Nanocarrier-based dermopharmaceutical formulations for the topical management of atopic dermatitis.

Atopic dermatitis (AD) is a chronic disease that affects the skin, and that is characterized by highly itchy inflammation, frequent eczematous lesions, and a fluctuating course. The current treatment consists of a multi-stage approach that aims to establish persistent disease control towards the improvement of the quality of life of the patients. Topical therapy is the basis of AD treatment, however, due to the difficulty of crossing the skin barrier, topical application of drugs remains a challenge. In fact, in addition to the low skin bioavailability, and limited accessibility to deeper skin of the drugs - due to difficulty in penetrating the epidermis - implemented drugs in the clinical are associated with serious adverse effects, which are responsible for safety and efficacy limitations, leading to a reduction in patients' compliance. Nanotechnology arises as an emerging approach for the treatment of AD, allowing for controlled release, targeted delivery, improved penetration, and bioavailability of drugs assets, resulting in marked improved therapeutic efficacy and reduction of adverse effects. Although its promising outputs, additional studies are needed to recognize the toxicological characteristics, cost-benefit, and long-term safety of nanocarriers applied to this end. Advanced drug delivery systems, particularly nanoemulsions, liposomes, ethosomes, transfersomes, solid lipid nanoparticles, nanostructured lipid carriers, nanocrystals, polymeric nanoparticles, and polymeric micelles have been used, and are thoroughly addressed in this review as promising nanoformulations towards the topical treatment of AD.

Depressão miocárdica na sepse / Myocardial depression in sepsis

A disfunção miocárdica é um evento reconhecido na sepse e no choque séptico há muitos anos. Diversos mecanismos foram propostos, como a isquemia global do músculo cardíaco e a liberação de mediadores inflamatórios com propriedades depressoras miocárdicas pelos macrófagos tissulares. O mecanismo de ação destes mediadores também foi extensamente estudado, sugerindo serem o óxido nítrico e a esfingosina os efetores da disfunção mediada pelo TNF-a e pela IL-1B. O tratamento específico da disfunção miocárdica na sepse e no choque séptico ainda não foi encontrado, porém sabe-se que a mesma é reversível após o controle da doença de base

The myocardial dysfunction is a well known event in sepsis and septic shock. Many mechanisms were proposed such as global ischemia of the cardiac muscle and the inflammatory mediators production leading to myocardial depression. The mechanism of action of these mediators has also been studied. Nitric oxide and esfingosin are possible effectors of the dysfunction that is mediated by TNF-a and IL-1B. The specific treatment of the myocardial dysfunction in sepsis and septic shock has not been defined. The heart function improves after the control of the disease