Helicobacter pylori plays an important role in the etiology of peptic ulcer disease. Its prevalence appears to be higher in developing countries. We evaluated the seroprevalence of H. pylori and risk factors associated with infection in voluntary blood donors who attended the main blood center of the city of Salvador, Brazil. The subjects responded to an epidemiological questionnaire, with information about sex, age, race, lifestyle, social-economic level indicators, and residence and hygiene conditions. Anti-H. pylori antibody was determined by ELISA (Cobas Core, Roche). Three hundred and seven subjects were included in the study. Anti-H. pylori antibody results were indeterminate in 33 individuals (10.8%), who were excluded from analysis. Among the remaining 274 subjects, 187 (68.2%) were anti-H. pylori positive. Based on multivariate logistic regression analysis three variables were found to be significantly associated with a higher prevalence of H. pylori infection: absence of plumbing in the residence during childhood, a history of rainwater invading the dwelling during childhood, and low ingestion of milk.
Objectives: This study aimed to analyze the profile of pharmaceutical clinical interventions performed concurrently with the medical prescription evaluation service. Methods: This is a cross-sectional, prospective and observational study conducted at the General Intensive Care Unit of a public hospital in Santa Catarina, Brazil, with 8 beds in full occupation. The study included 54 patients hospitalized from February to July 2017. Included in the study were medical prescriptions and pharmaceutical interventions recorded in the electronic medical record of patients of both genders of any race, origin, age and pathology. Medical prescriptions and pharmaceutical interventions that did not belong to the hospitalization unit studied and the study period were excluded from the study. Results: A total of 499 medical prescriptions belonging to 54 patients (48%), male patients (68%), hypertensive patients (27%), diabetic patients (22%) and polytrauma patients (13%) were analyzed. Of the prescriptions analyzed, 91.1% had a need for pharmaceutical intervention with a total of 64.2% acceptance. The main drug-related problems were drug interaction (40%), potential adverse effect (28%) and need for dose adjustment (13%). The classes of drugs that most needed intervention were analgesics (23%), cardiovascular (14%) and antimicrobials (13%). Conclusions: In assessing clinical pharmaceutical interventions as a benefit in addition to critical care in the Intensive Care Unit we emphasize the percentage of acceptance of pharmaceutical interventions (64%), mostly those involving increased risk for adverse effects and drug interactions, thus contributing to the prevention of complications.
Introduction Obesity is a complex and multifactorial metabolic disorder characterized by the accumulation of body fat; physical exercise increases energy expenditure and promotes a reparative effect through modulation of endogenous antioxidant defenses. Objective To evaluate the effects of the high-fat diet (HFD) on oxidative stress parameters in skeletal muscles of rats using aerobic exercise training protocols (AETP), moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT). Methods The study was quantitative and experimental. Animals received 8 weeks of HFD or normal diet (ND), followed by 9 weeks of HFD or ND and the two AETPs. Results HFD did not alter the formation of thiobarbituric acid reactive substances (TBA-RS), total sulfhydryl and protein carbonyl content in the soleus and plantaris muscles; in contrast, the protocols caused a decrease in TBA-RS levels in the plantaris muscle and increased the sulfhydryl content in the soleus muscle, while MICT increased the sulfhydryl content in the plantaris muscle and reduced protein carbonyl content in both muscles. HFD reduced SOD activity in the plantaris muscle while the MICT protocol enhanced SOD in the soleus muscle and both protocols reversed the decrease in SOD in the plantaris muscle. HFD increased CAT activity in the soleus muscle, the HIIT protocol prevented this alteration and both protocols increased CAT in the plantaris muscle. HFD reduced GSH-Px activity in both muscles, and the MICT protocol prevented this reduction in the soleus muscle, while the HIIT protocol partially prevented this decrease. The MICT protocol did not prevent the reduction of GSH-Px and the HIIT protocol partially prevented this decrease in the plantaris muscle. Conclusions HFD elicited oxidative stress in the skeletal muscle of rats, and both protocols were able to prevent most of the alterations in oxidative stress parameters caused by the HFD. Level of evidence IV; Investigation of treatment outcomes.
In this study, poly(hydroxybutyrate-co-hydroxyvalerate) (PHBV) and poly(l-lactide) (PLA) microspheres containing ibuprofen were prepared with the aim of prolonging the drug release. The oil-in-water (O/W) emulsion solvent evaporation technique was used, varying the polymer ratio. All formulations provided spherical particles with drug crystals on the surface and a porous and rough polymeric matrix when PHBV was used and smooth external surface when prepared with PLA. The in vitro dissolution profiles show that the formulation containing PHBV/PLA at the proportion of 30/70 presented the best results in terms of prolonging the ibuprofen release. The analysis of the concentration of ibuprofen in the blood of rats showed that maximum levels were achieved at between one and two hours after administration of the immediate-release form (pure drug), while the prolonged microspheres led to a small amount of the drug being released within the first two hours and reached the maximum level after six hours of administration. It was concluded that it is possible to prolong the release of ibuprofen through its incorporation into PHBV/PLA microspheres.Uniterms: Microspheres/preparation. Poly(hydroxybutyrate-co-hydroxyvalerate). Poly(l-lactide). Ibuprofen/release. Drugs/controlled release/in vitro study. Drugs/controlled release/in vivo evaluation.No presente estudo foram preparadas microesferas de poli(hidroxibutirato-co-hidroxivalerato) (PHBV) e poli(ácido láctico) (PLA) com o objetivo de prolongar a liberação do ibuprofeno, utilizado como fármaco modelo. Empregou-se o método de emulsificação e evaporação do solvente óleo em água (O/A), variando-se a proporção entre os polímeros. Todas as formulações originaram partículas esféricas com cristais de fármaco aderidos à superfície externa. As microesferas apresentaram superfície rugosa e porosa, quando o PHBV foi utilizado, e superfície externa lisa, quando preparadas com o PLA. Os perfis de dissolução in vitro evidenciaram que a formulação que continha PHBV/PLA na proporção de 30/70 apresentou melhores resultados para prolongar a liberação do ibuprofeno. Através da análise da concentração de ibuprofeno no plasma de ratos, após administração oral, verificou-se que os níveis máximos ocorreram entre 1 e 2 horas após a administração de ibuprofeno não encapsulado, enquanto o fármaco presente nas microesferas atingiu um pico máximo após 6 horas da administração. Conclui-se, portanto, que é possível prolongar a liberação do ibuprofeno após a sua incorporação às microesferas preparadas com os polímeros PHBV e PLA, especialmente na proporção de 30/70. Unitermos: Microesferas/preparação. Poli(hidroxibutirato-co-hidroxivalerato). Poli(ácido láctico). Ibuprofeno/liberação. Fármacos/liberação controlada/estudo in vitro. Fármacos/liberação controlada/ avaliação in vivo.
Background and Aims: Upper GI bleeding (UGIB) is a medical emergency associated with elevated mortality and significant costs to the health care system. EGD is currently the method of choice for the diagnosis and management of these conditions. However, the location of bleeding lesions and technical difficulties in achieving endoscope stability may challenge even the most experienced endoscopists. Herein, we demonstrate the use of the cap and underwater technique as a helpful aid in these situations.Methods: We present a case series of 4 patients with acute UGIB who underwent EGD with suboptimal endoscopic visualization or technical difficulties in identifying the source of bleeding. A transparent plastic cap was attached to the distal tip of the gastroscope, and the water immersion technique (underwater) was used for endoscopic re-evaluation of the bleeding site.Results: Three patients presented with duodenal bleeding, and 1 was diagnosed with diffuse bleeding from the esophagus. The clear and accurate identification of the source of bleeding and effective hemostasis were possible after cap and underwater technique evaluation in all patients. Conclusion:The use of the cap and underwater technique is a simple, safe, and low-cost strategy that improves the identification and control of UGIB in locations with poor visibility and technical challenges during endoscopic evaluation. (VideoGIE 2021;-:1-4.
Spontaneous intramural intestinal hemorrhage associated with oral anticoagulation therapy is rare and often associated with an abnormal coagulation profile (1). The jejunum and ileum are the most frequently involved bowel segments (2). Clinical presentation may range from abdominal pain to intestinal hemorrhage or obstruction (1). Reported sonography findings are non-specific, as they can also occur in inflammatory conditions. The main findings include a thickened bowel wall with an echogenic submucosa that is indicative of bleeding in this layer (2,3). It is important to recognize this clinical entity in order to avoid unnecessary interventions.
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