Use of inflammatory molecules to predict the occurrence of fever in onco-hematological patients with neutropenia

Febrile neutropenia remains a frequent complication in onco-hematological patients, and changes in the circulating level of inflammatory molecules (IM) may precede the occurrence of fever. The present observational prospective study was carried out to evaluate the behavior of plasma tumor necrosis factor alpha (TNF-α), soluble TNF-α I and II receptors (sTNFRI and sTNFRII), monocyte chemoattractant protein-1 [MCP-1 or chemokine (c-c motif) ligand 2 (CCL2)], macrophage inflammatory protein-1α (MIP-1α or CCL3), eotaxin (CCL11), interleukin-8 (IL-8 or CXCL8), and interferon-inducible protein-10 (IP-10 or CXCL10) in 32 episodes of neutropenia in 26 onco-hematological patients. IM were tested on enrollment and 24-48 h before the onset of fever and within 24 h of the first occurrence of fever. Eight of 32 episodes of neutropenia did not present fever (control group) and the patients underwent IM tests on three different occasions. sTNFRI levels, measured a median of 11 h (1-15) before the onset of fever, were significantly higher in patients presenting fever during follow-up compared to controls (P = 0.02). Similar results were observed for sTNFRI and CCL2 levels (P = 0.04 for both) in non-transplanted patients. A cut-off of 1514 pg/mL for sTNFRI was able to discriminate between neutropenic patients with or without fever during follow-up, with 65% sensitivity, 87% specificity, and 93% positive predictive value. Measurement of the levels of plasma sTNFRI can be used to predict the occurrence of fever in neutropenic patients.

Avaliação da espalhabilidade e do teor de flavonoides em forma farmacêutica semissólida contendo extratos de Calendula officinalis L. (Asteraceae) / Evaluation of spreadability and flavonoid content in semisolid pharmaceutical form containing extracts of Calendula officinalis L. (Asteraceae)

O objetivo deste estudo foi avaliar a característica reológica (espalhabilidade) e quantificar os princípios ativos (flavonoides) de preparações semissólidas (pomadas) contendo extratos de Calendula officinalis L. (Asteraceae). A partir da droga vegetal dessa espécie, foram obtidos dois tipos de extratos preparados por percolação na proporção de 1:5 utilizando-se mistura hidroalcóolica (etanol:água 62:38) e hidroglicólica (propilenoglicol:água 9:1). As pomadas contendo esses extratos, além de excipientes lanolina e vaselina, foram preparadas por duas técnicas distintas: solução (a quente) e suspensão (a frio). Análises para determinar a espalhabilidade através das relações entre área, esforço limite e teor de flavonoides foram realizadas a partir de amostras das pomadas preparadas. Os resultados demonstraram que as pomadas contendo extratos hidroalcoólicos e hidroglicólicos, preparadas por suspensão (a frio), exibiram as maiores relações entre área e esforço limite (0,34 e 0,33 mm2 g-1, respectivamente). No entanto, as pomadas preparadas com extratos hidroalcoólicos por suspensão resultaram nos maiores valores de flavonoides totais (0,004% m/m calculados como hiperosídeos).

The aim of this study was to assess the rheological properties (spreadability) and assay the active ingredients (flavonoids) in semi-solid preparations (ointments) containing extracts of marigold (Calendula officinalis L. - Asteraceae). The herbal drug from this species was separated from the dried inflorescence and two types of extracts were prepared by percolation at a ratio of 1:5, one with an ethanol:water mixture (62:38) and the other with propylene glycol: water (9:1). Ointments were prepared from these extracts, lanolin and vaseline, by two different techniques: solution (hot) and suspension (cold). Samples of each ointment were analyzed, to determine the spreadability, as the ratio between area of spread and limiting applied weight, and the flavonoid content. The results showed that ointments prepared by cold suspension, containing hydroalcoholic and hydroglycolic extract, exhibited the highest area:limiting weight ratios (0.34 and 0.33 mm2 g-1 , respectively). Secondly, ointments prepared by suspension, with hydroalcoholic extracts, had the highest total flavonoid content (0.004% w/w, calculated as hyperoside).