Investigation of urban ethnoveterinary in three veterinary clinics at east zone of São Paulo city, Brazil.

ETHNOPHARMACOLOGICAL RELEVANCE: Urban Ethnoveterinary should be further explored because of its value as it resists conventional medical care. In addition, the comparison between the resources used by Ethnoveterinary and Ethnopharmacology should be investigated in depth, increasing the availability of new bioactive potential in human and veterinary medicines. This project aimed to determine whether plants are used in the health care of dogs and/or cats in urban area and to compare its uses with other ethnoveterinary and ethnopharmacological data. MATERIALS AND METHODS: Three veterinary clinics from east area of São Paulo city were selected, in order to record the offering of plants to pets by their owners. Individual interviews were conducted from May to November 2012 and consisted of application of semi-structured interviews and questionnaires. A literature search was performed to compare our findings with other ethnopharmacological and ethnoveterinarian data from the literature. RESULTS: A total of 273 people were interviewed and 46 (16.84%) of them utilize medicinal plants for their pets. Most plant species are exclusively home grown (57.9%). The plants most cited were Plectranthus barbatus Andrews, Matricaria chamomilla L. and Foeniculum vulgare Mill. The most frequent route of administration, part utilized and mode of preparation was oral (80.35%), leaves (89.47%) and infusion (61.90%), respectively. From 19 cited plants, 14 (73.7%) are mentioned in ethnoveterinary literature, whereas 11 (57.9%) are used for the same purposes. All plants reported in our study have at least one common use with ethnopharmacology. CONCLUSION: The survey provided evidence of ethnoveterinary use of medicinal plants for dogs and/or cats in urban area of São Paulo, complementarily with the official veterinary, and showed that the plants used in pets are also used in humans with the same purposes and routes of administration, as well as in other animals.

Parents' perspectives on the deaths of their children in two Brazilian paediatric intensive care units.

OBJECTIVES: To evaluate the quality of care offered to terminally ill children and their families in the last days of life in two Brazilian Paediatric Intensive Care Units (PICUs) from the parents' perspectives. METHODS: This was a qualitative, exploratory study. Parents of a child who had died in one of the PICUs 6-12 months previously were invited to take part in two interviews: a private meeting with the PICU assistant physician who cared for their child, to discuss and review any outstanding issues related to the diagnosis, treatment, and prognosis, and a recorded interview with a researcher who was not involved in the child's treatment. Data from the interviews with the researcher were posteriorly grouped in categories according to recurrent terms. RESULTS: Six categories emerged, three of which are reported here. The quality of communication was low; the medical staff frequently used technical terms, limiting understanding. Parental participation in the decision-making process was scarce; decisions were based on the medical perspective. Finally, families reported uncompassionate attitudes from the medical staff and excessive technology in the final moments surrounding the child's death, although nurses were highly involved with palliative care measures and demonstrated sympathetic and supportive postures. CONCLUSION: The interviews uncovered deficiencies in the care provided to parents in the PICUs, indicating a need for changes in practice.

Lamellar body count and stable microbubble test on tracheal aspirates from infants for the diagnosis of respiratory distress syndrome.

OBJECTIVES: To evaluate the performance of lamellar body count in tracheal aspirates from intubated preterm babies to predict respiratory distress syndrome. DESIGN: Case-control study. SETTING: Three neonatal intensive care units. PATIENTS: Seventy-two patients not older than 3 days were included in the study, 38 preterm infants with respiratory distress syndrome, 16 preterms without respiratory distress syndrome, and 18 term infants. All required mechanical ventilation. INTERVENTIONS: Lamellar body count was performed in an automated cell counter. Tracheal samples were diluted in dithiothreitol without centrifugation and kept frozen at -20°C until use. Samples were placed in a dithiothreitol-containing test tube at a ratio of one part tracheal aspirate to six parts dithiothreitol solution, vortexed for 10 secs, and aspirated by the cell counter. Lamellar body count was performed using the platelet channel. All results were multiplied by seven. The stable microbubble test was done for comparison. MEASUREMENTS: Lamellar body count and stable microbubble test. MAIN RESULTS: Lamellar body count was significantly lower in the respiratory distress syndrome group compared with the non respiratory distress syndrome preterm group and also with the term group. The median and interquartile range obtained for lamellar body count were 38,500/µL (14,000-112,000) for the respiratory distress syndrome group, 822,500/µL (442,000-962,500) for the non respiratory distress syndrome preterm group, and 633,000/µL (322,000-1,608,000) for the term group (p < .001). The sensitivity and specificity of lamellar body count and stable microbubble test for the diagnosis of respiratory distress syndrome were calculated, taking into consideration the respiratory distress syndrome and the non respiratory distress syndrome preterm groups. Considering a cutoff point of 200,000 lamellar bodies/µL, lamellar body count sensitivity was 92.1% (95% confidence interval 78.6-98.3) and lamellar body count specificity was 93.8% (95% confidence interval 69.8-99.8). The area under the curve was 0.94 (95% confidence interval 0.84-1.00). CONCLUSIONS: Lamellar body count and stable microbubble test can be rapidly and easily performed on tracheal aspirates and they seem to have very good performance for diagnosing respiratory distress syndrome in intubated patients.

Phase diagrams of alkali halides using two interaction models: a molecular dynamics and free energy study.

Phase diagrams for potassium and sodium chlorides are determined by molecular dynamics and free energy calculations. Two rigid-ion interaction models, namely, the Born-Mayer-Huggins (BMH) and Michielsen-Woerlee-Graaf (MWG) effective pair potentials, have been used. The critical and triple point properties are discussed and compared with available experimental and simulation data. The MWG model reproduces the experimental liquid-gas equilibria better than the BMH model, being the accordance very good in the lowest temperature region of the coexistent liquids, particularly for NaCl. However, both models underestimate the critical temperatures of KCl and NaCl. Relatively to the solid-gas equilibria, the models do not reproduce well the experimental data. As for the solid-liquid coexistences either the BMH or the MWG models appear unrealistic.

A proteína C ativada recombinante humana no tratamento da sepse grave / The recombinant human activated protein C in the treatment of severe sepsis

O objetivo deste artigo é fazer uma revisão bibliográfica a fim de obter informações atualizadas sobre o papel da proteína C ativada recombinante humana (drotrecogina alfa) no tratamento da sepse grave. Enfatizar seu uso na criança. Foi realizada revisão bibliográfica através do Public Medline entre os anos de 2000 a 2003. Foram selecionados artigos originais. A partir da literatura revisada, pode-se observar que ainda há poucos estudos relacionados ao uso de proteína C ativada recombinante humana no tratamento da sepse grave. Além disso, seu uso ainda não está definido para crianças. Estudos têm demonstrado que alguns pacientes com sepse grave podem se beneficiar da terapia com proteína C ativada recombinante humana.

Síndrome da pele escaldada estafilocócica em crianças / Staphylococcal scalded skin syndrome in children

A Síndrome da Pele Escaldada Estafilocócica abrabge um espectro variado de doenças bolhosas induzidas por toxinas esfoliativas do Stafilococcus aureus, cujo exato mecanismo de ação permanece indefinido até hoje. O sítio inicial de colonização da bactéria pode ser as narinas, a nasofaringe, conjuntiva, umbigo e/ou o sangue, além da pele. Na forma generalizada ou clássica (Doença de Ritter), um quadro febril e de eritema cutâneo evolui em um período de 24-48 horas com a formação de bolhas flácidas por toda a superfície da pele. Uma forma mais leve e localizada é o impetigo bolhoso.O diagnóstico é baseado sobretudo no quadro clínico. A utilização precoce de antibióticos pode rapidamente erradicar a doença, assim como evitar a progressão da exfoliação. Devido ao crescente número de casos da síndrome relacionados a berçários, salas de parto e unidades de tratamento intensivo neonatal, faz-se imperativa a utilização de estratégias de controle de infecção nestas unidades, como o uso apropriado de antissépticos, tratamento antibiótico de atendentes infectados e uso de mupirocina nasal para a erradiação de carreadores. Avanços em pesquisas sobre a etiologia da doença e alternativas de tratamento, como anticorpos específicos para as toxinas, prometem auxiliar no manejo desta condição.

Uso de surfactante exógeno no tratamento da bronquiolite viral grave: relato de caso / Exogenous surfactant trament for sevre acute viral bronchiolitis: case report

Objetivo: descrever os possíveis efeitos clínicos e laoratoriais da instilação traqueal de surfactante exógeno a um lactente com bronquiolite viral aguda grave e submetido a ventilação mecânica. Relato: menina de 2 meses de idade com diagnóstico clínico de bronquiolite viral aguda e subetida a ventilação mecânica, necessitando de altos picos de pressão inspiratória positiva (35 a 45cmH2O) e elevada fração de oxigênio inspirado (FiO2=0,9), sem resposta clínica favorável ou melhora na gasometria arterial. Optou-se por instilar surfactante exógeno endotraqueal (Exosurf, Glaxo 50 mg/kg) para permitir utilizar um regime ventilatório menos agressivo. Resultados: quatro horas após a administração do surfactante, foi possível reduzir o pico inspiratório de pressão (PIP) de 35 para 30 cmH20; a FiO2 de 0,9 para 0,6 e aumentar a pressão positiva ao final de expiração (PEEP) de 6 para 9 cmH2O. Neste período observou-se uma elevação na relação paO2/FiO2 de 120 para 266. Ao completar 24 horas, a FiO2 pode ser reduzida até 0,4. Discussão: neste relato pretendemos demonstrar que a inativação do surfactante pode ser um fator decisivo na evolução desfavorável de alguns casos graves de bronquiolite. A instilação traqueal de surfactante, nestes casos, além de promover uma rápida resposta clínica permite que se adotem técnicas ventilatórias menos agressivas