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De Oliveira Demitto F.,State University of Maringá | Do Amaral R.C.R.,Graduada em Farmac Mestranda | Biasi R.P.,FarmaceUtica | Guilhermetti E.,Mestra em Analises Clinicas Pela Uem | And 2 more authors.
Jornal Brasileiro de Patologia e Medicina Laboratorial | Year: 2012

Introduction: Due to the ubiquity of nosocomial yeast infections of the genus Candida spp., studies in this area have become increasingly relevant. Objective: To evaluate the antifungal Candida spp. Susceptibility profile of hospitalized patients from the Regional University Hospital of Maringá-PR (HURM). Material and Methods: The samples were submitted to broth microdilution test (MD) according to protocol M27-A3 in order to determine the minimum inhibitory concentration (MIC) and disk diffusion test according to protocol M44-A2, both from Clinical Laboratory Standards Institute (CLSI). Results and discussion: We obtained 91 isolates from urine samples, blood culture, catheter tip, endotracheal secretions, among others, from which 38 were Candida albicans, 23 were C. tropicalis, 16 were C. gabrata, 10 were C. parapsilosis, and four were C. krusei. Among the tested antifungal medications, amphotericin B, voriconazole and anidulafungin proved to be the most effective. Conclusion: In the comparison between broth microdilution and disk diffusion (DD) methods, fluconazole showed good correlation for most Candida spp., which corroborates the usefulness of DD in the screening of main antifungal agents used in clinical practice. Nonetheless, cases of resistance detected by DD need to be confirmed by MD method, which avoids false-resistant results and maximizes the treatment efficacy and reliability.

Weber M.B.,Federal University of Health Sciences, Porto Alegre | Dal'Forno T.,Grande Rio University | Zechmeister-Prado D.,Farmaceutica
Surgical and Cosmetic Dermatology | Year: 2011

Introduction: After puberty, most women develop some amount of cellulite.With the increasing number of dermatological consultations about treating cellulite, a broader understanding of the characteristics, wishes and expectations of these patients regarding their quality of life has become necessary. Objective: To develop and validate an instrument to evaluate the quality of life of patients with cellulite. Methods: The study consisted of two stages: in the first, instruments for assessing patients' quality of life were developed and validated; in the second, two questionnaires were administered to 100 females with cellulite, aged 18 to 45. Results: The reliability of the results was assessed using factorial analysis and Cronbach's alpha test. With the use of exploratory factorial analysis, it was possible to test (1) the hypothesis that all questions in the shortened questionnaire measured a single factor (cellulite) and (2) the hypothesis that each block of questions in the full version of the questionnaire measured a single domain or factor among the parameters being assessed (dressing style, physical activity, partner, feelings and change in daily habits). Conclusion: The validation analysis showed that both questionnaires effectively measure cellulite patients' quality of life.

Neves A.F.,Farmacia Hospitalar | Martins A.,Enfermeira | Queiroz A.M.M.,Hematologista | Thome E.D.,Dermatologista | And 2 more authors.
Revista Brasileira de Hematologia e Hemoterapia | Year: 2010

Sickle cell disease is characterized by several clinical and pathophysiological changes including painful leg ulcers. These are difficult to heal and require the support of a multidisciplinary team in their management. The treatment of pain in these patients usually involves the use of opioids. In order to reduce the use of systemic opioids, we evaluated an easy-to-use low-cost morphine gel (0.12%) that was applied before and after changing leg ulcer dressings of sickle cell patients treated in Hemorio hospital. Based on the Analogue Pain Scale (APS) we evaluated the analgesic effect of the gel with 28 patients. All presented with a degree of pain of 7 or 8 before applying the gel. A total absence of pain was observed by 24 patients (85.7%) within thirty minutes of applying the gel, with the analgesia effect being maintained for a period of 24 hours and thus the use of other analgesics was not requiring. In 3 patients (10.7%) no pain was reported for a period of 12 hours. Only 1 patient (3.6%) reported no analgesic effect thirty minutes after the application of the gel. Our results indicate that the morphine gel was effective in controlling the pain of leg ulcers in this group of sickle cell patients. A controlled study should be designed to assess this important subject.

Sodre H.R.S.,Farmaceutica | Da Matos S.B.,Federal University of Bahia | De Jesus A.L.S.R.,Especialista em Analises Clinicas | De Mendonca Lima F.W.,Federal University of Bahia
Jornal Brasileiro de Patologia e Medicina Laboratorial | Year: 2010

Introduction: HTLV is a retrovirus with high prevalence in Salvador, Bahia, when compared to other Brazilian capitals. The study of its risk factors is very important in order to understand the infection dynamics in the municipality. Objective: To assess the prevalence and some risk factors for HTLV-I/II infection among people assisted by the Family Health Program (FHP) in Salvador, Bahia, Brazil. Materials and methods: Biological samples were obtained from FHP health centers in Salvador city. Immunoassays were performed by ELISA method for HTLV antibody detection. Retrospective data about potential risk factors to HTLV infection were obtained through questionnaire. Results: 765 samples were tested, 529 (69.2%) females and 236 (30.8%) males. The overall HTLV-I/II seroprevalence was 1.96%, increasing according to age. HTLV-I/II seroprevalence was 2.16% and 1.89% for males and females, respectively (p = 0.833). Among seropositive individuals, 84.6% reported having a steady sexual partner and 61.5% do not use condoms frequently in their sexual intercourses, what similarly was observed among seronegative with 76.5% and 67.4%, respectively. Conclusion: The seroprevalence found is considered high compared to other Brazilian municipalities. The analyzed risk factors were not statistically different between HTLV-I/II seronegative and seropositive groups. The vertical transmission was not an important factor for virus maintenance.

Kich D.M.,FarmaceUtica | De Souza Vieira F.A.,University Feevale | Bassuino M.,Biomedico | Linden R.,University Feevale
Jornal Brasileiro de Patologia e Medicina Laboratorial | Year: 2012

Introduction: The interest in vitamin D has increased significantly in recent years. Epidemiological studies conducted over the past 25 years have shown a steady increase in vitamin D deficiency. The diagnostic marker of choice to determine vitamin D levels is the concentration of 25-hidroxy-vitamin D (25(OH)D) in the fractions D2 (25(OH)D2) and D3 (25(OH)D3). Objective: To develop an analytical method using high-performance liquid chromatography with diode-array detection (HPLC-DAD) for the determination of 25(OH)D2 and 25(OH)D3 in plasma. Materials and methods: 25(OH)D3 and 25(OH)D2 were extracted from plasma samples with hexane and dodecaphenone was used as internal standard. The separation was performed in an ACE 5 C18 column, with particle size of 5 μm (4,6 × 150 mm), mobile phase methanolwater (80:20, v/v) and quantification at 265 nm. Results: Accuracy was in the range of 98.4 to 107.5%. Intra-assay precision was between 6.5 and 9.2% for 25(OH)D3 and 3.7 and 8.7 for 25(OH)D2. Inter-assay precision was between 2.9 and 6% for 25(OH)D3 and 4 and 4.5 for 25(OH)D2. The limit of quantification was 10 ng/l. Concentrations of 25(OH)D3 in samples from 32 elderly patients were between 10.1 and 32.4 ng/ml, characterizing vitamin D deficiency in this group. Discussion: The method allowed the quantification of 25(OH)D2 and 25(OH)D3. Furthermore, the sample preparation was relatively simple and fast. The method was selective with an adequate separation of metabolites and internal standard with no interfering substances. Conclusion: Not only did the developed method show suitable analytical performance, but it may also be applied in clinical conditions.

Sato N.S.,University of Sao Paulo | Sato N.S.,Instituto Adolfo Lutz IAL | Da Silva Zerbini L.C.M.,Instituto Adolfo Lutz IAL | De Melo C.S.,Instituto Adolfo Lutz IAL | And 9 more authors.
Jornal Brasileiro de Patologia e Medicina Laboratorial | Year: 2012

Introduction: The appropriateness of IgM antibody detection in the diagnosis of syphilis has been extensively discussed. Objective: This study aimed at assessing the detection of anti-T. pallidum IgM antibody (TP-IgMAb) in serum samples from patients with recent syphilis in seroconversion and in the monitoring of post-treatment serological response. Methods: Serum samples from 11 individuals. Results: At seroconversion, positive Tp-IgMAb was detected in 10 samples and IgM reactivity previous to Venereal Disease Research Laboratory (VDRL) was detected in one sample. Seroreversion was found in samples from three treated patients with secondary syphilis and in one individual with reinfection. Conclusion: Tp-IgMAb detection proved to be a potential diagnostic marker for active syphilis, and IgM capture enzyme linked immunosorbent assay (ELISA-IgM) performance was similar to VDRL in post-treatment monitoring.

Herkenhoff M.E.,Ciencia Animal Genetica | Gaulke R.,Biomedicina | De Souza J.G.,Biologia | Thome N.S.,Farmaceutica | And 2 more authors.
Jornal Brasileiro de Patologia e Medicina Laboratorial | Year: 2012

Introduction: Prothrombin (factor II) is a blood protein synthesized in the liver in the presence of vitamin K. It is a thrombin precursor, which induces fbrin formation. Prothrombin G20210A mutation and high prothrombin levels have been closely associated with thrombophilia. This allelic variant is a single mutation, also denominated single nucleotide polymorphism (SNP), in which guanine is replaced with adenine in the messenger ribonucleic acid (mRNA) cleavage of nucleotide 20210. The replacement is characterized by the presence of allele A and the absence of mutation in allele G. Objective: To quantify the number of individuals homozygous for allele G, allele A and heterozygotes. The samples were collected in Paraná and Santa Catarina from January 1 st, 2009 to October 10th, 2010 and were sent to Genolab Análises Genéticas. Methods: Analysis of single mutation by polymerase chain reaction in real time (RT-PCR). Results: From 243 individuals, 51.03% were from Paraná and 48.97% were from Santa Catarina. 88.89% individuals were homozygous for G genotype, none of them were homozygous for A. Only 11.11% were heterozygotes. Santa Catarina presented a higher frequency in heterozygous genotype in comparison with Paraná. Conclusion: This study showed that patients with suspected thrombophilia should undergo genotype identifcation in both states.

de Tarso Ponte Pierre Filho P.,Medico oftalmologista da Santa Casa de Sobral | Gomes P.R.P.,Medico oftalmologista da Santa Casa de Sobral | Pierre E.T.L.,Farmaceutica | Pinheiro Neto F.B.,Medico oftalmologista da Santa Casa de Sobral
Revista Brasileira de Oftalmologia | Year: 2010

Purpose: To evaluate the profile of all the visits to the ophthalmic emergency service at a tertiary hospital in the city of Sobral, Ceará, northeast of Brazil. Methods: A survey was carried out of all patients attended at ophthalmology emergency service of the department of ophthalmology of Santa Casa of Sobral, during the period between may and october 2008. Data on patient's age, sex, level of education, residential address, health insurance status, average distance to our service, time between the initial symptoms and first visit to the hospital, site of medical evaluation indication, diagnosis, and veracity of emergency indication. All these data were collected during interview and ophthalmological examination. Results: A total number of 1,024 patients were analyzed in the study. Mean and standard deviation to age was 31.5 ± 17.1 years (ranging from zero to 81). Sixty-five per cent of the patients were male and 35% female. Twenty-one per cent of the patients lived at least 50 kilometers away from the Santa Casa of Sobral. Ocular traumas (40.9%) of any nature were the most frequent occurrence, followed by infections (29%). About 45 % of cases were not considered as a true emergency and could be managed in primary or secondary health care centers. About the initial symptoms and first visit to the hospital, only 24% of the patients went to the ophthalmology emergency room on the same day in which their symptoms started. Conclusion: A great number of patients attended or treated at the ophthalmology emergency service of Santa Casa of Sobral presented with common ocular disorders of simple resolution. Therefore there is a failure in the primary and secondary health care to manage it. Certainly a considerable proportion of these patients had conditions which could have been diagnosed and treated in an ophthalmic outpatient clinic or by general practitioners.

The Brazilian physiotherapeutic product market features several bronchodilators and expectorants made from ivy (Hedera helix L. - Araliaceae) extracts and with different compositions in terms of the amount of dry extract and marker per ml of solution. Aiming to contribute to the understanding of these differences, the clinical literature on the species was surveyed, focusing on aspects related to extract concentration and number of markers. It was found that, globally, there are three different commercial ivy extract formats, prepared with a drug:extract ratio of 3-6:1, 5-7,5:1 and 4-8:1, generating different marker percentages. The first two formats can be found on the Brazilian market and have effective and safe clinical grounds, demonstrating that this species has a variable range of action. The most relevant clinical multicenter study was conducted by Fazio and colleagues (2009), using product with concentration of markers are provided, in Brazil, by only the 5-7,5:1-type formulation phytotherapeutic products, while the 3-6:1-type formulation products has contents below the minimum used in that study. The safety profiles of the various types of Hedera helix-based products are well established, with minor, primarily gastrointestinal adverse effects. © Copyright Moreira Jr. Editora. Todos os direitos reservados.

Bulffer R.F.,Farmaceutica | Castro J.A.,Quimica | Fanelli S.L.,Quimica
Acta Bioquimica Clinica Latinoamericana | Year: 2011

Chagas' Disease is an endemic parasitic disease in South and Central America. There are two drugs available for medical treatment of the disease, Nifurtimox (Nfx) and Benznidazol (Bz). There are no standardized or accessible protocols in regional laboratorios to determine the levels of antichagasic drugs in blood. A spectrophotometric method for Nfx and Bz determination in blood is presented in the present work. Blood metabolites are extracted through Extrelut® columns. Extracts are evaporated, redissolved in metanol/water mixanalysed by spectrophotometry at 400 nm and 320 nm for Nfx and Bz, respectively. They are quantified comparing with standard Nfx or Bz solutions in the solvent. The methodology used was validated between 0.5 and 50 μg/mL of blood for Nfx, and between 0.5 and 100 μg/mL of blood for Bz. The accuracy, precision, lineality and robustness of the method were satisfactory. The procedure was applied determining blood concentrations after administration of both drugs to rats.

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