Factors associated with mortality of patients with COVID-19 on invasive mechanical ventilation: A retrospective cohort study in a university hospital in Northeastern Brazil.

The aim of this study is to identify the factors associated with mortality in patients with COVID-19 undergoing invasive mechanical ventilation at a university hospital in Northeastern Brazil. This is a retrospective cohort from April to August 2020 through an analysis of medical records, considering the demographic profile, comorbidities, complications, supports, respiratory and laboratory parameters. A total of 65 patients required invasive mechanical ventilation, of which 64.6% died in the ICU. They were older, had more comorbidities, shorter length of stay in the intensive care unit, received more support such as palliative care and two vasopressors simultaneously, showed lower levels of pH, hemoglobin and calcium, and higher levels of bicarbonate, lactate, prothrombin time, international normalized ratio, troponin and ferritin at the start of invasive mechanical ventilation. Furthermore, the time course of pH, arterial oxygen partial pressure to fractional inspired oxygen ratio, arterial carbon dioxide partial pressure, lactate, hemoglobin, platelets, lymphocytes, neutrophil-to-lymphocyte ratio, coagulation parameters, calcium, urea, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, ferritin, static compliance, airway resistance, tidal volume, and noradrenaline doses showed association with mortality. There was a high mortality rate in invasively mechanically ventilated COVID-19 patients, with some associated factors identified at the start of invasive mechanical ventilation and others identified over time.

Distribution in marine fish and EDI estimation of contaminants of emerging concern by vortex-assisted matrix solid-phase dispersion and HPLC-MS/MS.

Due to their persistence or continuous discharge, toxic substances are present in the aquatic environment, and can bioaccumulate and biomagnify in the food web, generating a significant ecological risk and a threat to human health. The present study assess the occurrence and tissue (muscle, liver, stomach and gills) distribution of 59 anthropogenic contaminants of emerging concern (CECs) in marine fish from Brazil. A simpler and faster analytical methodology based on vortex-assisted matrix solid-phase dispersion (VA-MSPD) and liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) was developed and validated. Limits of quantification ranged from 3.31 to 114 ng g-1 dw with recovery rates between 60 and 140 % and relative standard deviation below 20 %. The ultraviolet filters 4-hydroxybenzophenone (4HB) (benzophenone-3 metabolite) and benzocaine (Et-PABA), and the antibacterial salicylic acid were frequently accumulated in muscle and liver at concentrations between 39.5 and 21.0 ngg-1 dw. The determined concentrations resulted to be lower than the tolerable daily intake recommended by the European Food Safety Authority (EFSA).

Análise dos desfechos maternos e fetais relacionados à COVID-19 durante a gestação / Analysis of maternal and fetal outcomes related to COVID-19 during pregnancy

O SARS-CoV-2 é um vírus RNA transmitido pelo contato direto ou indireto por gotículas infectadas. No que se refere à COVID-19 e à gestação, referências apontam que nesse período as mulheres possuem maior susceptibilidade a complicações obstétricas e perinatais. O presente estudo objetiva compreender e compilar aspectos da infecção e os principais desfechos negativos maternos e fetais documentados na literatura atual, relacionados à infecção pelo novo coronavírus durante a gestação. Trata-se de uma revisão integrativa de literatura embasada pela análise de 2.441 artigos no total, dos quais 62 foram incluídos na pesquisa, sendo 38 deles da base de dados PubMed e 24 da BVS (Biblioteca Virtual em Saúde), nos idiomas inglês e português. Em conclusão, mulheres grávidas com diagnóstico da patologia podem precisar de assistência de alta complexidade. A associação à doença pode apresentar riscos ou complicações como coagulopatias, pré-eclâmpsia, prematuridade e outros desfechos negativos que serão abordados neste artigo.(AU)

SARS-CoV-2 is an RNA virus, transmitted by direct or indirect contact by infected droplets. Regarding to COVID-19 and pregnancy, references indicate that during this period, women are more susceptible to obstetric and perinatal complications. This study aims to understand and compile aspects of infection and the main negative maternal and fetal outcomes documented in the current literature, related to the infection by the new coronavirus during pregnancy. This is an integrative literature review based on the analysis of 2,441 articles in total, of which 62 were included in the survey, 38 from the PubMed database and 24 from BVS (Biblioteca Virtual em Saúde) in English and Portuguese languages. In conclusion, pregnant women diagnosed with the pathology may need highly complex assistance. The association with the disease may present risks for complications such as coagulopathies, pre-eclampsia, prematurity and other negative outcomes that will be addressed in this article.(AU)

Impact of Intravenous Methadone Administered Intraoperatively on Postoperative Opioid Utilization.

BACKGROUND: Studies have shown that intravenous methadone intraoperatively can reduce opioid usage postoperatively. OBJECTIVE: This study's purpose was to evaluate the effect of intravenous methadone on postoperative opioid use. METHODS: A prospective, single-center observational study was conducted to evaluate patients who received intravenous methadone intraoperatively. A control group was identified by matching procedure, gender, and age in a 1:3 ratio of methadone to control. Exclusion criteria included patients less than 18 years old or on methadone maintenance therapy. The primary outcome was morphine milligram equivalents (MME) administered 24h postoperatively. Secondary outcomes included MME administered 48h and 72h postoperatively, discharge prescription MME, daily mean postoperative pain scores, and length of hospital stay. A subgroup analysis was performed comparing opioid-naïve patients. RESULTS: A total of 240 patients were included in the analysis. At 24h, postoperative MME was increased in the methadone group (142.6 vs 84.5; P = 0.0026). Postoperative MME was also increased in the methadone group at 48h and 72h. Daily pain scores were similar between both groups at all time intervals. Discharge prescription MME was reduced in the methadone group compared with controls, but not statistically significant. A subgroup analysis of opioid-naïve patients showed a significant reduction in MME at 48h (P = 0.0240) and daily pain scores at 24h (P = 0.0366) in the methadone group. CONCLUSION AND RELEVANCE: Intravenous methadone intraoperatively did not show a significant reduction in postoperative opioid use and discharge prescription MMEs when comparing all patients; however, benefit was seen when examining opioid-naïve patients.

Gestational risk as a determining factor for cesarean section according to the robson classification groups / Risco gestacional como fator determinante para cesariana de acordo com os grupos da Classificação Robson

Abstract Objective To analyze and compare the frequency of cesarean sections and vaginal deliveries through the Robson Classification in pregnant women attended at a tertiary hospital in two different periods. Methods Cross-sectional, retrospective study of birth records, comprising 4,010 women, conducted from January 2014 to December 2015 in the only public regional referral hospital for the care of high- risk pregnancies, located in Southern Brazil. Results The overall cesarean section rate reached 57.5% and the main indication was the existence of a previous uterine cesarean scar. Based on the Robson Classification, groups 5 (26.3%) and 10 (17.4%) were the most frequent ones. In 2015, there was a significant increase in the frequency of groups 1 and 3 (p < 0.001), when compared with the previous year, resulting in an increase in the number of vaginal deliveries (p < 0.0001) and a reduction in cesarean section rates. Conclusion The Robson Classification proved to be a useful tool to identify the profile of parturients and the groups with the highest risk of cesarean sections in different periods in the same service. Thus, it allowsmonitoring in a dynamic way the indications and delivery routes and developing actions to reduce cesarean rates according to the characteristics of the pregnant women attended.

Resumo Objetivo Analisar e comparar a frequência de partos cesáreos e vaginais através da classificação de Robson em gestantes atendidas em um hospital terciário em dois períodos distintos. Métodos Estudo transversal retrospectivo de registros de nascimento, compreendendo 4.010 mulheres, realizado de janeiro de 2014 a dezembro de 2015 no único hospital público de referência regional para atendimento de gestações de alto risco, localizado no sul do Brasil. A via de parto foi avaliada e as mulheres foram classificadas de acordo com a Classificação de Robson. Resultados A taxa geral de cesariana foi de 57,5% e a principal indicação foi a existência de cicatriz uterina por cesariana prévia. Quando aplicada a Classificação de Robson, os grupos mais frequentes foram o 5 (26,3%) e o 10 (17,4%). No ano de 2015, ocorreu um aumento significativo da frequência dos grupos 1 e 3 (p < 0,001), quando comparado ao ano anterior, resultando em aumento do número de partos vaginais (p < 0,0001) e redução das taxas de cesariana. Conclusão A Classificação de Robson mostra ser uma ferramenta útil para identificar o perfil das parturientes e os grupos com maior risco de cesariana em diferentes períodos em um mesmo serviço. Desta forma, permitemonitorar de forma dinâmica as indicações e vias de parto e desenvolver ações para redução das taxas de cesariana conforme as características das gestantes atendidas.

Gestational Risk as a Determining Factor for Cesarean Section according to the Robson Classification Groups.

OBJECTIVE: To analyze and compare the frequency of cesarean sections and vaginal deliveries through the Robson Classification in pregnant women attended at a tertiary hospital in two different periods. METHODS: Cross-sectional, retrospective study of birth records, comprising 4,010 women, conducted from January 2014 to December 2015 in the only public regional referral hospital for the care of high- risk pregnancies, located in Southern Brazil. RESULTS: The overall cesarean section rate reached 57.5% and the main indication was the existence of a previous uterine cesarean scar. Based on the Robson Classification, groups 5 (26.3%) and 10 (17.4%) were the most frequent ones. In 2015, there was a significant increase in the frequency of groups 1 and 3 (p < 0.001), when compared with the previous year, resulting in an increase in the number of vaginal deliveries (p < 0.0001) and a reduction in cesarean section rates. CONCLUSION: The Robson Classification proved to be a useful tool to identify the profile of parturients and the groups with the highest risk of cesarean sections in different periods in the same service. Thus, it allows monitoring in a dynamic way the indications and delivery routes and developing actions to reduce cesarean rates according to the characteristics of the pregnant women attended.

OBJETIVO: Analisar e comparar a frequência de partos cesáreos e vaginais através da classificação de Robson em gestantes atendidas em um hospital terciário em dois períodos distintos. MéTODOS: Estudo transversal retrospectivo de registros de nascimento, compreendendo 4.010 mulheres, realizado de janeiro de 2014 a dezembro de 2015 no único hospital público de referência regional para atendimento de gestações de alto risco, localizado no sul do Brasil. A via de parto foi avaliada e as mulheres foram classificadas de acordo com a Classificação de Robson. RESULTADOS: A taxa geral de cesariana foi de 57,5% e a principal indicação foi a existência de cicatriz uterina por cesariana prévia. Quando aplicada a Classificação de Robson, os grupos mais frequentes foram o 5 (26,3%) e o 10 (17,4%). No ano de 2015, ocorreu um aumento significativo da frequência dos grupos 1 e 3 (p < 0,001), quando comparado ao ano anterior, resultando em aumento do número de partos vaginais (p < 0,0001) e redução das taxas de cesariana. CONCLUSãO: A Classificação de Robson mostra ser uma ferramenta útil para identificar o perfil das parturientes e os grupos com maior risco de cesariana em diferentes períodos em um mesmo serviço. Desta forma, permite monitorar de forma dinâmica as indicações e vias de parto e desenvolver ações para redução das taxas de cesariana conforme as características das gestantes atendidas.

Comparison of Oropharyngeal Dysphagia in Brazilian Children with Prenatal Exposure to Zika Virus, With and Without Microcephaly.

Severe brain damage associated with Zika-related microcephaly (ZRM) have been reported to result in oropharyngeal dysphagia (OPD); however, it is unknown if OPD presents in children with prenatal Zika virus (ZIKV) exposure but only mild or undetectable abnormalities. The aims of this study were: to compare the frequency and characteristics of OPD in children with ZRM and in children without microcephaly born to mothers who tested polymerase chain reaction positive (PCR+) for ZIKV during pregnancy; and to investigate the concordance of caregiver reports of OPD with the diagnosis from the clinical swallowing assessment (CSA). Between Mar/2017 and May/2018, we evaluated 116 children (n = 58 with microcephaly, n = 58 children without microcephaly born to ZIKV PCR + mothers) participating in the Microcephaly Epidemic Research Group (MERG) cohort of children born during the 2015-2016 ZIKV epidemic in Pernambuco, Brazil. To assess OPD we used: a CSA; a clinical assessment of the stomatognathic system; and a questionnaire administered to caregivers. The frequency of OPD was markedly higher in children with ZRM (79.3%) than in the exposed but normocephalic group (8.6%). The children with microcephaly also presented more frequently with anatomic and functional abnormalities in the stomatognathic system. There was a high degree of agreement between the caregiver reports of OPD and the CSA (κ = 0.92). In conclusion, our findings confirm that OPD is a feature of Congenital Zika Syndrome that primarily occurs in children with microcephaly and provide support for policies in which children are referred for rehabilitation with an OPD diagnosis based on caregiver report.

Rapid and cost-effective multiresidue analysis of pharmaceuticals, personal care products, and antifouling booster biocides in marine sediments using matrix solid phase dispersion.

Currently, there are many contaminants of concern that need to be accurately determined to help assess their potential environmental hazard. Despite their increasing interest, yet few environmental occurrence data exist, likely because they are present at low levels and in very complex matrices. Therefore, multiresidue analytical methods for their determination need to be highly sensitive, selective, and robust. Particularly, due to the trace levels of these chemicals in the environment, an extensive extraction procedure is required before determination. This work details the development of a fast and cheap vortex-assisted matrix solid-phase dispersion-high performance liquid chromatography tandem-mass spectrometry (VA-MSPD-HPLC-MS/MS) method for multiresidue determination of 59 contaminants of emerging concern (CECs) including pharmaceuticals, personal care products, and booster biocides, in sediment. The validated method provided high sensitivity (0.42-36.8 ngg-1 dw quantification limits), wide and good linearity (r2 > 0.999), satisfactory accuracy (60-140%), and precision below 20% for most target analytes. In comparison with previous methods, relying on traditional techniques, the proposed method demonstrated to be more environmentally friendly, cheaper, simpler, and faster. The method was applied to monitor the occurrence of these compounds in sediments collected in Brazil, using only 2 g dw sediment samples, free-solid support, and 5 mL methanol as extraction solvent. The UV filter avobenzone, the UV stabilizer and antifreeze methylbenzotriazole, the preservative methylparaben, the fluoroquinolone antibiotic ciprofloxacin, and the biocides irgarol and 4,5-dichloro-2-octyl-4-isothiazolin-3-one were determined at concentrations in the range 1.44-69.7 ngg-1 dw.

Thin-layer convective drying behaviour of brazilian peppertree leaves / Secagem em camada delgada de folhas de aroeira

Studies on the drying kinetics of medicinal, aromatic and spice plants are a necessary step towards establishing the combination of drying parameters that would not qualitatively and quantitatively alter the quality of the fresh product. The purpose of this study was to investigate the drying kinetics of Brazilian peppertree (Schinus terebinthifolius) leaves and to verify whether the theoretical diffusion and the semi-empirical Lewis drying models were capable of accurately predicting the drying curves of the product at 35, 40, and 45°C, with a dry air mass flow rate of 0.731 kg s-1 m-2. Leaves were collected at 0800 h, 1200 h and 1700 h. The goodness of fit between experimental and predicted values was based on the correlation coefficient, root mean square error, mean absolute percentage error, mean bias error, and fit index. Residual plot analysis was also considered in the selection of the most effective drying model. Temperature had a pronounced effect on mass transfer and drying rate decreased continuously during the course of drying. Leaf collection time had little influence on the drying kinetics. Effective moisture diffusivity was found to increase with temperature. The results indicated that the Lewis model was considered a better predictor of the thin-layer drying behaviour of Brazilian peppertree leaves than the theoretical model based on Fick's second law of diffusion.

Estudos sobre a cinética da secagem de plantas medicinais, aromáticas e condimentares são necessários para o estabelecimento de parâmetros operacionais de secagem de forma a não alterar significativamente a qualidade e o perfil fitoquímico dessas plantas. O objetivo do presente trabalho foi investigar a cinética da secagem das folhas da aroeira-vermelha (Schinus terebinthifolius), além de verificar se o modelo teórico de difusão e o modelo semi-empírico de Lewis são capazes de predizer com acurácia as curvas de secagem do produto a 35, 40 e 45°C, com fluxo de ar seco de 0,731 kg s-1 m-2. As folhas foram coletadas às 8:00, 12:00 e 17:00 h. O grau de adequação dos valores obtidos pelas curvas de secagem àqueles obtidos experimentalmente foi avaliado empregando-se o coeficiente de determinação, a raiz do erro quadrático médio, o erro percentual absoluto médio, o viés médio e o índice de ajuste. A análise da dispersão dos resíduos também foi utilizada na escolha do modelo de predição mais efetivo. Observou-se que a temperatura tem efeito significativo na transferência de massa e a taxa de secagem diminuiu continuamente ao longo da secagem. O horário de coleta das folhas não teve influência significativa sobre a cinética da secagem. A difusividade efetiva da água aumentou com o aumento da temperatura. Os resultados evidenciaram que o modelo de Lewis descreve com maior grau de acurácia a secagem de folhas de aroeira-vermelha que o modelo teórico baseado na Segunda Lei de Difusão de Fick.

Longitudinal Study of Delta-Aminolevulinate Dehydratase Activity and Oxidative Profile in Healthy Pregnant Women.

Pregnancy is characterized by changes in various organs, triggering changes in the use of energy substrates and increased oxygen consumption. In addition, gestation is an oxidative event that can be assessed by the relationship between free radicals and antioxidants produced by the body. Excessive production of free radicals has detrimental effects such as damage to enzymes, carbohydrates, and DNA. Thus, the objective of this study was to evaluate the oxidative status and antioxidant responses throughout pregnancy through a longitudinal study. Reactive oxygen species were analyzed by means of thiobarbituric acid reactive substances and nitric oxide, the antioxidant system through vitamin C, sulfhydryl groups, total antioxidant capacity, and ferric reducing ability of plasma as well as enzymes such as catalase and delta-aminolevulinate-dehydratase in pregnant women in the three gestational trimesters (n = 30). According to the results, the markers of oxidative damage showed significant differences in the different gestational trimesters where they were increased in the second trimester when compared to the first trimester. The antioxidant defenses responded differently in each gestational trimester, suggesting a response pattern to try to combat the damage caused by free radicals, in order to stabilize the increase of oxidative stress caused in the second gestational trimester.

Obese rats are more vulnerable to inflammation, genotoxicity and oxidative stress induced by coal dust inhalation than non-obese rats.

Obesity is an important nutritional disorder worldwide. Its association with environmental pollution may trigger an increase in oxidative stress and inflammatory parameters. Coal is a resource used throughout the world as an important fuel source for generating electricity. The ashes released by the coal combustion cause serious problems for human health due to their high toxicity and their capacity to bioaccumulate. The aim of this work was to investigate the effects of coal dust inhalation in the organs of obese and non-obese Wistar rats. Pro-inflammatory cytokines, oxidative stress, oxidative damage, histological analysis, comet assay, and micronuclei were investigated. Both obesity and coal dust inhalation increased the pro-inflammatory cytokines IL-1ß and TNF-α and decreased HSP70 levels in serum, however, in obese animals that inhaled coal dust these changes were more pronounced. Liver histological analysis showed severe microvesicular steatosis in obese animals that inhaled coal dust. Lung histologic investigation showed abnormalities in lung structure of animals exposed to coal dust and showed severe lung distensibility in obese animals exposed to coal dust. The comet assay showed DNA damage in animals subjected to coal. In addition, there were modulations in enzymatic activities and damage to protein and lipids. Based on our results, the coal dust inhalation can potentiate the pro-inflammatory profile present in obese rats. We also observed an increase in the protein oxidative damage in obese rats that inhaled coal dust. Taken together, our results suggest that the combination of obesity and coal inhalation increased the risks of the development of diseases related to oxidative stress and inflammation.

Sample as solid support in MSPD: A new possibility for determination of pharmaceuticals, personal care and degradation products in sewage sludge.

A method based on matrix-solid phase dispersion (MSPD), focused on the principles of green analytical chemistry, aimed at the use of alternative solid supports and less toxic solvents, was developed for the simultaneous determination of 19 pharmaceuticals, 4 personal care products (PPCPs) and 4 degradation products in sewage sludge samples. Higher recoveries were achieved when 2 g sample was macerated for 5 min in a glass mortar, transferred to a centrifuge tube, and 1 min vortex agitation with 5 mL methanol. The performance of the method was evaluated through linearity, recovery, precision (intra-day), method detection and quantification limits (MDL and MQL) and matrix effect. The calibration curves prepared in methanol and in the matrix extract showed a correlation coefficient ranging from 0.98 to 0.99. MQL values ranged from 1.25 to 1250 ng g-1. Recoveries between 50 and 120% were reached with RSDs lower than 20% for most compounds. The method presented low and medium matrix effects for most analytes. This method was successfully applied to real samples and of the 27 compounds determined, amitriptyline, carbamazepine, diclofenac, haloperidol, ketoconazole, miconazole, albendazole, mebendazole, thiabendazole, triclosan and triclocarban were detected in concentrations between 2.5 and 5400 ng g-1.

Atividade antimicrobiana in vitro dos extratos aquosos, hidroalcoólicos e alcoólicos das folhas de espécies da família Myrtaceae frente à cepas de bactérias de interesse / Antimicrobial activity in vitro of aqueous extracts, hydroalcoholic and spirits of Myrtaceae family species leaves front of the strains of interest of bacteria

Introdução: a Organização Mundial da Saúde (OMS) tem incentivado o estudo de plantas tradicionalmente conhecidas como medicinais, tendo como objetivo avaliar cientificamente os benefícios da utilização de medicamentos fitoterápicos e de conhecer, ao mesmo tempo, a segurança de seu uso indevido. Objetivos: este trabalho teve como objetivo avaliar a atividade antimicrobiana do extrato aquoso, hidroalcoólico e alcoólico de folhas de espécies da família Myrtaceae frente às cepas de bactérias de interesse. Metodologia: a análise da atividade antibacteriana dos extratos das folhas das plantas, jambo, azeitona preta, pitanga e goiaba foram verificados a partir do teste de difusão em Ágar Mueller-Hinton. As cepas utilizadas, após reativação, foram diluídas em solução salina estéril a 0,85%. Sendo consideradas com potencial antimicrobiano aqueles extratos que geraram halos ≥ 7 mm (sete milímetros). Resultados: os resultados encontrados na análise dos dados do extrato aquoso demonstraram que Eugenia uniflora, Syzygium cumini e Psidium guajava apresentaram atividade antimicrobiana sobre Staphylococcus aureus, na concentração de 100 mg/mL. Na análise dos dados dos extratos hidroalcoólico, Syzygium cumini demonstrou atividade antimicrobiana na concentração de 100 mg/mL sobre Pseudomonas aeruginosa, diante de Staphylococcus aureus, Eugenia uniflora, Syzygium malaccense, Syzygium cumini e Psidium guajava demonstraram atividade na concentração de 100 mg/mL cada. Observando os resultados dos extratos alcoólicos, Psidium guajava e Syzygium cumini demonstraram atividade antimicrobiana diante das quatro cepas estudadas. Conclusão: o presente estudo demonstrou que os extratos alcoólicos das espécies em estudo apresentaram melhor atividade antimicrobiana e maior espectro de ação quando comparado ao extrato aquoso e hidroalcoólico.

Introduction: this study aimed to evaluate the antimicrobial activity of aqueous extract, hydro-alcoholic and alcoholic leaf front Myrtaceae family species to strains of bacteria of interest. Objective: this study aimed to evaluate the antimicrobial activity of aqueous extract, hydro alcoholic and alcoholic leaves Myrtaceae front family species to strains of bacteria of interest. Methodology: the antibacterial activity of plant leaves extracts, rose apple, black olive, cherry and guava were verified from the diffusion test on Mueller-Hinton agar. Where the strains used after reactivation were diluted in 0.85% sterile saline. Being considered with antimicrobial potential that statement that generated halos ≥ 7 mm (seven millimeters). Results: the results of the analysis of the aqueous extract data demonstrated that Eugenia uniflora, Syzygium cumini and Psidium guajava showed antimicrobial activity against Staphylococcus aureus at a concentration of 100 mg/mL. In the data analysis of hydro-alcoholic extracts, Syzygium cumini demonstrated antimicrobial activity at a concentration of 100 mg/mL of Pseudomonas aeruginosa, before Staphylococcus aureus, Eugenia uniflora, Syzygium malaccense, Syzygium cumini and Psidium guajava showed activity at a concentration of 100 mg/mL each. Noting the results of alcoholic extracts, Psidium guajava and Syzygium cumini demonstrated antimicrobial activity against the four strains studied. Conclusion: the present study demonstrated that the alcoholic extracts of the species under study presented better antimicrobial activity and a greater spectrum of action when compared to the aqueous and hydroalcoholic extract.

Evaluation of alternative environmentally friendly matrix solid phase dispersion solid supports for the simultaneous extraction of 15 pesticides of different chemical classes from drinking water treatment sludge.

This study describes the development, optimization and validation of a method for the extraction of 15 pesticides of different chemical classes in drinking water treatment sludge (DWTS) by vortex-assisted Matrix Solid Phase Dispersion (MSPD) with determination by gas chromatography coupled to mass spectrometry. It focused on the application of alternative and different solid supports to the extraction step of the MSPD. The main parameters that influenced the extraction were studied in order to obtain better recovery responses. Recoveries ranged from 70 to 120% with RSD below 20% for all analytes. Limits of quantification (LOQ) of the method ranged from 5 to 500 µg kg-1 whereas the analytical curves showed correlation coefficients above 0.997. The method under investigation used low volume of solvent (5 mL), low sample mass (1.5 g) and low mass of chitin (0.5 g), an environmentally friendly support. It has advantages, such as speed, simplicity and low cost material, over other methods. When the method was applied, 4 out of 15 pesticides were detected in the DWTS samples in concentrations below the LOQ.

Study of vortex-assisted MSPD and LC-MS/MS using alternative solid supports for pharmaceutical extraction from marketed fish.

A procedure based on vortex-assisted matrix solid-phase dispersion (MSPD) for the extraction of 15 pharmaceuticals from fish samples with determination by liquid chromatography-tandem mass spectrometry (LC-MS/MS) was validated. Florisil, C18, diatomaceous earth, chitin, and chitosan were evaluated as solid supports. Best results were obtained with 0.5 g of diatomaceous earth, 0.5 g of sodium sulfate, and 5 mL of methanol. Analytical recoveries ranged from 58 to 128 % with relative standard deviation (RSD) lower than 15 %. Limit of quantification (LOQ) values for the 15 compounds ranged from 5 to 1000 ng g(-1). The method under investigation has shown to be a simple and fast extraction tool with minimum instrumentation and low amount of reagent, resulting in method low cost. Besides, alternative materials, such as chitin and chitosan, which were applied to the dispersion step for the first time, were found to be interesting alternatives.

Clinical, cytogenetic, and molecular characterization of six patients with ring chromosomes 22, including one with concomitant 22q11.2 deletion.

We report here on six patients with a ring chromosome 22 and the range of cytogenetic and phenotypic features presented by them. Genomic analysis was carried out using classical and molecular cytogenetics, MLPA (Multiplex Ligation-dependent Probe Amplification) and genome-wide SNP-array analysis. The ring was found in all patients, but Patient 6 displayed constitutional mosaicism with a normal cell line. Five patients had deletions in the ring chromosome 22, and in four of them the breakpoints--unique for each patient--could be identified by genome-wide SNP-array analysis. One patient presented with a 22q11.2 deletion concomitant with the deletion caused by the ring formation. Common phenotypic features included autism, speech delay and seizures, as previously reported for individuals with r(22) and/or 22q13.3 deletions. Investigation of the genes within the deletions revealed multiple genes related to development of the central nervous system, psychomotor delay, severe language impairment, hypotonia, and autistic symptoms. There was no clear correlation between the severity of clinical features and the size of the deleted segment. This study underscores the variability in ring structure and clinical presentation of the r(22) and adds information to the limited literature on this rare disorder.

Manejo dos sintomas climatéricos em pacientes com câncer de mama / Management of menopausal symptoms in patients with breast cancer

O câncer de mama é a neoplasia maligna mais frequente nas mulheres, inclusive na pós-menopausa. O tratamento hormonal e quimioterápico dessa doença pode induzir o aparecimento de sintomas vasomotores, atrofia urogenital, alteração da função sexual e instalação da menopausa precocemente, os quais merecem avaliação e controle. O tratamento dos sintomas climatéricos em pacientes sobreviventes do câncer de mama tem grande relevância clínica, pois, em razão do aumento da incidência e dos avanços na abordagem terapêutica, o número de mulheres que sobrevivem ao câncer de mama e experimentam sintomas climatéricos tem aumentado. Objetivou-se identificar na literatura evidências recentes acerca das opções terapêuticas na redução dos sintomas climatéricos. Dessa forma, foi realizada uma revisão na literatura por meio de consulta nas principais bases de dados, priorizando artigos mais recentes e com maior nível de evidência. Os estudos randomizados controlados sobre o uso de fitoterápicos, acupuntura e ioga no tratamento de fogachos em pacientes com câncer de mama são limitados, tanto nas opções de tratamento e tempo de seguimento quanto na comprovação científica de sua eficácia. Abordando os tratamentos farmacológicos, vários inibidores da recaptação de serotonina (paroxetina, fluoxetina e citalopram) e inibidores da recaptação de serotonina e adrenalina (venlafaxina e desvenlafaxina) têm sido mais eficazes que o placebo na redução dos sintomas vasomotores em estudos a curto prazo em mulheres com câncer de mama. A avaliação dos sintomas e seu impacto na qualidade de vida, além do desejo da paciente, são determinantes na escolha do tratamento. Independentemente do tipo de tratamento indicado, as modificações de estilo de vida devem ser recomendadas.(AU)

Breast cancer is the most commonly diagnosed malignancy in women, including after menopause. The hormonal and chemotherapeutic treatment of this disease can induce the appearance of vasomotor symptoms, urogenital atrophy, abnormal sexual function and installation of early menopause that require evaluation and control. The treatment of climacteric symptoms in breast cancer survivors is of great clinical relevance, once the number of women experiencing menopausal symptoms has increased because of the high incidence of breast cancer and advances in therapeutic approach. The purpose is to identify recent evidence in the literature on the therapeutic options in reducing these menopausal symptoms. Thus, a literature review through consultation was held in the main databases, prioritizing newer and higher level of evidence items. Randomized controlled trials on the use of herbals, acupuncture and yoga in the treatment of hot flashes in patients with breast cancer are limited, such as treatment options, follow-up time and the scientific evidence of its effectiveness. Addressing the pharmacological treatments, several serotonin reuptake inhibitors (paroxetine, fluoxetine and citalopram) and reuptake inhibitors of serotonin and adrenaline (venlafaxine and desvenlafaxine) have been more effective than placebo in reducing vasomotor symptoms in short-term studies in women with breast cancer. The evaluation of symptoms and their impact on quality of life, beyond the desire of the patient, are determinant in the choice of treatment. Regardless of the type of treatment indicated, changes in lifestyle should be recommended.(AU)

Synthesis and antimycobacterial activity of isoniazid derivatives from renewable fatty acids.

This work describes the synthesis of a series of fatty acid hydrazide derivatives of isoniazid (INH). The compounds were tested against Mycobacterium tuberculosis H37Rv (ATCC 27294) as well as INH-resistant (ATCC 35822 and 1896 HF) and rifampicin-resistant (ATCC 35338) M. tuberculosis strains. The fatty acid derivatives of INH showed high antimycobacterial potency against the studied strains, which is desirable for a pharmaceutical compound, suggesting that the increased lipophilicity of isoniazid plays an important role in its antimycobacterial activity.

Avaliação endometrial em pacientes usuárias de tamoxifeno / Endometrial assessment in patients taking tamoxifen

O câncer de mama é a neoplasia maligna mais frequente em mulheres tanto no Brasil quanto no mundo. A doença é mais comum acima dos 50 anos, coincidindo com a faixa etária de risco para o câncer de endométrio. O tamoxifeno é um modulador seletivo de receptor de estrogênio (SERMs), usadona terapêutica das mulheres portadoras de câncer de mama. Assim como os outros SERMs (raloxifeno,toremifeno,arzoxifeno e lasoxifeno), o tamoxifeno pode atuar como antagonista ou agonista, dependendo do tecido-alvo.Nestas pacientes, o uso destes agonistas seletivos embora apresente maior benefício do que risco para o tratamento do câncer de mama, pode causar efeitos secundários no endométrio, com aumento do risco para doenças malignas. Consensos atuais, porém, não demonstram benefício de nenhum método de rastreio para câncer endometrial de rotina. O que se recomenda, nas pacientes na pré e pós-menopausa com câncer de mama, é o exame ginecológico com intervalo anual e o prosseguimento com propedêutica, através de biópsia do endométrio nas pacientes pós-menopausa que apresentam sangramento vaginal.(AU)

Breast cancer is the most common malignancy in women both in Brazil and in the world. The disease is more common over 50 years, coinciding with the age of risk for endometrial cancer. Tamoxifen is a selective modulator of estrogen receptor (SERMs) used in the treatment of women with breast cancer. Like other SERMs (raloxifene, toremifene, arzoxifeno and lasoxifeno), tamoxifen may act as antagonist or agonist depending on the target tissue. In these patients, although showing greater benefit of what risk for the treatment of the breast cancer, can cause side effects on the endometrium, with increased risk for malignant diseases. Current consensus, however, do not demonstrate any benefit from routine screening method for endometrial cancer. Women with breast cancer should undergo annual gynecologic examinations for premenopausal and postmenopausal patients and further workup by means of biopsy in patients with postmenopausal vaginal bleeding.(AU)

Profiling the NIH Small Molecule Repository for compounds that generate H2O2 by redox cycling in reducing environments.

We have screened the Library of Pharmacologically Active Compounds (LOPAC) and the National Institutes of Health (NIH) Small Molecule Repository (SMR) libraries in a horseradish peroxidase-phenol red (HRP-PR) H2O2 detection assay to identify redox cycling compounds (RCCs) capable of generating H2O2 in buffers containing dithiothreitol (DTT). Two RCCs were identified in the LOPAC set, the ortho-naphthoquinone beta-lapachone and the para-naphthoquinone NSC 95397. Thirty-seven (0.02%) concentration-dependent RCCs were identified from 195,826 compounds in the NIH SMR library; 3 singleton structures, 9 ortho-quinones, 2 para-quinones, 4 pyrimidotriazinediones, 15 arylsulfonamides, 2 nitrothiophene-2-carboxylates, and 2 tolyl hydrazides. Sixty percent of the ortho-quinones and 80% of the pyrimidotriazinediones in the library were confirmed as RCCs. In contrast, only 3.9% of the para-quinones were confirmed as RCCs. Fifteen of the 251 arylsulfonamides in the library were confirmed as RCCs, and since we screened 17,868 compounds with a sulfonamide functional group we conclude that the redox cycling activity of the arylsulfonamide RCCs is due to peripheral reactive enone, aromatic, or heterocyclic functions. Cross-target queries of the University of Pittsburgh Drug Discovery Institute (UPDDI) and PubChem databases revealed that the RCCs exhibited promiscuous bioactivity profiles and have populated both screening databases with significantly higher numbers of active flags than non-RCCs. RCCs were promiscuously active against protein targets known to be susceptible to oxidation, but were also active in cell growth inhibition assays, and against other targets thought to be insensitive to oxidation. Profiling compound libraries or the hits from screening campaigns in the HRP-PR H(2)O(2) detection assay significantly reduce the timelines and resources required to identify and eliminate promiscuous nuisance RCCs from the candidates for lead optimization.