S. mutans (p<0.05), however, no difference was found among BTAM groups (p> 0.05). The results of degree of conversion and softening of solvent showed no statistical difference between BTAM and control groups (p>0.05). The addition of 5% BTAM showed higher antibacterial activity than the negative control, and copolymerization with comonomer blend of adhesive resin and BTAM was detected at the dentin/ adhesive interface.


O objetivo do presente estudo foi avaliar a adicao do 2-[3-(2HBenzotriazol- 2-yl)-4-hidroxifenil]etil metacrilato (BTAM) a um adesivo experimental. Uma resina adesiva base experimental foi formulada com BisGMA, TEGDMA e HEMA e a essa resina foi adicionado o BTAM nas concentracoes de 1, 2,5 e 5%, em peso, alem de um grupo controle sem adicao. Os adesivos experi - mentais foram avaliados quanto ao potencial antimicrobiano contra Streptococos mutans, grau de conversao com FTIR, degradacao em solvente e analise da interface com microespectroscopia Raman. Os dados foram analisados considerando um nivel de significancia de 5%. Os resultados obtidos no teste antimicrobiano contra S. mutans mostrou dife renca estatisticamente significativa do grupo com 5% de BTAM em relacao aos demais grupos e ao controle negativo (p<0,05). Os resultados de grau de conversao e degradacao em solvente dos grupos com BTAM nao apresentaram diferenca quando comparado ao grupo controle (p>0,05). Foi possivel observar a penetracao do BTAM na dentina. A adicao de BTAM na concentracao de 5% mostrou atividade antimicrobiana comparado ao controle negativo, alem de ter sido capaz de copolimerizar e penetrar na dentina.


Asunto(s)
Humanos , Metacrilatos/química , Adhesivos , Recubrimiento Dental Adhesivo , Recubrimientos Dentinarios , Cementos de Resina
12.
J Biomed Mater Res B Appl Biomater ; 103(8): 1663-9, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25611332

RESUMEN

The use of bioactive materials instead of inert materials to fill the root canal space could be an effective approach to achieve a hermetic seal and stimulate the healing of periapical tissues. The purpose of this study was to develop and characterize an endodontic sealer based on a glycerol salicylate resin and α-tricalcium phosphate (αTCP) at physical and chemical properties. Different sealers were formulated using 70% of a glycerol salicylate resin and 30% of a mixture of calcium hydroxide and αTCP (0, 5, 10, or 15%, in weight). Sealers formulated were characterized based on setting time, in vitro degradation over time, pH, cytotoxicity, and mineral deposition. Sealers presented setting time ranging from 240 to 405 min, and basic pH over 8.21 after 28 days. Higher αTCP concentration leads to sealers with low solubility. Cell viability after 48 h in direct contact with sealers was similar to a commercial sealer used as reference. The 10% and 15% αTCP sealers exhibited a calcium-phosphate layer on the surface after immersion in water and SBF for 7 days. Glycerol salicylate sealers with 10% and 15% α-tricalcium phosphate showed reliable physical-chemical properties and apatite-forming ability.


Asunto(s)
Fosfatos de Calcio/farmacología , Fibroblastos/metabolismo , Éteres de Glicerilo/farmacología , Ensayo de Materiales , Materiales de Obturación del Conducto Radicular/farmacología , Salicilatos/farmacología , Animales , Fosfatos de Calcio/química , Línea Celular , Supervivencia Celular/efectos de los fármacos , Fibroblastos/citología , Éteres de Glicerilo/química , Ratones , Materiales de Obturación del Conducto Radicular/química , Salicilatos/química
13.
Crit Care ; 17(2): R63, 2013 Apr 04.
Artículo en Inglés | MEDLINE | ID: mdl-23557378

RESUMEN

INTRODUCTION: Contemporary information on mechanical ventilation (MV) use in emerging countries is limited. Moreover, most epidemiological studies on ventilatory support were carried out before significant developments, such as lung protective ventilation or broader application of non-invasive ventilation (NIV). We aimed to evaluate the clinical characteristics, outcomes and risk factors for hospital mortality and failure of NIV in patients requiring ventilatory support in Brazilian intensive care units (ICU). METHODS: In a multicenter, prospective, cohort study, a total of 773 adult patients admitted to 45 ICUs over a two-month period requiring invasive ventilation or NIV for more than 24 hours were evaluated. Causes of ventilatory support, prior chronic health status and physiological data were assessed. Multivariate analysis was used to identifiy variables associated with hospital mortality and NIV failure. RESULTS: Invasive MV and NIV were used as initial ventilatory support in 622 (80%) and 151 (20%) patients. Failure with subsequent intubation occurred in 54% of NIV patients. The main reasons for ventilatory support were pneumonia (27%), neurologic disorders (19%) and non-pulmonary sepsis (12%). ICU and hospital mortality rates were 34% and 42%. Using the Berlin definition, acute respiratory distress syndrome (ARDS) was diagnosed in 31% of the patients with a hospital mortality of 52%. In the multivariate analysis, age (odds ratio (OR), 1.03; 95% confidence interval (CI), 1.01 to 1.03), comorbidities (OR, 2.30; 95% CI, 1.28 to 3.17), associated organ failures (OR, 1.12; 95% CI, 1.05 to 1.20), moderate (OR, 1.92; 95% CI, 1.10 to 3.35) to severe ARDS (OR, 2.12; 95% CI, 1.01 to 4.41), cumulative fluid balance over the first 72 h of ICU (OR, 2.44; 95% CI, 1.39 to 4.28), higher lactate (OR, 1.78; 95% CI, 1.27 to 2.50), invasive MV (OR, 2.67; 95% CI, 1.32 to 5.39) and NIV failure (OR, 3.95; 95% CI, 1.74 to 8.99) were independently associated with hospital mortality. The predictors of NIV failure were the severity of associated organ dysfunctions (OR, 1.20; 95% CI, 1.05 to 1.34), ARDS (OR, 2.31; 95% CI, 1.10 to 4.82) and positive fluid balance (OR, 2.09; 95% CI, 1.02 to 4.30). CONCLUSIONS: Current mortality of ventilated patients in Brazil is elevated. Implementation of judicious fluid therapy and a watchful use and monitoring of NIV patients are potential targets to improve outcomes in this setting. TRIAL REGISTRATION: ClinicalTrials.gov NCT01268410.


Asunto(s)
Mortalidad Hospitalaria , Unidades de Cuidados Intensivos , Respiración Artificial/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Estudios de Cohortes , Femenino , Mortalidad Hospitalaria/tendencias , Humanos , Unidades de Cuidados Intensivos/tendencias , Masculino , Persona de Mediana Edad , Ventilación no Invasiva/mortalidad , Ventilación no Invasiva/tendencias , Estudios Prospectivos , Respiración Artificial/tendencias , Resultado del Tratamiento
14.
Toxicon ; 60(5): 773-81, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22750534

RESUMEN

A basic phospholipase A2 (LmrTX) isoform was isolated from Lachesis muta rhombeata snake venom and partially characterized. The venom was fractionated by molecular exclusion chromatography in ammonium bicarbonate buffer followed by reverse-phase HPLC on a C-5 Discovery® Bio Wide column. From liquid chromatography-electrospray ionization/mass spectrometry, the molecular mass of LmrTX was measured as 14.277.50 Da. The amino acid sequence showed a high degree of homology between PLA2 LmrTX from L. muta rhombeata and other PLA2 from snake venoms, like CB1 and CB2 from Crotalus durissus terrificus; LmTX-I and LmTX-II from Lachesis muta muta. LmrTX had PLA2 activity in the presence of a synthetic substrate and alkylation of histidine residues significantly inhibited (P < 0.05) the enzymatic activity of LmrTX and its anticoagulant and antithrombotic activity. In this study, we examined the ability of the LmrTX in altering thrombus formation in living mouse, using a photochemically induced arterial thrombosis model. The control animals that did not receive protein injection showed a normal occlusion time, which was around 57 ± 7.8 min. LmrTX, the PLA2 from L. muta rhombeata venom, caused a change in the occlusion time to 99 ± 10 min with doses of 7.5 µg/mice. Additionally, LmrTX showed the anticoagulant activity in vitro and ex vivo and prolonging the time aggregation in wash platelet induced by ADP and Thrombin.


Asunto(s)
Venenos de Crotálidos/enzimología , Fosfolipasas A2/genética , Fosfolipasas A2/metabolismo , Trombosis/inducido químicamente , Secuencia de Aminoácidos , Animales , Secuencia de Bases , Cromatografía en Gel , Cromatografía Líquida de Alta Presión , Cromatografía Liquida , Espectrometría de Masas , Ratones , Datos de Secuencia Molecular , Análisis de Secuencia de ADN , Especificidad de la Especie
16.
Rev. bras. farmacogn ; 18(supl): 718-723, Dec. 2008. ilus, graf, tab
Artículo en Portugués | LILACS | ID: lil-509451

RESUMEN

Mimosa paraibana Barneby foi submetida a um estudo fitoquímico para o isolamento de seus constituintes químicos, através de métodos cromatográficos usuais, e posterior identificação estrutural, utilizando-se métodos espectroscópicos de RMN ¹H e 13C uni e bidimensionais, além de comparações com modelos da literatura. Deste estudo pioneiro, foram isolados e identificados cinco constituintes da fase clorofórmica: uma mistura dos esteróides, β-sitosterol e estigmasterol, a 15¹-hidroxi-feofitina A, a 5,7-dihidroxiflavanona, o 3,4,5-trihidroxibenzoato de etila e o ácido p-cumárico. A atividade antioxidante das fases hexânica, clorofórmica e acetato de etila foi avaliada utilizando o radical estável DPPH (1,1-difenil-2-picril-hidrazil) e os resultados comparados com o padrão ácido ascórbico. A avaliação da citotoxicidade das fases foi realizada empregando-se o ensaio de letalidade contra Artemia salina. Dos extratos avaliados, somente o hexânico mostrou baixa toxicidade.


The phytochemical study of Mimosa paraibana Barneby led to the isolation of its chemical constituents, through the usual chromatographic methods, and further structural identification, using ¹H and 13C NMR spectroscopic methods based on one and two-dimensional techniques, in addition to comparison with literature data. From this pioneering investigation with M. paraibana, five constituents were isolated and identified from the chloroform extract: a mixture of β-sitosterol and stigmasterol, 15¹-hydroxy-phaeophytin A, 5,7-dihydroxyflavanone, ethyl 3,4,5-trihydroxybenzoate and p-coumaric acid. The antioxidant activity of the hexane, chloroform and ethyl acetate extracts of M. paraibana were measured using the 1,1-diphenyl-2-picryl-hydrazyl (DPPH) free radical scavenging assay and the results compared with standard ascorbic acid. The toxicity activity of the extracts were performed using the bioassay of Artemia salina.

17.
Rev. bras. farmacogn ; 18(2): 245-248, abr.- jun. 2008. tab
Artículo en Portugués | LILACS | ID: lil-488663

RESUMEN

O óleo essencial das folhasde Rollinia leptopetala foi obtido por hidrodestilação em aparelho de Clevenger e a sua composição química foi analisada através de CG-EM. Com essa técnica, foi possível identificar 22 constituintes em uma mistura complexa demonoterpenos (54,5 por cento) e sesquiterpenos (45,5 por cento). O principal componente encontradonas folhas foi o biciclogermacreno (22,47 por cento). O óleo essencial foi avaliado numa linhagem de Staphylococcus aureus portadora de bomba de efluxo responsável pela resistência norfloxacino. Embora o óleo essencial não tenha apresentado atividade antibacteriana relevante in vitro, ele apresentou atividade moduladora da resistência, ou seja, em combinação com o norfloxacino observou-se uma redução de 4x na concentração inibitória mínima do antibiótico, indicando inibição de bomba de efluxo.


The essential oil from the leaves of Rollinia leptopetala was obtained by hydrodistillation in Clevenger's apparatus and its chemical composition was analyzed by GC-MS. With this technique could be identified 22 constituents in a complex mixture of monoterpenes (54.5 percent) and sesquiterpenes (45.5 percent). The main component found in the leaves was the bicyclogermacrene (22.47 percent). The essential oil was assayed against a strain of Staphylococcus aureus possessing efflux mechanism of resistance to norfloxacin. Although the essential oil did not display relevant antibacterial activity in vitro, it modulated the activity of the norfloxacin, i.e. in combination with the antibiotic it was observed a fourfold reduction in the minimum inhibitory concentration for norfloxacin, indicating inhibition of efflux pump.

18.
Cad Saude Publica ; 19(1): 127-33, 2003.
Artículo en Inglés | MEDLINE | ID: mdl-12700791

RESUMEN

The incidence of AIDS and other sexually transmitted diseases (STDs) is increasing among adolescents. In order to better understand high-risk sexual behavior among students, a cross-sectional study based on a self-answered anonymous questionnaire was conducted in 10 public and private high schools in Rio de Janeiro, Brazil. Data were obtained on sociodemographics, knowledge of STD/AIDS, and sexual behavior. Among 945 students aged 13-21, 59% were sexually initiated, and the median age at first sexual intercourse was 15 years (range: 7-19). Although 94% reported being aware of the need for condom use for protection, only 34% informed always using condoms during sex. Low family income was associated with unsatisfactory knowledge (OR = 9.40; 95% CI = 6.05-14.60) and inconsistent condom use (OR = 11.60; 95% CI = 5.54-24.30). However, unsatisfactory knowledge was not associated with inconsistent condom use. School-based educational programs should focus on sexual behavior more than on transmission of knowledge, as well as targeting low-income students.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Conducta Sexual , Enfermedades de Transmisión Sexual/prevención & control , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Síndrome de Inmunodeficiencia Adquirida/transmisión , Adolescente , Conducta del Adolescente , Adulto , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Asunción de Riesgos , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/transmisión , Factores Socioeconómicos
19.
Cad. saúde pública ; Cad. Saúde Pública (Online);19(1): 127-133, jan.-fev. 2003. tab
Artículo en Inglés | LILACS | ID: lil-331196

RESUMEN

The incidence of AIDS and other sexually transmitted diseases (STDs) is increasing among adolescents. In order to better understand high-risk sexual behavior among students, a cross-sectional study based on a self-answered anonymous questionnaire was conducted in 10 public and private high schools in Rio de Janeiro, Brazil. Data were obtained on sociodemographics, knowledge of STD/AIDS, and sexual behavior. Among 945 students aged 13-21, 59 percent were sexually initiated, and the median age at first sexual intercourse was 15 years (range: 7-19). Although 94 percent reported being aware of the need for condom use for protection, only 34 percent informed always using condoms during sex. Low family income was associated with unsatisfactory knowledge (OR = 9.40; 95 percent CI = 6.05-14.60) and inconsistent condom use (OR = 11.60; 95 percent CI = 5.54-24.30). However, unsatisfactory knowledge was not associated with inconsistent condom use. School-based educational programs should focus on sexual behavior more than on transmission of knowledge, as well as targeting low-income students


Asunto(s)
Adolescente , Síndrome de Inmunodeficiencia Adquirida , Conducta del Adolescente , Conducta Sexual , Estudiantes , Estudios Transversales
20.
Chemotherapy ; 48(3): 144-7, 2002 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-12138331

RESUMEN

BACKGROUND: Natural products are a relevant source of antiviral drugs. Five medicinal plants used in Argentina have been assayed to detect inhibition of viral growth. METHODS: Antiviral activity of the infusions and methanolic extracts of Aristolochia macroura, Celtis spinosa, Plantago major, Schinus areira, Petiveria alliacea and four extracts obtained from the leaves and stems of the last plant were evaluated by the plaque assay. RESULTS: P. alliacea, unlike A. macroura, C. spinosa, P. major and S. areira, inhibited bovine viral diarrhea virus (BVDV) replication. Neither P. alliacea nor the assays of the other plants were active against herpes simplex virus type 1, poliovirus type 1, adenovirus serotype 7 and vesicular stomatitis virus type 1. Four extracts of P. alliacea were assayed to detect anti-BVDV activity. Ethyl acetate (EC(50) of 25 microg/ml) and dichloromethane (EC(50) of 43 microg/ml) extracts were active; moreover, promising SI (IC(50)/EC(50)) values were obtained. CONCLUSION: BVDV is highly prevalent in the cattle population, there are no antiviral compounds available; additionally, it is a viral model of the hepatitis C virus. For these reasons and in view of the results obtained, the isolation and characterization of the antiviral components present in the P. alliacea extracts is worth carrying out in the future.


Asunto(s)
Diarrea Mucosa Bovina Viral/tratamiento farmacológico , Virus de la Diarrea Viral Bovina/efectos de los fármacos , Phytolaccaceae/química , Extractos Vegetales/farmacología , Animales , Argentina , Bovinos , Virus de la Diarrea Viral Bovina/patogenicidad , Plantas Medicinales/química
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