Anacardium occidentale L. (cajueiro) in the healing of skin wounds: an experimental study in rats.

PURPOSE: To analyze the effects of Anacardium occidentale Linn on the healing of skin wounds. METHODS: Twenty Wistar male rats were distributed into four groups (with five animals each one): negative control group (NCG), treated with saline solution; cashew tree group (CG), treated with hydroalcoholic extract of the bark of A. occidentale Linn; manipulated cashew tree group (MCG), with the ointment of extract of the bark of A. occidentale Linn; positive control group (PCG), treated with sunflower oil. All animals were examined daily, observing the macroscopic aspects of the surgical wound. Hematoxylin-eosin staining was used for tissue morphology analysis and Masson's trichrome for better collagen fiber characterization. RESULTS: On day 7, the MCG group had the expansion of the surgical wound covered by crust, exceeding the initial limits. On day 21, the wounds were observed to be completely closed and epithelialized in the NCG and CG groups. PCG and MCG still had remnants of crusts on the wound. The NCG was the only one not to present an abscess in histopathological analysis. CONCLUSIONS: There was a prolongation of the healing phase of the animals treated with the extract, and the animals in the NCG showed a better outcome by histological analysis.

Can diabetes mellitus modify the plasma concentrations of rifampicin in patients under treatment for tuberculosis?

Abstract Rifampicin is a key component of treatment for tuberculosis and its efficacy is determined by the blood levels attained after therapeutic doses. However, there is a high variability of rifampicin blood levels that is related to both the patient and the formulation used. To date, the effect of diabetes mellitus on the plasma levels of rifampicin was low exploited, which could be relevant either by the significant increase of the comorbidity worldwide as by the probable influence of diabetes on the rifampicin exposure. The study aims to evaluate whether diabetes mellitus contribute to the variation of the maximum concentration of rifampicin in patients with tuberculosis treated with a daily dose of 10 mg/kg. Rifampicin and glycated hemoglobin were measured by high-performance liquid chromatography, and blood glucose by spectrophotometry. A total of 62 male patients were included in the study, and 26 presented diabetes mellitus. Rifampicin plasma levels in 2-h plasma samples collected at day 61 ranged from 3 µg/mL to 14.2 µg/mL. Drugs levels were similar between diabetic and non-diabetic patients and were not correlated with blood glucose and glycated hemoglobin. Moreover, a high percentage of patients in both groups presented low levels of rifampicin.

Can diabetes mellitus modify the plasma concentrations of rifampicin in patients under treatment for tuberculosis?

Rifampicin is a key component of treatment for tuberculosis and its efficacy is determined by the blood levels attained after therapeutic doses. However, there is a high variability of rifampicin blood levels that is related to both the patient and the formulation used. To date, the effect of diabetes mellitus on the plasma levels of rifampicin was low exploited, which could be relevant either by the significant increase of the comorbidity worldwide as by the probable influence of diabetes on the rifampicin exposure. The study aims to evaluate whether diabetes mellitus contribute to the variation of the maximum concentration of rifampicin in patients with tuberculosis treated with a daily dose of 10mg/kg. Rifampicin and glycated hemoglobin were measured by high-performance liquid chromatography, and blood glucose by spectrophotometry. A total of 62 male patients were included in the study, and 26 presented diabetes mellitus. Rifampicin plasma levels in 2-h plasma samples collected at day 61 ranged from 3µg/mL to 14.2µg/mL. Drugs levels were similar between diabetic and non-diabetic patients and were not correlated with blood glucose and glycated hemoglobin. Moreover, a high percentage of patients in both groups presented low levels of rifampicin.

Concentrations of rifampicin in pre-dose samples in patients with pulmonary tuberculosis.

Rifampicin is used in both phases of treatment for tuberculosis. In chronic use, the short half-life and the self-induction of metabolism can decrease the levels of the drug below the minimal inhibitory concentration. The aim of the study was to investigate whether plasma concentrations of rifampicin are sustained above 0.5µg/mL in patients with tuberculosis using 600mg/day. Rifampicin was measured in plasma by high-performance liquid chromatography and a sputum smear microscopy was performed in all days of the study. A total of 44 male patients completed the study. On days 31, 61 and 91, the mean plasma concentrations of rifampicin were 0.6 (0.5)µg/mL, 0.55 (0.5)µg/mL and 0.46 (0.4)µg/mL. There was a high variation of rifampicin levels leading to a high percentage of samples with concentrations below 0.5µg/mL. There was no significant association between the frequency of samples with drug levels below 0.5µg/mL with the conversion of the sputum microscopy. These data suggest that pre-doses samples offer limited information on the exposure of M. tuberculosis to rifampicin.

Concentrations of rifampicin in pre-dose samples in patients with pulmonary tuberculosis

ABSTRACT Rifampicin is used in both phases of treatment for tuberculosis. In chronic use, the short half-life and the self-induction of metabolism can decrease the levels of the drug below the minimal inhibitory concentration. The aim of the study was to investigate whether plasma concentrations of rifampicin are sustained above 0.5 µg/mL in patients with tuberculosis using 600 mg/day. Rifampicin was measured in plasma by high-performance liquid chromatography and a sputum smear microscopy was performed in all days of the study. A total of 44 male patients completed the study. On days 31, 61 and 91, the mean plasma concentrations of rifampicin were 0.6 (0.5) µg/mL, 0.55 (0.5) µg/mL and 0.46 (0.4) µg/mL. There was a high variation of rifampicin levels leading to a high percentage of samples with concentrations below 0.5 µg/mL. There was no significant association between the frequency of samples with drug levels below 0.5 µg/mL with the conversion of the sputum microscopy. These data suggest that pre-doses samples offer limited information on the exposure of M. tuberculosis to rifampicin.

Levels of primaquine and carboxyprimaquine in patients with malaria vivax from the Brazilian Amazon basin.

In the last two years, a substantial increase in the number of malaria vivax cases has occurred in the Brazilian Amazon basin. The adequate exposure of hypnozoites to primaquine is a matter of interest as these dormant forms are responsible for the maintenance or even the increase of malaria burden in endemic areas. The aim of this study was to estimate the levels of primaquine and carboxyprimaquine in whole blood samples of patients with P. vivax treated with chloroquine and an abbreviated regimen of primaquine (0.5 mg/kg/d for 7 days), with adequate clinical and parasitological outcomes after 180 days of follow-up. A total of 40 male patients met the criteria for inclusion in the study. Primaquine and carboxyprimaquine were measured by high-performance liquid chromatography. The levels of primaquine in whole blood samples ranged from 40-238 ng/mL, 42-196 ng/mL and 42-150 ng/mL on days 1, 3 and 7. The levels of carboxyprimaquine in whole blood samples ranged from 87-234 ng/mL, 96-252 ng/mL and 74-448 ng/mL on days 1, 3 and 7. These data provide a reliable estimation of exposure of the infecting parasite to primaquine. Based on the regional pattern of relapse, the estimated blood levels of primaquine can be considered effective against hypnozoites of the local circulating strains of P. vivax.

Salicytamide: a New Anti-inflammatory Designed Drug Candidate.

Salicytamide is a new drug developed through molecular modelling and rational drug design by the molecular association of paracetamol and salicylic acid. This study was conducted to assess the acute oral toxicity, antinociceptive, and antioedematogenic properties of salicytamide. Acute toxicity was based on the OECD 423 guidelines. Antinociceptive properties were investigated using the writhing, hot plate and formalin tests in Swiss mice. Antioedematogenic properties were evaluated using the carrageenan-induced paw oedema model and croton oil-induced dermatitis in Wistar rats. Salicytamide did not promote behavioural changes or animal deaths during acute oral toxicity evaluation. Furthermore, salicytamide exhibited peripheral antinociceptive activity as evidenced by the reduction in writhing behaviour (ED50 = 4.95 mg/kg) and licking time in the formalin test's inflammatory phase. Also, salicytamide elicited central antinociceptive activity on both hot plate test and formalin test's neurogenic phase. Additionally, salicytamide was effective in reducing carrageenan or croton oil-induced oedema formation. Overall, we have shown that salicytamide, proposed here as a new NSAID candidate, did not induce oral acute toxicity and elicited both peripheral antinociceptive effects (about 10-25 times more potent than its precursors in the writhing test) and antioedematogenic properties. Salicytamide also presented central antinociceptive activity, which seems to be mediated through opioid-independent mechanisms. These findings reveal salicytamide as a promising antinociceptive/antioedematogenic drug candidate.

Tendências de prescrição de antimicrobianos em idosos hospitalizados em um hospital universitário / Prescriptions of antimicrobial drugs for elderly people hospitalized in a universit y hospital

Este estudo teve como objetivo identificar tendências na prescrição de antimicrobianos em idosos hospitalizados em um hospital universitário no Estado do Pará. Estudo observacional e transversal que avaliou e analisou prontuários em relação a características do paciente, diagnóstico e tratamento, sendo tendências de prescrição identificadas por análise de frequência. Foram avaliados 299 prontuários, sendo observada uma predominância de idosos jovens (80%), do sexo feminino (56,5%), que tiveram como principal causa de internação infecções do trato respiratório. O tratamento foi predominantemente empírico, predominando a utilização de cefalosporinas de 3ª geração, macrolídeos e quinolonas. Quando relacionada a patologia ao medicamento predominou a utilização de cefalosporinas para o tratamento de infecções do trato respiratório e complicações da diabetes mellitustipo II. Identificou-se a necessidade de desenvolvimento de protocolos clínicos na instituição para padronização do tratamento e estímulo ao uso racional de antimicrobianos com o objetivo de garantir a segurança do paciente.

Trends in antimicrobial prescription for hospitalized elderly people in a university hospital in the state of Pará, Brazil, are identified. The transversal study evaluated and analyzed clinical cards on patients´ characteristics, diagnosis and treatments. Prescription trends are identified by the analysis of frequency. Further, 299 clinical cards were evaluated with a predominance of young female (56.5%) elderly people (80%), with infections of the respiration tract as the main cause of hospitalization. The predominantly empiric treatment comprised third generation cephalosporins, macrolides and quinolones. When pathology is related to medicine, the use of cephalosporins prevailed in the treatment of infections of the respiratory tract, with complications caused by Type 2 diabetes mellitus. The development of clinical protocols is required for the standardization of treatments and to stimulate the rational use of antimicrobial drugs to warrant the patient´s safety.