Acute effect of passive cycle-ergometry and functional electrical stimulation on nitrosative stress and inflammatory cytokines in mechanically ventilated critically ill patients: a randomized controlled trial

Early mobilization is beneficial for critically ill patients because it reduces muscle weakness acquired in intensive care units. The objective of this study was to assess the effect of functional electrical stimulation (FES) and passive cycle ergometry (PCE) on the nitrous stress and inflammatory cytometry in critically ill patients. This was a controlled, randomized, open clinical trial carried out in a 16-bed intensive care unit. The patients were randomized into four groups: Control group (n=10), did not undergo any therapeutic intervention during the study; PCE group (n=9), lower-limb PCE for 30 cycles/min for 20 min; FES group (n=9), electrical stimulation of quadriceps muscle for 20 min; and FES with PCE group (n=7), patients underwent PCE and FES, with their order determined randomly. The serum levels of nitric oxide, tumor necrosis factor alpha, interferon gamma, and interleukins 6 and 10 were analyzed before and after the intervention. There were no differences in clinical or demographic characteristics between the groups. The results revealed reduced nitric oxide concentrations one hour after using PCE (P<0.001) and FES (P<0.05), thereby indicating that these therapies may reduce cellular nitrosative stress when applied separately. Tumor necrosis factor alpha levels were reduced after the PCE intervention (P=0.049). PCE and FES reduced nitric oxide levels, demonstrating beneficial effects on the reduction of nitrosative stress. PCE was the only treatment that reduced the tumor necrosis factor alpha concentration.

Pharmacovigilance of patients with multiple myeloma being treated with bortezomib and/or thalidomide

In order to evaluate the main adverse effects of drug protocols using bortezomib and/or thalidomide for the treatment of multiple myeloma, we conducted a prospective study. Data were collected through interviews, clinical observation, and from hospital records. A total of 59 patients were included. There was a predominance of females, 36 (61%) vs 23 (39%) males, and of whites, 49 (83.1%) vs 10 (16.9%) blacks. Age ranged from 40 to 94 years, with a median of 65 years (SD=11.6). Regarding staging at diagnosis, 27 (45.7%) patients were in stage III-A, with 12 (20.3%) patients having serum creatinine ≥2 mg/dL. The main adverse effects in the bortezomib treatment group (n=40) were: neutropenia (42.5%), diarrhea (47.5%), and peripheral neuropathy in 60% of cases, with no difference between the iv (n=26) and sc (n=14) administration routes (P=0.343). In the group treated with thalidomide (n=19), 31.6% had neutropenia, 47.4% constipation, and 68.4% peripheral neuropathy. Neutropenia was associated with the use of alkylating agents (P=0.038). Of the 3 patients who received bortezomib in combination with thalidomide, only 1 presented peripheral neuropathy (33.3%). Peripheral neuropathy was the main adverse effect of the protocols that used bortezomib or thalidomide, with a higher risk of neutropenia in those using alkylating agents. Improving the identification of adverse effects is critical in multiple myeloma patient care, as the patient shows improvements during treatment, and requires a rational and safe use of medicines.

Adherence to drug therapy in kidney disease

Non-adherence to drug therapy has not been extensively studied in patients with chronic kidney disease (CKD). The objective of the present study was to identify determinants of non-adherence to drug therapy in patients with CKD, not on dialysis. A prospective cohort study involving 149 patients was conducted over a period of 12 months. Adherence to drug therapy was evaluated by the self-report method at baseline and at 12 months. Patients who knew the type of drug(s) and the respective number of prescribed pills in use at the visit preceding the interview were considered to be adherent. Patients with cognitive decline were assessed by interviewing their caregivers. Mean patient age was 51 ± 16.7 years. Male patients predominated (60.4 percent). Univariate analysis performed at baseline showed that non-adherence was associated with older age, more pills taken per day, worse renal function, presence of coronary artery disease, and reliance on caregivers for the administration of their medications. In multivariate analysis, the factors that were significantly associated with non-adherence were daily use of more than 5 pills and drug administration by a caregiver. Longitudinal evaluation showed an increase in non-adherence over time. Medication non-adherence was lower (17.4 percent) at the baseline period of the study than after 1 year of the study (26.8 percent). Compared to the baseline period, the percentage of adherent patients who became non-adherent (22 percent) was lower than the percentage of non-adherent patients who became adherent (50 percent). In CKD patients not on dialysis, non-adherence was significantly associated with the number of pills taken per day and drug administration by third parties. Adherence is more frequent than non-adherence over time.

Hemencyrtus herbertii Ashmead (Hymenoptera: Encyrtidae) como parasitóides de dípteros muscóides coletados em Itumbiara, Goiás / Hemencyrtus herbertii Ashmead (Hymenoptera: Encyrtidae) as parasitoid of muscoids dipterous collected in Itumbiara Goiás, Brazil

This study determined the species of hosts of the parasitoid Hemencyrtus herbertii Ashmead (Hymenoptera: Encyrtidae) in human feces, cattle liver and chicken viscera, collected in Itumbiara, Goias. The pupae were obtained by the flotation method. They were individually placed in gelatin capsules until the emergence of adult flies or their parasitoids. The overall prevalence of parasitism was 23.7 percent.

Microhimenópteros parasitóides de dípteros muscóides coletados em diferentes substratos em área de mata em Itumbiara, Goiás / Microhimenopterous parasitoids of muscoids dipterous collected from different substrata in a wood area in Itumbiara, Goias, Brazil

This paper reports the occurrence of parasitoids in pupae of flies (Diptera) collected from several different substrata in Itumbiara, Goiás, Brazil. The pupae were isolated by flotation. They were individually placed into gelatin capsules and kept until the emergency of adult flies or their parasitoids. From March 2001 through April 2002, a total of 684 parasitoids and 830 pupae of flies were collected from humans feces, chicken viscera, fish, and bovine kidney. Brachymeria podagrica were identified in a high number of samples. The prevalence of parasitism was of 82.4 percent.

Parasitoids of flies collected in chicken viscera in Itumbiara, Goiás, Brazil

Este estudo teve como objetivo determinar as espécies de parasitoides associados com moscas coletadas em vísceras de galinha, em Itumbiara, Goiás. Armadilhas contendo vísceras de galinha como isca foram utilizadas para atrair a moscas. As pupas, obtidas pelo método de flutuaçäo, foram colocadas individualmente em cápsulas de gelatina (nº 00) e mantidas em laboratório até a emergência das moscas e/ou dos parasitoides. A prevalência total de parasitismo foi de 20,0 por cento. Brachymeria podagrica, Hemencyrtus sp. (Hymenoptera: Encyrtidae), Nasonia vitripennis (Hymenoptera: Pteromalidae), Paraganaspis egeria (Díaz, Gallardo & Wash) (Hymenoptera: Figitidae), apresentaram prevalência de parasitismo de 8,9 por cento, 10,8 por cento, 0,9 por cento e 0,3 por cento, respectivamente.

Ocorrência de Brachymeria podagrica (Fabricius) (Hymenoptera: Chalcididae) como parasitóide de dípteros coletados em diferentes substratos em Itumbiara, Sul de Goiás, Brasil / Occurrence of Brachymeria podagrica (Fabricius) (Hymenoptera: Chalcididae) as parasitoid of díptera collected in different substrata in Itumbiara, South of Goiás, Brazil

This work aimed to study the prevalence of parasitism of the parasitoid Brachymeria podagrica in Itumbiara, Goiás, using five different substrata: cattle kidneys, human feces, viscera of chicken, fish and cattle liver. The pupae were obtained by the flotation method. They were individually placed in gelatin capsules until the emergency of the adult flies or their parasitoids. The prevalence of parasitism was of 13.8 percent

Paraganspis egeria Díaz, Gallardo & Walsh (Hymenoptera: Figitidae: Eucoilinae) as potential agent in the biocontrol of muscoid dipterous collected in several substracts in Itumbiara, Goias, Brazil

Este estudo determinou as espécies de hospedeiros do parasitóide Paraganspis egeria (Díaz, Gallardo & Walsh, 1996) (Hymenoptera: Figitidae) em esterco bovino, fezes humanas, rins de bovino, galinha e carcaça de suíno. As pupas foram obtidas pelo método de flutuaçäo. Elas foram colocadas individualmente em cápsulas de gelatina e mantidas até a emergência das moscas e/ou parasitóides. A prevalência total de parasitismo foi de 3,4 por cento

Pachycrepoideus vindemiae Rondani (Hymenoptera: Pteromalidae) as parasitoid of Diptera, in Brazil

Este estudo determinou as espécies de hospedeiros do parasitóide Pachycrepoideusvindemiae Rondani (Hymenoptera: Pteromalidae) em fezes humanas, rins e fígado de bovino, peixe e frutos. As pupas, obtidas pelo método de flutuaçäo, foram colocadas individualmente em cápsulas de gelatina e mantidas até a emergência das moscas e/ou parasitóides. A prevalência total de parasitismo foi de 15,7 por cento. Este trabalho registra a primeira ocorrência de Pachycrepoideusvindemiae em pupas de Peckiachrysostoma

Soroprevalência da sífilis em gestantes HIV-negativas, obtida de três testes diagnósticos: VDRL, ELISA, TPHA / Syphilis seroprevalwence in HIV-negative pregnant women, using tree diagnostic tests: VDRL, ELISA M and TPHA

A sífilis é uma infecçäo crônica com diversas manifestaçöes clínicas que ocorrem ao longo de estágios variados. Apesar do seu declínio última década, tem sido, novamente, um importante problema de saúde pública. No Brasil, a média de prevalência é de 4 por cento pelo VDRL, em gestantes atendidas em serviços públicos. Na gestaçäo constitui problema importante, pela gravidade das lesöes e pela possiblidade real da profilaxia medicamentosa. É grande a dificuldade de se proceder ao diagóstico nesta fase, e ainda sim, mesmo com tratamento apropriado, durante a gestaçäo a infecçäo fetal poderá ocorrer em mais de 14,0 por cento dos casos. O presente trabalho objetiva determinar a soroprevalência da sífilis por meio da realizaçäo de prova de VDRL confirmada por teste específico