Experimental Yellow Fever in the Squirrel Monkey (Saimiri spp.): Hematological, Biochemical, and Immunological Findings.

Between 2016 and 2018, Brazil experienced the largest sylvatic epidemic of yellow fever virus (YFV). Despite to the magnitude and rapid spread of the epidemic, little is known about YFV dispersion. The study evaluated whether the squirrel monkey is a good model for yellow fever (YF) studies. Methods: Ten animals were infected with 1 × 106 PFU/mL of YFV, with one negative control. Blood samples were collected daily during the first 7 days and at 10, 20 and 30 days post infection (dpi) for detection of viral load and cytokines by RT-qPCR; measurements of AST, ALT, urea and creatinine were taken; IgM/IgG antibodies were detected by ELISA, and hemagglutination inhibition and neutralization tests were performed. The animals exhibited fever, flushed appearance, vomiting and petechiae, and one animal died. Viremia was detected between 1 and 10 dpi, and IgM/IgG antibodies appeared between 4 and 30 dpi. The levels of AST, ALT and urea increased. The immune responses were characterized by expression of S100 and CD11b cells; endothelial markers (VCAM-1, ICAM-1 and VLA-4), cell death and stress (Lysozyme and iNOS); and pro-inflammatory cytokines (IL-8, TNF-α, and IFN-γ) and anti-inflammatory cytokines (IL-10 and TGF-ß). The squirrel monkeys showed changes similar to those described in humans with YF, and are a good experimental model for the study of YF.

The use of medicinal plants in venous ulcers: a systematic review with meta-analysis.

The aim of this study was to systematically review the use of medicinal plants for the treatment of varicose ulcers. The databases used in the search were: Medline/Pubmed, Scopus, Cinhal, Lilacs and Web of Science. The selection process was divided into two phases: the reading of titles and abstracts and the full reading of selected articles. The item description was compared with the checklist of the Consolidated Standards of Reporting Trials. The initial search produced 3505 articles and seven were selected for inclusion in the systematic review. Of the included studies, 7 (100%) evaluated the reduction of the ulcer area, 4 (57·14%) evaluated reepithelisation, 2 (28·57%) evaluated bacterial flora and 1 (14·28%) evaluated the oxygen pressure and percutaneous carbon dioxide. The level of evidence rating indicated that five studies (71·42%) were rated at level 2 and two (28·57%) were rated at level 3. The quality assessment was performed using the Jadad scale, which is prevalent in the literature. The quality score of the Jadad questionnaire ranges from 0 to 5; here, the studies analysed had an average of 2·5. A meta-analysis was performed on two studies that analysed the effects of Mimosa tenuiflora hydrogel in the treatment of venous ulcer and included 42 patients with a mean age of 60·5 years and a mean duration of treatment of 10·5 weeks. Heterogeneity was assessed using I2 ; we obtained a high value of 84%. We concluded that, despite the efficacy of the incorporation of Ageratina pichinchensis into the gel, the hydrogel that incorporated M. tenuiflora appeared to be a promising candidate for the management of venous ulcers.

Pharmaceutical care in hypertensive patients: a systematic literature review.

BACKGROUND: Since the conception of pharmaceutical care in 1990, many studies have been published purported to implement and/or evaluate interventions under this aegis; however, most have been criticized in methodological approach. As such, there is a need to assess the scientific rigor of the published studies and examine the biases that may compromise the hardiness of their findings. OBJECTIVES: The aim of this review is to describe and appraise published research on the management of patients diagnosed with essential hypertension under the guise of pharmaceutical care. METHODS: MEDLINE, EMBASE, Scopus, and LILACS databases from January 1990 to July 2011 were searched using the keywords "pharmaceutical care," "hypertension," and "blood pressure." Included were clinical trials assessing the impact of pharmaceutical care on outcomes for hypertensive patients. Two independent reviewers abstracted data on descriptive characteristics, research design and outcomes, and study limitations. RESULTS: The literature search identified 917 articles, of which 16 satisfied the inclusion criteria. The studies were conducted primarily in North America (8) and in ambulatory settings (9). Sample sizes ranged from 24 to 235 patients, with most studies reporting a 6-month patient follow-up period. Many studies (9) were randomized clinical trials but generally had a low-quality methods score according to the Jadad scale. Blood pressure (BP) (15), medication adherence (11), and quality of life (9) were the most common outcome measures. As expected, systolic BP was the outcome most positively impacted by the pharmaceutical intervention. CONCLUSIONS: This database search revealed that most of the included studies evaluated the impact of pharmaceutical care on clinical and humanistic outcomes and few studies showed statistically significant improvement in BP. However, a lack of hardiness and many important limitations were common in the studies analyzed. As such, recommendations are made to improve in research design and to demonstrate the effectiveness of the intervention.