bluuebunny/crossref_metadata_2025 huggingface dataset:
Triagem auditiva neonatal com emissão otoacústica transiente utilizando estímulo de banda estreita
Authors: Côrtes-Andrade Isabela Freixo , Sena-Yoshinaga Taise Argolo , Almeida Mabel Gonçalves , Lewis Doris Ruthy
Published: July 2015

OBJETIVO: avaliar a sensibilidade e a especificidade de um equipamento automático de Emissão Otoacustica Evocada Transiente que utiliza um estímulo de banda estreita, Narrow. MÉTODOS: foi analisado o resultado da Triagem Auditiva Neonatal de 300 neonatos. A Emissão Otoacústica Evocada Transiente foi realizada com um equipamento portátil automático, com o estímulo de banda estreita - Narrow. Todos os neonatos foram submetidos ao Potencial Evocado Auditivo de Tronco Encefálico com o estímulo clique, duração 100μs como padrão-ouro. RESULTADOS: o percentual de "passa" na Triagem Auditiva Neonatal foi de 90,7%. Considerando os resultados do padrão-ouro, foi observado uma taxa de falso-positivo de 9%. A sensibilidade e especificidade encontradas foram de 100% e 92%, respectivamente. CONCLUSÃO: o estímulo de banda estreita - Narrow mostrou-se eficaz para ser utilizado nos programa de Triagem Auditiva Neonatal Universal.
Intervenção fonoaudiológica precoce num paciente com paralisia facial após otomastoidite
Authors: Romão Adriana Maria , Cabral Celina , Magni Cristiana
Published: July 2015

De ocorrência frequente, a paralisia facial é uma patologia que acomete a face ea expressão facial. Dentre as etiologias possíveis será destacada uma de ocorrência pouco comum, a Otomastoidite. A intervenção fonoaudiológica iniciada precocemente colabora para o retorno da mobilidade e funções da musculatura reduzindo assim a atrofia muscular e surgimento de sincinesias e contraturas. O objetivo do estudo foi reabilitar um paciente acometido pela paralisia facial após otomastoidite com a intervenção fonoaudiológica precoce e descrever a aplicação de uma proposta de intervenção terapêutica diferenciada. Na metodologia optou-se por exercícios miofuncionais específicos, avaliação e acompanhamento audiológico. Nos resultados, após nove semanas de acompanhamento, observou-se melhora expressiva na simetria do sorriso, adequação das funções estomatognáticas e presença dos reflexos acústicos estapedianos.
Dentoalveolar mandibular changes with self-ligating versus conventional bracket systems: A CBCT and dental cast study
Authors: Almeida Marcio Rodrigues de , Futagami Cristina , Conti Ana Cláudia de Castro Ferreira , Oltramari-Navarro Paula Vanessa Pedron , Navarro Ricardo de Lima
Published: July 2015

OBJECTIVE: The aim of the present study was to compare dentoalveolar changes in mandibular arch, regarding transversal measures and buccal bone thickness, in patients undergoing the initial phase of orthodontic treatment with self-ligating or conventional bracket systems. METHODS: A sample of 25 patients requiring orthodontic treatment was assessed based on the bracket type. Group 1 comprised 13 patients bonded with 0.022-in self-ligating brackets (SLB). Group 2 included 12 patients bonded with 0.022-in conventional brackets (CLB). Cone-beam computed tomography (CBCT) scans and a 3D program (Dolphin) assessed changes in transversal width of buccal bone (TWBB) and buccal bone thickness (BBT) before (T1) and 7 months after treatment onset (T2). Measurements on dental casts were performed using a digital caliper. Differences between and within groups were analyzed by Student's t-test; Pearson correlation coefficient was also calculated. RESULTS: Significant mandibular expansion was observed for both groups; however, no significant differences were found between groups. There was significant decrease in mandibular buccal bone thickness and transversal width of buccal bone in both groups. There was no significant correlation between buccal bone thickness and dental arch expansion. CONCLUSIONS: There were no significant differences between self-ligating brackets and conventional brackets systems regarding mandibular arch expansion and changes in buccal bone thickness or transversal width of buccal bone.
Changes in lower dental arch dimensions and tooth alignment in young adults without orthodontic treatment
Authors: Mauad Bruno Aldo , Silva Robson Costa , Aragón Mônica Lídia Santos de Castro , Pontes Luana Farias , Silva Júnior Newton Guerreiro da , Normando David
Published: July 2015

OBJECTIVE: The aim of this longitudinal study, comprising young adults without orthodontic treatment, was to assess spontaneous changes in lower dental arch alignment and dimensions. METHODS: Twenty pairs of dental casts of the lower arch, obtained at different time intervals, were compared. Dental casts obtained at T1 (mean age = 20.25) and T2 (mean age = 31.2) were compared by means of paired t-test (p < 0.05). RESULTS: There was significant reduction in arch dimensions: 0.43 mm for intercanine (p = 0.0089) and intermolar (p = 0.022) widths, and 1.28 mm for diagonal arch length (p < 0.001). There was a mild increase of approximately 1 mm in the irregularity index used to assess anterior alignment (p < 0.001). However, regression analysis showed that changes in the irregularity index revealed no statistically significant association with changes in the dental arch dimensions (p > 0.05). Furthermore, incisors irregularity at T2 could not be predicted due to the severity of this variable at T1 (p = 0.5051). CONCLUSION: Findings suggest that post-growth maturation of the lower dental arch leads to a reduction of dental arch dimensions as well as to a mild, yet significant, increase in dental crowding, even in individuals without orthodontic treatment. Furthermore, dental alignment in the third decade of life cannot be predicted based on the severity of dental crowding at the end of the second decade of life.
Craniofacial changes and symptoms of sleep-disordered breathing in healthy children
Authors: Pacheco Maria Christina Thomé , Fiorott Bruna Santos , Finck Nathalia Silveira , Araújo Maria Teresa Martins de
Published: July 2015

INTRODUCTION: The main cause of mouth breathing and sleep-disordered breathing (SDB) in childhood is associated with upper airway narrowing to varying degrees. OBJECTIVE: The aim of this study was to assess the prevalence of morphological and functional craniofacial changes and the main clinical symptoms of SDB in healthy children. METHODS: A cross-sectional observational study was conducted. A sample comprising 687 healthy schoolchildren, aged 7-12 years old and attending public schools, was assessed by medical history, clinical medical and dental examination, and respiratory tests. The self-perceived quality of life of mouth breathing children was obtained by a validated questionnaire. RESULTS: Out of the total sample, 520 children were nose breathers (NB) while 167 (24.3%) were mouth breathers (MB); 32.5% had severe hypertrophy of the palatine tonsils, 18% had a Mallampati score of III or IV, 26.1% had excessive overjet and 17.7% had anterior open bite malocclusion. Among the MB, 53.9% had atresic palate, 35.9% had lip incompetence, 33.5% reported sleepiness during the day, 32.2% often sneezed, 32.2% had a stuffy nose, 19.6% snored, and 9.4% reported having the feeling to stop breathing while asleep. However, the self-perception of their quality of life was considered good. CONCLUSION: High prevalence of facial changes as well as signs and symptoms of mouth breathing were found among health children, requiring early diagnosis and treatment to reduce the risk of SDB.
Sterilizing elastomeric chains without losing mechanical properties. Is it possible?
Authors: Pithon Matheus Melo , Ferraz Caio Souza , Rosa Francine Cristina Silva , Rosa Luciano Pereira
Published: July 2015

OBJECTIVE: To investigate the effects of different sterilization/disinfection methods on the mechanical properties of orthodontic elastomeric chains. METHODS: Segments of elastomeric chains with 5 links each were sent for sterilization by cobalt 60 (Co60) (20 KGy) gamma ray technology. After the procedure, the elastomeric chains were contaminated with clinical samples of Streptococcus mutans. Subsequently, the elastomeric chains were submitted to sterilization/disinfection tests carried out by means of different methods, forming six study groups, as follows: Group 1 (control - without contamination), Group 2 (70°GL alcohol), Group 3 (autoclave), Group 4 (ultraviolet), Group 5 (peracetic acid) and Group 6 (glutaraldehyde). After sterilization/disinfection, the effectiveness of these methods, by Colony forming units per mL (CFU/mL), and the mechanical properties of the material were assessed. Student's t-test was used to assess the number of CFUs while ANOVA and Tukey's test were used to assess elastic strength. RESULTS: Ultraviolet treatment was not completely effective for sterilization. No loss of mechanical properties occurred with the use of the different sterilization methods (p > 0.05). CONCLUSION: Biological control of elastomeric chains does not affect their mechanical properties.
Literatura e infância: entre filosofia, história e "despropósitos"
Authors: Silva Márcia Cabral da
Published: July 2015

Neste estudo, sublinham-se algumas reflexões no âmbito da relação entre literatura, infância e experiência. De modo específico, almeja-se pensar sobre a dimensão filosófica da linguagem em diálogo com obras literárias contemporâneas que trazem ao primeiro plano a infância. Por um lado, opera-se uma reflexão sobre a relação entre ficção e infância, com especial ênfase na produção protagonizada por personagens crianças e em sua capacidade de ver a realidade por outra perspectiva, de filosofar. Por outro, enfatiza-se o exame de estratégias literárias capazes de causar estranhamento em relação ao caráter descritivo e comunicativo da linguagem cotidiana. Para desenvolver o exame, privilegiam-se as seguintes obras: Exercícios de ser criança (1999) e Memórias inventadas: a infância (2003), de Manoel de Barros.
Do livro ilustrado ao aplicativo: reflexões sobre multimodalidade na literatura para crianças
Authors: Moraes Giselly Lima de
Published: July 2015

Este trabalho busca refletir sobre a diversidade de recursos semióticos presente na literatura infantil contemporânea, analisando os efeitos dos avanços tecnológicos sobre o texto literário. Utilizando alguns conceitos originários dos estudos sobre a multimodalidade, analisa os potenciais de sentido resultantes da articulação entre recursos verbais e não verbais na literatura impressa e digital, a partir das obras Flicts, "A girafa" e "Cigarra", da série "Ave, palavra", de Angela Lago, e do aplicativo de literatura para crianças Es así, de Paloma Valdivia. A autora apresenta elementos para afirmar que o avanço dos estudos da multimodalidade contribui para melhorar a experiência literária por parte das crianças na contemporaneidade ao oferecer meios para conhecer e mediar os processos de interpretação e fruição de textos multimodais.
A sombra do mundo: excesso e aprisionamento em Diomedes: a trilogia do acidente, de Lourenço Mutarelli
Authors: Cardoso André Cabral de Almeida
Published: July 2015

O objetivo deste artigo é examinar a maneira como a estética dos filmes noir é apropriada por Lourenço Mutarelli em sua narrativa em quadrinhos Diomedes: a trilogia do acidente. Dividida entre a tentativa de representar o real e um forte impulso de estilização, essa estética age como elemento estruturador da narrativa, criando um mundo caracterizado pelo excesso e a degradação, do qual aparentemente não há saída.
Rasga Coração, de Vianinha, e Hair: aproximação e distanciamento num contexto de contracultura
Authors: Oliveira Éwerton Silva de
Published: July 2015

Considerando a estrutura formal e conteudística das obras, e os movimentos políticos e culturais dos jovens dos anos 1960 e 1970 - dentre eles, a contracultura - no contexto norte-americano e no processo histórico brasileiro (este último incluindo a plena vigência de uma ditadura militar), o presente artigo procura analisar como o musical Hair (1967), dos atores norte-americanos James Rado e Gerome Ragni, e a peça Rasga coração (1974), do dramaturgo brasileiro Oduvaldo Vianna Filho (Vianinha), sobretudo por meio de suas personagens jovens, representam a presença da contracultura (em suas inovações e contradições, semelhanças e diferenças) nos Estados Unidos e no Brasil. O diferente enfoque de ambas as peças a este movimento político-cultural também é enfatizado no artigo.
Perigosas brincadeiras: a infância em Marcelo Mirisola e Furio Lonza
Authors: Ji Renan
Published: July 2015

Pequena novela publicada em 2012, Teco, o garoto que não fazia aniversário já antecipa a expectativa de uma obra bufônica e irreverente, dadas as posturas pouco ortodoxas que seus autores - Marcelo Mirisola e Furio Lonza - frequentemente assumem, tanto na cena literária quanto no estilo. Mimetizando a estrutura e a escrita dos livros infantis, os autores subvertem o gênero ao apontar para uma revisão extrema do imaginário e da iconografia acerca da infância. Representações tradicionais da criança - herdadas do imaginário romântico e burguês de fins do século XVIII e início do XIX e que chegam de certa forma até nossos dias - são completamente reviradas pelo nonsense farsesco, pela crítica social e pela violência das grandes cidades. Em meio à divertida inversão de valores (que não poupa alfinetadas às contradições da sociedade e às personalidades do meio intelectual e artístico), Mirisola e Lonza acenam com a possibilidade de questionarmos e repensarmos nossa concepção do que é o infantil, para além da inocência, dos brinquedos coloridos e dos ideais de educação e subjetivação.
Literaturas e infâncias: pesquisa (d)e pós-graduação como espaço político
Authors: Dalvi Maria Amélia
Published: July 2015

Discutem-se teses defendidas em programas de pós-graduação brasileiros em torno das relações entre literatura e infância (1987-2012). Busca-se compreender o que nos pode dizer a presença reiterada ou a ausência de certos temas, questões, referenciais, procedimentos e conclusões. Esse tipo de investigação permite rastrear indícios de conquistas e desafios para aqueles que se dedicam à área, pensando a pós-graduação como um espaço político de produção de cultura em torno dessas relações.
Environmental factors on seed germination, seedling survival and initial growth of sacha inchi (Plukenetia volubilis L.)
Authors: Cardoso Amanda Ávila , Obolari Amana de Magalhães Matos , Borges Eduardo Euclydes de Lima e , Silva Cristiane Jovelina da , Rodrigues Haroldo Silva
Published: July 2015

Abstract: Sacha inchi (Plukenetia volubilis L.) is an Amazon species of elevated agro-industrial potential due the high content of omega-3 and omega-6 in its seeds. Despite of it, little information about its propagation by seeds is currently available. Thus, the aim of this study was to assess seed germination, seedling survival and growth of this species under different conditions of substrate (on paper, between papers and paper roll), light (continuous darkness, 12-h photoperiod and continuous light) and temperature (continuous temperature at 20, 25, 30, 35 and 40 °C). Germination is stimulated by substrates with increased surface contact with the seeds, presence of light and temperatures between 25 and 35 °C. Survival and initial growth of seedlings are favored by vermiculite, continuous light and 30 °C temperature. These conditions allow rapid and uniform germination of seeds and better establishment and development of seedlings. We encourage the propagation of sacha inchi by seeds, since we consider it a feasible technique.
Aryl removal methods and passion fruit seed positions: Germination and emergence
Authors: Silva Sérgio Macedo , Oliveira Roberta Camargos de , Almeida Risely Ferraz de , Sá Júnior Adílio de , Santos Carlos Machado dos
Published: July 2015

Abstract: Yellow passion fruit has conquered a significant position in the agribusiness of tropical fruits; therefore, farmers have been interested in expanding their groves, and technical information that guarantees the high yield of the farmings is needed. Aiming to observe factors related to the propagative material targeted at quality and maximization of the genetic potential, the objective of the study consisted in assessing germination and emergence of passion fruit seeds collected in three positions in the fruits and submitted to different methods of mucilage removal (aryl). The passion fruits were split in three parts: distal, medial and proximal and the contents of each part was divided in two. The content of each part of the fruit was submitted to mechanical and by fermentation methods for removal of aryl. It is concluded that the seed position in the fruit does not interferes with the germination. The aryl removal method by mechanical extraction affects the germination and seedling emergence.
Maturation of seeds of Poincianella pluviosa (Caesalpinoideae)
Authors: Silva João Paulo Naldi , Centeno Danilo da Cruz , Figueiredo-Ribeiro Rita de Cássia Leone , Barbedo Claudio José
Published: July 2015

The persistence of viable seeds in the soil is an important way to assure plant propagation, especially for species which produce seeds with short lifespan. Poincianella pluviosa is a tree species which seeds have short to medium storability at room temperature. The comprehension of the maturation process is crucial to understand its strategy for propagation and it could provide tools to improve seed viability in ex situ conditions. Flowers were tagged in two consecutive cycles of maturation and pods were periodically harvested until dispersion. Seeds were classified based on their morpho-physiological features, capability to germinate and develop seedlings. The complete maturation process was attained 315-330 days after anthesis, a period longer than reported for seed viability at room temperature. The maximum dry mass and seed vigor were reached at the end of maturation, although elevated seedling production was obtained before physiological maturity. We suggest that the precocious ability to produce seedlings in a long maturation could be a strategy to overcome environmental constraints, as the species is distributed in a wide range of phytogeographic domains in Brazil.
Influence of light and temperature on the germination of Passiflora incarnata L. seeds
Authors: Zucareli Valdir , Henrique Luma Alana Vieira , Ono Elizabeth Orika
Published: July 2015

Abstract: The study aimed to assess the influence of temperature and light on germination of Passiflora incarnata L seeds. The treatments consisted of five temperature conditions (25, 30, 35, 20-30 and 30-20 °C) and two light conditions (constant light and constant darkness). The experimental design was completely randomized in a 2 x 5 factorial arrangement (light x temperature). The seeds were kept in a germination chamber during the period of 30 days. The germinated seeds were counted daily. At the end of the experiment, the percentage of seed germination (PSG), germination speed index (GSI), the germination rate (GR) and relative frequency of germination (RFG) were calculated. The data obtained were subjected to analysis of variance and means were compared by Tukey test at 5% probability. The relative frequency of germination was represented as graphs. It was observed that light has an inhibitory effect on seed germination. The constant temperature of 35 °C and the alternating temperatures of 30/20 °C promoted a higher germination seed index for Passiflora incarnata.
Benefits of maltodextrin intake 2 hours before cholecystectomy by laparotomy in respiratory function and functional capacity: a prospective randomized clinical trial
Authors: Zani Fabiana Vieira Breijão , Aguilar-Nascimento José Eduardo , Nascimento Diana Borges Dock , Silva Ageo Mário Cândido da , Caporossi Fernanda Stephan , Caporossi Cervantes
Published: July 2015

ABSTRACT Objective: To evaluate the change in respiratory function and functional capacity according to the type of preoperative fasting. Methods: Randomized prospective clinical trial, with 92 female patients undergoing cholecystectomy by laparotomy with conventional or 2 hours shortened fasting. The variables measured were the peak expiratory flow, forced expiratory volume in the first second, forced vital capacity, dominant handgrip strength, and non-dominant handgrip strength. Evaluations were performed 2 hours before induction of anesthesia and 24 hours after the operation. Results: The two groups were similar in preoperative evaluations regarding demographic and clinical characteristics, as well as for all variables. However, postoperatively the group with shortened fasting had higher values than the group with conventional fasting for lung function tests peak expiratory flow (128.7±62.5 versus 115.7±59.9; p=0.040), forced expiratory volume in the first second (1.5±0.6 versus 1.2±0.5; p=0.040), forced vital capacity (2.3±1.1 versus 1.8±0.9; p=0.021), and for muscle function tests dominant handgrip strength (24.9±6.8 versus 18.4±7.7; p=0.001) and non-dominant handgrip strength (22.9±6.3 versus 17.0±7.8; p=0.0002). In the intragroup evaluation, there was a decrease in preoperative compared with postoperative values, except for dominant handgrip strength (25.2±6.7 versus 24.9±6.8; p=0.692), in the shortened fasting group. Conclusion: Abbreviation of preoperative fasting time with ingestion of maltodextrin solution is beneficial to pulmonary function and preserves dominant handgrip strength.
Esophageal eosinophilia in pediatric patients with cerebral palsy
Authors: Nápolis Ana Carolina Ramos de , Alves Flavia Araujo , Rezende Erica Rodrigues Mariano de Almeida , Segundo Gesmar Rodrigues Silva
Published: July 2015

ABSTRACT Objective: To describe the clinical picture, test results, and clinical evolution of patients with cerebral palsy associated with diagnosis of eosinophilic esophagitis, monitored at tertiary centre. Methods: Cross-sectional, retrospective and descriptive study that evaluated the medical records data of pediatric patients with diagnosis of cerebral palsy and eosinophilic esophagitis in a tertiary center of pediatric gastroenterology between August 2005 and August 2013. Results: Seven out of 131 patients with cerebral palsy had the diagnosis of eosinophilic esophagitis. The mean age at diagnosis of eosinophilic esophagitis was 52.3 months and the mean number of eosinophils in esophagus was 35 per high-power field. Symptoms more frequent were recurrent vomiting and disphagia. Endoscopic alterations found were mucosal thickening, vertical lines, mucosal opacificacion and white plaques. Conclusion: The frequency of eosinophilic esophagitis found was higher than in general pediatric population. The investigation of eosinophilic esophagitis should be done regularly in those patients, once this entity could overlap other gastrointestinal diseases.
The impact of erlotinib use in non-small-cell lung cancer patients treated in a private reference general hospital and in a private cancer clinic from 2005 to 2011
Authors: Bognar Cinthia Leite Frizzera Borges , Simon Sergio Daniel , Gansl Rene Claudio , Abramoff Roberto , Aisen Marcelo , Lopes Junior Gilberto de Lima , Smaletz Oren , Peres Stela Verzinhasse , Tabacof Jacques
Published: July 2015

ABSTRACT Objective: To report the demographic data and clinical outcomes of non-small-cell lung cancer patients exposed to erlotinib in any line of treatment. Methods: This was a retrospective cohort study of nonsmall-cell lung cancer patients from a reference general hospital and a private oncology clinic, who received erlotinib from 2005 to 2011. Statistical analysis was performed and we evaluated demographic data and response to treatment, by correlating the results of this first cohort published in Brazil with results of current literature. Results: A total of 44 patients were included; 65.9% were diagnosed with adenocarcinoma, and 63.6% had metastatic disease. The mean age was 63.3 years. The median follow-up was 47.9 months. Epidermal growth factor receptor mutation screening was performed in 22.7% of patients (n=10), with mutation present in 30% of patients. The median overall survival was 46.3 months, and there was a higher probability of survival at 60 months for females compared to males (29.4% versus 15.8%; p=0.042). The other variables did not present significant statistical difference. Conclusion: We collected the largest cohort of patients with non-small-cell lung cancer who have used erlotinib in Brazil to date, and demonstrated that outcomes of patients treated at our clinic during the study period were consistent with the results of current literature in similar patients.
Factors associated with functional impairment of elderly patients in the emergency departments
Authors: Lopes Maria Carolina Barbosa Teixeira , Lage Julieth Santana Silva , Vancini-Campanharo Cássia Regina , Okuno Meiry Fernanda Pinto , Batista Ruth Ester Assayag
Published: July 2015

ABSTRACT Objective: To assess the functional capacity of elderly patients in the emergency department as to Basic and Instrumental Activities of Daily Living. Methods: A cross-sectional study of 200 elderly patients admitted to the emergency department of a teaching hospital in São Paulo (SP), Brazil. The functional capacity of the elderly was assessed by the Katz index and Lawton & Brody scale. Statistical analyses were performed using analysis of variance, Bonferroni correction, χ2 test, or the likelihood ratio test. Results: Most seniors were independent (65%), and the degree of dependence was related to age, female gender, being single and widowed, and presence of cerebrovascular disease and dementia. The more dependent elderly for Instrumental Activities of Daily Living had increased dependence for Basic Activities. Conclusion: We emphasize the importance of assessing the functional capacity of the elderly in the emergency department as it provides data for the nursing care in order to minimize or to avoid their functional impairment.
Probabilistic graphic models applied to identification of diseases
Authors: Sato Renato Cesar , Sato Graziela Tiemy Kajita
Published: July 2015

ABSTRACT Decision-making is fundamental when making diagnosis or choosing treatment. The broad dissemination of computed systems and databases allows systematization of part of decisions through artificial intelligence. In this text, we present basic use of probabilistic graphic models as tools to analyze causality in health conditions. This method has been used to make diagnosis of Alzheimer´s disease, sleep apnea and heart diseases.
Expanding the pool of kidney donors: use of kidneys with acute renal dysfunction
Authors: Matos Ana Cristina Carvalho de , Requião-Moura Lúcio Roberto , Clarizia Gabriela , Durão Junior Marcelino de Souza , Tonato Eduardo José , Chinen Rogério , Arruda Érika Ferraz de , Filiponi Thiago Corsi , Pires Luciana Mello de Mello Barros , Bertocchi Ana Paula Fernandes , Pacheco-Silva Alvaro
Published: July 2015

ABSTRACT Given the shortage of organs transplantation, some strategies have been adopted by the transplant community to increase the supply of organs. One strategy is the use of expanded criteria for donors, that is, donors aged >60 years or 50 and 59 years, and meeting two or more of the following criteria: history of hypertension, terminal serum creatinine >1.5mg/dL, and stroke as the donor´s cause of death. In this review, emphasis was placed on the use of donors with acute renal failure, a condition considered by many as a contraindication for organ acceptance and therefore one of the main causes for kidney discard. Since these are well-selected donors and with no chronic diseases, such as hypertension, renal disease, or diabetes, many studies showed that the use of donors with acute renal failure should be encouraged, because, in general, acute renal dysfunction is reversible. Although most studies demonstrated these grafts have more delayed function, the results of graft and patient survival after transplant are very similar to those with the use of standard donors. Clinical and morphological findings of donors, the use of machine perfusion, and analysis of its parameters, especially intrarenal resistance, are important tools to support decision-making when considering the supply of organs with renal dysfunction.
Lung transplantation
Authors: Afonso Júnior José Eduardo , Werebe Eduardo de Campos , Carraro Rafael Medeiros , Teixeira Ricardo Henrique de Oliveira Braga , Fernandes Lucas Matos , Abdalla Luis Gustavo , Samano Marcos Naoyuki , Pêgo-Fernandes Paulo Manuel
Published: July 2015

ABSTRACT Lung transplantation is a globally accepted treatment for some advanced lung diseases, giving the recipients longer survival and better quality of life. Since the first transplant successfully performed in 1983, more than 40 thousand transplants have been performed worldwide. Of these, about seven hundred were in Brazil. However, survival of the transplant is less than desired, with a high mortality rate related to primary graft dysfunction, infection, and chronic graft dysfunction, particularly in the form of bronchiolitis obliterans syndrome. New technologies have been developed to improve the various stages of lung transplant. To increase the supply of lungs, ex vivo lung reconditioning has been used in some countries, including Brazil. For advanced life support in the perioperative period, extracorporeal membrane oxygenation and hemodynamic support equipment have been used as a bridge to transplant in critically ill patients on the waiting list, and to keep patients alive until resolution of the primary dysfunction after graft transplant. There are patients requiring lung transplant in Brazil who do not even come to the point of being referred to a transplant center because there are only seven such centers active in the country. It is urgent to create new centers capable of performing lung transplantation to provide patients with some advanced forms of lung disease a chance to live longer and with better quality of life.
Pancreas transplantation: review
Authors: Meirelles Júnior Roberto Ferreira , Salvalaggio Paolo , Pacheco-Silva Alvaro
Published: July 2015

ABSTRACT Vascularized pancreas transplantation is the only treatment that establishes normal glucose levels and normalizes glycosylated hemoglobin levels in type 1 diabetic patients. The first vascularized pancreas transplant was performed by William Kelly and Richard Lillehei, to treat a type 1 diabetes patient, in December 1966. In Brazil, Edison Teixeira performed the first isolated segmental pancreas transplant in 1968. Until the 1980s, pancreas transplants were restricted to a few centers of the United States and Europe. The introduction of tacrolimus and mycophenolate mofetil in 1994, led to a significant outcome improvement and consequently, an increase in pancreas transplants in several countries. According to the International Pancreas Transplant Registry, until December 31st, 2010, more than 35 thousand pancreas transplants had been performed. The one-year survival of patients and pancreatic grafts exceeds 95 and 83%, respectively. The better survival of pancreatic (86%) and renal (93%) grafts in the first year after transplantation is in the simultaneous pancreas-kidney transplant group of patients. Immunological loss in the first year after transplant for simultaneous pancreas-kidney, pancreas after kidney, and pancreas alone are 1.8, 3.7, and 6%, respectively. Pancreas transplant has 10 to 20% surgical complications requiring laparotomy. Besides enhancing quality of life, pancreatic transplant increases survival of uremic diabetic patient as compared to uremic diabetic patients on dialysis or with kidney transplantation alone.
Sustainability, natural and organic cosmetics: consumer, products, efficacy, toxicological and regulatory considerations
Authors: Fonseca-Santos Bruno , Corrêa Marcos Antonio , Chorilli Marlus
Published: July 2015

The interest in sustainable products has increased along the years, since the choice of products, packaging and production processes have a great impact on the environment. These products are classified by regulatory agencies in different categories, aggregating advantages to the product and increasing the demand by consumers. However, there is no harmonization in guidelines of these certifying agencies and each cosmetic industry formulates their product and packaging in a more rational way, which causes less damage to the environment. Many cosmetic products have in their formulation natural products that perform a specific biological function, but these products should be evaluated on efficacy and toxicological aspects. The aim of this article is to approach sustainability, natural and organic cosmetics, considering the consumer and the efficacy, toxicological and regulatory aspects.
Pullulan: an advantageous natural polysaccharide excipient to formulate tablets of alendronate-loaded microparticles
Authors: Ferreira Luana Mota , Velasquez Aline de Arce , Schaffazick Scheila Rezende , Cruz Letícia
Published: July 2015

This work reports the preparation of tablets by direct compression of sodium alendronate-loaded microparticles, using pullulan as filler. The tableting properties of pullulan were compared with those of microcrystalline cellulose and lactose. Pullulan tablets showed low variations in average weight, thickness and drug content. Moreover, these tablets exhibited a higher hardness compared to the other excipients. In vitro release studies showed that only pullulan was capable to maintain gastroresistance and release properties of microparticles, due to its ability to protect particles against damage caused by compression force. Thus, pullulan was considered an advantageous excipient to prepare tableted microparticles.
Physical chemistry evaluation of stability, spreadability, in vitro antioxidant, and photo-protective capacities of topical formulations containing Calendula officinalis L. leaf extract
Authors: Deuschle Viviane Cecília Kessler Nunes , Deuschle Regis Augusto Norbert , Bortoluzzi Mariana Rocha , Athayde Margareth Linde
Published: July 2015

Calendula is used widely in cosmetic formulations that present phenolic compounds in their chemical constitution. The objective of our research was to develop and evaluate the stability of topical formulations containing 5% hydro-ethanolic extract of calendula leaves, including spreadability, and in vitro photo-protective, and antioxidant capacity. To evaluate the stability, we used organoleptic characteristics, pH, and viscosity parameters. Antioxidant capacity was measured by the DPPH (2,2-diphenyl-1-picrylhydrazyl) method, and the photo-protective capacity by SPF spectrophotometric measure. All formulations were stable. The calendula extract formulations in gel and cream showed no significant variations in pH, and the cream formulations presented lower viscosity variations than gel formulations. The spreadability of the gel formulations was superior to those in cream. The formulations also presented good antioxidant capacities and an FPS of around 1.75. In accordance with the results, the formulations can be used as antioxidants, but considering the low SPF obtained, calendula cannot be considered as a stand-alone sunscreen, yet may well be tested in future studies towards verifying enhancement of synthetic sunscreens.
Microemulsion based on Pterodon emarginatus oil and its anti-inflammatory potential
Authors: Pascoa Henrique , Diniz Danielle Guimarães Almeida , Florentino Iziara Ferreira , Costa Elson Alves , Bara Maria Teresa Freitas
Published: July 2015

This article reports the development of a pharmaceutical product containing vegetable actives from a Brazilian medicinal plant. The possibility of forming a microemulsion using Pterodon emarginatus ("sucupira") oil was evaluated and the anti-inflammatory potential of this microemulsion was also examined. A formulation was developed using P. emarginatus oil, a mixture of ethoxylated Castor Oil (Ultramone(r) R-540/propylene glycol 2:1) (surfactant/cosurfactant) and distilled water at a ratio of 10:15:75, respectively. The microemulsion which was selected was then subjected to the preliminary stability test and analyzed in terms of average diameter of droplets, pH, zeta potential, and polydispersity index, on the 1st, 7th, 15th, and 30th days after preparation and stored at different temperatures (5 ± 2 °C, 25 ± 2 °C, and 40 ± 2 °C). The anti-inflammatory in vivo activity of both oil and formulation were evaluated, using the experimental model of croton oil-induced ear edema. The preliminary stability test showed that the microemulsion stored at 5 and 25 °C retained its original features throughout the 30-day period. The anti-inflammatory potential of both oil and formulation was shown to be statistically significant (p < 0.001), when compared to the control group, however, the microemulsion proved to be more effective (p < 0.05) than the oil when applied directly to the ear.
Tetramethylpyrazine protects Schwann cells from ischemia-like injury and increases cell survival in cold ischemic rat nerves
Authors: Yang Ming-Ming , Huang Wei , Jiang Dian-Ming
Published: July 2015

Tetramethylpyrazine (TMP), a major active ingredient of Ligusticum wallichi Franchat extract (a Chinese herb), exhibits neuroprotective properties in ischemia. In this study, we assessed its protective effects on Schwann cells (SCs) by culturing them in the presence of oxygen glucose deprivation (OGD) conditions and measuring cell survival in cold ischemic rat nerves. In the OGD-induced ischemic injury model of SCs, we demonstrated that TMP treatment not only reduced OGD-induced cell viability losses, cell death, and apoptosis of SCs in a dose-dependent manner, and inhibited LDH release, but also suppressed OGD-induced downregulation of Bcl-2 and upregulation of Bax and caspase-3, as well as inhibited the consequent activation of caspase-3. In the cold ischemic nerve model, we found that prolonged cold ischemic exposure for four weeks was markedly associated with the absence of SCs, a decrease in cell viability, and apoptosis in preserved nerve segments incubated in University of Wisconsin solution (UWS) alone. However, TMP attenuated nerve segment damage by preserving SCs and antagonizing the decrease in nerve fiber viability and increase in TUNEL-positive cells in a dose-dependent manner. Collectively, our results indicate that TMP not only provides protective effects in an ischemia-like injury model of cultured rat SCs by regulating Bcl-2, Bax, and caspase-3, but also increases cell survival and suppresses apoptosis in the cold ischemic nerve model after prolonged ischemic exposure for four weeks. Therefore, TMP may be a novel and effective therapeutic strategy for preventing peripheral nervous system ischemic diseases and improving peripheral nerve storage.
Contrasting the crospovidones functionality as excipients for direct compression
Authors: Ramírez Daniel García , Robles Leopoldo Villafuerte
Published: July 2015

Specific values of technological properties of excipients allow the establishment of numerical parameters to define and compare their functionality. This study investigates the functionality of Polyplasdones XL and XL10. Parameters studied included tablet disintegration profiles, compactibility profiles and powder flow. The results allowed the establishment of quantitative surrogate functionalities of technological performance, such as absolute number, and as a value relative to the known microcrystalline cellulose type 102. Moreover, the establishment of an explicit functionality to improve the technological performance of two diluents and a model drug was investigated, as was setting up of these functionalities, as quantitative values, to determine the input variables of each material and its probable functionality in a drug product. Disintegration times of pure Polyplasdone XL and its admixtures were around half that of Polyplasdone XL10. The improvement in tablet compactibility was 25-50% greater for Polyplasdone XL10 than Polyplasdone XL. Crospovidones proportions of up to 10% have little effect on the flow properties of other powders, although pure Polyplasdone XL10 and its admixtures display compressibility indexes about 20% greater than Polyplasdone XL. The observed results are in line with a smaller particle size of Polyplasdone XL10 compared to Polyplasdone XL.
The medicine selection process in four large university hospitals in Brazil: Does the DTC have a role?
Authors: Lima-Dellamora Elisangela da Costa , Caetano Rosangela , Osorio-de-Castro Claudia Garcia Serpa
Published: July 2015

Knowledge about evidence-based medicine selection and the role of the Drug and Therapeutics Committee (DTC) is an important topic in the literature but is scarcely discussed in Brazil. Our objective, using a qualitative design, was to analyze the medicine selection process performed in four large university hospitals in the state of Rio de Janeiro. Information was collected from documents, interviews with key informants and direct observations. Two dimensions were analyzed: the structural and organizational aspects of the selection process and the criteria and methods used in medicine selection. The findings showed that the DTC was active in two hospitals. The structure for decision-making was weak. DTC members had little experience in evidence-based selection, and their everyday functions did not influence their participation in DTC activities. The methods used to evaluate evidence were inadequate. The uncritical adoption of new medicines in these complex hospital facilities may be hampering pharmaceutical services, with consequences for the entire health system. Although the qualitative approach considerably limits the extent to which the results can be extrapolated, we believe that our findings may be relevant to other university hospitals in the country.
Average bioequivalence of single 500 mg doses of two oral formulations of levofloxacin: a randomized, open-label, two-period crossover study in healthy adult Brazilian volunteers
Authors: Kano Eunice Kazue , Koono Eunice Emiko Mori , Schramm Simone Grigoleto , Serra Cristina Helena dos Reis , Abib Junior Eduardo , Pereira Renata , Freitas Márcia Sayuri Takamatsu , Iecco Maria Cristina , Porta Valentina
Published: July 2015

Average bioequivalence of two 500 mg levofloxacin formulations available in Brazil, Tavanic(c) (Sanofi-Aventis Farmacêutica Ltda, Brazil, reference product) and Levaquin(c) (Janssen-Cilag Farmacêutica Ltda, Brazil, test product) was evaluated by means of a randomized, open-label, 2-way crossover study performed in 26 healthy Brazilian volunteers under fasting conditions. A single dose of 500 mg levofloxacin tablets was orally administered, and blood samples were collected over a period of 48 hours. Levofloxacin plasmatic concentrations were determined using a validated HPLC method. Pharmacokinetic parameters Cmax, Tmax, Kel, T1/2el, AUC0-t and AUC0-inf were calculated using noncompartmental analysis. Bioequivalence was determined by calculating 90% confidence intervals (90% CI) for the ratio of Cmax, AUC0-t and AUC0-inf values for test and reference products, using logarithmic transformed data. Tolerability was assessed by monitoring vital signs and laboratory analysis results, by subject interviews and by spontaneous report of adverse events. 90% CIs for Cmax, AUC0-t and AUC0-inf were 92.1% - 108.2%, 90.7% - 98.0%, and 94.8% - 100.0%, respectively. Observed adverse events were nausea and headache. It was concluded that Tavanic(c) and Levaquin(c) are bioequivalent, since 90% CIs are within the 80% - 125% interval proposed by regulatory agencies.
Chromatographic analysis and antiproliferative potential of aqueous extracts of Punica granatum fruit peels using the Allium cepa test
Authors: Kuhn Andrielle Wouters , Tedesco Marília , Boligon Aline Augusti , Athayde Margareth Linde , Laughinghouse IV Haywood Dail , Tedesco Solange Bosio
Published: July 2015

Punica granatum L., locally known as romanzeira, is native to Asia but found throughout Brazil. P. granatum is used for treating inflammatory, infectious and respiratory diseases. The aim of this study was to evaluate the chromatography and genotoxicity of an aqueous extract of P. granatum (pomegranate) fruit peel using the Allium cepa L. test. The experiment set-up entailed 7 treatments: T1-distilled water, T2-tea 5 g.L-1, T3-tea 10 g.L-1, T4-glyphosate at 9.6%, T5-glyphosate with subsequent recovery in distilled water, T6-glyphosate with subsequent recovery in tea 5 g.L-1 and T7-glyphosate with subsequent recovery in tea 10 g.L-1. The rootlets were collected and fixed in ethanol:acetic acid (3:1) for 24 hours, then stored in 70% ethanol under refrigeration. Analysis was performed using high performance liquid chromatography for the quantification of the extracted phenolic compounds. Gallic acid, catechin, caffeic acid, and rutin were abundant in the extracts of P. granatum. The extracts were found to exhibit antiproliferative potential but not antimutagenic or genotoxic activity.
Análise vocal acústica: efeito do treinamento auditivo-visual para graduandos de Fonoaudiologia
Authors: Medina Vanessa , Simões-Zenari Marcia , Nemr Nair Kátia
Published: July 2015

Objetivo Verificar a efetividade de treino para avaliação acústica da voz com graduandos de Fonoaudiologia. Métodos Estudo realizado com 14 estudantes de curso de graduação em Fonoaudiologia, que participaram de seis encontros semanais teóricos e práticos, com duração total de quatro horas e meia. Foram abordados os conceitos básicos para avaliação vocal acústica perceptivo-auditiva e foi praticada a análise espectrográfica de cada parâmetro, visualmente e auditivamente. Para verificar a efetividade da proposta, os graduandos realizaram, antes e ao final do treino, a avaliação das medidas de extração automáticas e de aspectos da espectrografia de banda estreita de uma amostra de 15 vozes, normais e alteradas em variados graus. O desempenho dos alunos foi considerado nos dois momentos, comparando-se os erros e acertos em relação à análise prévia realizada por especialista, com índice Kappa >0,70. Para comparação entre os resultados obtidos pelos graduandos, nos dois momentos, utilizou-se o teste de McNemar. Resultados Para todos os parâmetros analisados, as médias de acerto foram maiores no momento pós-treino, com maioria dos índices acima de 90%; o mesmo observou-se em relação à média geral (24,2% no momento pré-treino e 93,0% no momento pós-treino). Conclusão O treino mostrou-se efetivo para a aprendizagem dos graduandos, podendo ser incorporado às disciplinas que envolvem os conceitos de avaliação da voz e transformado em material didático disponível para outros grupos
Perfil e satisfação com o trabalho de profissionais da rede de atenção à saúde auditiva
Authors: Escarce Andrezza Gonzalez , Lemos Stela Maris Aguiar , Carvalho Sirley Alves da Silva
Published: July 2015

Objetivo Verificar o perfil e a satisfação com a estrutura do serviço, política de recursos humanos e rotina de trabalho de profissionais que integram equipes de uma Rede de Atenção à Saúde Auditiva. Métodos Trata-se de um estudo realizado com 34 profissionais pertencentes à Rede de Atenção à Saúde Auditiva de duas microrregiões de Minas Gerais. A pesquisa se deu por meio da aplicação de um questionário estruturado, composto por seis eixos (caracterização do profissional, dados do atendimento/perfil do serviço, conhecimento do profissional quanto ao perfil da população atendida, caracterização do trabalho em equipe, satisfação do profissional e comunicação e trabalho. Foi realizada análise descritiva da distribuição de frequência de todas as variáveis categóricas e análise das medidas de tendência central e de dispersão das variáveis contínuas. Resultados A maioria dos profissionais pertencia à categoria fonoaudiólogo, eram contratados e recebiam entre R$ 1.091,00 e R$ 2.180,00. Metade deles relatou haver discussão dos casos clínicos e planejamento de ações, pelas equipes. A maioria referiu não haver demanda administrativa e discussão dos resultados alcançados. Todas as equipes possuíam fonoaudiólogos que se manifestaram satisfeitos com a maior parte dos aspectos do serviço no qual estavam inseridos. Como itens de insatisfação foram citados: “política de recursos humanos”, “equipamentos para diagnóstico” e “política salarial”. Conclusão O instrumento utilizado permitiu realizar o delineamento do perfil dos profissionais pertencentes à Rede de Atenção à Saúde Auditiva e verificar que estes estão satisfeitos com a maioria dos aspectos analisados.