Simultaneous determination of alpha-, beta- and gamma-hydroxybutyric acids in micro-pulverized human hair by GC-MS: Method development, validation and application.

An analytical method was developed and validated for the simultaneous determination of alpha, beta and gamma-hydroxybutyric acids (AHB, BHB and GHB, respectively) in human hair. Hair samples (10 mg) were pulverized and submitted to extraction using methanol (1 mL) for 10 min. The extract was centrifuged, filtered, and evaporated to dryness at 40 °C under a gentle N2 flow, dissolved in ethyl acetate (0.050 mL) and derivatized using 0.050 mL of BSTFA containing 1% TMCS, at °C for 40 min. The derivatives were determined by GC/MS. Aliquots of natural hair ("blank") samples after water extraction (3 steps) were pulverized, spiked with AHB, BHB, GHB or d6-GHB and used for method validation. Figures of merit showed the method's feasibility. The LOQ values were 1 ng mg-1 for BHB and AHB and 0.6 ng mg-1 for GHB, and mean recoveries were 54%, 69% and 75% for AHB, BHB and GHB respectively. Precision and bias were better than 15% and 20% respectively. Calibration curves (LOQ to 20 ng mg-1 for AHB and BHB and LOQ to 16 ng mg-1 for GHB) obtained in 5 days were pooled for statistical analysis, but the data were heteroscedastic, as demonstrated by the White test. Therefore, weighted linear regression and data transformations were applied and the best results were obtained using the Box-Cox transformation [c' = (cλ-1)/λ] for GHB and log transformation for AHB and BHB. Authentic hair samples were collected from the posterior head vertex of 23 volunteers (16 females and 7 males). Four of them declared having type-2 diabetes (T2D). Only female volunteers reported hair treatments such as dyeing, flat ironing, straightening and/or bleaching. Dyeing appeared not to affect GHB levels in hair, but no data were found in the literature about other cosmetic treatments. GHB levels varied from < LOQ to 1.5 ng mg-1. BHB levels varied from < LOQ to 3.4 ng mg-1 and from < LOQ to 1.8 ng mg-1 in non-diabetic volunteers with or without family history of T2D, respectively. However, in diabetics, BHB levels varied from 3.4 to 5.2 ng mg-1. The levels of AHB varied from < LOQ to 1.2 ng mg-1 in non-diabetic individuals, and from 1.1 to 6.2 ng mg-1 in diabetics. Our results showed that AHB levels in hair have potential to as a biomarker for T2D, but this needs to be further studied with larger groups of volunteers. To our knowledge, this is the first published method for the determination of AHB and BHB in human hair.

Armas de fogo e suicídios

Existe praticamente um consenso de que a proporção de suicídios cometidos com armas de fogo em relação ao suicídio total é a melhor maneira de medir indiretamente a prevalência dessas armas. No entanto, essa proxy não é precisa para localidades com baixa densidade populacional, tendo em conta que os suicídios são eventos raros. Para contornar esse problema, exploramos as características socioeconômicas das vítimas de suicídio, de modo a propor uma nova proxy para prevalência de arma de fogo. Avaliamos o nosso indicador com microdados de suicídio do Ministério da Saúde (MS), entre 2000 e 2010.

Point pattern analysis with spatially varying covariate effects, applied to the study of cerebrovascular deaths.

This article proposes a modeling approach for handling spatial heterogeneity present in the study of the geographical pattern of deaths due to cerebrovascular disease.The framework involvesa point pattern analysis with components exhibiting spatial variation. Preliminary studies indicate that mortality of this disease and the effect of relevant covariates do not exhibit uniform geographic distribution. Our model extends a previously proposed model in the literature that uses spatial and non-spatial variables by allowing for spatial variation of the effect of non-spatial covariates. A number of relative risk indicators are derived by comparing different covariate levels, different geographic locations, or both. The methodology is applied to the study of the geographical death pattern of cerebrovascular deaths in the city of Rio de Janeiro. The results compare well against existing alternatives, including fixed covariate effects. Our model is able to capture and highlight important data information that would not be noticed otherwise, providing information that is required for appropriate health decision-making.

Avaliando a efetividade da Lei Maria da Penha / Evaluating the effectiveness of Maria da Penha Law

A superação da violência doméstica é um dos grandes desafios das políticas públicas no Brasil. A Lei nº 11.340, conhecida como Lei Maria da Penha (LMP), sancionada em 2006, representou um marco institucional importante nesse caminho, pois procurou tratar de forma integral o problema da violência doméstica, e não apenas da imputação de uma maior pena ao ofensor. Contudo, mais de oito anos após a sanção da LMP, há uma completa lacuna acerca de estudos empíricos que procurassem avaliar o seu efeito, que foi o objeto deste trabalho. Construímos um modelo de diferenças em diferenças, em que os homicídios contra mulheres que ocorreram dentro das residências foram confrontados com aqueles que acometeram os homens. Nossos resultados indicaram que a lei cumpriu um papel relevante para conter a violência de gênero, ainda que sua efetividade não tenha se dado de maneira uniforme no país, uma vez que a sua eficácia depende da institucionalização de vários serviços protetivos nas localidades, qu

Efficacy and safety of the brand-risperidone versus similar-risperidone in elderly patients with neuropsychiatric disorders: a retrospective study / Eficácia e segurança da risperidona-referência versus risperidona-similar em pacientes idosos com transtornos neuropsiquiátricos: um estudo retrospectivo

To compare the efficacy and tolerability of brand-risperidone against similar-risperidone in elderly outpatients. Method: The medical files of 16 elderly outpatients from the IPq-HCFMUSP treated with two formulations of risperidone (brand and similar) between July/1999 and February/2000 were reviewed. Two independent raters, using the Clinical Global Impression scale, evaluated the efficacy of the treatment with risperidone and the frequency of adverse effects. Results: Comparing October/1999 to November/1999, Rater 1 observed a trend (p=0.059) and Rater 2 found a statistically significant difference, in favor of the brand-risperidone group (p=0.014). Comparing October/1999 to February/2000, Rater 1 observed no statistically significant difference (p=0.190), but the Rater 2 found a statistically significant difference in favor of the brand-risperidone group (p=0.029). Comparing November/1999 to February/2000, both raters found no statistically significant differences between both risperidone formulations. Regarding adverse effects, a statistically significant difference (p=0.046) was found in favor of the patients treated with brand-risperidone. Conclusions: The risperidone-reference, compared to similar-risperidone, showed a trend toward greater efficacy and tolerability.

Comparar a eficácia e a tolerabilidade da risperidona-referência versus a risperidona-similar em pacientes idosos. Métodos: Os prontuários de 16 pacientes do IPq-HCFMUSP tratados com duas formulações de risperidona (referência e similar) entre julho/1999 e fevereiro/2000 foram revisados. Dois examinadores independentes, utilizando a escala de Impressão Clínica Global, avaliaram a eficácia do tratamento com risperidona e a freqüência de efeitos colaterais. Resultados: Comparando outubro/1999 e novembro/1999, o avaliador 1 observou uma tendência (p=0,059) e o examinador 2 encontrou uma diferença estatisticamente significativa a favor da risperidona-referência (p=0,014). Comparando outubro/99 com fevereiro/2000, o avaliador 1 não encontrou diferença estatisticamente significativa (p=0,190), mas o examinador 2 encontrou uma diferença estatisticamente significativa a favor da risperidona-referência (p=0,029). Entre novembro/1999 e fevereiro/2000, ambos examinadores não encontraram diferença significativas entre as formulações. Quanto aos efeitos colaterais, houve diferença significativa (p=0,046) a favor do grupo risperidona-referência. Conclusões: A risperidona-referência, quando comparada à risperidona-similar, mostrou tendência a maior eficácia e tolerabilidade.

Efficacy and safety of brand-risperidone versus similar-risperidone in elderly patients with neuropsychiatric disorders: A retrospective study.

To compare the efficacy and tolerability of brand-risperidone against similar-risperidone in elderly outpatients. METHOD: The medical files of 16 elderly outpatients from the IPq-HCFMUSP treated with two formulations of risperidone (brand and similar) between July/1999 and February/2000 were reviewed. Two independent raters, using the Clinical Global Impression scale, evaluated the efficacy of the treatment with risperidone and the frequency of adverse effects. RESULTS: Comparing October/1999 to November/1999, Rater 1 observed a trend (p=0.059) and Rater 2 found a statistically significant difference, in favor of the brand-risperidone group (p=0.014). Comparing October/1999 to February/2000, Rater 1 observed no statistically significant difference (p=0.190), but the Rater 2 found a statistically significant difference in favor of the brand-risperidone group (p=0.029). Comparing November/1999 to February/2000, both raters found no statistically significant differences between both risperidone formulations. Regarding adverse effects, a statistically significant difference (p=0.046) was found in favor of the patients treated with brand-risperidone. CONCLUSIONS: The risperidone-reference, compared to similar-risperidone, showed a trend toward greater efficacy and tolerability.

Comparar a eficácia e a tolerabilidade da risperidona-referência versus a risperidona-similar em pacientes idosos. MÉTODOS: Os prontuários de 16 pacientes do IPq-HCFMUSP tratados com duas formulações de risperidona (referência e similar) entre julho/1999 e fevereiro/2000 foram revisados. Dois examinadores independentes, utilizando a escala de Impressão Clínica Global, avaliaram a eficácia do tratamento com risperidona e a freqüência de efeitos colaterais. RESULTADOS: Comparando outubro/1999 e novembro/1999, o avaliador 1 observou uma tendência (p=0,059) e o examinador 2 encontrou uma diferença estatisticamente significativa a favor da risperidona-referência (p=0,014). Comparando outubro/99 com fevereiro/2000, o avaliador 1 não encontrou diferença estatisticamente significativa (p=0,190), mas o examinador 2 encontrou uma diferença estatisticamente significativa a favor da risperidona-referência (p=0,029). Entre novembro/1999 e fevereiro/2000, ambos examinadores não encontraram diferença significativas entre as formulações. Quanto aos efeitos colaterais, houve diferença significativa (p=0,046) a favor do grupo risperidona-referência. CONCLUSÕES: A risperidona-referência, quando comparada à risperidona-similar, mostrou tendência a maior eficácia e tolerabilidade.