Análise de intoxicação por medicamentos / Analysis of drug intoxication / Análisis de intoxicaciones medicamentosas

Os Centros de Assistência Toxicológica possuem uma importância relevante na promoção, prevenção e controle de agravos à saúde em casos de intoxicação, pois fornece um serviço de orientação e atendimento especializado para lidar com essas situações e para minimizar os prejuízos causados pelos agentes tóxicos. Diante disso, o objetivo do estudo foi analisar o perfil epidemiológico de intoxicações por medicamento, no período de 2017 a 2021, no estado do Ceará. Este estudo está caracterizado como epidemiológico exploratório- descritivo, de abordagem quantitativa, em que serão analisados os dados secundários do registro de casos de intoxicações por medicamento, registrados no Sistema Nacional de Agravos de Notificação, entre os anos de 2017 e 2021. Os dados foram coletados no período de março a abril de 2022. As variáveis levantadas são faixa etária, sexo, circunstâncias das intoxicações, óbito. Nas análises epidemiológicas foi feito o cálculo dos registros de intoxicação por medicamentos coletados no SINAN-TABNET. Resultados: Os resultados desse estudo no período de 2017 a 2021 permitiram a identificação do perfil de intoxicações medicamentosas no Estado do Ceará. Observamos que dentre as variáveis estudadas houve uma prevalência do sexo feminino, faixa etária entre 20-39 anos, e dentre as circunstâncias demostradas, a tentativa de suicídio apresentou dados mais alarmantes. Conclusão: Verificamos a necessidade de medidas efetivas no combate ao uso incorreto dos medicamentos, com ações sociais para conscientizar a população para o uso racional dos medicamentos e orientação para os riscos apresentados por medicamentos devido seu abuso intencional ou não intencional, e uma reavaliação do perfil das pessoas com alta prevalência de intoxicações.

The Toxicological Assistance Centers are relevant in promoting, preven- tion, and control of health aggravations in cases of poisoning, as it provides a specialized guidance and assistance service to deal with such situations and to minimize the damage caused by toxic agents. Therefore, the aim of the study was to analyze the epidemiolog- ical profile of medication poisonings in the period from 2017 to 2021 in the state of Ceará. This study is characterized as an exploratory-descriptive epidemiological study, with a quantitative approach, in which secondary data from the record of drug poisoning cases, registered in the National System of Notifiable Diseases, registered in the years 2017 to 2021 will be analyzed. collected from March to April 2022. The variables are age group, sex, circumstances of poisoning, death. In the epidemiological analyses, the calculation of the records of intoxication by drugs collected in SINAN-TABNET was performed. Results: The results of this study in the period from 2017 to 2021 allowed the identification of the profile of drug poisoning in the State of Ceará. We observed that among the variables studied, there was a prevalence of females, the age group is 20-39 years, and among the circumstances, suicide attempt presented the most alarming data. Conclusion: We verified the need for effective measures to combat the misuse of medi- cine, with social actions to make the population aware about the rational use of medi- cines and guidance for the risks presented by medicines due to their intentional or unin- tentional abuse, and a reassessment of the profile of the people with a high prevalence of poisoning.

Los Centros de Asistencia Toxicológica son relevantes en la promoción, prevención y control de los agravamientos de la salud en casos de intoxicación, ya que proporciona un servicio especializado de orientación y asistencia para hacer frente a es- tas situaciones y minimizar los daños causados por los agentes tóxicos. Por lo tanto, el objetivo del estudio fue analizar el perfil epidemiológico de las intoxicaciones medica- mentosas en el período de 2017 a 2021 en el estado de Ceará. Este estudio se caracteriza por ser un estudio epidemiológico exploratorio-descriptivo, con enfoque cuantitativo, en el que se analizarán datos secundarios del registro de casos de intoxicación medicamentosa, inscritos en el Sistema Nacional de Enfermedades de Declaración Obli- gatoria, registrados en los años 2017 a 2021. recogidos de marzo a abril de 2022. Las variables son grupo de edad, sexo, circunstancias de la intoxicación, muerte. En los aná- lisis epidemiológicos se ha realizado el cálculo de los registros de intoxicaciones por drogas recogidos en SINAN-TABNET. Resultados: Los resultados de este estudio en el período de 2017 a 2021 permitieron identificar el perfil de las intoxicaciones por drogas en el Estado de Ceará. Observamos que entre las variables estudiadas, hubo una preva- lencia de fe- varones, el grupo de edad es de 20-39 años, y entre las circunstancias, el intento de suicidio pre-sentó los datos más alarmantes. Conclusiones: Verificamos la necesidad de medidas eficaces para combatir el uso indebido de medicamentos, con ac- ciones sociales de concienciación de la población sobre el uso racional de medicamentos y orientación sobre los riesgos que presentan los medicamentos por su abuso intencional o no intencional, y una reevaluación del perfil de las personas con alta prevalencia de intoxicaciones.

Comparison of new Brazilian legislation for the approval of advanced therapy medicinal products with existing systems in the USA, European Union and Japan.

BACKGROUND AIMS: Advanced therapy medicinal products (ATMPs) are a class of biological products for human use that are based on genes, cells and tissues. The first ATMP received marketing authorization in Europe in 2009, whereas Brazil granted the first authorization in 2020. The objective of this study was to compare the regulatory models adopted by Brazil, the USA, Japan and the European Union, which comprise the member countries of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use, with regard to the marketing authorization of ATMPs. METHODS: The authors performed a review of the scientific literature and official documents of the regulatory agencies in the aforementioned countries. RESULTS: The legislation and regulatory guidelines adopted by the regulatory agencies exhibit similarities and differences. It was not possible to assess whether these differences can be translated into divergent final recommendations by regulatory authorities upon a request for marketing authorization. CONCLUSIONS: In the future, it will be appropriate to start a progressive process of harmonization between these agencies in terms of terminology, legal recommendations and characterization requirements. This is particularly important for emerging countries such as Brazil. In this sense, some measures can be taken to achieve alignment between regulators.

Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular Consensus on genetically modified cells. Special Article: Advanced therapy medicinal products in Brazil: regulatory panorama.

Advanced therapy medicinal products, considered special medications, requires Anvisa approval for use and commercialization in Brazil. They include the advanced cellular therapy products, tissue engineering products and gene therapy products, which due to their complexity involve innovation and risks, optimized regulatory channels for their development and life cycle monitoring. The scientific elements and the compliance with applicable regulatory aspects are fundamental pillars for the advancement of clinical trials, the positive evidence of the benefit-risk profile and the definition of the critical quality attributes, from the perspective of making safe, effective and high-quality products available to the population. The approval models of these products in Brazil adapt to the specificities and characteristics of the technology and the patient target population, with accelerated regulatory analyses, use in emergency situations by risk controls and specific monitoring mechanisms, principally those related to rare diseases without other therapeutic alternatives. The opportune access to the advance therapy product with safety, efficacy and quality involves innovative normative elements that include the long-term follow-up of the safety and efficacy and of the adaptive pharmacovigilance requisites, as well as the traceability mechanisms for the start-off materials, products and patients.

Acute Caffeine and Coconut Oil Intake, Isolated or Combined, Does Not Improve Running Times of Recreational Runners: A Randomized, Placebo-Controlled and Crossover Study.

The aim was to evaluate the effect of caffeine (CAF) and extra virgin coconut oil (CO), isolated or combined, on running performance in runners. Methods: A randomized, placebo-controlled, and crossover study was conducted with thirteen recreational runners aged 18-40. All volunteers performed a 1600 m time trial at a 400 m track, each ingesting four different substances: (1) placebo (water), (2) decaffeinated coffee plus isolated CAF (DECAF + CAF), (3) decaffeinated coffee plus isolated CAF plus soy oil (DECAF + CAF + SO), and (4) decaffeinated coffee plus isolated CAF plus extra virgin coconut oil (DECAF + CAF + CO). The substances were ingested 60 min before the trials, the order of the situations was randomized, and there were one-week intervals between them. At the end of the trials, the Borg scale was applied to evaluate the rating of perceived exertion (RPE) and the time was measured. Results: Our data did not show differences in running time among the trials (placebo: 7.64 ± 0.80, DECAF + CAF: 7.61 ± 1.02, DECAF + CAF + SO: 7.66 ± 0.89, and DECAF + CAF + CO: 7.58 ± 0.74 min; p = 0.93), nor RPE (placebo: 6.15 ± 2.03, DECAF + CAF: 6.00 ± 2.27, DECAF + CAF + SO: 6.54 ± 2.73, and DECAF + CAF + CO: 6.00 ± 2.45 score; p = 0.99). Lactate concentrations (placebo: 6.23 ± 2.72, DECAF + CAF: 4.43 ± 3.77, DECAF + CAF + SO: 5.29 ± 3.77, and DECAF + CAF + CO: 6.17 ± 4.18 mmol/L; p = 0.55) also was not modified. Conclusion: Our study shows that ingestion of decaffeinated coffee with the addition of isolated CAF and extra virgin CO, either isolated or combined, does not improve 1600 m running times, nor influence RPE and lactate concentrations in recreational runners. Thus, combination of coffee with CO as a pre-workout supplement seems to be unsubstantiated for a short-distance race.

Controle de riscos potenciais em serviços de hemoterapia no Brasil: uma abordagem para autoridades reguladoras / Control of potential risk in blood establishments in Brazil: a strategy for regulating authorities

Objetivo. Descrever a situação sanitária dos serviços de hemoterapia (SH) brasileiros avaliados pelo sistema nacional de vigilância sanitária em 2013. Método. Neste estudo descritivo, o perfil sanitário dos SH foi avaliado utilizando-se o Método de Avaliação de Risco Potencial de Serviços de Hemoterapia (MARPSH) desenvolvido pela Agência Nacional de Vigilância Sanitária (Anvisa). O MARPSH se fundamenta na mensuração do risco potencial associado a pontos críticos de controle do ciclo do sangue e envolve a avaliação de 471 itens de estrutura e processo. A partir dessa avaliação, os SH são classificados em cinco categorias de risco: baixo, médio-baixo, médio, médio-alto e alto. Os resultados foram analisados quanto ao tipo de serviço (considerando desde hemocentros coordenadores até unidades de coleta), tipo de financiamento (público/privado) e macrorregião brasileira. Resultados. Foram avaliados 1 212 estabelecimentos, o que correspondeu a 60% do universo de estabelecimentos do Brasil. Entre os avaliados, 81% estavam em situação satisfatória (grau de atendimento aos requisitos sanitários igual ou superior a 70%, o que corresponde às categorias de médio, médio-baixo e baixo risco). O número de itens sem conformidade de estrutura e processo foi maior na região Norte, nas agências transfusionais (localizadas em hospitais, com função de armazenar, realizar testes de compatibilidade entre doador e receptor e transfundir os hemocomponentes) e nos serviços públicos. Conclusão. O uso do MARPSH facilitou a avaliação dos SH no Brasil e revelou oportunidades objetivas de melhoria que devem ser atendidas pelas autoridades reguladoras, especialmente nos serviços públicos.

Objective. To describe the sanitary status of Brazilian blood establishments (BE) assessed by the national health surveillance system in 2013. Method. In the present descriptive study, the sanitary profile of BE was assessed using the Blood Establishment Potential Risk Assessment Method (Método de Avaliação de Risco Potencial de Serviços de Hemoterapia, MARPSH), developed by the National Sanitary Surveillance Agency (Anvisa). The MARPSH involves the evaluation of 471 structure and process items to produce an assessment of potential risk associated with critical control points in the blood cycle (vein-to-vein). Based on this assessment, BE are classified into five risk categories: low, medium-low, medium, medium-high, and high. The results were analyzed regarding the type of service (considering all levels, from coordinating centers to collection units), type of financing (public/private) and geographic region. Results. Of the existing BE, 1 212 (60%) were assessed in 2013. Of these, 81% met ≥ 70% of the sanitary requirements (satisfactory status, corresponding to medium, medium-low, and low risk categories). Transfusion agencies (hospital units with the role of storing, running compatibility tests between donors and recipients, and transfusing blood components) and public establishments had the highest number of non-conformity structure and process items. Conclusion. The use of the MARPSH facilitated the assessment of BE in Brazil and revealed objective opportunities for improvement. These gaps should be addressed by regulating authorities, especially in public services.

A Vigilância Sanitária no controle de riscos potenciais em serviços de hemoterapia no Brasil / Health Surveillance in the control of potential risks in hemotherapy services in Brazil

RESUMO O artigo descreve a situação sanitária dos serviços de hemoterapia avaliados pela Vigilância Sanitária em 2011 e 2012 por meio do Método de Avaliação de Risco Potencial de Serviços de Hemoterapia (MARPSH), classificando-os em cinco categorias: Baixo, Médio-Baixo, Médio, Médio-Alto e Alto. Dos 560 avaliados, houve acréscimo de 9% nos classificados como de baixo risco e queda de 6% entre os de alto. Os principais problemas foram encontrados na região Norte, em agências transfusionais e serviços públicos. Destacaram-se não conformidades relacionadas à gestão da qualidade, de pessoal e de equipamentos. Apesar das melhorias observadas, notaram-se serviços críticos com comprometimento à segurança e à eficácia dos produtos e serviços.

ABSTRACT The article describes the risks of hemotherapy services evaluated by the Health Surveillance in 2011 and 2012 through the Valuation Method of Potential Risks in Hemotherapy Services (MARPSH), classifying them into five categories: Low, Medium-Low, Medium, Medium-High and High. Of the 560 evaluated, there was an increase of 9% among the classified as low risk and a decrease of 6% among the high risk. The main problems were found in the Northern Region, in transfusion agencies (Hospital Blood Banks) and public services. Nonconformities were mostly related to quality management, of personnel and of equipment. Despite the observed improvements, there were services with critical aspects related to their commitment to the safety and effectiveness of products and services.

Sand flies (Diptera, Psychodidae, Phlebotominae), vectors of Leishmania protozoa, at an Atlantic Forest Conservation Unit in the municipality of Nísia Floresta, Rio Grande do Norte state, Brazil.

BACKGROUND: Sand flies are insect vectors of protozoa from the genus Leishmania, causative parasites of visceral and American tegumentary leishmaniases. The present study discusses the bioecological aspects of sand fly species, transmitters of Leishmania protozoa, in different ecotopes of an Atlantic Forest Conservation Unit located in the metropolitan region of Natal, Rio Grande do Norte state, Brazil. METHODS: Two monthly captures were made in 1 year, using CDC light traps, in two anthropized and two preserved environments. RESULTS: A total of 2936 sand flies belonging to the following ten species were captured: Evandromyia walkeri, Evandromyia evandroi, Psychodopygus wellcomei, Sciopemyia sordellii, Psathyromyia brasiliensis, Lutzomyia longipalpis, Evandromyia lenti, Psathyromyia shannoni, Nyssomyia whitmani and Nyssomyia intermedia. The most common species was E. walkeri (77.6%), followed by E. evandroi (17.5%). Forest was the site with the greatest abundance (32.4%), followed by bamboo grove (26.3%). CONCLUSIONS: Sand flies were generally more abundant in the rainy season and L. longipalpis, a vector species of Leishmania infantum, was adapted to anthropized environments. It was confirmed that P. wellcomei, a vector of Leishmania braziliensis in Amazônia, is a species associated with more preserved environments, and occurs only in the rainy season.

Regulação de sangue no Brasil: contextualização para o aperfeiçoamento / Blood regulation in Brazil: contextualization for improvement

A utilização dos produtos do sangue como medicamentos essenciais e o reconhecimento das dimensões dos riscos transfusionais demandam dos países uma ação regulatória com foco em qualidade e segurança. Nesse campo, os órgãos reguladores têm papel fundamental em imprimir socialmente a garantia de que os componentes do sangue serão produzidos e utilizados de acordo com as normas técnicas vigentes. Assim, na busca para gerenciar os riscos sanitários envolvidos no processamento e uso do sangue, o modelo regulatório brasileiro, baseado na construção de uma política nacional de sangue, sob gestão do Estado, vem passando por aprimoramento conceitual e inovação de seus instrumentos. Com a inserção das boas práticas de fabricação preconizadas pela Organização Munidal da Saúde nas normativas brasileiras, o país avança na visão dos estabelecimentos de sangue como centros produtores de produtos biológicos originados do sangue para fins terapêuticos e fortalece a necessidade de desenvolvimento de mecanismos para a segurança no atendimento a doadores e receptores. O desenvolvimento de uma política nacional de sangue coordenada pelo Estado e a instituição de um sistema nacional de vigilância sanitária com poder fiscalizatório legitimado são elementos essenciais utilizados no Brasil para garantia de sangue em quantidade, qualidade, segurança e em tempo oportuno à população. Este artigo tem por objetivo discutir o contexto atual do modelo regulatório de sangue no Brasil na perspectiva de apontar desafios para o aperfeiçoamento desse modelo.

The use of blood products as essential medicines and the recognition of the high risk associated with blood transfusions require governments to take regulatory action with a focus on quality and safety. In this scenario, regulatory agencies play an essential role in socially advancing the guarantee that blood components will be produced according to current operating rules. Thus, in the effort to manage sanitary risks involved in the processing and use of blood, the Brazilian regulatory model, based on the construction of a national blood policy overseen by the State, has undergone conceptual improvement and review of the tools employed to achieve its goals. With the inclusion of good manufacturing practices as part of the Brazilian norms, as recommended by the World Health Organization, the country has moved forward in its view of blood facilities as manufacturing centers producing blood-derived biologics for therapeutic applications. It has also strengthened the need to develop safety mechanisms for blood donors and recipients. The development of a State-coordinated national blood policy and the institution of a national surveillance system with legitimate power of inspection are essential elements used in Brazil to guarantee the amount, quality, safety, and timeliness of blood supply to the population. The present article aims to discuss the present context of the blood regulatory model in Brazil so as to identify the challenges for improvement of this model.

Regulação de sangue no Brasil: contextualização para o aperfeiçoamento / Blood regulation in Brazil: contextualization for improvement

A utilização dos produtos do sangue como medicamentos essenciais e o reconhecimento das dimensões dos riscos transfusionais demandam dos países uma ação regulatória com foco em qualidade e segurança. Nesse campo, os órgãos reguladores têm papel fundamental em imprimir socialmente a garantia de que os componentes do sangue serão produzidos e utilizados de acordo com as normas técnicas vigentes. Assim, na busca para gerenciar os riscos sanitários envolvidos no processamento e uso do sangue, o modelo regulatório brasileiro, baseado na construção de uma política nacional de sangue, sob gestão do Estado, vem passando por aprimoramento conceitual e inovação de seus instrumentos. Com a inserção das boas práticas de fabricação preconizadas pela Organização Munidal da Saúde nas normativas brasileiras, o país avança na visão dos estabelecimentos de sangue como centros produtores de produtos biológicos originados do sangue para fins terapêuticos e fortalece a necessidade de desenvolvimento de mecanismos para a segurança no atendimento a doadores e receptores. O desenvolvimento de uma política nacional de sangue coordenada pelo Estado e a instituição de um sistema nacional de vigilância sanitária com poder fiscalizatório legitimado são elementos essenciais utilizados no Brasil para garantia de sangue em quantidade, qualidade, segurança e em tempo oportuno à população. Este artigo tem por objetivo discutir o contexto atual do modelo regulatório de sangue no Brasil na perspectiva de apontar desafios para o aperfeiçoamento desse modelo.

The use of blood products as essential medicines and the recognition of the high risk associated with blood transfusions require governments to take regulatory action with a focus on quality and safety. In this scenario, regulatory agencies play an essential role in socially advancing the guarantee that blood components will be produced according to current operating rules. Thus, in the effort to manage sanitary risks involved in the processing and use of blood, the Brazilian regulatory model, based on the construction of a national blood policy overseen by the State, has undergone conceptual improvement and review of the tools employed to achieve its goals. With the inclusion of good manufacturing practices as part of the Brazilian norms, as recommended by the World Health Organization, the country has moved forward in its view of blood facilities as manufacturing centers producing blood-derived biologics for therapeutic applications. It has also strengthened the need to develop safety mechanisms for blood donors and recipients. The development of a State-coordinated national blood policy and the institution of a national surveillance system with legitimate power of inspection are essential elements used in Brazil to guarantee the amount, quality, safety, and timeliness of blood supply to the population. The present article aims to discuss the present context of the blood regulatory model in Brazil so as to identify the challenges for improvement of this model.

Evaluating Potential P-gp Substrates: Main Aspects to Choose the Adequate Permeability Model for Assessing Gastrointestinal Drug Absorption.

The success of an oral drug route administration depends on many factors that interfere in its bioavailability, therapeutic efficacy and clinical safety. In human cells, ATP-dependent efflux transporter proteins, such as P-glycoprotein (P-gp), BCRP and MRP2, reduce the absorption of drugs. A tiered approach chosen to evaluate drugs as substrates or inhibitors of efflux pumps, particularly P-gp, should be carefully selected, since each study method has advantages and intrinsic limitations to their processes. Depending on the adopted study conditions, the results may not correspond to the real characteristics of the drug regarding to its modulation by specific efflux proteins. This mini-review aims at summarizing the role of P-gp in the drugs oral absorption and correlating some of the most used permeability methods to determine the drug condition as P-gp substrate. Studies about P-gp have shown that it is a dynamic protein, facilitating secretion of endogenous compounds, as aldosterone, and protecting cells against xenobiotics. Different efflux assays are employed to evaluate drugs as P-gp substrates. In an initial planning, MDCK-MDR1 tend to be the chosen method for efflux studies due its ability of express P-gp, followed by studies conducted in Caco-2 models. However, it is necessary to evaluate the advantages and disadvantages of each method to generate sound results and to set the correlation in vitro x in situ x in vivo.

[Blood regulation in Brazil: contextualization for improvement]. / Regulação de sangue no Brasil: contextualização para o aperfeiçoamento.

The use of blood products as essential medicines and the recognition of the high risk associated with blood transfusions require governments to take regulatory action with a focus on quality and safety. In this scenario, regulatory agencies play an essential role in socially advancing the guarantee that blood components will be produced according to current operating rules. Thus, in the effort to manage sanitary risks involved in the processing and use of blood, the Brazilian regulatory model, based on the construction of a national blood policy overseen by the State, has undergone conceptual improvement and review of the tools employed to achieve its goals. With the inclusion of good manufacturing practices as part of the Brazilian norms, as recommended by the World Health Organization, the country has moved forward in its view of blood facilities as manufacturing centers producing blood-derived biologics for therapeutic applications. It has also strengthened the need to develop safety mechanisms for blood donors and recipients. The development of a State-coordinated national blood policy and the institution of a national surveillance system with legitimate power of inspection are essential elements used in Brazil to guarantee the amount, quality, safety, and timeliness of blood supply to the population. The present article aims to discuss the present context of the blood regulatory model in Brazil so as to identify the challenges for improvement of this model.

Entre revelar e esconder: pais e filhos em face da descoberta da homossexualidade / Between revealing and hiding: parents and children faced with the disclosure of homosexuality / Entre revelar y esconder: padres e hijos frenta al descubrimiento de la homosexualidad

Este trabalho trata da relação entre pais e filhos quando diante da situação social da descoberta da homossexualidade. Foram ouvidos 20 jovens brasileiros do sexo masculino entre 18 e 24 anos de idade, universitários, de camadas médias e que se autoidentificam como homossexuais. Privilegiamos conhecer as experiências vividas por esses jovens no sentido de assumir a homossexualidade em casa. O reconhecimento da homossexualidade pelos familiares e, sobretudo, entre eles mesmos movimenta nesses jovens todo um conjunto de medos que se expressam em formas concretas de violência, sofrimento psíquico e incertezas. Procuramos compreender como esses jovens lidam com as agressões e os sofrimentos que cotidianamente recaem sobre suas vidas, indo de encontro a um esforço coercitivo de seus familiares para os adequarem à norma sexual hegemônica.

This paper addresses parent-child relations when faced with the social situation of the disclusure of homosexuality. Twenty 18-to-24 year old young middle-class male college students who self-identify as gay were heard, privileging their coming out experiences at home. The recognition of their homosexuality by their families, and particularly by themselves activates a variety of fears and concrete forms of violence, psychological distress and uncertainty. We seek to understand how these youths cope with aggression and suffering, reacting to a coercive effort by their relatives to adequate them to the hegemonic sexual norm.

Este artículo estudia la relación entre padres e hijos ante la situación social de descubrimiento de la homosexualidad. Se entrevistaron 20 jóvenes brasileños de sexo masculino, de entre 18 y 24 años de edad, universitarios, de camadas medias y que se autoidentifican como homosexuales. Se privilegió conocer las experiencias vividas por esos jóvenes, en el sentido de asumir su homosexualidad en casa. El reconocimiento de la homosexualidad por parte de los familiares y, especialmente, entre ellos mismos, pone en movimiento en los jóvenes un conjunto de miedos que se expresan en formas concretas de violencia, sufrimiento psíquico e incertidumbre. Se procura comprender cómo esos jóvenes lidian con las agresiones y sufrimientos que cotidianamente recaen sobre sus vidas al ir en contra del esfuerzo coercitivo de sus familiares para adecuarlos a la norma sexual hegemónica.

Anthelmintic activity of Eucalyptus staigeriana encapsulated oil on sheep gastrointestinal nematodes.

The anthelmintic activity of Eucalyptus staigeriana essential oil has previously been inferred through both in vitro and in vivo tests. Thus, the encapsulation process generally improves oil stability, promotes controlled release in target organs, reduces dosage, and increases efficacy. The aims of this study were to analyze and encapsulate E. staigeriana essential oil and to verify its anthelmintic activity in sheep. The encapsulation process was accomplished through emulsion using a 4% chitosan solution as the matrix. Anthelmintic activity was established through controlled testing using 18 sheep that were separated into three groups: group 1 was treated with a single dose of 365 mg/kg of E. staigeriana encapsulated oil, group 2 was treated with 200 µg/kg of ivermectin, and group 3 was treated with a 4% chitosan solution as a negative control. The sheep were euthanized and necropsied 13 days posttreatment to evaluate worm burden. Limonene was the major oil component (72.91%). The final product was a hydrogel with 36.5% (m/m) E. staigeriana essential oil per gram. Its efficacy on gastrointestinal nematodes was 60.79%. The highest efficacy was against abomasal nematodes, with 83.75% efficacy. Further studies are necessary to explore the possibility of increasing the hydrogel efficacy; nevertheless, we can state that E. staigeriana encapsulated oil had anthelmintic activity and can be used in gastrointestinal nematode control.

Brazilian gutta-percha points. Part II: thermal properties

This study was undertaken to explore the effect of heating on gutta-percha, analyzing the occurrence of endothermic peaks corresponding to the transformation that occurs in the crystalline structure of the polymer during thermal manipulation. This study also seeked to determine the temperature at which these peaks occur, causing a transformation from the beta- to the alpha-form, and from the alpha- to the amorphous phase. Eight nonstandardized gutta-percha points commercially available in Brazil (Konne, Tanari, Endopoint, Odous, Dentsply 0.04, Dentsply 0.06, Dentsply TP, Dentsply FM) and pure gutta-percha (control) were analysed using differential scanning calorimetry (DSC) and thermogravimetry analysis (TGA). The transition temperatures were determined and analysed. With the exception of Dentsply 0.04 and Dentsply 0.06, the majority of the products showed thermal behaviour typical of beta-gutta-percha, with two endothermic peaks, exhibiting two crystalline transformations upon heating from ambient temperature to 130°. Upon cooling and reheating, few samples presented two endothermic peaks. It was concluded that heating dental gutta-percha to 130°C causes changes to its chemical structure which permanently alter its physical properties.

Este estudo teve como objetivo analisar, através da Calorimetria Diferencial de Varredura (DSC) e Análise Termogravimétrica (TGA), os efeitos do aquecimento sobre o polímero guta-percha, bem como explorar a ocorrência de picos endotérmicos, os quais correspondem às transformações cristalinas do polímero guta-percha, o que é traduzido em transições de fases (fase beta para alfa e fase alfa para amorfa). Foram utilizadas 8 marcas comerciais de cones de guta-percha não-estandardizados disponíveis no mercado brasileiro (Konne, Tanari, Endopoint, Odous, Dentsply 0.04, Dentsply 0.06, Dentsply TP, Dentsply FM), além da guta-percha pura (controle). As temperaturas de transição foram determinadas e analisadas. Com exceção das amostras Dentsply 0.04 e Dentsply 0.06, todas as demais apresentaram duas transformações cristalinas de fase quando submetidas ao aquecimento da temperatura ambiente até 130°C, comportamento típico de guta-percha em fase beta. Ao serem resfriadas e reaquecidas, poucas amostras apresentaram dois picos endotérmicos. É possível concluir que o aquecimento a 130°C causa danos na estrutura química do polímero guta-percha, o qual altera de forma definitiva suas propriedades físicas.

Clinical relevance of trans 1.4-polyisoprene aging degradation on the longevity of root canal treatment

This in vivo study investigated the time of degradation of root filling material (trans 1,4-polyisoprene) retrieved from endodontically treated teeth and correlated the occurrence of degradation with the longevity of endodontics. Thirty-six root-filled teeth with different filling times (2 to 30 years) and with and without periapical lesions were selected. All teeth presented clinical indication for root canal retreatment. The association among filling time, presence of periapical lesion and root filling material degradation was investigated. Root filling samples were retrieved from the root canals using a Hedströ m file without solvent. The trans 1,4-polyisoprene was isolated by root filling solubilization in chloroform followed by filtration and centrifugation. GPC and FT-IR were the analytical techniques utilized. Degradation of trans 1,4-polyisoprene occurred with time, as a slow process. It is an oxidative process, and production of carboxyl and hydroxyl groups in the residual polymer were observed. Statistically significant decrease of molar mass was observed after 5 (p=0.0001) and 15 (p=0.01) years in teeth with and without periapical lesion, respectively. Bacteria participated in polymer degradation. Gutta-percha aging was proven an important factor for the long-term success of endodontic treatment. The findings of the present study showed that, after 15 years, polymer weight loss may decrease the capacity of the filling mass to seal the root canal space and prevent re-infection, thus compromising significantly the longevity of root canal therapy.

Este estudo in vivo avaliou a degradação do material obturador e a influência deste fator na longevidade do tratamento endodôntico. Foram selecionados 36 pacientes (3-30 anos) com canais tratados endodonticamente, com e sem lesões periapicais, e indicação de retratamento endodôntico. Foi investigada a associação entre o tempo de tratamento, presença de lesão periapical e a degradação do material obturador. O material obturador foi removido com uma lima Hedströ em sem uso de solvente. O polímero trans 1,4- poliisopreno foi isolado do material obturador através de solubilização em clorofórmio, seguido de filtragem e centrifugação. GPC e FT-IR foram os métodos analíticos utilizados. A degradação do trans 1,4- poliisopreno foi observada com o tempo, sendo um processo lento e oxidativo, com formação de grupos carboxílicos e hidroxilas no polímero residual. Após 5 (p=0,0001) e 15 (p=0,01) anos, em dentes com e sem lesões periapicais, respectivamente, houve decréscimos significantes na massa molar do material obturador. A infecção bacteriana participa no processo de degradação do polímero. O envelhecimento da guta-percha é um fator que influencia o sucesso a longo prazo do tratamento endodôntico. Após 15 anos, a longevidade do tratamento pode ser significantemente afetada pela redução da capacidade de selamento causada pela perda de massa molar do polímero, permitindo a reinfecção do sistema de canais radiculares.

Brazilian gutta-percha points: Part I: chemical composition and X-ray diffraction analysis / Cones nacionais de guta-percha. Parte I: composição química e análise por difração de raios X

Oito marcas de cones de guta-percha disponíveis no mercado brasileiro (Konne, Tanari, Endopoint, Odous, Dentsply 0.04, Dentsply 0.06, Dentsply TP e Dentsply FM) foram analisadas quimicamente e por difração de raios X; e suas composições, comparadas. A porção orgânica (guta-percha e ceras/resinas) foi separada da porção inorgânica (ZnO e BaSO4) através da dissolução em clorofórmio. O polímero guta-percha foi precipitado com adição de acetona. A fração inorgânica foi analisada por microanálise elementar. Microanálise por energia dispersiva de raios X (EDX) e difração por raios X foram utilizadas para identificar os elementos e compostos (BaSO4 e ZnO). A quantidade de sulfato de bário foi calculada através da porcentagem de enxofre detectada na microanálise elementar. Todas as análises foram executadas em triplicata. As médias e os desvios padrões das porcentagens em peso de guta-percha nas diferentes marcas analisadas foram: Konne (17,6 ± 0,30), Tanari (15,2 ± 0,30), Endopoint (16,7 ± 0,23), Odous (18,8 ± 0,20), Dentsply 0.04 (15,7 ± 0,17), Dentsply 0.06 (16,6 ± 0,17), Dentsply TP (21,6 ± 0,15) e Dentsply FM (16,3 ± 0,23). As médias e os desvios padrões das quantidades de óxido de zinco encontrados foram: Konne (79,9 ± 0,10), Tanari (81,9 ± 0,07), Endopoint (81,3 ± 0,40), Odous (79,7 ± 0,26), Dentsply 0.04 (77,9 ± 0,03), Dentsply 0.06 (78,2 ± 0,07), Dentsply TP (69,8 ± 0,19) e Dentsply FM (72,6 ± 0,70). O método utilizado foi apropriado para quantificação dos componentes guta-percha, ceras/resinas, óxido de zinco e sulfato de bário. Foram encontrados cones que não apresentaram sulfato de bário na composição. Foi detectada uma concentração exagerada de ceras/resinas no cone Dentsply FM (p = 0,0003). O cone Dentsply TP apresentou a maior porcentagem de guta-percha.