Chromatographic method development using multivariate approaches for organic solvents optimized analysis in [18F]fluorocholine.

A fast and simple method using Gas Chromatography combined with Flame Ionization Detection (GC-FID) was developed for the determination of ethanol, acetonitrile, dibromomethane, dimethylaminoethanol, and dimethyl sulfoxide in [18F]fluorocholine. The combination of fractional factorial design, Doehlert design, and Desirability function was used to evaluate the operational parameters and to establish the best working condition. The validation results revealed that the proposed method has good recovery (85.1-104.1%) and repeatability (RSD ≤8.1%). Correlation coefficients (R ≥ 0.983) indicated good linearity over a wide range. The limit of detection (≤2.5 ppm) and the limit of quantification (≤7.5 ppm) were satisfactory. The proposed method is based on minimum manual operation, sample preparation free, direct injection technique, and short chromatographic separation time. This method is useful for routine analysis of organic solvents in [18F]fluorocholine, feasible for the modernization of specific monograph, and was therefore successfully implemented to assess samples manufactured by Nuclear Technology Development Center (CDTN).

A Qualitative Study of the Spiritual Aspects of Parenting a Child with Down Syndrome.

Parenting a child with Down syndrome can sometimes present certain difficulties and, thus, spirituality may function as a dimension related to finding meaning in life and as a coping resource. Spirituality is a critical dimension of nursing care, but scarce knowledge is available to specifically inform family nursing practice. The aim of this study was to explore the spiritual aspects of parenting a child with Down syndrome, as a qualitative secondary analysis. This is an observational qualitative study, based on in-depth interviews from 42 participants. Data analysis found seven categories that concern meaning and purpose in life: hope, family strength, spiritual practices, personal beliefs, and love, and trust in healthcare providers. Spirituality is a resource in parents' lives who are living in this situation. Nurses should consider this dimension in supporting families and in improving management of this life and health condition.

Medical Interns and COVID-19: results of national research.

OBJECTIVE Assess the impact of COVID-19 on medical students' internships in public and private institutions in Brasil, in addition to estimating the quality of the measures taken by their respective Universities in the face of the problem and the availability of personal protective equipment (PPE). METHODS A descriptive cross-sectional quantitative analysis study carried out with 317 students undergoing medical internship from March 31, 2020, to April 12, 2020. The survey was conducted through an online questionnaire using the SurveyMonkey tool with 20 questions. Interns from the fourth to the sixth year of medical schools in the country were randomly included in the study through a survey sent by Whatsapp application. Statistical analysis was performed using the Chi-Square, considering p <0.05 as significant. RESULTS Four main topics were identified in the research: student demographic data; how classes and courses are being taught; the use and ease of access to personal protective equipment and the students' fears and perspectives for the future. CONCLUSION The study clarified that although half of the students still have some degree of content and, in their majority, they are satisfied, there is still a lot of difficulty in obtaining personal protective equipment, which prevents students from returning safely to their internships.

Medical Interns and COVID-19: results of national research

SUMMARY OBJECTIVE Assess the impact of COVID-19 on medical students' internships in public and private institutions in Brasil, in addition to estimating the quality of the measures taken by their respective Universities in the face of the problem and the availability of personal protective equipment (PPE). METHODS A descriptive cross-sectional quantitative analysis study carried out with 317 students undergoing medical internship from March 31, 2020, to April 12, 2020. The survey was conducted through an online questionnaire using the SurveyMonkey tool with 20 questions. Interns from the fourth to the sixth year of medical schools in the country were randomly included in the study through a survey sent by Whatsapp application. Statistical analysis was performed using the Chi-Square, considering p <0.05 as significant. RESULTS Four main topics were identified in the research: student demographic data; how classes and courses are being taught; the use and ease of access to personal protective equipment and the students' fears and perspectives for the future. CONCLUSION The study clarified that although half of the students still have some degree of content and, in their majority, they are satisfied, there is still a lot of difficulty in obtaining personal protective equipment, which prevents students from returning safely to their internships.

RESUMO OBJETIVO Avaliar o impacto da Covid-19 durante o internato dos alunos de medicina em escolas públicas e particulares no Brasil, além de estimar a qualidade das medidas tomadas pelas respectivas universidades diante do agravo e da disponibilização de equipamento de proteção individual. MÉTODO Um estudo de análise quantitativa transversal, com caráter descritivo, foi realizado com 317 alunos cursando o internato médico durante o período de 31 de março de 2020 a 12 de abril de 2020. A pesquisa foi realizada por meio de um questionário on-line com 20 perguntas pela ferramenta SurveyMonkey. Os internos do 4o ao 6o ano das faculdades de medicina do País foram incluídos no estudo de forma randômica ao receberem a pesquisa pelo aplicativo WhatsApp. A análise estatística foi realizada por meio do Qui-quadrado, considerando p<0,05 como significante. RESULTADOS Quatro temas principais foram identificados na pesquisa: dados demográficos dos alunos; como as aulas e estágios do curso estão sendo ministrados; a utilização e facilidade de aquisição do equipamento de proteção individual e medos e perspectivas futuras dos estudantes. CONCLUSÕES O estudo mostrou que apesar de metade dos alunos continuarem tendo algum grau de conteúdo e, na maioria, estarem satisfeitos, ainda há muita dificuldade em se obter equipamento de proteção individual, o que impede que os alunos retornem com segurança aos seus campos de estágio, além de causar medo de contaminação e de continuar atendendo os pacientes.

Preclinical acute toxicity, biodistribution, pharmacokinetics, radiation dosimetry and microPET imaging studies of [(18)F]fluorocholine in mice.

[(18)F]Fluorocholine ([(18)F]FCH) has been proven to be effective in prostate cancer. Since [(18)F]FCH is classified as a new radiopharmaceutical in Brazil, preclinical safety and efficacy data are required to support clinical trials and to obtain its approval. The aim of this work was to perform acute toxicity, biodistribution, pharmacokinetics, radiation dosimetry and microPET imaging studies of [(18)F]FCH. The results could support its use in nuclear medicine as an important piece of work for regulatory in Brazil.

Prevalence and clinical significance of potential drug-drug interaction in hematopoietic stem cell transplantation.

Patients undergoing hematopoietic stem cell transplantation (HSCT) are at risk of developing potential drug-drug interactions (PDDIs). The aim of this study was to assess the prevalence of PDDIs that occur in HSCT patients on the day of hematopoietic stem cell infusion. We performed a cross-sectional study based on the evaluation of prescriptions to HSCT patients on the day of infusion (day 0). The PDDIs were analyzed using the DRUG-REAX(®) system and classified according to the severity level, available scientific evidence, time of onset, and potential clinical impact. Forty patients undergoing HSCT were included in this study; 33 patients (82.5%) were exposed to at least one major and one contraindicated PDDI in a concomitant manner. All patients exposed to PDDIs had an increased risk of cardiotoxicity. Most cases of PDDIs were classified as being of major severity (80.9%), with time of onset not specified (61.9%), and with good or excellent scientific evidence (52.4%). HSCT patients have a high prevalence of clinically significant PDDIs. The management of PDDIs requires an approach that includes biochemical tests, installation of cardiac monitors, periodic electrocardiograms, implementation of electronic prescriptions with a PDDI alert system, and availability of the PDDI databases.

SENTRY antimicrobial surveillance program report: Latin American and Brazilian results for 1997 through 2001.

The alarming emergence and spread of antimicrobial resistance among common bacteria threatens the effectiveness of therapy for many infections. Surveillance of antimicrobial resistance is essential to identify the major problems and guide adequate control measures. Several resistance surveillance programs have been implemented in North America and Europe in the last decade; however, very few programs have assessed antimicrobial resistance in Latin American countries. The SENTRY Antimicrobial Surveillance Program was initiated in 1997 and represents the most comprehensive surveillance program in place at the present time worldwide. The SENTRY Program collects consecutive isolates from clinically documented infections in more than 80 medical centers worldwide (10 in Latin America). The isolates are collected according to the type of infection (objectives) and susceptibility tested in a central microbiology laboratory by reference broth microdilution methods according to NCCLS guidelines. The Program also incorporated molecular typing (ribotyping and PFGE) and resistance mechanism analysis of selected isolates. In this report we present a very broad analysis of the data generated by testing almost 20,000 bacterial isolates against more than 30 antimicrobial agents. The susceptibility results (MIC(50), MIC(90) and % susceptible) are presented in 11 tables according to the organism and site of infection. The data from Brazil, as well as the data from isolates collected in 2001, are analyzed separately. This report allows the evaluation of the activities numerous antimicrobial agents against clinical isolates collected in Latin American countries.

SENTRY antimicrobial surveillance program report: latin american and brazilian results for 1997 through 2001

The alarming emergence and spread of antimicrobial resistance among common bacteria threatens the effectiveness of therapy for many infections. Surveillance of antimicrobial resistance is essential to identify the major problems and guide adequate control measures. Several resistance surveillance programs have been implemented in North America and Europe in the last decade; however, very few programs have assessed antimicrobial resistance in Latin American countries. The SENTRY Antimicrobial Surveillance Program was initiated in 1997 and represents the most comprehensive surveillance program in place at the present time worldwide. The SENTRY Program collects consecutive isolates from clinically documented infections in more than 80 medical centers worldwide (10 in Latin America). The isolates are collected according to the type of infection (objectives) and susceptibility tested in a central microbiology laboratory by reference broth microdilution methods according to NCCLS guidelines. The Program also incorporated molecular typing (ribotyping and PFGE) and resistance mechanism analysis of selected isolates. In this report we present a very broad analysis of the data generated by testing almost 20,000 bacterial isolates against more than 30 antimicrobial agents. The susceptibility results (MIC50, MIC90 and percent susceptible) are presented in 11 tables according to the organism and site of infection. The data from Brazil, as well as the data from isolates collected in 2001, are analyzed separately. This report allows the evaluation of the activities numerous antimicrobial agents against clinical isolates collected in Latin American countries.

Skin and soft tissue infections in Latin American medical centers: four-year assessment of the pathogen frequency and antimicrobial susceptibility patterns.

We report the results of pathogen frequency and antimicrobial susceptibility of isolates collected from skin and soft tissue infections (SSTIs) in Latin American medical centers during the first 4 years (1997-2000) of the SENTRY Antimicrobial Surveillance Program. Ten laboratories participated each year distributed among nine cities in six countries. A total of 1,789 bacterial isolates were susceptibility tested by reference broth microdilution at the coordinating central laboratory. Results from isolates collected during the year 2000 were compared with those from isolates collected during the prior three years. Selected carbapenem-resistant Pseudomonas aeruginosa were genotyped by automated ribotyping to evaluate the occurrence of clonal, epidemic dissemination. The five most frequently isolated species were (n/%): Staphylococcus aureus (584/32.8%), Escherichia coli (233/13.1%), P. aeruginosa (211/11.9%), Enterococcus spp. (137/7.7%), and Klebsiella spp. (127/5.8%). The most problematic antimicrobial resistances were related to the high prevalence of multi-drug resistant (MDR) Gram-negative bacilli. Carbapenem resistance among non-fermentative Gram-negative bacilli was much higher than that reported in other regions evaluated in the SENTRY Program. Only 74.9% of P. aeruginosa and 84.9% of Acinetobacter spp. were considered susceptible to imipenem. The antimicrobial susceptibility rates of P. aeruginosa decreased during the study period for most antimicrobial agents evaluated. More than 40% of K. pneumoniae and nearly 10% of E. coli showed an extended spectrum beta-lactamase phenotype. Only 73.4% of E. coli and 76.0% of Enterobacter spp. were susceptible to ciprofloxacin. The molecular typing of carbapenem-resistant P. aeruginosa demonstrated clonal dissemination in two institutions. These reported results indicate that rates of resistance among isolates causing SSTI continue to raise in Latin America, with specific concerns for the high prevalence of MDR Gram-negative bacilli. National and international surveillance programs as a guide to focusing intervention strategies should assist in the control of escalating antimicrobial resistance in this geographic area.

Alterações citológicas da semi-mucosa do lábio inferior em pacientes expostos às radiações solares e o uso do fumo / Cytological Alterations of the Lower Lip Semi-Mucosa in Patients Exposed to Tobacco and Solar Radiation

Este relato consiste no estudo citológico das alterações que o tabaco e as radiações solares podem causar no epitélio estratificado pavimentoso da semi-mucosa labial. Material e métodos: Foram obtidas pelo método de citologia esfoliativa 278 lâminas de 139 pacientes, divididos em quatro grupos de pacientes: grupo 1- controle, grupo 2 - expostos ao sol, grupo 3 - fumantes, e grupo 4 - fumantes combinado com exposição ao sol. Resultados: Os laudos foram fornecidos por microscopia óptica; e, a partir de uma média ponderada, constatou-se um aumento de células córneas (queratina) no grupo 4 (27,53%), exposto à radiação solar; e o maior número de células intermediárias e binucleadas no grupo 3 (57,69% e 1,04%), respectivamente, no grupo de fumantes, demonstrando-se que o tabaco e as radiações solares influenciam alterações celulares no epitélio da semi-mucosa labial, podendo induzir às afecções cancerizáveis e ao câncer do lábio inferior. Conclusão: A citologia esfoliativa é um método simples e econômico e deve ser usada nessa população de risco, como prevenção primária do câncer do lábio inferior.

This paper consists in the study of the cytological alterations that tobacco and the solar radiation can cause in the epithelium of the labial semi-mucosa. Material and methods: There were obtained from the exfoliated cytology method, 278 scrapings from 139 patients, divided into four groups: group 1- control, group 2 - exposed to sun radiation, group 3 - smokers and group 4-smokers exposed to sun radiation (27,53%). Results: The reports were given by optic microscopy and starting from a pondered average, there was observed an increased number of horny cells in the group number 4 exposed to sun radiation, and an increased number of intermediary (57,69%) and binucleated cells (1,04%) in the group of smokers, demonstrating that tobacco and solar radiation can cause alterations in cells of the epithelium of the labial semi-mucosa, leading possibly to pre-malignant diseases and lower lip cancer. Conclusions: The exfoliative cytology is a simple and economic method and should be used in this risk population as primary prevention of lower lip cancer.