[Sick fat (adiposopathy) as the main contributor to metabolic syndrome].

Obesity, primarily the accumulation of visceral fat (prone to lipolysis and inflammation) is considered the most important pathogenetic link in insulin resistance, metabolic syndrome and type 2 diabetes mellitus. The purpose of the review was to present and summarize current information on the negative impact of adipose tissue dysfunction and the role of this phenomenon in the pathogenesis of the metabolic syndrome and type 2 diabetes mellitus. Material and methods. A systematic search of Web of Science, EMBASE, MEDLINE, and Google Scholar databases was performed. Results. Adipose tissue secretes a huge variety of biologically active substances - free fatty acids, adipokines, inflammatory mediators. These substances have a negative effect on insulin-sensitive and all other tissues, inducing inextricably linked freeradical oxidation, mitochondrial dysfunction, histotoxic hypoxia, maladaptive autophagy, apoptosis, dysregulation of transcriptome and post-translational processes, overload of non-fat tissues with lipids (lipotoxicity) enhanced by hyperinsulinemia, and many other cytotoxic mechanisms. Target organ damage disrupts the finely tuned network of feedbacks between the brain, liver, gut, microbiome, muscles, adipose tissue, classic glands and the rest of the organs, provided by myokines, hepatokines, bathokines and other substances, among others. Based on some experimental and clinical data, we agree with the notions that the qualitative aspect - adipocyte dysfunction (adiposopathy) - is at least as important as cell mass. Sick fat has a number of differences from healthy tissue, among which there are indicated mitochondrial dysfunction, inflammation, disorders of browning, cell death, and removal of senescent cells (senolysis). The obesity paradox can be explained from the pathophysiological point of view by this distinction (although the main explanation, in our opinion, should be sought in the internal validity of the works revealing this phenomenon). Conclusion. The treatment of obesity and its consequences should be based on «healing¼ rather than «extermination¼ of adipocytes. Implementation of this approach requires homeostatic influence on neuroimmunoendocrine regulation. Of the available tools, metformin, incretin drugs, sodium-glucose transporter inhibitors, and bariatric surgery probably meet this requirement the most.

Biotechnological applications of nanostructured hybrids of polyamine carbon quantum dots and iron oxide nanoparticles.

The combination of different nanomaterials has been investigated during the past few decades and represents an exciting challenge for the unexpected emerging properties of the resulting nano-hybrids. Spermidine (Spd), a biogenic polyamine, has emerged as a useful functional monomer for the development of carbon quantum dots (CQDs). Herein, an electrostatically stabilized ternary hybrid, constituted of iron oxide-DNA (the core) and spermidine carbon quantum dots (CQDSpds, the shell), was self-assembled and fully characterized. The as-obtained nano-hybrid was tested on HeLa cells to evaluate its biocompatibility as well as cellular uptake. Most importantly, besides being endowed by the magnetic features of the core, it displayed drastically enhanced fluorescence properties in comparison with parent CQDSpds and it is efficiently internalized by HeLa cells. This novel ternary nano-hybrid with multifaceted properties, ranging from fluorescence to superparamagnetism, represents an interesting option for cell tracking.

Сapsule endoscopy for diagnosis of celiac disease.

In this review we analyzed the guidelines for diagnosis and management of celiac disease, as well as the recent studies published on this issue. Capsule endoscopy could be used in patients unwilling or unable to undergo conventional endoscopy, in patients who have discordant results between serological and histopathological investigation, in patients with nonresponsive or refractory celiac disease.

Atividade alelopática dos lixiviados de Asemeia extraaxillaris (Polygalaceae) sobre o crescimento de Ipomoea cordifolia / Allelopathic activity of leachates from Asemeia extraaxillaris (Polygalaceae) on the growth of Ipomoea cordifolia

RESUMO O objetivo desse trabalho foi avaliar a atividade alelopática dos lixiviados das raízes e folhas secas de Asemeia extraaxillaris sobre o crescimento de corda de viola Ipomoea cordifolia em casa de vegetação, para avaliação dos efeitos sobre o estresse oxidativo. Nos bioensaios foram utilizadas três concentrações (0,25 - 5,00 e 10,00 g) e um controle, com quatro repetições de 10 plantas, cultivadas em solo durante 30 dias. Os lixiviados possuem ação alelopática e o maior efeito foi verificado para o pó das raizes. O efeito inibitório foi dose-dependente e o aumento do estresse oxidativo foi observado pelos níveis da catalase, peroxidase, superóxido dismutase, glutationa redutase, peroxidação lipídica e síntese de formazan. Concluiu-se que A. extraaxillaris possui substâncias capazes de afetar a emergência, o crescimento e o estresse oxidativo de I. cordifolia.

ABSTRACT The purpose of this article is to assess the allelopathic activity of leachates from the roots and dried leaves of Asemeia extraaxillaris on the germination and growth of corda de viola (Ipomoea cordifolia) in a greenhouse, and evaluate its effect on oxidative stress. For the bioassays, three concentrations (0.25, 5.00, and 10.00 g) and one control were used, with four replications of 10 plants, cultivated in soil for 30 days. The leachates exhibited allelopathic action, and the greatest effect was found in the root powder. The inhibitory effect was dose-dependent and the increase in oxidative stress was observed by the levels of catalase, peroxidase, superoxide dismutase, glutathione reductase, lipid peroxidation, and formazan synthesis. It was affirmed that A. extraaxillaris contains substances capable of affecting seedling emergence, growth, and oxidative stress in I. cordifolia.

The presence of Microlobius foetidus cause changes in the antioxidant defense of Urochloa decumbens?

Urochloa decumbens (Stapf) R. D. Webster (Poaceae) is an exotic species with has spread rapidly through the Cerrado area of Pantanal, Mato Grosso do Sul, Brazil. It has covered the soil aggressively turning it into cultivated pastures. Thus, it has become a challenge to protect native areas due its capacity of exclusion of native species. It has been observed that Microlobius foetidus (Jacq.) M.Sousa & G.Andrade species (Fabaceae) shows a dominant pattern over the development of U. decumbens. This work shows that M. foetidus interfere on the natural growth of U. decumbens within 10 m ratio. Between 15 and 20 m, it was observed an increase of Importance Value index (IVI) and Relative cover (RC) values. It was also observed a variation on the antioxidant defense system of U. decumbens within 10m ratio from M. foetidus. The enzymes superoxide dismutase, catalase and peroxidase present higher levels of activity then those found for glutathione reductase. This data indicates that M. foetidus may have an effect on U. decumbens, increase the activity of antioxidant enzymes. This effect probably happens as means to neutralize the toxic effects of the oxygen generated due to the presence of allelochemicals, which increases oxidative stress.

Avaliação da atividade antioxidante e alelopática do extrato etanólico e frações das cascas do caule de Zanthoxylum rhoifolium Lam., Rutaceae / Assessment of antioxidant and allelopathic activities of ethanolic extract and solvent fractions from stem bark of Zanthoxylum rhoifolium Lam. (Rutaceae)

The purpose of this study was to test for antioxidantand allelopathic activities in stem bark of Zanthoxylum rhoifolium Lam., Rutaceae, with the eventual aim of discovering biologically active substances. The plant material was subjected to ethanolic extraction and this extract was partitioned, yielding hexane, chloroform, ethyl acetate and hydroalcoholic fractions. Antioxidant activity was estimated by the reduction of phosphomolybdenum complex, of DPPH. and of thiobarbituric acid-reactive substances (TBARS). To detect allelopathy, the samples were tested, at four concentrations, on the germination and development of the radicle and hypocotyl of L. sativa seeds. The samples showed significant antioxidant activity against the reduction of the phosphomolybdenum complex, as compared to rutin, and reduction of TBARS, ascompared to BHT, as well as allelopathic activity, since they stimulated growth and seed germination. The chloroform and ethyl acetate fractions showed the best antioxidant potentials, with 204.17% and 127.11% compared to rutin, in the reduction of phosphomolybdenum complex, as did the crude ethanolic extract and hexane fraction, with 64.2% and 60.9% compared to BHT, in the TBARS method. In the allelopathic assay, the chloroform fraction stood out as the only sample that stimulated the growth of both the radicle and hypocotyl at most concentrations, ranging from 41 to 144%, while the ethyl acetate fraction achieved the greatest stimulus in this bioassay, increasing the growth of the hypocotyl by 274%. This is the first study that demonstrates the antioxidant and allelopathic activities of the species Z. rhoifolium...

Este trabalho teve como objetivo o estudo das atividades antioxidante e alelopática das cascas do caule de Zanthoxylum rhoifolium Lam., Rutaceae, de modo a conduzir à descoberta de substâncias biologicamente ativas. O material vegetal foi submetido à extração etanólica e este extrato foi fracionado obtendo as frações (hexano, clorofórmio, acetato de etila e hidroalcoólica). Para a avaliação da atividade antioxidante, empregaram-se os métodos de redução do complexo fosfomolibdênio, de redução do radical DPPH e das substâncias reativas ao acido tiobarbitúrico (TBARS). Quanto à alelopatia, as amostras foram testadas em quatro concentrações sobre a germinação e o desenvolvimento de radícula e hipocótilo das sementes de Lactuca sativa. As amostras evidenciaram atividade antioxidante significativa frente ao método de redução do complexo fosfomolibdênio quando comparada à rutina, e do TBARS quando comparado ao BHT, assim como a atividade alelopática, uma vez que estimularam tanto a germinação como o crescimento das sementes. A fração clorofórmica e acetato de etila demonstraram melhor potencial antioxidante com 204,17% e 127,11% em relação à rutina no método de formação do complexo fosfomolibdênio, e o extrato bruto e a fração hexano com 64,2% e 60,9%, em relação ao BHT, no método TBARS. No ensaio alelopático, destaca-se a fração clorofórmica, pois foi a única amostra que estimulou o crescimento do hipocótilo e radícula na maioria das concentrações, variando de 41 a 144%, e a fração acetato de etila que apresentou a maior porcentagem de estímulo nesse bioensaio, demonstrando estímulo de 274% do crescimento do hipocótilo. Este é o primeiro trabalho que demonstra a atividade antioxidante e alelopática de Z. rhoifolium...

Identificação de δ tocotrienol e de ácidos graxos no óleo fixo de urucum (Bixa orellana Linné) / Identification of δ tocotrienols and fatty acids in fixed oil of annatto (Bixa orellana Linné)

Bixa orellana é uma planta nativa do Brasil, conhecida popularmente como urucum. O objetivo desse estudo foi extrair o óleo das sementes de B. orellana e, a partir dele, isolar e identificar o tocotrienol e quantificar seus ácidos graxos. A extração do óleo realizou-se em aparelho Soxhlet utilizando hexano como solvente extrator. O tocotrienol foi isolado por meio de métodos cromatográficos e identificado por espectrometria de ressonância magnética nuclear RMN 1H e RMN 13C. Os ácidos graxos foram quantificados por cromatografia gasosa acoplada ao espectrômetro de massa. Os resultados demonstraram a presença de δ -tocotrienol e, dentre os ácidos graxos, a ocorrência do ácido aracdônico, que até o presente momento não havia sido relatada na espécie em estudo.

Bixa orellana is a native plant of Brazil, popularly known as annatto. The purpose of this study was to isolate the oil from the seeds of B. orellana and from it, identify the antioxidant tocotrienol and quantify its fatty acids. The extraction of the oil was performed in a Soxhlet apparatus using hexane as solvent. The tocotrienol was isolated by chromatographic methods and identified by spectrometric methods NMR 1H and 13C. The fatty acids present in the oil were quantified by gas chromatography coupled with mass spectrometry. Results demonstrated the presence of δ-tocotrienol and among the fatty acids, the arachidonic acid was present, a substance which so far had not been previously reported.

Avaliação da atividade fitotóxica com enfoque alelopático do extrato das cascas de Celtis iguanaea (Jacq. ) Sargent Ulmaceae e purificação de dois triterpenos / Evaluation of the phytotoxic activity focused on the allelopathic effect of the extract from the bark of Celtis iguanaea (Jacq. ) Sargent Ulmaceae and purification of two terpenes

A espécie Celtis iguanaea (Jacq.) Sargent é popularmente conhecida como esporão de galo ou grão de galo. As folhas são indicadas pelo uso popular para o tratamento de dores no corpo e no peito, para reumatismo, asma, cólicas, má digestão e como diurético; as raízes são utilizadas para infecções urinárias e as cascas para a febre. O presente trabalho objetivou contribuir para o estudo fitoquímico e atividade fitotóxica com enfoque alelopático das cascas de Celtis iguanaea. O extrato etanólico foi submetido à partição com os solventes hexano, clorofórmio e acetato de etila. As substâncias friedelina e epifriedelinol (triterpenos) foram isoladas da fração hexano e identificadas por meio de métodos espectroscópicos de RMN de ¹H e 13C. O extrato bruto na concentração de 0,1 mg mL-1 causou inibição acentuada do hipocótilo em 34,97% e estimulou o crescimento da radícula em 29,64% de plântulas de Lactuca sativa. No ensaio de toxicidade frente à Artemia salina o extrato bruto e frações apresentaram uma CL50 superior a 1000 μg mL-1, indicando que o mesmo não possui efeito tóxico.

The species Celtis iguanaea (Jacq.) Sargent is popularly known as "esporão de galo" or "grão de galo". Its leaves are recommended by the popular use for the treatment of body and chest aches, as well as for rheumatism, asthma, cramps, indigestion and as diuretic; its roots are used for urinary infections and its bark for fever. This study aimed to contribute to the phytochemical investigation of the toxic activity focused on the allelopathic effect of the bark of Celtis iguanaea. The ethanol extract was subjected to solvent partition with hexane, chloroform and ethyl acetate. The substances friedelin and epifriedelinol (triterpenes) were isolated from the hexane fraction and identified by spectroscopic methods ¹H and 13C NMR. The crude extract at a concentration of 0.1 mg mL-1 caused marked inhibition of hypocotyl in 34.97% and stimulated radicle growth in 29.64% seedlings of Lactuca sativa. In the toxicity test against Artemia salina the crude extract and fractions showed an LC50 higher than 1000 μg mL-1, indicating that it has no toxic effect.

Evaluation of the adherence to a new potassium chloride storage and handling hospital protocol: an observational study.

The study aim to deal with problem of manage potassium chloride concentrate solution after the introduction of a new protocol on correct use (storage and handling) of these drugs in a high specialization-teaching hospital. The study, conducted from January 2009 to March 2009, was divided in two part: observation of the compliance of concentrated electrolytes solutions storage in 14 wards and prospective observational study on the compliance to the new protocol in the steps of prescription, preparation and administration of these drugs. 49 preparations and administrations of electrolytes solutions were observed. Medical prescriptions were made in a dedicated schedule in 40.8% (20/49), in therapy sheet in 36.7% (18/49), in 14.3% (7/49) the prescription was verbal and after written. Patient identified data was present in 85.7% of cases, solvent type in 61.2%, prescription date in 69.4%, prescription hour in 10.2%, signature of prescriptor in 77.6%, administration speed in 57.1%, administration date in 71.4%, administration hour in 32.7%. Data show a scarce knowledge of the protocol by the physicians or a difficulty in using an additional schedule respect to the existent. Lack of the prescriptor's signature was an important problem such as the absence of speed, date and hour of administration.

Acompanhamento farmacoterapêutico a pacientes usuários de enfuvirtida / Pharmaceutical care of patients treated with enfuvirtide

Enfuvirtida é um inibidor de fusão que interfere nascélulas com a penetração do vírus HIV. Sua aplicaçãoé feita por via subcutânea, o que provoca efeitos nocivos no local da aplicação. Os pacientes em uso deenfuvirtida deixam de usá-la constantemente, sugerindo uma baixa adesão devido às diferentes reações quepodem ocorrer com a administração subcutânea do medicamento. O objetivo da pesquisa, portanto, foi avaliar a relação entre a adesão e o acompanhamento farmacoterapêutico a pacientes usuários de enfuvirtida. A pesquisa foi realizada com pacientes com AIDS emuso de enfuvirtida, no CRE Metropolitano. Dados do perfil clínico e sócio-econômico foram coletados por meio de entrevistas. As entrevistas foram agendadas, mensalmente, para verificar a adesão do paciente ao uso de enfuvirtida durante os meses de setembro de 2008 a junho de 2009. Algumas peculiaridades do uso da forma farmacêutica injetável e a posologia de duas vezes por dia são identificadas como fatores limitantes para o tratamento. A maioria dos pacientes reconhece a importância do tratamento. Porém, cerca de 40%relatam dificuldades na aplicação e são intolerantes às reações adversas causadas pela aplicação subcutânea. Cerca de 33% deles, devido à assistência que estão recebendo, ainda esperam a liberação de novos medicamentos para a troca de esquema sem interrompero uso de enfuvirtida.

Enfuvirtide is a fusion inhibitor that interferes with the penetration of HIV into cells. It is injected subcutaneously, causing adverse side effects at the application site. Patients using enfuvirtide often discontinue the treatment, suggesting low compliance due to the various reactions provoked by the subcutaneous administration of the drug. The objective of this research was thus to assess the connection between pharmacotherapeutic follow-up and adherence of patients to the enfuvirtide regimen. The survey was conducted on AIDS patients prescribed enfuvirtide at a Metropolitan CRE (Brazilian Specialty Public Health Center). Data on the clinical profile and socioeconomic conditions were collected by interview. The interviews were scheduled monthly, to monitor patient adherence to the enfuvirtide treatment over the period from September 2008 to June 2009. Some peculiarities of the use of the injectable pharmaceutical form and the twice-daily injections are identified as limiting factors for the treatment. Most patients recognized its importance, but about 40% reported difficulties in injecting the drug and were intolerant of the adverse reactions caused by subcutaneous administration. About 33% of them, due to the accompaniment they are receiving, are still awaiting the release of new medicines so as to change their treatment plan without interrupting the use of enfuvirtide.

Substituições de esquemas antirretrovirais no Estado do Paraná / Changes of antiretroviral regimen in Paraná

O controle da AIDS no Brasil apresenta resultados favoráveis devido à política seguida pelo Ministério da Saúde que dá ênfase conjunta, na prevenção e atenção à doença com o fornecimento gratuito dos medicamentos. O Ministério da Saúde através do Programa Nacional de DST/AIDS (PN-DST/AIDS) seleciona e compra os medicamentos antirretrovirais (ARVs) e os distribui aos estados. O PN-DST/AIDS distribui 17 medicamentos ARV, em 29 formas farmacêuticas a todos os estados do Brasil. No Paraná, o Centro de Medicamentos do Paraná (CEMEPAR) é o responsável pelo recebimento desses e pela distribuição às 36 Unidades Dispensadoras de Medicamentos (UDMs). Foi realizado um levantamento no estado do Paraná/CEMEPAR no período de janeiro a dezembro/2008 sobre as solicitações enviadas para cadastro de início de tratamento e/ou troca de esquema ARV onde foi observado que 70,56% referiu-se à troca de esquema e, também, que das 5.992 solicitações enviadas, 8,34% (500) apresentavam algum tipo de erro. A pesquisa demonstrou a importância da análise das solicitações, que é um serviço diferenciado realizado pelo estado do Paraná onde foi possível verificar a alta ocorrência de troca de esquemas e a necessidade de um acompanhamento farmacoterapêutico para melhorar a adesão ao tratamento.

The Aids control program in Brazil has been achieving favorable results, owing to the policy adopted by the Ministry of Health, which gives emphasizes both prevention and care for the disease, with the free distribution of medications. The Ministry of Health selects and buys all antiretroviral medications through the National Program DST/AIDS (PN-DST/AIDS) and distributes 17 ARV medications in 29 pharmaceutical forms to all states of Brazil. In Parana State, CEMEPAR (Medicine Center of Parana), is responsible for receiving these medications and redistributing them to the 36 Medicine Distribution Units (UDMs). All requests to change ARV regimen or to start ARV treatment are sent to CEMEPAR for analysis and authorization. An analysis was made of the requests sent to CEMEPAR from January to December 2008 by all of the UDMs where the patients received their medications and it was found that 70.56% were for changes of ARV regimen and that, in 8.34% of all requests, there was some kind of mistake. The survey demonstrated the importance of analyzing the requests, which is a specific service provided by the state of Parana, in which it was possible to observe the high frequency of changes of treatment schemes and a need for pharmacotherapeutic guidance, to improve patient adherence to the treatment.

[The endocannabinoid system and prospects her stimulation in clinical medicine].

The history of use by the man of plants of a sort Cannabis totals more than 4000 years. The people have begun to use Cannabis in stone century. On Taiwan archaeologist the rests of utensils made with application of stalks Cannabis more of 10000 years back were found. Cannabis (Cannabis sativa, Cannabis sowing, named also "Indian") - cultural plant, which has set of applications. From it received fibres for hemp of ropes and make a fabric similar on linen. Its stalks went on manufacture glossy of a paper and building of plates. Her sabadilla were used for graziery a bird; oil from sabadilla Cannabis offered as fuel instead of diesel. The greatest popularity Cannabis has received as raw material for reception of products (marijuana, hashish etc.), causing at the man psychotropic--first of all psychomymetic--effects, that at their regular application can result in formation of dependence. Besides the attempts were undertaken to use preparations Cannabis in the medical purposes: at migraine, spasmes, vomiting, pains of a different origin etc.

Atenção farmacêutica voltada ao Diabetes Melittus / Pharmaceutical care on Diabetes Mellitus

Foi realizada uma pesquisa junto aos profissionais farmacêuticos no município de Curitiba, no estado do Paraná, Brasil, com o objetivo de buscar informações necessárias à dispensão de medicamentos específicos ao portador de diabetes mellitus. Observou-se a falta de conhecimento no que se refere à temática abordada, incluindo procedimentos e produtos. Na discussão apresentou-se uma análise crítica dos resultados e inseriu-se os aspectos cognitivos necessários à elucidação de inúmeras dúvidas encontradas junto aos profissionais. Para tanto, propõe-se medidas de atualização sobre o diabetes mellitus pelo profissional farmacêutico, demonstrando-se as vantagens em promover o esclarecimento das dúvidas dos pacientes no momento da dispensação e, propõe-se a incorporação, no cotidiano do profissional, da atenção farmacêutica nos cuidados primários à saúde do portador do diabetes