PVP solid dispersions containing Poloxamer 407 or TPGS for the improvement of ursolic acid release

Abstract Solid dispersions (SDs) of ursolic acid (UA) were developed using polyvinylpyrrolidone K30 (PVP K30) in combination with non-ionic surfactants, such as D-α-tocopherol polyethylene glycol 1000 succinate (TPGS) or poloxamer 407 (P407) with the aim of enhancing solubility and in vitro release of the UA. SDs were investigated using a 24 full factorial design, subsequently the selected formulations were characterized for water solubility, X-ray diffractometry (XRD), differential scanning calorimetry (DSC), particle diameter, scanning electron microscopy, drug content, physical-chemical stability and in vitro release profile. SDs showed higher UA water-solubility than physical mixtures (PMs), which was attributed by transition of the drug from crystalline to amorphous or molecular state in the SDs, as indicated by XRD and DSC analyses. SD1 (with P407) and SD2 (with TPGS) were chosen for further investigation because they had higher drug load. SD1 proved to be more stable than SD2, revealing that P407 contributed to ensure the stability of the UA. Furthermore, SD1 and SD2 increased UA release by diffusion and swelling-controlled transport, following the Weibull model. Thus, solid dispersions obtained with PVP k-30 and P407 proved to be advantageous to enhance aqueous solubility and stability of UA.

Caracterização molecular e fenotípica de Klebsiella spp. produtoras de NDM / Molecular and phenotypic characterization of Klebsiella spp. NDM producers

O perfil de resistência, que algumas das espécies do complexo Klebsiella pneumoniae podem expressar, representa uma grande ameaça à saúde humana, particularmente quando resistentes aos carbapenêmicos, que são amplamente utilizados no tratamento de infecções graves em pacientes hospitalizados. O principal mecanismo de resistência aos carbapenêmicos é a produção de carbapenemases, particularmente dos tipos KPC e NDM. Um dos compostos desenvolvidos para o tratamento de infecções causadas por cepas produtoras de KPC é a combinação ceftazidimaavibactam (CAZ-AVI), mas que não tem atividade inibitória sobre metalo-betalactamases, a exemplo das NDMs. Os objetivos deste trabalho foram determinar a frequência das espécies do complexo K. pneumoniae e da coprodução de KPC, avaliar a clonalidade dos isolados, a sensibilidade ao aztreonam-avibactam (ATM-AVI), o desempenho do disco de meropenem (MEM) com inibidores para detecção de coprodução de NDM e KPC e desenvolver um teste de triagem para prever a sensibilidade ao ATM-AVI. Um total de 113 isolados do complexo K. pneumoniae produtoras de NDM ou coprodutoras de NDM e KPC, provenientes da coleção de bactérias do Grupo Fleury, coletadas períodos pré e pós início do uso de CAZ-AVI no Brasil, foram utilizadas neste estudo. A identificação da espécie e a presença dos genes blaNDM e blaKPC foi confirmada por PCR multiplex. A clonalidade dos isolados foi avaliada por eletroforese em campos pulsados (PFGE) após clivagem com XbaI. A produção de carbapenemases foi confirmada utilizando-se o teste Blue Carba. O desempenho dos discos de meropenem e CAZ-AVI contendo um ou mais inibidores de carbapenemases foi comparado com o teste molecular. A pré-difusão combinada foi realizada pré-incubando-se o ágar não inoculado com disco de CAZ-AVI, e a seguir aplicando-se o inóculo bacteriano e um disco de ATM após remover o disco de CAZ-AVI. Após incubação, os halos foram aferidos e correlacionados com a concentração inibitória mínima para ATM-AVI. As CIMs para ATM e ATM-AVI foram determinadas segundo o EUCAST. A identificação das espécies por PCR evidenciou as seguintes frequências: K. pneumoniae 75,2% (n=85); K. quasipneumoniae 16,8% (n=19), e K. variicola 8% (n=9). Uma fração de 12,4% (n=14) dos isolados apresentaram os genes blaNDM e blaKPC e 87,6% (n=99) apenas blaNDM. A análise dos perfis de PFGE de K. pneumoniae evidenciou a presença de cinco grupos clonais predominantes. Isolados do principal grupo clonal Ap (n=15) foram detectados nas cidades de São Paulo e Porto Alegre durante todo o período analisado. O grupo clonal Lp foi detectado nas cidades de São Paulo e Recife em 2019. Os dois principais grupos clonais no período pré-CAZ-AVI continham maior número de isolados do que aqueles no período de uso do CAZ-AVI. Os perfis de PFGE de K. quasipneumoniae evidenciaram quatro grupos clonais predominantes, e presentes apenas no estado de São Paulo, com persistência do grupo clonal Aq desde 2017. Quanto à K. variicola, foram observados dois grupos clonais predominantes Av e Bv, o primeiro presente apenas em São Paulo desde 2018 e o segundo em Porto Alegre apenas em 2019. Calculando-se a diferença entre os diâmetros de halo do disco MEM contendo EDTA e ácido fenilborônico (AFB) e o maior dos halos obtidos para MEM com EDTA ou AFB, observou-se que todos os isolados com coexpressão de KPC e NDM apresentaram diferença ≥ 5 mm. Uma fração de 42,3% dos isolados positivos apenas para blaNDM apresentaram sensibilidade para ATM (CIM ≤ 4 mg/L). Todos os isolados testados apresentaram CIM para ATM-AVI ≤ 1/4 mg/L, sendo a CIM90 0,125/4 mg/l. No teste de pré-difusão combinada, o menor diâmetro de halo obtido foi de 23 mm. A espécie predominante na amostragem foi K. pneumoniae. A disseminação clonal, observada neste estudo, contrasta com a diversidade clonal descrita em outros locais do mundo para produtores de NDM, exceto Grécia e China. Considerando os pontos de corte atuais para ATM, é provável que haja resposta clínica adequada no uso de ATM-AVI no tratamento de infecções causadas por isolados produtores de NDM e coprodutores de KPC e NDM. Utilizando-se o valor de corte de ≤ 5 mm para a diferença entre halos de inibição, de MEM com AFB e EDTA e o segundo maior halo com inibidor, a sensibilidade foi de 100% e a especificidade foi de 96,1,0%. O método de pré-difusão com CAZ-AVI e ATM é um método simples e o diâmetro ≥ 23 mm tem excelente correlação com a CIM para ATM-AVI ≤ 1/4 mg/L

The resistance profile, which some species of the Klebsiella pneumoniae complex may express, represent a great threat to human health, particularly when resistant to carbapenems, which are widely used in the treatment of severe infections in hospitalized patients. The main mechanism of resistance to carbapenems is the production of carbapenemases, particularly KPCs and NDMs. One of the compounds developed for the treatment of infections caused by KPC-producing strains is the combination ceftazidime-avibactam (CAZ-AVI), but which has no inhibitory activity on metallobetalactamases, as is the case for NDMs. The objectives of this work were to determine the frequency of K. pneumoniae complex species and KPC co-production, evaluate the clonality of isolates, the susceptibility to aztreonam-avibactam (ATM-AVI), the performance of meropenem (MEM) disks with inhibitors for detecting NDM co-production and KPC and develop a screening test to predict sensitivity to ATM-AVI. A total of 113 NDM-producing or NDM and KPC co-producing K. pneumoniae complexes, from the Fleury Group's bacteria collection, collected in the pre- and post-starting periods of CAZ-AVI use in Brazil, were used in this study. Species identification and the presence of the blaNDM and blaKPC genes were confirmed by multiplex PCR. The clonality of the isolates was evaluated by pulsed field electrophoresis (PFGE) after cleavage with XbaI. Carbapenemase production was confirmed using the Blue Carba test. The performance of MEM and CAZ-AVI disks containing one or more carbapenemase inhibitors was compared with the molecular test. Combined pre-diffusion was performed by preincubating the uninoculated agar with a CAZ-AVI disk, and then applying the bacterial inoculum and na ATM disk after removal of the CAZ-AVI disk. After incubation, halos were measured and correlated with the minimum inhibitory concentration (MIC) for ATM-AVI. ATM and ATM-AVI MICs were determined according to EUCAST. The identification of species by PCR evidenced the following frequencies: K. pneumoniae 75.2% (n=85); K. quasipneumoniae 16.8% (n=19), and K. variicola 8% (n=9). A fraction of 12.4% (n=14) of the isolates had the blaNDM and blaKPC genes and 87.6% (n=99) had only blaNDM. The analysis of the PFGE profiles of K. pneumoniae evidenced the presence of five predominant clonal groups. Isolates from the main clonal group Ap (n=16) were detected in the cities of São Paulo and Porto Alegre throughout the analyzed period. The clonal group Lp was detected in the cities of São Paulo and Recife 2019. The PFGE profiles of K. quasipneumoniae showed four predominant clonal groups, present only in the state of São Paulo, with persistence of the clonal group Aq since 2017. As for K. variicola, two predominant clonal groups Av and Bv were observed, the first present only in São Paulo since 2018 and the second in Porto Alegre only in 2019. Calculating the difference between the inhibition zone diameters of the MEM disk containing EDTA and phenylboronic acid (AFB) and the largest of the inhibition zone diameters obtained for MEM with EDTA or AFB, it was observed that all isolates with co-expression of KPC and NDM showed a difference 5 ≥mm. A fraction of 42.3% of isolates positive only for blaNDM showed sensitivity to ATM (MIC ≤ 4 mg/L). All tested isolates presented MIC for ATM-AVI ≤ 1/4 mg/L, being the MIC90 0.125/4 mg/l. In the combined pre-diffusion test, the smallest inhibition zone diameter obtained was 23 mm. The predominant species in the sample was K. pneumoniae, but a significant fraction of the other species in the complex was also observed in the sample. The clonal spread observed in this study contrasts with the clonal diversity described elsewhere in the world for NDM-producing isolates, except Greece and China. Considering the current cut-off points for ATM, it is likely that there is an adequate clinical response in the use of ATM-AVI in infections caused by NDM-producing and KPC-NDM co-producing isolates in Brazil. Using the cutoff value of 5 mm for the difference between inhibition zones, of MEM with AFB and EDTA and the second largest zone of MEM with inhibitor, the sensitivity was 100% and the specificity was 96.1%. The pre-diffusion method with CAZ-AVI and ATM is a simple method and the diameter ≥ 23 mm has excellent correlation with the MIC for ATM-AVI ≤ 1/4 mg/L

In vitro skin retention and drug permeation study of Tongluo-Qutong rubber plaster by UPLC/UV/MS/MS

Abstract Tongluo-Qutong rubber plaster (TQRP), a typical Chinese patent medicine that contains 13 different herbal remedies, is widely used in clinical practice for the treatment of cervical spondylosis and osteoarthritis. However, due to a lack of in vitro transdermal studies, the active ingredients of TQRP have not been fully elucidated. This presents a huge obstacle for quality evaluation, pharmacokinetic studies and clinical safety assessment of TQRP. In this work, a UPLC/UV/MS/MS method was established and validated to evaluate five analytes in TQRP. The validation demonstrated linearity (r > 0.99), specificity (no co-eluting peaks at the retention times of the analytes), and precision (RSD < 15%) within acceptable parameters. A skin permeation study was performed to determine the concentrations of drugs delivered to the dermis. The 24-hour cumulative permeation of ferulic acid, aleo-emodin, emodin and piperine were 303.68, 709.31, 671.06 and 25561.01 ng/cm2, respectively. According to the fitting data of the TQRP active components, skin permeation was mainly due to a combination of passive diffusion and drug release after matrix erosion

Revista Urología Colombiana RUC: 35 de años evolución, cambio e impacto / Revista Urología Colombiana RUC: 35 years of evolution, change and impact

La Revista Urología Colombiana materializa un objetivo de la Sociedad Colombiana de Urología (SCU) como medio de difusión científico oficial de los resultados de investigación original, y de otro tipo trabajos de diferente diseño metodológico, con el único propósito de contribuir al incremento del conocimiento médico en el campo de nuestra especialidad. Tardaría casi 30 años desde la fundación de la SCU para lograr la aparición de RUC, que precedida por publicaciones efímeras como el "Boletín de Actividades" o el resumen del congreso.

The Revista Urología Colombiana materializes an objective of the Colombian Society of Urology (SCU) as a means of official scientific dissemination of the results of original research, and other work of different methodological design, with the sole purpose of contributing to the increase of medical knowledge in the field of our specialty. It would take almost 30 years since the foundation of the SCU to achieve the appearance of RUC, which was preceded by ephemeral publications such as the "Bulletin of Activities" or the summary of the congress.

Aplicación de herramientas de visualización de la información para la toma de decisiones en las bibliotecas: el caso de la Biblioteca Provincial Martí, de Villa Clara, Cuba / Use of information visualization tools for decision-making in libraries: the case of Martí Provincial Library in Villa Clara, Cuba

El estudio tuvo como objetivo examinar la viabilidad de la aplication de herramientas que ilustren el uso de la colección y de la institución, por parte la comunidad usuaria de la Biblioteca Provincial Martí, y contribuyan a una mejor toma de decisiones. La investigación se basó en una combinación de métodos cualitativos y cuantitativos; entre ellos, los matemáticos y estadísticos y las herramientas de visualización de la información. La muestra comprendió 1 422 usuarios, representativa del 25 por ciento del total de la población de la Biblioteca Provincial Martí, de Villa Clara. A partir de la información que se generó en el sistema de control estadístico de la institución, se recolectaron, se procesaron y se analizaron indicadores relativos al índice de captación, los servicios por usuarios, el uso de la biblioteca, el índice de circulación de la colección, el índice de rotación de la colección y el co-uso de los documentos por temáticas. Los datos revelaron aspectos esenciales de la gestión de la institución objeto de estudio y la necesidad de acometer acciones con respecto a su política de adquisición y de difusión, a fin de revertir los aspectos con incidencia negativa. El trabajo concluye con el reconocimiento de que la aplicación de esta novedosa forma de tratar los datos es una alternativa para la presentación de información en el proceso de la toma de decisiones de cualquier institución similar(AU)

The purpose of the study was to examine the viability of the application of tools that illustrate the use of the collection and the institution, by the user community of the Martí Provincial Library, which contributes to better decision-making.The research was based on a combination of qualitative and quantitative methods, among them mathematical and statistical, and information visualization tools. The sample was composed of 1 422 users representing 25 percent of the total population of Martí Provincial Library in Villa Clara. Starting from the information generated by the statistical control system of the institution, indicators were collected, processed and analyzed which had to do with the following variables: recruitment rate, services per user, use of the library, collection circulation rate, collection turnover rate, and document co-use by subject. The data revealed essential aspects of management at the study institution, as well as the need to implement actions related to their acquisition and dissemination policy with a view to improving deficient areas. The paper recognizes that application of this novel way to treat data is an alternative for the presentation of information in the decision-making process at any similar institution(AU)

An attempt to enhance solubility of metoclopramide base by Solid dispersion strategy and its application on development of Transdermal device

Chemotherapy induced nausea and vomiting (CINV) is an issue, which usually occurs in cancer patient. Despite high bioavailability of oral and intravenous administration, these have some drawbacks. The oral route causes hepatic first pass metabolism and intravenous route is invasive in nature. Hence, antiemetic drug by means of transdermal route is necessary to administer in such cases. The aim of the present investigation is to develop suitable Transdermal Therapeutic System (TTS) with an objective to enhance solubility and skin permeability properties of metoclopramide base. Preformulation study begins with an approach to enhance solubility of 40 metoclopramide base by solid dispersion technique. transdermal films were prepared with 41 the solid dispersion as well as with pure drug. Phase solubility study at various temperatures reveals binding constants (Ka, 95-350 M-1 for PVP K30; 56-81 M-1 for HPßCD). Spontaneity of solubilization was justified by AL type linear profiles. The films showed satisfactory diffusion (%), permeation rate and flux after 8 h study. The transdermal patches as prepared were analyzed under FTIR, DSC and SEM. Both solubility and permeability rate in this investigation have been enhanced. So, it can be affirmed that this route would effectively enhance bioavailability

COVID-19: Epidemia de información no científica en grupos peruanos de Facebook / COVID-19: Epidemic of non-scientific information on Peruvian Facebook groups

El fenómeno denominado infodemia consiste en un flujo masivo de información que se produce durante las crisis sociales. La difusión y el consumo de información por diversos medios oficiales y no oficiales sobre la enfermedad del coronavirus (COVID-19) y los aspectos relacionados con los métodos de prevención, los síntomas de la enfermedad, las opciones terapéuticas, entre otros, han crecido de forma continua desde su reporte oficial a finales del año 2019.1) La información sin sustento científico o la información científica indebidamente utilizada y disponible en las redes sociales podría favorecer la promoción de medidas de seguridad ineficientes, opciones terapéuticas de eficacia desconocida, o ambos,2,3 por lo que resulta importante cuantificar ese tipo de información como una de las estrategias de afrontamiento4 y de aproximación a la almetría de las publicaciones científicas sobre COVID-19 en las redes sociales.5 En ese sentido, nuestro objetivo fue estimar la proporción de publicaciones con contenido verificado en artículos científicos que son compartidos en grupos de Facebook dedicados a la COVID-19 y que fueron creados entre los meses de enero y marzo del año 2020(AU)

La otra cara de la información: la desinformación y la información imprecisa como retos para la gestión de la información institucional / The other side of information: misinformation and inaccurate information as challenges to institutional information management

Este trabajo pretendió abordar un problema muy actual de los sistemas de información relativo a la calidad de la información, principalmente en sus manifestaciones de desinformación y de información imprecisa, así como lo relativo a los vacíos de información. Se realizó una conceptualización de estas manifestaciones a partir de un análisis documental, tomando el criterio de autores contemporáneos de gran relevancia. Se consideraron algunos atributos de estas manifestaciones y el modelo de Karlova-Fisher relativo a su difusión social. Se valoraron las características de estas manifestaciones y el efecto que puede provocar en la toma de decisiones, así como en el manejo de la información en las instituciones. Se concluye con los retos que estas constituyen para la gestión de información institucional, entre los que se incluyen, por su importancia, algunos ajustes en la alfabetización informacional(AU)

The purpose of the study was to address a very current problem faced by information systems which has to do with information quality, mainly as manifested by misinformation and inaccurate information, and information gaps. Conceptualization of these manifestations was based on document analysis, taking into account the opinions of contemporary authors of great relevance. Some attributes of these manifestations were considered, as well as their social diffusion following the Karlova-Fisher model. An evaluation was conducted of the characteristics of the manifestations and their potential effect on decision making and information management at institutions. An analysis was also performed of the challenges posed by these manifestations to institutional information management, including, due to their importance, some adjustments to information literacy(AU)

Plan de comunicación del Sistema de Inteligencia Colaborativa para el Grupo Empresarial BioCubaFarma / Communication plan for the Collaborative Intelligence System at BioCubaFarma Business Group

El presente trabajo tuvo como objetivo diseñar un plan de comunicación para el Sistema de Inteligencia Colaborativa del Grupo Empresarial BioCubaFarma correspondiente al período 2019-2020. Se utilizó una metodología basada en la propuesta de Paul Capriotti en torno a la planificación de la comunicación. Se emplearon el análisis documental, la encuesta y la observación no participante como técnicas, así como el cuestionario y la guía de observación como instrumentos de recopilación de información. Se incorporó el enfoque de la Norma española UNE 166006:2018 para la gestión de la vigilancia e inteligencia, que reconoce a la comunicación como uno de los componentes de este sistema de gestión, y se resaltó su importancia en la generación, conservación, diseminación y uso de la información en relación con sus públicos. A partir de un diagnóstico del proceso de vigilancia e inteligencia en el sector se definieron los públicos, los canales de comunicación, la temporalidad y el alcance del plan de comunicación. Se estableció un sistema de objetivos y se especificaron sus estrategias y tácticas. Se definieron las formas de evaluación y se analizó la comunicación desde su dinamismo, complejidad, intersubjetividad e interacción social, aspectos que contribuyen a la gestión del sistema de inteligencia colaborativa para la co-creación, difusión y promoción de productos y servicios informacionales de vigilancia e inteligencia como sustento de la toma de decisiones(AU)

The current paper had as objective to design a communication plan for the Collaborative Intelligence System of BioCubaFarma Enterprises Group, (period 2019-2020). A methodology based on Paul Capriotti's proposal related to the communication planning was used. Documental analysis, survey and non-participatory observation as techniques, and questionnaire and observation guide as instruments of data collection, were applied. The approach of the Spanish standard UNE 166006:2018 on surveillance and intelligence management was incorporated. The standard recognizes communication as one of the components of this system, highlighting its importance for generation, conservation, dissemination and use of information in relation to its audiences. A diagnosis of surveillance and intelligence processes in the sector was done in order to define audiences, communication channels, temporality and the scope of the Communication Plan. A target system was established, and its corresponding strategies with their tactics were specified and described. Based on the specific objectives and their strategies, the forms of assessment were defined. The communication was analyzed from its dynamism, complexity, inter-subjectivity and social interaction. These aspects contribute to the collaborative intelligence system management for co-creation, dissemination and promotion of information products and services related to surveillance and intelligence, which support decision-making processes(AU)

A gestão da informação como ferramenta para o compliance: uma perspectiva preliminar no contexto da diminuição de riscos e aumento de competitividade nas organizações brasileiras do setor da saúde / La gestión de la información como herramienta de cumplimiento: una perspectiva preliminar en el contexto de la reducción de riesgos y la mayor competitividad en las organizaciones del sector brasileño de la salud / Information management as a tool for compliance: a preliminary perspective in the context of risk reduction and increased competitiveness in brazilian health sector organizations

A implementação de programas de compliance vem sendo cada vez mais difundida nos ambientes organizacionais, se destacando o compliance, com vistas a estar em conformidade com as questões jurídicas, aumentando a eficiência e minimizando os riscos. O objetivo do presente artigo situa-se na análise da difusão do compliance a partir da perspectiva na gestão da informação, bem como seu impacto nos aspectos jurídicos no Brasil, e com isso, refletir sobre as vantagens da adoção desses mecanismos como forma de ganho de competitividade. Dessa maneira, a presente pesquisa realizou um levantamento bibliográfico com o objetivo de realizar uma análise preliminar da gestão da informação enquanto ferramenta organizacional no contexto da saúde. Também foi analisado como o processo de compliance pode fazer uso da informação gerida com o intuito de diminuir o risco e aumentar a competitividade no contexto das organizações que possuem a saúde como área fim. Ressalta-se que se trata de uma pesquisa de caráter preliminar, que buscou chamar a atenção das organizações brasileiras do setor da saúde quanto ao uso da gestão da informação como ferramenta para o compliance. Sendo assim, concluiu-se preliminarmente que a prática do compliance, alinhada ao uso estratégico da informação, pode ser fundamental para a minimização de riscos e aumento da competitividade, especialmente pelo ganho de confiabilidade de ambiente, pautado na integridade e na segurança de investimentos(AU)

La implementación de programas de compliance (cumplimiento normativo) se ha generalizado cada vez más en entornos organizacionales, con miras a cumplir con los problemas legales, aumentar la eficiencia y minimizar los riesgos. El objetivo de este artículo es determinar la difusión del compliance desde la perspectiva de la gestión de la información, así como su impacto en los aspectos legales en Brasil, y con eso, reflexionar sobre las ventajas de adoptar estos mecanismos como una forma de obtener competitividade. En la presente investigación realizó una encuesta bibliográfica con el fin de realizar un análisis preliminar de la gestión de la información como herramienta organizativa en el contexto de la salud. También se analizó cómo el proceso de compliance puede hacer uso de la información administrada para reducir el riesgo y aumentar la competitividad en el contexto de las organizaciones que tienen la salud como área final. Esta es una investigación preliminar, que intenta atraer la atención de las organizaciones brasileñas del sector de la salud en cuanto al uso de la gestión de la información como herramienta para el compliance. Por lo tanto, se concluyó preliminarmente que la práctica del compliance, alineada con el uso estratégico de la información, puede ser fundamental para minimizar los riesgos y aumentar la competitividad, especialmente por la ganancia en la confiabilidad del entorno basada en la integridad y la seguridad de las inversiones(AU)

The implementation of compliance programs has been increasingly widespread in organizational environments, highlighting compliance, with a view to being in compliance with legal issues, increasing efficiency and minimizing risks. The objective of this article is to analyze the diffusion of compliance from the perspective of information management, as well as its impact on legal aspects in Brazil, and with that, to reflect on the advantages of adopting these mechanisms as a way of gaining competitiveness. In this way, the present research carried out a bibliographic survey with the objective of carrying out a preliminary analysis of information management as an organizational tool in the context of health. It was also analyzed how the compliance process can make use of managed information in order to reduce risk and increase competitiveness in the context of organizations that have health as an end area. It should be noted that this is a preliminary research, which sought to draw the attention of Brazilian organizations in the health sector regarding the use of information management as a tool for compliance. Therefore, it was preliminarily concluded that the practice of compliance, in line with the strategic use of information, can be fundamental to minimize risks and increase competitiveness, especially due to the gain in the reliability of the environment based on the integrity and security of investments(AU)

A raiz de la polemica originada por la difusión de un programa televisivo de opinion donde se denuncias maltratos a pacientes hospitalizados en instituciones nacionales de salud mental, la ACP emitió el siguiente comunicado que ponemos hoy como editorial de nuestra revista. [Editorial] / As a result of the controversy caused by the broadcast of a television opinion program where mistreatment of hospitalized patients in national mental health institutions is denounced, the ACP issued the following statement that we publish today as an editorial for our magazine. [Editorial]

A raiz de la polemica originada por la difusión de un programa televisivo de opinion donde se denuncias maltratos a pacientes hospitalizados en instituciones nacionales de salud mental, la ACP emitió el siguiente comunicado que ponemos hoy como editorial de nuestra revista.

As a result of the controversy caused by the dissemination of an opinion television program where mistreatment of hospitalized patients in national mental health institutions is reported, the ACP issued the following statement that we put today as the editorial of our magazine.

Atividade antagonista in vitro de bactérias ácido láticas isoladas de queijo de coalho artesanal do Sertão paraibano frente a microrganismos indicadores / Antagonist activity in vitro of lactic acid bacteria isolated from coalho cheese from Sertão paraibano front microorganisms indicators

Bactérias ácido láticas (BAL) produzem substâncias inibitórias de patógenos e deteriorantes de alimentos e isso tem despertado interesse sobre seu uso na preservação e na segurança sanitária desses produtos. Assim, o estudo foi realizado com o objetivo de avaliar a atividade inibitória de Streptococcus infantarius subsp. infantarius isoladas de queijo de coalho artesanal do Sertão da Paraíba frente a microrganismos indicadores. A avaliação do potencial antagônico foi realizada pela técnica de difusão em disco frente à estirpe reveladora Escherichia coli, isolada das mesmas amostras de queijos e frente ao patógeno de referência Escherichia coli ATCC 3539. Das 11 estirpes analisadas, 81,8% foram capazes de inibir o microrganismo indicador isolado dos mesmos queijos de coalho, enquanto 36,4% das bactérias láticas apresentaram inibição frente ao patógeno de referência. Conclui-se que as cepas Streptococcus infantarius subsp. infantarius isoladas de queijos de coalho do Sertão da Paraíba apresentam potencial antagônico e podem assegurar a qualidade microbiológica de alimentos fermentados, inclusive o queijo de coalho.(AU)

Lactic acid bacteria (BAL) produce pathogen inhibiting and food damaging substances and this has raised interest in their use in the preservation and health safety of these products. Thus, the study was carried out with the objective of evaluating the inhibitory activity of Streptococcus infantarius subsp. infantarius isolated from artisanal coalho cheese from Sertão da Paraíba against indicator microorganisms. The evaluation of the antagonistic potential was performed using the disk diffusion technique against the Escherichia coli revealing strain, isolated from the same cheese samples and against the reference pathogen Escherichia coli ATCC 3539. Of the 11 strains analyzed, 81.8% were able to inhibit the indicator microorganism isolated from the same coalho cheeses, while 36.4% of the lactic acid bacteria showed inhibition compared to the reference pathogen. It is concluded that the strains Streptococcus infantarius subsp. infantarius isolated from coalho cheeses from Sertão da Paraíba have antagonistic potential and can ensure the microbiological quality of fermented foods, including coalho cheese.(AU)

The era of digital diffusion and changes in biomedical publishing / La era de difusión digital y los cambios en la publicación biomédica

The technological revolution of recent years has produced an absolute and irremediable alteration in the creation, production, diffusion, distribution, reproduction, use and consumption of contents of biomedical scientific journals.1 These changes include the way of transmitting knowledge and represent new and renewed evolutionary strategies of communication. Thirty years ago, we could predict that the electronic and technological revolution would dramatically change and gradually reduce the use of printed publications.2 We have reached that point, and regional and global scientific journals are no unaware of these changes. There has been a gradual shift toward the online content publication as a priority form of dissemination.

La revolución tecnológica de los últimos años ha producido una alteración absoluta e irremediable en la creación, producción, difusión, distribución, reproducción, uso y consumo de contenidos de las revistas científicas biomédicas.1 Estos cambios incluyen la forma de transmitir el conocimiento y representan nuevas y renovadas estrategias evolutivas de comunicación. Hace treinta años, podíamos predecir que la revolución electrónica y tecnológica cambiaría drásticamente y reduciría gradualmente el uso de las publicaciones impresas.2 Hemos llegado a ese punto, y las revistas científicas regionales y mundiales no son ajenas a estos cambios. Se ha producido un cambio gradual hacia la publicación de contenidos en línea como forma prioritaria de difusión.

Antimicrobial activity of oregan and clove essential oils against some foodborne pathogens / Atividade antimicrobiona dos óleos essenciais de orégano e cravo frente a patógenos alimentares

The tendency to replace synthetic antimicrobials for natural ones in food industry and an increase in bacterial resistance to antibiotics resulted in a necessity to find new alternatives, and essential oils are emerging as promising substitutes for synthetic chemicals in food preservation. The objective of this work was to test the antimicrobial activity of oregano (OEO) and clove (CEO) essential oils over a range of bacteria, molds and yeast of importance as pathogens or food spoilage. The antimicrobial activity of oregano and clove essential oils were analyzed by disk diffusion method and broth microdilution test (MIC) of OEO and CEO were determined for each tested microorganism. OEO and CEO were evaluated in natura (IN) and after thermal processing (TP) at 120 o C for 5 min. Both OEO and CEO presented the same inhibition zones for IN and TP samples, for all tested microorganisms, indicating that these oils can be thermally processed maintaining their antimicrobial activity. For OEO and CEO, the more sensitive microorganisms were the fungi (Aspergillus niger, Penicillium citrinum and Candida albicans), followed by Staphylococcus aureus, Bacillus cereus and Methicillin - resistant Staphylococcus aureus (MRSA); the lowest antimicrobial activities were observed against Streptococcus mutans and Enterococcus faecalis. In general, OEO resulted in higher inhibition zones and lower MIC values for all tested microorganisms, suggesting that it was more effective as an antimicrobial agent than CEO (AU)

A preferência mundial para alimentos mais saudáveis e livres de aditivos químicos pelos consumidores, associada ao aumento da resistência bacteriana, resultaram na necessidade de medidas alternativas no setor de alimentos. Os óleos correspondem a antimicrobianos naturais e constituem uma classe emergente como substitutos dos produtos químicos sintéticos na conservação de alimentos. O objetivo deste trabalho foi avaliar a atividade antimicrobiana de óleos essenciais de orégano (OEO) e cravo (CEO ) frente a bactérias, fungos e leveduras de importância no setor de alimentos. OEO e CEO foram avaliados in natura (IN) e após processamento térmico (TP) a 120 o C por 5 minutos. Para avaliar a atividade antimicrobiana frente a cada microrganismo empregou-se o método de discodifusão e o teste de microdiluição em caldo (MIC). Tanto o OEO quanto o CEO apresentaram zonas de inibição semelhantes para amostras IN e TP, indicando que a atividade antimicrobiana desses óleos são resistentes a altas temperaturas. Os microrganismos mais sensíveis para ambos os óleos essenciais foram os fungos (Aspergillus niger, Penicillium citrinum e Candida albicans), seguidos por Staphylococcus aureus, Bacillus cereus e Staphylococcus aureus resistente à meticilina (MRSA). Já as cepas Streptococcus mutans e Enterococcus faecalis apresentaram uma maior resistência frente à atividade antimicrobiana dos óleos essenciais. Em geral, os maiores halos de inibição e menores valores de MIC foram obtidos quando empregado o OEO, sugerindo uma maior atividade microbiana do mesmo quando comparado ao CEO. (AU)

Desenvolvimento de métodos microbiológicos rápidos (MMRs) para avaliação da potência de agentes antimicrobianos e suas incertezas de medição / Development of rapid microbiological methods (RMMs) for evaluation of potency of antimicrobial agents and their measurement uncertainties

O método de difusão em ágar tem sido utilizado na avaliação da atividade antimicrobiana desde a descoberta da penicilina. Apesar disso, pouco avanço ocorreu no sentido de reduzir o tempo necessário para a determinação dos halos de inibição de crescimento. O objetivo deste projeto foi desenvolver, otimizar e validar métodos microbiológicos rápidos (MMRs) para a avaliação da potência de agentes antimicrobianos, além de identificar, quantificar e avaliar as principais fontes de incerteza associadas à determinação da potência. O projeto foi dividido em quatro etapas: 1) influência da composição do meio de cultura na formação dos halos de inibição; 2) estudo da incerteza de medição associada à determinação da potência de agentes antimicrobianos; 3) desenvolvimento, otimização e validação de métodos microbiológicos rápidos (MMRs) para determinação da potência de agentes antimicrobianos e 4) determinação dos parâmetros envolvidos na formação dos halos de inibição de crescimento e estudo dos mecanismos de difusão e crescimento microbiano. Os resultados deste projeto possibilitaram a redução do tempo necessário para a determinação do tamanho dos halos de inibição. Adicionalmente, contribuiu com a elucidação dos mecanismos de difusão e crescimento microbiano, possibilitando identificar e quantificar as principais fontes de incerteza de medição associadas à formação dos halos de inibição

Agar diffusion method has been used in the evaluation of antimicrobial activity since the discovery of penicillin. Nevertheless, little progress has occurred in order to reduce the time required for the determination of growth inhibition zones. The goal of this project was to develop, optimize and validate rapid microbiological methods (RMMs) for evaluation of potency of antimicrobials, as well as to identify, quantify and assess the main sources of uncertainty associated with potency. The project was divided into four steps: 1) influence of culture medium composition on inhibition zones; 2) study of measurement uncertainty associated with antimicrobials potencies; 3) development, optimization and validation of rapid microbiological methods (RMMs) for the determination of antimicrobials potencies and 4) determination of the parameters involved in the formation of inhibition zones and study of mechanisms of diffusion and microbial growth. The results of this project allowed the reduction of the time required for the determination of inhibition zone sizes. Additionally, it contributed to the elucidation of the mechanisms of diffusion and microbial growth, making it possible to identify and quantify the main sources of measurement uncertainty associated with formation of inhibition zone sizes

Thyroid-Associated Orbitopathy: Evaluating Microstructural Changes of Extraocular Muscles and Optic Nerves Using Readout-Segmented Echo-Planar Imaging-Based Diffusion Tensor Imaging

OBJECTIVE: We aimed to investigate the ability of readout-segmented echo-planar imaging (rs-EPI)-based diffusion tensor imaging (DTI) in assessing the microstructural change of extraocular muscles (EOMs) and optic nerves in patients with thyroid-associated orbitopathy (TAO) as well as in evaluating disease activity.MATERIALS AND METHODS: We enrolled 35 TAO patients and 22 healthy controls (HCs) who underwent pre-treatment rs-EPI-based DTI. Mean, axial, and radial diffusivity (MD, AD, and RD) and fractional anisotropy (FA) of the medial and lateral EOMs and optic nerve for each orbit were calculated and compared between TAO and HC groups and between active and inactive TAO groups. Factors such as age, sex, disease duration, mediation, and smoking history between groups were also compared. Logistic regression analysis was used to evaluate the predictive value of significant variables for disease activity.RESULTS: Disease duration was significantly shorter in active TAOs than in inactive ones (p < 0.001). TAO patients showed significantly lower FA and higher MD, AD, and RD than HCs for both medial and lateral EOMs (p < 0.001), but not the AD value of lateral EOMs (p = 0.619). Active patients had significantly higher FA, MD, and AD than inactive patients for medial EOMs (p < 0.005), whereas only FA differed significantly in the lateral EOMs (p = 0.018). The MD, AD, and RD of optic nerves were significantly lower in TAO patients than HCs (p < 0.05), except for FA (p = 0.129). Multivariate analysis showed that the MD of medial EOMs and disease duration were significant predictors for disease activity. The combination of these two parameters showed optimal diagnostic efficiency for disease activity (area under the curve, 0.855; sensitivity, 68.4%; specificity, 96.9%).CONCLUSION: rs-EPI-based DTI is promising in assessing microstructural changes of EOMs and optic nerves and can help to indicate the disease activity of TAO, especially through the MD of medial EOMs.

The Clinical Efficacy of Pulmonary Hypertension-Specific Agents in Idiopathic Pulmonary Fibrosis: Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials

BACKGROUND: Pulmonary hypertension (PH) is common in patients with idiopathic pulmonary fibrosis (IPF) and is associated with poor outcomes. This study was performed to determine the clinical efficacy of PH-specific therapeutic agents for IPF patients.METHODS: We performed a systematic review and meta-analysis using MEDLINE, EMBASE, and the Cochrane Central Register. We searched randomized controlled trials (RCTs) without language restriction until November 2018. The primary outcome was all-cause mortality to end of study.RESULTS: We analyzed 10 RCTs involving 2,124 patients, 1,274 of whom received PH-specific agents. In pooled estimates, the use of PH-specific agents was not significantly associated with reduced all-cause mortality to end of study compared with controls (hazard ratio, 0.99; 95% confidence interval [CI], 0.92, 1.06; P = 0.71; I² = 30%). When we performed subgroup analyses according to the type of PH-specific agent, sample size, age, forced vital capacity, diffusion lung capacity, and the extent of honeycombing, PH-specific agents also showed no significant association with a reduction in all-cause mortality. A small but significant improvement in quality of life, measured using the St. George Respiratory Questionnaire total score, was found in the PH-specific agent group (mean difference, −3.16 points; 95% CI, −5.34, −0.97; P = 0.005; I² = 0%). We found no significant changes from baseline in lung function, dyspnea, or exercise capacity. Serious adverse events were similar between the two groups.CONCLUSION: Although PH-specific agents provided small health-related quality-of-life benefits, our meta-analysis provides insufficient evidence to support their use in IPF patients.

Molecular epidemiology and characterization of Streptococcus mutans strains in Korea / 대한구강보건학회지

OBJECTIVES: We investigated the characteristics of Streptococcus mutans in the national culture collection from Korea. Twenty-nine (dental plaque, n=27; endodontic infections, n=1; blood, n=1) isolates were included in this study.METHODS: Antimicrobial susceptibilities were tested using the disk diffusion test. Multilocus sequence typing (MLST), serotyping, and collagen-binding genes were used for polymerase chain reaction (PCR) and direct sequencing. A collagen-binding (to assess the adhesion properties) assay was performed. S. mutans demonstrated high susceptibility to antimicrobial agents. Differences in collagen-binding abilities of the cnm-positive and -negative groups were compared using the Mann-Whitney U test (P<0.05).RESULTS: MLST analyses revealed 25 sequence types (STs), 17 of which (ST213-ST229) contained new alleles. The strains were classified into four serotypes with the c type encompassing 79.3% of all strains, while the e, f, and k types representing 6.9% each. Analysis of the cnm and cbm genes, which encode the two surface adhesin components of S. mutans, revealed three cnm-positive strains, each displaying greater adhesion ability than those of the cnm-negative strains.CONCLUSIONS: This study highlights the presence of a wide variety of S. mutans genotypes in Korea. These findings may provide useful information regarding the pathogenesis of infectious diseases, such as dental caries.

Feasibility of Simultaneous Multislice Acceleration Technique in Diffusion-Weighted Magnetic Resonance Imaging of the Rectum