Emollients in dermatological creams: Early evaluation for tailoring formulation and therapeutic performance.

The targeted choice of the emollient of a cream determines its physicochemical properties and clinical effectiveness. This work researched the effects of emollient properties on the final characteristics and potential performance of oil-in-water dermatological creams. Seven emollients with different chemical characteristics and structures (alkane, triglyceride, ether, silicone, vegetable oils, and mineral oil) were tested in a model formulation. Early stability, pH, droplet size distribution, rheology, tackiness, adhesivity, spreadability, tribology, and release profile of a lipophilic substance model (in Franz cells, through a synthetic membrane, for six hours) were assessed. The creams had acid epicutaneous pH and a "shear-thinning" "solid-like" viscoelastic behavior. Among the seven emollients' properties, polarity, density, and viscosity were the most influential. Droplet parameters were the most impacted, pH and release were moderately affected, and the textural properties were lowly to moderately impacted. The emollient substitution in the model formulation affected the experimental parameters differently, allowing formulation optimization and tailoring its potential therapeutic performance regarding drug release, coadjutant effects, and dwell time on the skin. By looking at the creams' characteristics, it was possible to select the best-suited emollients for releasing a lipophilic drug, applying on painful skin, and formulation in wash-off products or leave-on protective barrier creams.

Proliferation and differentiation of Trypanosoma cruzi inside its vector have a new trigger: redox status.

Trypanosoma cruzi proliferate and differentiate inside different compartments of triatomines gut that is the first environment encountered by T. cruzi. Due to its complex life cycle, the parasite is constantly exposed to reactive oxygen species (ROS). We tested the influence of the pro-oxidant molecules H2O2 and the superoxide generator, Paraquat, as well as, metabolism products of the vector, with distinct redox status, in the proliferation and metacyclogenesis. These molecules are heme, hemozoin and urate. We also tested the antioxidants NAC and GSH. Heme induced the proliferation of epimastigotes and impaired the metacyclogenesis. ß-hematin, did not affect epimastigote proliferation but decreased parasite differentiation. Conversely, we show that urate, GSH and NAC dramatically impaired epimastigote proliferation and during metacyclogenesis, NAC and urate induced a significant increment of trypomastigotes and decreased the percentage of epimastigotes. We also quantified the parasite loads in the anterior and posterior midguts and in the rectum of the vector by qPCR. The treatment with the antioxidants increased the parasite loads in all midgut sections analyzed. In vivo, the group of vectors fed with reduced molecules showed an increment of trypomastigotes and decreased epimastigotes when analyzed by differential counting. Heme stimulated proliferation by increasing the cell number in the S and G2/M phases, whereas NAC arrested epimastigotes in G1 phase. NAC greatly increased the percentage of trypomastigotes. Taken together, these data show a shift in the triatomine gut microenvironment caused by the redox status may also influence T. cruzi biology inside the vector. In this scenario, oxidants act to turn on epimastigote proliferation while antioxidants seem to switch the cycle towards metacyclogenesis. This is a new insight that defines a key role for redox metabolism in governing the parasitic life cycle.

The pterocarpanquinone LQB-118 inhibits tumor cell proliferation by downregulation of c-Myc and cyclins D1 and B1 mRNA and upregulation of p21 cell cycle inhibitor expression.

The incidence of cancer grows annually worldwide and in Brazil it is the second cause of death. The search for anti-cancer drugs has then become urgent. It depends on the studies of natural and chemical synthesis products. The antitumor action of LQB-118, a pterocarpanquinone structurally related to lapachol, has been demonstrated to induce mechanisms linked to leukemia cell apoptosis. This work investigated some mechanisms of the in vitro antitumor action of LQB-118 on prostate cancer cells. LQB-118 reduced the expression of the c-Myc transcription factor, downregulated the cyclin D1 and cyclin B1 mRNA levels and upregulated the p21 cell cycle inhibitor. These effects resulted in cell cycle arrest in the S and G2/M phases and inhibition of tumor cell proliferation. LQB-118 also induced programmed cell death of the prostate cancer cells, as evidenced by internucleosomal DNA fragmentation and annexin-V positive cells. Except the cell cycle arrest in the S phase and enhanced c-Myc expression, all the mechanisms observed here for the in vitro antitumor action of LQB-118 were also found for Paclitaxel, a traditional antineoplastic drug. These findings suggest new molecular mechanisms for the LQB-118 in vitro antitumor action.

Immune status of Fanconi anemia patients: decrease in T CD8 and CD56dim CD16+ NK lymphocytes.

Fanconi anemia (FA), a rare genetic disease in which patients' life is compromised mainly by hematological abnormalities and cancer prone, seems to be affected by subtle immune cell irregularities. Knowing that FA presents developmental abnormalities and, based on recent reports, suggesting that natural killer (NK) CD56(dim) and NK CD56(bright) correspond to sequential differentiation pathways, we investigated if there were changes on the total number of NK cells and subsets as well as on T CD4 and T CD8 lymphocytes and their ratio. A large sample of FA patients (n = 42) was used in this work, and the results were correlated to clinical hematological status of these patients. Among FA patients, a decreased proportion of T CD8(+) and NK CD56(dim)CD16(+) cells were observed when compared to healthy controls as well as an imbalance of the subsets NK lymphocytes. Data suggest that FA patients might have a defective cytotoxic response due to the lower number of cytotoxic cells as well as impairment in the differentiation process of the NK cells subsets which may be directly related to impairment of the immune surveillance observed in these patients.

Increased IL10 plasmatic levels in Fanconi anemia patients.

Fanconi anemia (FA) is a rare disease, autosomal recessive and X linked, which is clinically prone to development of hematological abnormalities and neoplasms, especially acute myeloid leukemia. In this work IL-10 and TGF-ß levels were measured on FA patients' plasma since they are the regulatory cytokines of TNF-α and INF-γ which had been described to be overexpressed in this genetic disease. Our results show increased IL-10 plasma levels in 25% of FA patients studied, but levels of TGF-ß within the normal range. TNF-α and INF-γ were also measured and found to be increased in 24% and 23% of FA patients, respectively. However, no inverse correlation was observed between augmented levels of IL-10 and TNF or IFN-γ. Patients with elevated levels of TNF-α and INF-γ presented bone marrow hypocellularity. IL-10 levels did not appear to be determinant for bone marrow cellularity. These data suggest that IL-10 is also a feature of Fanconi anemia pathophysiology.

Pterodon polygalaeflorus essential oil modulates acute inflammation and B and T lymphocyte activation.

The increased life expectancy of the population has led to increasing incidences of cancer, chronic inflammatory and autoimmune diseases. Thus the continuous search for new drugs is necessary because ineffectiveness and adverse effects have been described for standard drugs. Essential oils are important sources of bioactive metabolites and several clinical trials have been developed using them. The Pterodon genus has been used in traditional medicine to treat rheumatic disorders, thus this work investigated the properties of essential oil from Pterodon polygalaeflorus fruits (EsOPpg) on acute inflammation and lymphocyte activation. The essential oil was obtained by hydrodistillation and its components were identified by GC/MS. The anti-inflammatory response was assessed using the air pouch model. Antinociceptive potential was evaluated using the writhing model. Lymphocyte phenotyping, cell cycle and apoptosis were analyzed by flow cytometry. EsOPpg promoted a reduction in leukocyte counts and protein concentration in the exudate, and reduced vasodilatation and inflammatory cell infiltrate in air pouch tissue. No antinociceptive effect was demonstrated for the doses tested. EsOPpg inhibited lymphocyte proliferation, arresting the cell cycle in G1 phase, and induced apoptosis in these cells. EsOPpg downregulated both the total number of CD8(+) T cells and the activated subpopulation (CD8(+)CD69(+)), while promoting upregulation of the total number of CD19(+) and CD19(+)CD69(+) B cells. In conclusion, Pterodon polygalaeflorus essential oil diminished the acute inflammatory response and inhibited lymphocyte proliferation, reducing neutrophil recruitment into the cavity and air pouch tissue and promoting distinct modulations of the activation level of each lymphocyte subpopulation.

[Difficult endotracheal intubation in a patient with right aortic arch: clinical report]. / Entubação pulmonar selectiva em doente com arco aórtico direito. Caso clínico.

Congenital aortic arch abnormalities are usually rare in the adult. We report the case of difficult endotracheal intubation in a patient with a right aortic arch.

Apoptosis and expression of anti- and pro-apoptotic proteins in peripheral blood mononuclear cells of Fanconi anaemia patients: a study of 73 cases.

Fanconi anaemia (FA) is a rare genetic disease whose patients have a high predisposition to haematological abnormalities and cancer. Fas expression levels in peripheral blood lymphocytes samples of 73 FA patients were measured to verify if alterations in Fas expression could lead to predisposition/resistance to spontaneous or PHA induced apoptosis, as well as, to reflect some haematological features of this disease. The anti- and pro-apoptotic proteins Bcl-2 and Bax were also evaluated. FA patients samples could be divided into three different groups based on Fas expression: 20 samples had low, 32 normal and 21 increased Fas levels when compared to 41 control samples. No correlation was found between Fas and Bcl-2 expression but a good association was obtained with Bax, in the subgroup with increased Fas expression. The best correlation was seen between Bax expression and apoptosis. Out of the 15 samples with high Bax expression, 11 underwent apoptosis whereas only one out of seven samples with low levels of Bax displayed increased induced apoptosis. Most patients with normal haematological features expressed Fas within normal levels. It is difficult to establish, however, if Fas-expression is involved in the cause or is a consequence of the effects observed.

Cardiac papillary fibroelastoma of a mitral valve chordae revealed by stroke.

We report the case of a young male patient referred to our hospital after having a stroke due to a papillary fibroelastoma arising from a mitral valve chorda. The tumor was identified by two-dimensional echocardiography and was treated by surgery with preservation of valve integrity. Cardiac papillary fibroelastoma as an uncommon source of cerebral emboli is discussed.

Impact of season and discharge weight on complications and growth of Kangaroo Mother Care treated low birthweight infants in Mozambique.

This study aimed to determine the impact of season and weight at discharge on growth rate and complications in low birthweight infants treated with Kangaroo Mother Care (KMC) in Maputo, Mozambique. The study population included 246 infants of birthweight < 2000 g. Follow-up until 2400 g was obtained in 64%. There were no seasonal differences in weight gain and the risk of complications of infants treated with KMC in hospital. During the cold season after discharge, the risk of serious complications, including death, was higher (risk ratio 1.96; p = 0.02) and more readmissions occurred (risk ratio 2.77; p = 0.04). We postulate that after discharge mothers are unable to comply with the kangaroo position at all hours of the day and that exposure to low ambient temperatures may explain the more frequent occurrence of complications in the cold season. The weight at discharge did not affect complications or growth rate. We conclude that the current policy to discharge infants when having gained weight on 3 consecutive days, regardless of the actual weight, or whether the weight at birth has been regained, is adequate. In the cold season particularly, more efforts may be needed to ensure compliance with kangaroo position after discharge and to educate mothers on early signs of complications such as bronchopneumonia to encourage timely care seeking. With this method, low birthweight infants can grow adequately.

Evidence of Nef truncation in human immunodeficiency virus type 2 infection.

Human immunodeficiency virus (HIV)-2 differs from HIV-1 in its relative lower transmissibility and pathogenicity. To understand the virologic basis of these differences, the nef gene from HIV-2-seropositive persons was analyzed because of its importance for disease progression in the genetically related simian immunodeficiency virus (SIV[MAC]). Proviral nef sequences from 60 HIV-2-infected persons were amplified from peripheral blood lymphocytes, and nef open-reading frames were screened by a transcription and translation assay for the presence of full-length (32- to 36-kDa) or truncated (<32 kDa) Nef proteins. Overall, 6 (10%) of 60 persons had truncated Nef proteins; of these, 5 were among the 36 asymptomatic subjects (13.9%) and only 1 was among the 24 symptomatic subjects (4.2%) (P =.23). The results of this study document the presence of defective nef genes in HIV-2 infections with a prevalence higher than that previously seen in HIV-1-infected cohorts of long-term nonprogressors or patients with AIDS.

Avaliaçäo clínica e laboratorial do defeito genético de síntese de tireoglobulina: estudo de duas famílias com cinco indivíduos afetados / Clinical and laboratorial evaluation of genetic defects of thyroglobulin synthesis: study in two families with five affected subjects

Säo descritos aspectos clínicos, laboratoriais e de biologia molecular em quatro pacientes pertencentes a duas famílias (Se, Fu) näo relacionadas entre si (JGSe: 9a, M; MGSe: 5a, F; ITFu: 9a, M e RHFu: 8a, M), portadores de bócio congênito e graus variados de hipotireoidismo, atribuídos a defeito de síntese de tireoglobulina (Tg). Caracteristicamente, os níveis séricos basais de Tg säo, desproporcionalmente, baixos em relaçao ao aumento de massa exibido pela tireóide (JGSe = 5,5 ng/mL; MGSe = 2,6 ng/mL; ITFu = 2 ng/mL e RHFu < 0,5 ng/mL). Em dois deles, aquelas medidas de Tg nao se elevaram após estímulo exógeno com TSH bovino: JGSe: Tg (pico) = 4,6 ng/mL e MGSe: Tg (pico) = 2,1 ng/mL. Em todos, a pesquisa de autoanticorpos (anti-TPO e TRAb) foi negativa. A análise do DNA genômico dos quatro afetados indicou ausência de polimorfismo, sugerindo que os defeitos observados näo decorrem de inserçöes ou deleçöes significativas no gene da Tg. Por näo haver indicaçao cirúrgica no momento da avaliaçäo dos pacientes, näo foi possível obter tecido tireóideo para realizaçäo de outros estudos bioquímicos e de biologia molecular os quais indicariam o erro molecular presente nestas famílias.

Intrapericardial paraganglioma.

We describe the case of an intrapericardial pheochromocytoma located in the anterior surface of the heart and spreading over the pulmonary trunk. Under cardiopulmonary bypass (CPB) the tumor was removed. "En bloc" resection of the anterior wall of the right ventricular infundibulum and the pulmonary trunk was performed, with implantation of a fresh aortic homograft in the pulmonary position to avoid free pulmonary regurgitation.

Aspectos ecológicos da vegetação rupestre da serra dos carajás, estado do pará, brasil

General ecological aspects of the tropical scrub vegetation on rocky outcrops ("campo rupestre") of the Serra dos Carajás, Pará, Brazil, are discussed, with information on its floral composition, the associations of plant species with soil type and animals, and the geographical distributions of component plant species. The plant community studied is composed of a total of 232 species, mostly herbaceous, belonging to 145 genera and 58 plant families. The two most common families were Gramineae and Leguminosae, followed by Cyperaceae, Myrtaceae, Rubiaceae, Malpighiaceae, Euphorbiaceae and Compositae. Some families have arboreal species sporadically found in forest islands ("capões de árvores") or as isolated trees, such as Anacardiaceae, Rutaceae, Sapotaceae and Vochysiaceae. Some families are restricted in occurrence to areas where water accumulates, such as Begoniaceae, Burmaniaceae, Eriocaulaceae, Gentianaceae, etc. Some families occur only rarely, such as Acanthaceae, Annonaceae. Chrysobalanaceae, Palmae, Sterculiaceae, etc. It appears that the most common pollinators in the area are bees. Other animals are also associated with the plants of this community, such as tabanid horseflies, reptiles and birds. The soil on which this plant community is based, besides having a very thin organic layer associated with mosses and lichens, has a large number of termite nests, in the transition from dry to rainy season. The biological preservation of the study area is justified by the large number of endemic species (for example, Ipomoea cavalcanteiAustin), new species (for example, Erytroxylum nelson-rosaePlowman), species with potential as sources of drugs (for example. Pilocarpus microphylusStapf. ex. Wardleworth), and ornamental plant species (for example, Vellozia glochideaPohl), all of which belong to this community whose associated animals and soil types are yet so poorly researched.

São fornecidos aspectos ecológicos gerais da vegetação "rupestre" da Serra dos Carajás, envolvendo informações sobre composição floristica, associação solo/planta, fauna/planta e distribuição geográfica das espécies. Nesta vegetação foi registrado um total de 232 espécies, a maioria ervas, distribuídas em 145 gêneros e 58 famílias botânicas. As duas famílias mais bem representadas foram Gramineae e Leguminosae, seguidas de Cyperaceae, Myrtaceae, Rubiaceae, Malpighiaceae, Euphorbiaceae e Compositae. Algumas famílias apresentam espécies arbóreas esporadicamente representadas em "capões de árvores" ou isoladas como Anacardiaceae, Rutaceae, Sapotaceae e Vochysiaceae. Há famílias de ocorrência restrita em locais onde há acumulo de água, como Begoniaceae, Burmaniaceae, Eriocaulaceae, Gentíanaceae, etc. E finalmente aquelas famílias de ocorrência apenas ocasional, como Acanthaceae, Annonaceae. Chrysobalanaceae, Palmae, Sterculiaceae, etc. Parece que os polinizadores mais comumente encontrados na vegetação rupestre são as abelhas. Há também outros animais ali associados à biologia das plantas como meliponídeos, tabanídeos, répteis e pássaros. Além de apresentar uma insignificante camada lodosa, associada a musgos e líquens o solo onde se assenta a vegetação "rupestre" apresenta uma grande quantidade de ninhos de cupins, na transição entre as estações seca e chuvosa. A necessidade de preservação da área estudada justifica-se pela presença de inúmeras espécies endêmicas (ex. Ipomoea cavalcanteiAustin), espécies novas para a ciência (ex. Erytroxylum nelson-rosaePlowman), espécies medicinais (ex. Pilocarpus micmphylusStapf. ex. Wardleworth) e espécies ornamentais (ex. Vellozia glochideaPohl), todas associadas a uma fauna e a um tipo de solo que ainda carecem de pesquisas mais aprofundadas para melhor conhecê-los.

[Valve replacement with Macchi prosthesis]. / Substituição valvular com proótese de Macchi.

OBJECTIVE: to evaluate the performance of a new ball valve prosthesis. DESIGN: set up of two groups of patients who underwent mitral valve replacement with two different prosthesis: the Macchi prosthesis under evaluation and the well known Starr-Edwards model prosthesis. The chi-square test was used to compare the results. PATIENTS: Patients referred for valvular surgery. INTERVENTIONS: One group of 98 consecutive patients who underwent isolated mitral valve replacement with a Macchi prosthesis from January 1984 to June 30 1986 was compared to a matched group of 49 patients who received a Starr-Edwards prosthesis in the same period of time. Follow-up data were available from 99% patients in the Macchi group 96% in the Starr-Edwards group, with a mean follow-up time of 35.2 (2-57) and 42.9 (4-62) months, respectively. RESULTS: There was no statistical difference in the incidence per 100 patients--month of prosthetic complications--thromboembolism, hemorrhagic events, prosthetic endocarditis, reoperation and mechanical failure. CONCLUSIONS: In our experience and with the available follow-up data the Macchi prosthesis is a good cost effective option when there is indication for a ball valve prosthesis.

[Pseudoaneurysm of the outflow chamber of the left ventricle as a complication of bacterial endocarditis of the aortic valve -- a clinical case]. / Pseudoaneurisma da câmara de saída do ventrículo esquerdo como complicação de endocardite bacteriana da válvula aórtica--caso clínico.

After reporting a clinical case of a patient with a Staphylococcus Aureus Acute Endocarditis involving the aortic valve being complicated with cardiac failure irresponsive to medical treatment, which required a surgical procedure, the authors describe the preoperative echocardiography features. These features have the particularity of identifying a pseudoaneurysm rising in the outflow tract of the left ventricle, that involves the annulus and the anterior mitral leaflet, opening into the left atrium. They also take the opportunity to review the main local complications of Infective Endocarditis, affecting native or prosthetic valves, and make some comments on the diagnostic echocardiographic possibilities.

The "kangaroo-mother" method: evaluation of an alternative model for the care of low birth weight newborns in developing countries.

The "kangaroo-mother" method, that is nursing babies by continuously keeping them wrapped at the mother's breasts, has been proposed as an "appropriate technology" for the care of low birth weight (LBW) newborns in developing countries. We evaluated the effectiveness of this method as an alternative hospital care model in the Special Care nursery of the Central Hospital of Mapto, Mozambique. One hundred LBW newborns (mean birth weight 1329 g, SD +/- 208 g) were consecutively admitted to the "kangaroo-mother" section of the unit at the mean postnatal age of 11.6 days. Ninety-five of them were discharged alive after a mean period of 16.3 days of "kangaroo" nursing. During this period they were exclusively breast fed and their mean weight gain was 12.8 g/day. Besides being very effective in improving survival, this method favored the development of early mother-infant relations, which are certainly very important for the long term well-being of the child.