Syringeable Pluronic-α-cyclodextrin supramolecular gels for sustained delivery of vancomycin.

The ability of Pluronic® F127 to form supramolecular gels in the presence of αCD has been explored as a way to design syringeable gel formulations able to sustain drug release while using the lowest proportion of both components. The effects of αCD concentration range (0-9.7% w/v) in copolymer (6.5%, 13% and 20%) gel features were evaluated at 4, 20 and 37°C. An effective complexation of Pluronic and αCD was evidenced as a change in the surface pressure of the π-A isotherm of Pluronic on a subphase of CD solution and the apparition of new peaks in the X-ray spectra. Once the Pluronic and αCD solutions were mixed, the systems became progressively turbid solutions or white gels. The greater the αCD concentration was, the faster the gel formation. The supramolecular hydrogels were thixotropic and those containing 5% or more αCD had G' values above G″ at room temperature, but they were still easily syringeable. The values of both moduli increased as temperature raised; the effect being more evident for 13% and 20% w/v copolymer. The gels prepared with low proportions of αCD exhibited phase separation in few days, particularly when stored at 4 or 37 °C. By contrast, those prepared with 6.5% copolymer were stable for at least two months when stored at 20 °C. The gels were able to sustain vancomycin release for several days; the higher the αCD proportion, the slower the release was. Furthermore, the drug-loaded gels showed activity against Staphylococcus aureus. The results obtained highlight the role of the αCD concentration on the tuning of the rheological features and drug release profiles from Pluronic gels.

Early infection with Trichuris trichiura and allergen skin test reactivity in later childhood.

BACKGROUND: Allergic diseases cause a large and increasing burden in developed countries and in urban centres in middle-income countries. The causes of this increase are unknown and, currently, there are no interventions to prevent the development of allergic diseases. The 'hygiene hypothesis' has tried to explain the increase through a reduction in the frequency of childhood infections causing a failure to program the immune system for adequate immune regulation. Intestinal helminth parasites are prevalent in childhood in developing countries and are associated with a lower prevalence of allergen skin test reactivity and asthma. OBJECTIVES: To investigate whether children who had intestinal helminth infections during early childhood have a lower prevalence of allergen skin test reactivity later in childhood. METHODS: We re-visited a population of 1055 children from whom stool samples had been collected for detection of intestinal helminth infections for another study, and collected new stool samples and performed allergen skin prick testing. Information on potential confounding variables was collected. RESULTS: Children with heavy infections with Trichuris trichiura in early childhood had a significantly reduced prevalence of allergen skin test reactivity in later childhood, even in the absence of T. trichiura infection at the time of skin testing in later childhood. CONCLUSION: Early heavy infections with T. trichiura may protect against the development of allergen skin test reactivity in later childhood. Novel treatments to program immune-regulation in early childhood in a way that mimics the effects of early infections with T. trichiura may offer new strategies for the prevention of allergic disease.

Inflamação do parênquima pulmonar na asma e sua relação com as vias aéreas / Pulmonary parenchyma inflammation in asthma

A inflamação da asma não está limitada às vias aéreas e pode comprometer também o parênquima pulmonar periférico, no entanto, não há estudos na literatura que enfoquem a participação do parênquima pulmonar na asma. Objetivo: Caracterizar o infiltrado inflamatótrio do parênquima peribronquiolar e distal em vítimas de asma fatal, comparando-o ao de outras regiões de vias aéreas e a de tecido pulmonar de não asmáticos. Fragementos de tecido pulmonar obtidos de 20 pacientes com asma fatal e 10 controles, necropsiados no Serviço de verificacão de óbito da capital - São Paulo, foram submetidos a estudo de imuno-histoquímica e marcados com anticorpos anti-proteína básica principal (eosinófilos), anti-triptase (mastócitos), anti-elastase neutrofílica (neutrófilos) e anti-marcadores de superfície de linfócitos (CD3, CD$, CD* e CD20). Foram determinadas as densidades celulares no parênquima pulmonar periférico peribronquiolar e distal e nas áreas interna e externa das vias aéreas de grande e de pequeno calibre. Resultados: A densidade de eosinófilos foi significativamente maior nas duas regiões do parênquima pulmonar de asmáticos comparados aos controles, bem como as vias aéreas (p<0,02). Nos pacientes asmáticos a densidade eosinófilica se mostrou menos no parênquima distal em relação à da área interna da via aérea grande apenas (p<0,01). A densidade dos mastócitos foi maior no parênquima peribronquiolar bem como na área externa das vias aéreas de grande e de pequeno calibre de asmáticos comparados aos controles (p<0.04). Diferenças significativas quanto à densidade de linfócitos se restringiram às vias aéreas de asmáticos comparadas as de controles. Maior densidade de neutrófilos foi observada apenas no parênquima pulmonar de asmáticos (p=0.029). Conclusões: O parênquima pulmonar participa do processo inflamatório na asma fatal com aumento de células efetoras (mastócitos, neutrófilos e eosinófilos). A área externa da via aérea foi a região que melhor diferenciou o asmáticodo controle e com o maior número de diferenças significativas. A inflamação do parênquima peribronquiolar, associado ao da área externa da via áerea pequena, reforça o papel do pulmão distal na patofisiologia da asma.

[Care provided by nursing students in a neonatal intensive care unit from the mother's point of view]. / Cuidado prestado pelo acadêmico de enfermagem em unidade de terapia intensiva neonatal na ótica da mãe.

The objective of the present study is to investigate the perspective of mothers regarding the care given by academics of nursing to their newborn in a neonatal intensive therapy unit. This is a qualitative research based on a phenomenological approach which has as its philosophical framework the thought of Martin Heidegger expressed in his book Being and Time. The data used in the investigation were interviews given by ten mothers who had their newborns in a neonatal intensive therapy unit of a university hospital in the city of Rio de Janeiro. The interpretation of the data collected revealed that mothers viewed the nursing academics as solicitous beings regarding the care given to their newborns. They also acknowledged that these students were engaged in the assistance given and concerned with what was being done and to whom it was being done.

[An approach to the phenomenological interview]. / Um caminhar na aproximação da entrevista fenomenológica.

The purpose of this study is to describe my experiences about the phenomenological interview. It was developed in four moments, in order to adequate physical environment aspects, strategies of approaching the interviewers, the orientation question and the techniques to obtain the statements. The focus on researcher-subject/researched-subject has indicated adjustments in the utilization of the techniques and reoriented my person and professional development.

[Experience of women in labor. Nurses' observations]. / Vivência de parturientes: observação de enfermagem.

This study emerged from my own experience in Obstetric Nursing and my living in Obstetrics. I searched for comprehending the real meaning of delivery labor experiences as a situated phenomenon. It is a qualitative research with phenomenological approach. The lying-in women were the witnesses through the question: 'What was your daily experience in the pre-delivery room like?' Through analysis and hermeneutics of speeches, I have used the knowledge of Matin Heidegger's philosophical-theoretical referential. Thus, I managed to clarify that the parturient is fearful when left by herself in her experience, showing surprise for the labor of delivery is singular, noting down the pain as a possibility of the existential limit, being open to help and noticing the impersonality of care provided. With this watchful sense, I approached the comprehension of a lying-in woman as a being-in-a-world-with-health-professionals. This discovery indicated the possibility of new ways of caring in Obstetrics.