Effects of meso-tetrakis (4-sulfonatophenyl) porphyrin (TPPS4) aggregation on its spectral and kinetic characteristics and singlet oxygen production.

The present work reports the effects of meso-tetrakis (4-sulfonatophenyl) porphyrin (TPPS4) aggregation on its excited states absorption spectra, triplet states quenching by molecular oxygen and singlet oxygen production. Experimental techniques such as optical absorption, Z-scan with a white light continuum source and the Laser Flash Photolysis were used to fulfil the study. J-aggregates possess reverse saturable absorption in the 505-660 nm spectral range with a peak centered close to 540 nm. These facts together with their fast relaxation time suggest that they can be employed as material for ultrafast optical limiting and switching. Even though aggregation reduces the porphyrin excited-state lifetimes and quantum yields, it does not reduce the probability of the contact between the quencher and the excited aggregate. Aggregation does not change the contribution of energy transfer mechanisms to triplet state quenching by molecular oxygen. The production of singlet oxygen, the intense absorption in the phototherapeutic window and the high efficiency of conversion of light energy into heat, allow consider J-aggregates as a theranostic agent for photomedicine. It is proposed to use J-aggregates for diagnostics by photoacoustic images and in combination with a near-infrared photodynamic/photothermal dual mode therapy, thus improving synergistically the therapeutic response.

Analgesia for vaginal birth: Secondary analysis from the WHO Multicountry Survey on Maternal and Newborn Health.

OBJECTIVE: To evaluate the use of analgesia during labor in women who had a vaginal birth and to determine the factors associated with its use. METHODS: A secondary analysis was performed of the WHO Multicountry Survey on Maternal and Newborn Health, a cross-sectional, facility-based survey including 359 healthcare facilities in 29 countries. The prevalence of analgesia use for vaginal birth in different countries was reported according to the Human Development Index (HDI). Sociodemographic and obstetric characteristics of the participants with and without analgesia were compared. The prevalence ratios were compared across countries, HDI groups, and regions using a design-based χ2 test. RESULTS: Among the 221 345 women who had a vaginal birth, only 4% received labor analgesia, mainly epidural. The prevalence of women receiving analgesia was significantly higher in countries with a higher HDI than in countries with a lower HDI. Education was significantly associated with increased use of analgesia; nulliparous women and women undergoing previous cesarean delivery had a significantly increased likelihood of receiving analgesia. CONCLUSION: Use of analgesia for women undergoing labor and vaginal delivery was low, specifically in low-HDI countries. Whether low use of analgesia reflects women's desire or an unmet need for pain relief requires further studies.

Analgesia during Labor and Vaginal Birth among Women with Severe Maternal Morbidity: Secondary Analysis from the WHO Multicountry Survey on Maternal and Newborn Health.

AIM: To evaluate the use of analgesia for vaginal birth, in women with and without severe maternal morbidity (SMM) and to describe sociodemographic, clinical, and obstetric characteristics and maternal and perinatal outcomes associated with labor analgesia. METHODS: Secondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health (WHO-MCS), a global cross-sectional study performed between May 2010 and December 2011 in 29 countries. Women who delivered vaginally and had an SMM were included in this analysis and were then divided into two groups: those who received and those who did not receive analgesia for labor/delivery. We further compared maternal characteristics and maternal and perinatal outcomes between these two groups. RESULTS: From 314,623 women originally included in WHO-MCS, 9,788 developed SMM and delivered vaginally, 601 (6.1%) with analgesia and 9,187 (93.9%) without analgesia. Women with SMM were more likely to receive analgesia than those who did not experience SMM. Global distribution of SMM was similar; however, the use of analgesia was less prevalent in Africa. Higher maternal education, previous cesarean section, and nulliparity were factors associated with analgesia use. Analgesia was not an independent factor associated with an increase of severe maternal outcome (Maternal Near Miss + Maternal Death). CONCLUSIONS: The overall use of analgesia for vaginal delivery is low but women with SMM are more likely to receive analgesia during labor. Social conditions are closely linked with the likelihood of having analgesia during delivery and such a procedure is not associated with increased adverse maternal outcomes. Expanding the availability of analgesia in different levels of care should be a concern worldwide.

An Evaluation of Non-Surgical Periodontal Therapy in Patients with Rheumatoid Arthritis.

aim of this study was to evaluate the efficacy of periodontal scaling and oral hygiene instruction for patients with mild chronic periodontitis and rheumatoid arthritis through clinical periodontal parameters and laboratory tests for CRP (C- reactive protein) and ESR (erythrocyte sedimentation rate). Twelve individuals with rheumatoid arthritis and 12 healthy individuals were evaluated, with a mean age of 45.38 and 46.75 respectively, all female and with mild, chronic periodontitis. The participants were evaluated clinically and periapical radiographs were taken (T1), after which periodontal treatment was instituted. After ninety days (T2), new clinical and laboratory data were obtained. Probing depth, bleeding index, and plaque indexes were observed in both groups, and the results demonstrated reductions but no statistical differences. Laboratory tests for CRP and ESR produced higher values for the rheumatoid arthritis group with T1- T2 reductions on the average, but the values were still higher than in the health group. We conclude that periodontal therapy in patients with rheumatoid arthritis and mild chronic periodontitis showed a improvement in the periodontal clinical parameters and laboratory tests that were evaluated.