Optimization of enhanced oil recovery using ASP solution.

Many studies have been conducted to focused on developing an optimal alkali/surfactant/polymer (ASP) composition to increase the recovered fraction of oil in reservoirs that have already undergone water injection. To analyze the effect of alkali (Na2CO3), surfactant (lauryl sodium sulfate), and polymer (commercial xanthan gum) concentration on oil recovery, a complete factorial experimental design was performed with combinations of three variables (alkali, surfactant, and polymer) and three central point replications (2³ + 3). The experiments were carried out on a core holder using rock samples from the Botucatu formation. The simulated oil reservoirs have an average permeability of 348 mD and a temperature of 60 °C. The crude oil was acquired from the Carmópolis field, with 25.72 °API. Synthetic production water containing 40,000 mg L-1 of NaCl and 13,000 mg L-1 of Na2SO4 was injected through an HPLC pump to saturate the rock samples and to recover the oil in the secondary step. From the experimental results, it was verified that the surfactant and polymer concentrations are the most statistically significant independent variables and that first-order interactions are not statistically significant for the process. The oil recovery factors in the secondary stage ranged between 30 and 36 % of the OOIP, which are within the range reported in the literature. The optimal composition of the ASP fluid obtained a recovered fraction of oil of 62 % in the advanced step. Other combinations reported in the literature used higher concentrations of alkali, surfactant, and polymer with lower recoveries and higher cost in the injection design. Thus, the present study highlights the necessity to investigate the performance of each component of the ASP solution. In addition, the results obtained in this study are very attractive for possible full-scale applications.

Perfil das gestantes diagnosticadas com sífilis durante o pré-natal ou parto admitidas em maternidade de Belo Horizonte ­ MG / Profile of pregnant women diagnosed with syphilis in the maternity in Belo Horizonte ­ MG

Objetivo: Conhecer o perfil epidemiológico e identificar fatores de risco, eficácia do diagnóstico e tratamento durante o pré-natal de pacientes com histórico de sífilis admitidas em uma maternidade de Belo Horizonte, com o intuito de atuar de forma preventiva quanto à população local. Métodos: Estudo transversal, retrospectivo, com análise de prontuários e banco de dados de notificações de sífilis congênita e em gestantes obtidos entre janeiro/2017 e dezembro/2019, referentes a pacientes admitidas para parto, internação clínica ou atendimento de urgência. Resultados: Foram identificadas 198 gestantes com idade média de 24 anos. Avaliando os dados pré-natais, 65% foram acompanhadas no risco habitual com uma média de seis consultas. Na análise do diagnóstico, 58% não possuíam registro de teste treponêmico e 31,8% apresentaram teste reagente. Entre as pacientes, 21% relataram já ter tido sífilis previamente. O esquema de tratamento em 74,7% foi penicilina benzatina 7.200.000 UI. O tratamento concomitante do parceiro era desconhecido em 46% dos casos e confirmado em 33%. Na avaliação neonatal, 95 recém-nascidos apresentaram VDRL positivo; desses, 33% apresentaram titulação maior que a diluição de 1:8. No desfecho gestacional, houve quatro decessos fetais e dois abortamentos. Conclusão: Apesar de recursos diagnósticos e terapêuticos simples e de baixo custo, o controle da sífilis na gestação mostra-se um desafio. O rastreio da infecção durante o pré-natal nem sempre acontece em momento oportuno e a taxa de reinfecção materna é significativa, mostrando que orientações para prevenção ou tratamento não foram realizadas adequadamente.(AU)

Objective: To know the epidemiological profile, identify risk factors, effectiveness of diagnosis and treatment during prenatal care of patients admitted to the Maternity in Belo Horizonte with a history of syphilis, in order to act preventively towards the local population. Methods: Cross-sectional study, retrospective study, with analysis of medical records and a database of congenital syphilis notifications and in pregnant women obtained between January/2017 and December/2019, referring to patients admitted for delivery, clinical hospitalization or emergency care. Results: 198 pregnant women with an average age of 24 years were identified. Evaluating the prenatal data, 65% were followed up at usual risk with an average of six consultations. In the analysis of the diagnosis, 58% did not have a treponemal test record and 31.8% had a reagent test. 21% of patients reported having previously had syphilis. The treatment regimen in 74.7% was benzathine penicillin 7,200,000 IU. Concomitant treatment of the partner was unknown in 46% of cases and confirmed in 33%. In the neonatal assessment, 95 newborns showed positive VDRL test, of which 33% had a higher titre than the 1:8 dilution. In the gestational outcome, there were four fetal deceases and two abortions. Conclusion: Despite simple and low-cost diagnostic and therapeutic resources, controlling syphilis during pregnancy is a challenge. Screening for infection during prenatal care does not always happen in an opportune moment and the rate of maternal reinfection is significant, showing that guidelines for prevention or treatment have not been carried out.(AU)

Remediation of petroleum contaminated saline water using value-added adsorbents derived from waste coconut fibres.

Oil spill from petrochemical industries into marine areas has resulted in severe environmental pollution. The use of natural sorbents to clean marine areas affected by petroleum contaminants is a promising approach to alleviate this problem. Therefore, this study aims at developing an technique that uses waste coconut fibres (Cocos nucifera L.) pre-treated with a "green" solvent, viz. protic ionic liquid (PIL) [2-HEA][Ac], for the remediation of oil in saline water. Conventional chemical pre-treatments (mercerisation/acetylation) and the innovative treatment (using PIL), chemical characterisation, Scanning Electron Microscope, Fourier-transform infrared spectroscopy, and oil sorption tests in hydrodynamic simulation on a laboratory scale were conducted. The fibres treated with PIL[2-HEA][Ac] possessed more pores and hydrophobic content than the mercerised/acetylated coconut fibres, indicating the efficiency of sorption. The average sorption of the PIL[2-HEA][Ac] fibre was 1.40 ± 0.06 g/g and that of the mercerised/acetylated fibre was 1.32 ± 0.12 g/g. Although the difference in sorption results is not significant, according to the Tukey test, fibre pre-treatment with PIL[2-HEA][Ac] is more advantageous than conventional treatments because it exhibits better average sorption results; furthermore, the synthesis procedure for PIL[2-HEA][Ac] is simple, reusable and non-toxic. Therefore, the use of these petroleum biosorbents is a technology with environmental benefits, such as the availability of the biosorbent in the form of biodegradable waste and treated with a "green" solvent, both of which can be reused. Thus, it adds value for its use in industries with a circular economy product; that are environment-friendly and economical.

Técnica de rescate para prótesis arpe(R) fallida y resultados / Rescue technique for failed arpe(R) prosthesis and results

Introducción: Existen muchas técnicas para el tratamiento de la rizartrosis, ninguna de ellas con clara ventaja sobre las otras. La principal meta del tratamiento de esta, debe ser el alivio del dolor. La prótesis arpeR ha obtenido buenos resultados funcionales y de supervivencia a medio-largo plazo, pero no está exenta de complicaciones. Para su rescate, suelen emplearse las técnicas de Jones o Weilby, con buenos resultados. Objetivo: Descripción de técnica quirúrgica empleada para rescate de prótesis arpeR y de los resultados obtenidos con dicha cirugía. Material y métodos: Análisis estadístico descriptivo con STATA versión 12, dónde se recogen los resultados funcionales de todos los casos de prótesis arpeR, que han sido sometidos a revisión quirúrgica mediante técnica de Weilby sin extracción del vástago implantado; en nuestro centro. Resultados: Los resultados obtenidos han sido satisfactorios y comparables a los que aparecen con el empleo de técnicas de rescate para implantes trapeciometacarpianos ( tMCP) fracasados, en cuanto al alivio del dolor y al rango de movimiento; con un Kapandji medio de 9(0-10), un DASH score medio de 61.36 (18.18-88.63), EVA medio de 3 (0-8), fuerza pinza lateral 1.5 (1-5.5) Kg/cm2 y fuerza de pinza puño 8 (0.5-18)Kg/cm2. Conclusiones: La técnica de Weilby sin extracción de vástago protésico como salvamento de implante arpeR fracasada, es fácilmente reproducible y además obtiene unos resultados, en movilidad y alivio de dolor, comparables a los de otras técnicas de tenosuspensión empleadas en rescates de este tipo

There are many techniques for the treatment of rizarthrosis, none of them with clear advantage on the others. The main goal should be the relief of pain. The placement of prosthesis arpe(R) has obtained good functional results and survival in the medium-long term, but it has also had complications. When this surgery fails, the Jones or Weilby techniques are usually used with good results. Objective: Description of the surgical technique used for arpe(R) prosthesis salvagement and results Material and methods: Statistical descriptive analysis with STATA version 12 of the functional results of all cases of Arpe(R) prosthesis; which have undergone surgical revision through Weilby technique without extraction of the implanted stem, in our center. Results: The results obtained have been satisfactory and comparable to those that appear with the use of other revision techniques for unsuccessful trapeziometacarpal implants; with an average. Kapandji of 9 (0-10), a DASH score average of 61.36 (18.18-88.63), an average EVA of 3 (0-8), lateral clamp force 2.1 (1-5.5.5) Kg / cm2 and Clamp force fist 8 (0.5-18) Kg / cm2. Conclusions: The Weilby technique without prosthetic stem extraction is an easily reproducible procedure that gets good results in mobility and pain, comparable to other tenosuspension techniques used in revisions of unsuccessful Arpe(R) implant

Utilización de cadáveres para la enseñanza de la intubación orotraqueal / Use of corpses for teaching orotracheal intubation

A propósito de una consulta realizada por un profesional, relacionada con la práctica de intubación orotraqueal de cadáveres con fines formativos, el Comité de Ética Asistencial (CAE) del Hospital Universitario Marqués de Valdecilla ha considerado de especial relevancia la contextualización del proceso, tanto a nivel temporal como de infraestructura (tipo de centro sanitario); y sus principales reflexiones y conclusiones, se pretenden dar a conocer. Primero, que existe un vacío legal a este respecto, que provoca interpretaciones legales sin base fundada. Segundo, se recomienda que atendiendo al principio de autonomía de las personas, así como a la dignidad de las mismas, se debiera obtener un consentimiento informado para la realización de dichas prácticas; y, en el caso de no poder obtenerse, se recomienda que el alumno se abstenga de realizar el procedimiento (AU)

With regard to a query raised by a professional, related to the practice of the orotracheal intubation of bodies for training purposes, the Healthcare Ethics Committee (HEC) of the Hospital Universitario Marqués de Valdecilla has considered the contextualisation of the process to be particularly relevant, both in terms of time and infrastructure (type of health centre); and it is intended to publicise its main reflections and conclusions. First, there is a legal loophole in this respect, leading to legal interpretations which are not well-founded. Second, it is recommended that by following the principle of individual autonomy and the dignity of individuals, it should be possible to obtain informed consent to carry out such practices. In the event that the informed consent cannot be obtained, it is recommended that students refrain from performing the procedure (AU)

Saúde e sexualidade de adolescentes. Construindo equidade no SUS

[Apresentação]. Na tentativa de mitigar as dificuldades de acesso à saúde, a Coordenação-Geral de Saúde de Adolescentes e Jovens (CGSAJ), em parceria com a Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS), realizou o evento “Construindo a Equidade no SUS: Sexualidade na Adolescência e Juventude”, Oficina I, que teve como objetivo iniciar uma reflexão, para qualificar o cuidado e o acesso dessa população à saúde. Essa publicação é fruto do debate entre adolescentes, academia e profissionais de diversas áreas do MS e da OPAS/OMS. Convidamos a todas e todos as/os leitores a refletirem,a debaterem e a engajarem conosco em mais um grande desafio de qualificação da atenção e do cuidado no âmbito do SUS.

Saúde e sexualidade de adolescentes. Construindo equidade no SUS

[Apresentação]. Na tentativa de mitigar as dificuldades de acesso à saúde, a Coordenação-Geral de Saúde de Adolescentes e Jovens (CGSAJ), em parceria com a Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS), realizou o evento “Construindo a Equidade no SUS: Sexualidade na Adolescência e Juventude”, Oficina I, que teve como objetivo iniciar uma reflexão, para qualificar o cuidado e o acesso dessa população à saúde. Essa publicação é fruto do debate entre adolescentes, academia e profissionais de diversas áreas do MS e da OPAS/OMS. Convidamos a todas e todos as/os leitores a refletirem,a debaterem e a engajarem conosco em mais um grande desafio de qualificação da atenção e do cuidado no âmbito do SUS.

[Spontaneous and voluntary fetal losses in Brazil in 1999-2000: a study of associated factors]. / Perdas fetais espontâneas e voluntárias no Brasil em 1999-2000: um estudo de fatores associados.

Despite its illegality in Brazil, about 31% of all pregnancies end in abortion. Most abortions are performed by unskilled personnel and under unsafe conditions, resulting in increased female mortality. This study used data from a cross-sectional representative sample of 3,047 puerperal women, in 1999-2000, part of a national multicenter study on the prevalence of syphilis in Brazil. Of these, 1,838 women with at least one previous pregnancy before the reference pregnancy were included in the analysis. The outcomes studied were voluntary prior fetal loss, spontaneous prior fetal loss, and no prior fetal loss. The analysis was carried out using multinomial logistic regression. The results indicated a high number of fetal losses per woman (up to six); and 31% of the losses were voluntary. The absence of prenatal care, history of STD in the reference pregnancy, and absence of living children were factors that increased the odds of fetal loss. For voluntary fetal loss, being non-white, having more than one partner in the previous year, and an early age at first sexual intercourse also increased the odds of fetal loss. These data confirm the public health relevance of abortion in Brazil. Characteristics related to women´s vulnerability should be considered in family planning programs in order to reduce the number of abortions and their consequences. Counseling must also be provided, targeting women with a previous abortion.

Perdas fetais espontâneas e voluntárias no Brasil em 1999-2000: um estudo de fatores associados / Spontaneous and voluntary fetal losses in Brazil in 1999-2000: a study of associated factors

Apesar de ilegal no Brasil, cerca de 31% das gestações terminam em aborto. A maioria dos abortamentos provocados é realizada por pessoas não capacitadas, e em condições inseguras, resultando em aumento da mortalidade feminina. O presente estudo utilizou dados de uma amostra representativa de 3.047 puérperas, de 1999-2000, de corte transversal, parte de estudo multicêntrico nacional sobre soroprevalência de sífilis no Brasil. Destas, foram analisadas 1.838 puérperas com pelo menos uma gravidez anterior à gravidez de referência. Os desfechos estudados foram perdas fetais prévias (voluntária e espontânea) e ausência de perda fetal prévia. A análise foi conduzida por meio de regressão logística multinomial. Os resultados indicaram alto número de perdas fetais por mulher (até seis) e 31% das perdas foram voluntárias. A ausência de pré-natal, a história de DST na gravidez de referência e a ausência de filhos vivos aumentaram a ocorrência de perdas fetais. Para as perdas voluntárias, a raça/cor não branca, mais de um parceiro no ano anterior e idade precoce à primeira relação sexual também concorreram para o aumento da ocorrência. Características de vulnerabilidade destas mulheres devem ser consideradas em programas de planejamento familiar e de aconselhamento de mulheres, focalizando aquelas que já tiveram abortos, para a redução do número e consequências deste procedimento.

Despite its illegality in Brazil, about 31% of all pregnancies end in abortion. Most abortions are performed by unskilled personnel and under unsafe conditions, resulting in increased female mortality. This study used data from a cross-sectional representative sample of 3,047 puerperal women, in 1999-2000, part of a national multicenter study on the prevalence of syphilis in Brazil. Of these, 1,838 women with at least one previous pregnancy before the reference pregnancy were included in the analysis. The outcomes studied were voluntary prior fetal loss, spontaneous prior fetal loss, and no prior fetal loss. The analysis was carried out using multinomial logistic regression. The results indicated a high number of fetal losses per woman (up to six); and 31% of the losses were voluntary. The absence of prenatal care, history of STD in the reference pregnancy, and absence of living children were factors that increased the odds of fetal loss. For voluntary fetal loss, being non-white, having more than one partner in the previous year, and an early age at first sexual intercourse also increased the odds of fetal loss. These data confirm the public health relevance of abortion in Brazil. Characteristics related to women´s vulnerability should be considered in family planning programs in order to reduce the number of abortions and their consequences. Counseling must also be provided, targeting women with a previous abortion.

Prevenção e manejo da hemorragia pós-parto / Prevention and management of postpartum haemorrhage

Introdução: As síndromes hemorrágicas estão entre as principais causas obstétricas diretas de mortes maternas. Segundo dados da Organização Mundial de Saúde estima-se uma morte a cada quatro minutos. A hemorragia pós-parto reflete diretamente a qualidade da assistência, sendo uma das causas potencialmente prevenível e tratável. O desenvolvimento de manejos clínicos para seu controle torna-se de extrema importância na redução da mortalidade materna. Objetivo: Definir a melhor estratégia para a prevenção e o tratamento da hemorragia pós-parto, enfatizando o manejo ativo no terceiro estágio do trabalho de parto. Métodos: Foi realizada uma revisão de literatura no banco de dados Medline/PubMed, LILACS/SciELO, Cochrane Library e no site do Royal College of Obstetricians and Gynaecologists em busca das melhores evidências clínicas disponíveis, considerando-se o grau de recomendação. Resultados: Verificou-se que o manejo ativo da terceira fase do trabalho de parto é de fundamental importância para a prevenção da hemorragia pós-parto. O uso de uterotônicos, sendo a ocitocina o fármaco de primeira linha para este fim, a tração controlada de cordão umbilical com massagem uterina são a base deste tratamento. O tratamento cirúrgico também pode ser necessário e deve ter uma indicação precisa e de acordo com a experiência do cirurgião. Conclusão: Uma boa assistência a gestantes durante o trabalho de parto, principalmente uma conduta ativa no terceiro estágio, interfere de forma positiva para a prevenção de hemorragias maternas graves, contribuindo para o controle e diminuição da mortalidade materna.(AU)

Introduction: The haemorrhagic syndromes are the main causes of direct obstetric maternal deaths. According to data from the World Health Organization estimated one death every four minutes. Postpartum haemorrhage directly reflects the quality of care, being a potentially preventable and treatable causes. The development of clinical managements to their control it becomes of extremely important for reduction maternal mortality. Objective: The aim of this work was to search in literature the most important strategy to prevent and the treat the postpartum haemorrhage, emphaesing the active management in the third stage of labour. Methods: A revision of literature in the Medline/ PubMed, LILACS/ SciELO, Cochrane Library and in the site of the Royal College of Obstetricians and Gynaecologists data base was carried through, in search of the best clinical evidences available, take into account also the degree of recommendation. Results: It was founded that the active management of third stage of labour is fundamental for prevention of postpartum hemorrhage. The oxytocin was first line drug for this effect, the control umbilical lace traction with uterine massage is the base of this treatment. The surgery can be necessary and must have a straight indication and the experience of surgeon has a lot of importance. Conclusion: A good care for pregnant women during the labour, mainly in the active third stage of labour interferes in a positive way to prevent severe mothers' haemorrhages, and contributes to the reduction of maternal mortality.(AU)

Uso dos antirretrovirais na gestação e seus possíveis efeitos adversos / Use of antiretroviral agents during pregnancy and their possible adverse effects

A transmissão vertical do HIV tem sido a forma de transmissão que mais sofreu redução nos últimos anos. O principal fator determinante para tal diminuição foi o uso da terapia antirretroviral de alta potência (HAART) nas gestantes infectadas. Atualmente, a taxa de transmissão vertical do HIV em países desenvolvidos está em torno de 2%. Apesar de seu efeito benéfico indiscutível, alguns estudos mostram possíveis efeitos colaterais causados pelo uso dos antirretrovirais nas gestantes e nos recém-nascidos. Entre os efeitos adversos mais frequentes, estão aqueles que podem estar presentes em qualquer paciente que use a medicação, como hipersensibilidade, toxicidade mitocondrial e lipodistrofia. No entanto, existem também os efeitos colaterais específicos do uso destas medicações durante a gestação. Vários estudos têm sido realizados para determinar a segurança dos antirretrovirais no binômio mãe e feto. Os possíveis efeitos adversos descritos pelo uso dos antirretrovirais na gestação são: resistência à insulina e o desenvolvimento de diabetes gestacional; pré-eclâmpsia; aumento de incidência de malformações congênitas; maior índice de parto pré-termo e/ou de baixo peso ao nascer. Esta revisão discute os possíveis efeitos adversos e suas consequências

HIV vertical transmission has been the route of transmission that most declined in the last years. The main factor implied in this mother-to-child-transmission reduction was the routine use of highly active antiretroviral therapy (HAART) by infected pregnant women. Currently, the HIV vertical transmission rate in developed countries is about 2%. Although there is an incontestable benefic effect of antiretroviral therapy, some studies show possible adverse effects in pregnant women and newborns after using the antiretroviral therapy. There are collateral effects that can occur in any patient using these drugs, such as hypersensitivity, mitochondrial toxicity, and lipodystrophy. However, there are other collateral effects, which are specific to the use of these drugs during pregnancy. Several authors have studied antiretroviral treatment in pregnancy to determine the safety of HAART to the mother-child binomial. The possible adverse effects caused by antiretroviral therapy use during pregnancy are: insulin resistance and the development of gestational diabetes; preeclampsia; higher incidence of congenital abnormalities; higher rates of preterm birth, and/or low-birth weight. This review discusses the possible adverse effects and their consequences

HIV-1 RNA detection in the amniotic fluid of HIV-infected pregnant women.

This study is aimed at evaluating the potential to detect human immunodeficiency virus (HIV) in amniotic fluid (AF) collected at delivery from 40 HIV-positive pregnant women. Thirty patients had a plasma viral load (VL) below 1,000 copies/mL at delivery. VL was positive in three AF samples. No significant association was found between the HIV-1 RNA in AF and the maternal plasma samples. There was no HIV vertical transmission detected.

HIV-1 RNA detection in the amniotic fluid of HIV-infected pregnant women

This study is aimed at evaluating the potential to detect human immunodeficiency virus (HIV) in amniotic fluid (AF) collected at delivery from 40 HIV-positive pregnant women. Thirty patients had a plasma viral load (VL) below 1,000 copies/mL at delivery. VL was positive in three AF samples. No significant association was found between the HIV-1 RNA in AF and the maternal plasma samples. There was no HIV vertical transmission detected.

MFN2 point mutations occur in 3.4% of Charcot-Marie-Tooth families. An investigation of 232 Norwegian CMT families.

BACKGROUND: Point mutations in the mitofusin 2 (MFN2) gene has been identified exclusively in Charcot-Marie-Tooth type 2 (CMT2), and in a single family with intermediate CMT. MFN2 point mutations are probably the most common cause of CMT2. METHODS: Two-hundred and thirty-two consecutive unselected and unrelated CMT families with available DNA from all regions in Norway were included. We screened for point mutations in the MFN2 gene. RESULTS: We identified four known and three novel point mutations in 8 unrelated CMT families. The novel point mutations were not found in 100 healthy controls. This corresponds to 3.4% (8/232) of CMT families have point mutations in the MFN2 gene. The phenotypes were compatible with CMT1 in two families, CMT2 in four families, intermediate CMT in one family and distal Hereditary Motor Neuropathy (dHMN) in one family. This corresponds to 2.3% of CMT1, 5.5% of CMT2, 12.5% of intermediate CMT and 6.7% of dHMN families have a point mutation in the MFN2 gene. Point mutations in the MFN2 gene is likely to be the fourth most common cause to CMT after duplication of the peripheral myelin protein 22 (PMP22) gene, and point mutations in the Connexin32 (Cx32) and myelin protein zero (MPZ) genes. CONCLUSIONS: The identified known and novel point mutations in the MFN2 gene expand the clinical spectrum from CMT2 and intermediate CMT to also include possibly CMT1 and the dHMN phenotypes. Thus, genetic analyses of the MFN2 gene should not be restricted to persons with CMT2.

Predictors of postpartum viral load rebound in a cohort of HIV-infected Brazilian women.

OBJECTIVE: To assess the postpartum viral load of HIV-infected women treated with potent antiretrovirals (ARVs) during pregnancy, and look for predictors of viral load rebound. METHODS: Of 112 women who took potent ARVs during pregnancy, 60 took them as prophylaxis to prevent mother-to-child transmission of HIV. The remaining 52, who had AIDS, were treated continuously with ARVs before, during, and after pregnancy. Viral load was evaluated in the weeks before, just before, and after delivery. Viral load rebound was defined as a 0.5 log(10) increase in viral RNA as measured 6 months after delivery. RESULTS: A viral load rebound affected women much more often in the prophylaxis than in the treatment group (84.7% vs 15.3%; P<0.001), and was associated with ARV discontinuation. The women with a viral load rebound had a higher decline in CD4 lymphocyte percentage 6 months after delivery. On multivariate analysis, variables positively or negatively associated with a viral load rebound were a decline in CD4 lymphocyte count (P=0.01), the therapeutic use of potent ARVs (P<0.001), and the number of prenatal visits (P=0.03). CONCLUSION: Discontinuing the use of potent ARVs after delivery was associated with a decrease in CD4 lymphocyte count and a viral load rebound.

Applications of counter-current chromatography in organic synthesis purification of heterocyclic derivatives of lapachol.

This work describes the application of counter-current chromatography (CCC) as a useful, fast and economic alternative for the isolation and purification of heterocyclic derivatives from lapachol and beta-lapachone, two naturally occurring compounds from Tabebuia species, and nor-beta-lapachone, a synthetic congener of lapachol. The discussed data comprise four examples of purification of synthetic reactions with different solvent systems - the mixture of the oxazole and the imidazole from beta-lapachone; the quinoxaline from nor-beta-lapachone; and the purification of the N-oxides from the quinoxaline and the phenazine from nor-beta-lapachone from their respective not fully reacted substrates by means of aqueous reversed- and normal-phase elution modes and non-aqueous solvent systems. Traditional purification of these reaction products by silica gel column chromatography demanded a large amount of solvent and time and, in some cases, serious degradation of the products occurred, leading to low yield of the reaction. High-speed counter-current chromatography (HSCCC) was used as an alternative to optimize the process and raise the yield of the reactions.

Resultados maternos e perinatais de dez anos de assistência obstétrica a portadoras do vírus da imunodeficiência humana / Maternal and perinatal results in ten years of obstetrical care to human immunodeficiency virus-infected women

Objetivos: avaliar a transmissão vertical do vírus da imunodeficiência humana (HIV) e os fatores de risco associados à infecção perinatal. Métodos: estudo descritivo de 170 gestantes infectadas pelo HIV e seus 188 recém-nascidos, admitidas na Maternidade do Hospital das Clínicas da UFMG, no período de junho de 1994 a setembro de 2004. Foram analisados as características demográficas, o perfil sorológico e a via de parto das gestantes, assim como os resultados perinatais. As crianças foram acompanhadas por período de 18 meses após o nascimento. Os dados foram armazenados e analisados no Epi-Info, Versão 6.0. Estabeleceu-se intervalo de confiança a 95% (p<0,05). Resultados: o diagnóstico da infecção pelo HIV foi confirmado durante a gestação em 84 (45,4%) pacientes. A carga viral era inferior a 1000 cópias/mL em 60,4% das pacientes. O esquema predominante de uso dos anti-retrovirais foi a terapia tríplice (65,5 % ). Foi alta a taxa de cesariana: 79,5 %. A taxa de prematuridade foi 18,2%. Entre os 188 recém-natos houve 184 (97,8%) nativivos e quatro (2,2%) mortes perinatais. Dos nascidos vivos, 97,8% receberam zidovudina após o nascimento. A taxa global de transmissão matemo-fetal global foi 3,8%. As taxas de transmissão vertical do vírus, por período, foram: 60%, até 1996; 28%, entre 1996e 1998; 0,68%, entre 1999 e 2004. Não foram encontrados fatores de risco significativamente associados à infecção perinatal pelo HIV, devido ao pequeno número de recém-nascidos infectados (n=6). Conclusão: houve grande redução da transmissão vertical do HIV no período analisado. A taxa atual de transmissão é zero, confirmando que, adotando-se medidas adequadas, pode-se prevenir a transmissão perinatal do vírus.