Márcia Gisele Santos da Costa, Ana Cristina Cisne Frota, Camille Petruccio Brandão
et al.
Introdução: O Staphylococcus aureus é uma das principais causas de infecções invasivas associadas aos cuidados de saúde em crianças e adolescentes internados. A infecção por esse agente, em especial quando há bacteremia, está relacionada à elevada morbimortalidade na faixa pediátrica, com importante impacto nos custos do sistema de saúde. Objetivo: Estimar o custo hospitalar do tratamento de infecções por S. aureus para doenças invasivas que cursem com bacteremia, abscessos profundos, infecções músculo-osteoarticulares e sepse, em pacientes pediátricos internados em um hospital público universitário de alta complexidade. Métodos: Trata-se de um estudo descritivo, retrospectivo, realizado em um hospital universitário público pediátrico, localizado na cidade do Rio de Janeiro no período de 2020 a 2023. A população do estudo foi constituída por uma amostra de conveniência, ou seja, foram incluídos todos os casos de infecção por S. aureus (doenças invasivas bacteriêmicas, abscessos profundos, infecções músculo-osteoarticulares e sepse). Foram realizadas estimativas do custo direto por paciente utilizando a abordagem botton-up (de baixo para cima). Os custos foram estimados pela técnica de microcusteio. Foram estimados os custos médicos diretos, compostos por medicamentos, exames laboratoriais e de imagem, procedimentos e internação. Os materiais hospitalares foram contabilizados nos gastos com overhead. Os valores de medicamentos foram estimados pelos preços praticados nos processos de aquisição do hospital. Custos com procedimentos e exames foram estimados por meio do Sistema de Gerenciamento da Tabela de Procedimentos, Medicamentos e OPM do SUS (SIGTAP). Análise estatística: os valores foram expressos em média, mínimo, máximo e intervalo interquartil (IQR). Os valores se referem aos preços praticados em dezembro de 2024. Dados de overhead (luz, água, segurança, limpeza, rouparia, material hospitalar, hotelaria, serviços gerais, etc.) foram obtidos na Direção Administrativa da instituição. O estudo foi submetido à avaliação pelo Comitê de Ética e foi aprovado no parecer número 6.753.344. Resultados: Foram incluídos no estudo, 55 casos de infecção por S. aureus. A mediana de tempo de internação (Shapiro-Wilk p>0,05) foi de 30 dias (IQR 15-46,5) e a de internação na UTI foi de 12 dias (IQR 6-20). A idade média (Shapiro-Wilk p>0,05) foi de 5 anos (IQR 2-8) e as principais comorbidades foram: 7% neurológicas, 8% gastrointestinal e 7% hematológica. O custo médio (Shapiro-Wilk p>0,05) geral por paciente foi de: R$ 1.517,14 com medicamentos; R$ 314,02 com exames de laboratório; R$ 168,94 com exames de imagem; R$ 266,23 com procedimentos. O custo médio diário por leito foi de R$ 280,75 com recursos humanos e R$ 165,27 com overhead. Conclusões: O resultado do microcusteio identificou um custo médio por paciente para tratamento de infecção estafilocócica de R$ 15.513,25. Custos com recursos humanos e overhead foram as variáveis de maior peso.
Pharmacy and materia medica, Pharmaceutical industry
This study investigated the synergistic effect of ultrasound in combination with pH-shifting and heating modification on the physicochemical properties, structural characteristics, and emulsifying performance of safflower seed meal globulins (SMG). Furthermore, the efficacy of the modified protein (UHA-SMG) as a natural emulsifier was evaluated for preparing lycopene (LYC)-loaded high internal phase emulsions (HIPEs). Under the suitable modification conditions (ultrasonic power: 500 W, ultrasonic time: 5 min, temperature: 70 °C, pH: 9.0), UHA-SMG exhibited improved physicochemical properties, including altered micromorphology, reduced particle size and interfacial tension, as well as enhanced zeta-potential, surface hydrophobicity, wettability, and solubility. Structural characterization via far-UV circular dichroism, UV–Vis spectroscopy, and fluorescence spectroscopy indicated that the modification altered the secondary and tertiary structures of SMG, as evidenced by a rise in α-helical content and the redistribution of internal hydrophobic groups and aromatic amino acids. At a concentration of 2.0% (w/v), UHA-SMG successfully stabilized oil-in-water HIPEs with an internal phase volume of 75%. These HIPEs demonstrated typical shear-thinning behavior, gel-like rheological characteristics (G' > G''), and excellent stability against centrifugation, heating, and long-term storage. For LYC encapsulation, the HIPEs formulated with 2.0% (w/v) UHA-SMG achieved a high encapsulation efficiency of 96.39 ± 1.34% and provided markedly enhanced stability of LYC against UV irradiation, thermal degradation, and storage compared to free LYC. In summary, the synergistic triple-modification strategy (ultrasound, heating, and pH-shifting) significantly enhanced the functionality of SMG, rendering it a promising candidate as a bio-based stabilizer for HIPEs with considerable potential in lipophilic bioactive ingredient delivery systems.
Gums, as natural hydrocolloids, play a crucial role in enhancing the functionality and stability of food products. The present study focuses on the extraction, characterization, and functional evaluation of Cordia fruit gum for its application in value-added food formulations. Traditionally used in the pharmaceutical industry, Cordia gum remains underutilized in the food sector. This research aims to optimize the extraction process, ensuring maximum yield while preserving functional properties. The physicochemical characterization, including rheological behaviour, moisture content, solubility, and particle size distribution, was conducted to establish its potential as a functional ingredient. Functional property assessments, such as emulsifying, stabilizing, water-holding, and foaming capacities, were performed to explore its suitability in food formulations. Cordia gum was successfully incorporated into innovative food products, including ginger-garlic paste, flavoured drinks, and nutritional formulations for lactating mothers. The findings highlight Cordia gum as a natural alternative to synthetic stabilizers and emulsifiers, supporting clean-label and sustainable food innovations. The study contributes to bridging the research gap by demonstrating the commercial viability of Cordia gum in functional food applications, paving the way for further exploration in food product development
Gabrielle O'Brien, Ronith Ganjigunta, Paramveer S Dhillon
BackgroundOnline wellness influencers (individuals dispensing unregulated health and wellness advice over social media) may have incentives to oppose traditional medical authorities. Their messaging may decrease the overall effectiveness of public health campaigns during global health crises like the COVID-19 pandemic.
ObjectiveThis study aimed to probe how wellness influencers respond to a public health campaign; we examined how a sample of wellness influencers on Twitter (rebranded as X in 2023) identified before the COVID-19 pandemic on Twitter took stances on the COVID-19 vaccine during 2020-2022. We evaluated the prevalence of provaccination messaging among wellness influencers compared with a control group, as well as the rhetorical strategies these influencers used when supporting or opposing vaccination.
MethodsFollowing a longitudinal design, wellness influencer accounts were identified on Twitter from a random sample of tweets posted in 2019. Accounts were identified using a combination of topic modeling and hand-annotation for adherence to influencer criteria. Their tweets from 2020-2022 containing vaccine keywords were collected and labeled as pro- or antivaccination stances using a language model. We compared their stances to a control group of noninfluencer accounts that discussed similar health topics before the pandemic using a generalized linear model with mixed effects and a nearest-neighbors classifier. We also used topic modeling to locate key themes in influencer’s pro- and antivaccine messages.
ResultsWellness influencers (n=161) had lower rates of provaccination stances in their on-topic tweets (20%, 614/3045) compared with controls (n=242 accounts, with 42% or 3201/7584 provaccination tweets). Using a generalized linear model of tweet stance with mixed effects to model tweets from the same account, the main effect of the group was significant (β1=–2.2668, SE=0.2940; P<.001). Covariate analysis suggests an association between antivaccination tweets and accounts representing individuals (β=–0.9591, SE=0.2917; P=.001) but not social network position. A complementary modeling exercise of stance within user accounts showed a significant difference in the proportion of antivaccination users by group (χ21[N=321]=36.1, P<.001). While nearly half of the influencer accounts were labeled by a K-nearest neighbor classifier as predominantly antivaccination (48%, 58/120), only 16% of control accounts were labeled this way (33/201). Topic modeling of influencer tweets showed that the most prevalent antivaccination themes were protecting children, guarding against government overreach, and the corruption of the pharmaceutical industry. Provaccination messaging tended to encourage followers to take action or emphasize the efficacy of the vaccine.
ConclusionsWellness influencers showed higher rates of vaccine opposition compared with other accounts that participated in health discourse before the pandemic. This pattern supports the theory that unregulated wellness influencers have incentives to resist messaging from establishment authorities such as public health agencies.
Computer applications to medicine. Medical informatics, Public aspects of medicine
Glycogen synthase kinase-3β (GSK-3β) has been identified to promote inflammation and its inhibitors have also been proven to treat some inflammatory-mediated diseases in animal models. Allosteric inhibitors inherently have better therapeutical value due to their higher specificity than ATP-competitive ones. In this paper, we reported the discovery of a novel series of N, N-dibenzylcinnamamide (DBCA) compounds as allosteric GSK-3β inhibitors via a scaffold hopping strategy. The in vitro enzymatic evaluation showed most DBCA derivatives have inhibitory effects on GSK-3β in a micromolar scale. Among them, seven compounds D-27 ∼ 33 showed activities at lower micromolar levels. Kinetic analysis revealed this type of compound inhibited GSK-3β by an allosteric modulation. The in vitro cytokine release assay demonstrated that D-33 could reduce the release of proinflammatory cytokines IL-1β and IL-6 while keeping IL-12 and TNF-α intact, indicating it might be a potential safer candidate for certain inflammatory conditions, such as neuroinflammatory diseases. Finally, docking studies were performed to suggest binding modes that explain the impacts of candidates on the enzyme.
Mayara de Almeida Lima Ribeiro, Ana Caroline Silva Santos, Maria Caroline Andrade dos Santos
et al.
Introdução: Sabe-se que a maioria da população possui um estoque de medicamentos em suas residências, conhecidos também como farmacinha ou farmácia caseira. No contexto da Estratégia de Saúde da Família, as visitas domiciliares são espaços potentes para se analisar tais. Desta forma, o farmacêutico inserido nessa equipe pode observar e avaliar se os medicamentos estão sendo utilizados de forma racional. Objetivos: Analisar o estoque de medicamentos em domicílios de uma área da Estratégia de Saúde da Família (ESF). Material e Método: O estudo é descritivo e exploratório, com abordagem quali-quantitativa, realizada em residências de uma área da Estratégia de Saúde da Família (ESF) de um município na região centro-sul de Sergipe. A coleta de dados foi realizada entre maio e novembro de 2019, durante as visitas domiciliares dos residentes da equipe da ESF. Os dados analisados foram: cômodos, condições do armazenamento, presença de embalagem primária e/ou secundária, prazo de validade, além das classes terapêuticas dos medicamentos encontrados, através do sistema de classificação Anatômico Terapêutico Químico (Anatomical Therapeutic Chemical –ATC). Os dados foram computados no Excel e, analisados no programa Biostat versão 5.3. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Sergipe sob parecer 3.329.296. Resultados: Os dados foram coletados de 84 residências. Em 97,62% dos domicílios havia medicamentos armazenados. Quanto ao local de armazenamento, em 67,7% (n=55) das residências os medicamentos eram armazenados na cozinha. Em 21,95% (n=18) os medicamentos estavam expostos à luz, 15,85% (n=13) à umidade, e 46,34% (n=38) ao calor. Em 70,73% (n=58) os medicamentos estavam em embalagem primária, sendo que em 20,73% (n=17) havia medicamentos vencidos, os quais foram recolhidos e encaminhados para o órgão municipal responsável pela sua destinação final. Nas residências foram encontradas 455 especialidades de medicamentos, com média de 10,11 medicamentos por residência. O medicamento de maior frequência foi losartana potássica, 5,93% (n=27), seguido de hidroclorotiazida e dipirona sódica, 4,61% (n=21). O cloridrato de metformina teve uma frequência de 3,30% (n=15), assim como o paracetamol. Quanto às características dos medicamentos encontrados (forma farmacêutica) em 80,49% (n=66) das residências havia comprimidos e, em 42,68% (n=35) havia cápsulas. Discussão e Conclusões: A maioria da população tem estoque de medicamentos domiciliar. No entanto, armazenam em local inadequado, mantendo-os expostos à luz, umidade e calor, aumentando os riscos à saúde atrelados a esta prática equivocada. Assim, o farmacêutico durante a visita domiciliar pode prover informações adequadas, claras e seguras, evitando possíveis danos e garantindo maior qualidade de vida ao paciente.
Pharmacy and materia medica, Pharmaceutical industry
Introdução: Para a tomada de decisão, a Avaliação de Tecnologias em Saúde (ATS) inclui a análise baseada em evidências, levando em consideração várias dimensões não só clínicas e econômicas. No Brasil, a Comissão Nacional de Incorporação de Tecnologias no SUS (Conitec) é a agência responsável pelos processos de incorporação de tecnologias em saúde no Sistema Único de Saúde (SUS). O objetivo deste estudo foi analisar criticamente a ATS publicada pela Conitec e relacionadas ao tratamento de hemofilias, enfocando as dimensões da análise, critérios, resultados e fatores de decisão relevantes para a tomada de decisão. Métodos: Estudo descritivo, exploratório e retrospectivo relativo à ATS no nível federal pela Conitec no período de janeiro de 2012 até abril de 2020, para tratamento de pacientes com hemofilia. Resultados: Cinco relatórios e avaliações de medicamentos foram incluídos para análise. As dimensões encontradas foram evidências científicas sobre eficácia, segurança, questões relacionadas a doenças e necessidade não atendidas, ao uso da tecnologia, custos e participação social. Os fatores de decisão mais relevantes considerados para a tomada de decisão foram necessidades médicas não atendidas e falta de evidências de benefício do medicamento frente alternativas já disponíveis. Conclusão: O processo de ATS é decisório da Conitec para tratamento de hemofilias tem se desenvolvido, mas apesar dos avanços e das diretrizes metodológicas, é necessário um contínuo investimento no rigor científico dos processos de ATS, na transparência e na independência das decisões.
Pharmacy and materia medica, Pharmaceutical industry
Edilaine Tiburcio da Silva, Helena Hiemisch Lobo Borba, Felipe Fernando Mainka
et al.
Background/Aim: High-grade gliomas are aggressive brain neoplasms usually refractory to treatment. Recently new treatment approaches have emerged, including immunotherapies. Hence, the aim of the present study was to evaluate the efficacy and safety of immunotherapies in adult patients with high-grade gliomas. Methods: Searches were performed in three databases for relevant studies published until December 2020. Title and abstract screening, full-text review, data extraction, and risk of bias assessment were performed independently by two reviewers. Risk of bias assessment was performed according to the revised Cochrane risk-of-bias tool for randomized trials (RoB 2). Meta-analyses were performed with Review Manager software (version 5.4.1), using risk ratio and 95% confidence intervals as measure of effect, the Mantel-Haenszel method, and random effects models. The quality of evidence assessment was conducted according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: Nineteen studies were included in the systematic review, of which 15 reported comparable data for meta-analyses. The outcomes assessed in the meta-analyses were overall survival (OS) and progression-free survival (PFS), with subgroups at 6, 12, and more than 12 months. No statistical differences were observed between immunotherapy and conventional treatment, except for the OS subgroup over 12 months. The certainty on the evidence was moderate. Conclusion: There was no evidence of an additional benefit of immunotherapy compared to standard treatment in the synthesis of results from clinical trials. Further high-quality clinical trials are needed to improve the quality of evidence concerning immunotherapies for the treatment of high-grade gliomas.
Pharmaceutical industry, Pharmacy and materia medica
rozita dabbagafrouz, aliraza bafandeh zendeh, mohammad pasebani
Background and Objectives: The main purpose of this research is to design an innovation ecosystem model in the field of biotechnology in Tabriz and to determine the components of the innovation ecosystem that has been done by the ecosystem data method. Material and Methods: This study was conducted by grounded theory. Semi-structured interviews were used for data collection and data analysis was performed using Strauss and Corbin method and paradigm model. The statistical population of this study consisted of 18 faculty members of Tabriz University of Medical Sciences, directors of research and technology and higher education planning, and the university's relationship with industry and innovation institute of the province, managers of knowledge-based companies and experts of Iran's Scientific and Industrial Research Organization, managers of Zahravi Pharmaceutical Factories, Razi Serum Manufacturing, Dana Pharmaceutical Compan., whichwas done through purposive sampling and snowball method. The interviews were continued until saturation was achieved. Results: The components affecting the innovation ecosystem led to the creation of a data-based theory in the field of health innovation ecosystem by analyzing the results of the content of the interviews during the open, pivotal and selected coding process. The model designed in this study includes effective dimensions and components, barriers and strategies, causal, contextal, mediating and constituent elements that show the pivotal phenomenon, consequences and strategies. The identifiers and factors of the innovation ecosystem of 150 codes and 40 concepts, 5 main components of interviews and research literature were developed in the form of a conceptual model of data foundation. Based on the results of the research, causal factors (government, financial capital), central issue (university and research institutes), strategies (establishment of universities and research-based institutions, shortening the process of obtaining necessary permits, government support for research and development, material and spiritual incentives and increasing risky investment), consequences (economic development and growth) and underlying factors (attractiveness of place, banking services, intellectual property rights) intervening conditions (culture) were identified. Conclusion: The studied process was explained in the form of a story line of data foundation theory. Finally, the model of biotechnology innovation ecosystem was designed and analyzed
Synergetic innovation between pharmaceutical enterprises and scientific research institutions is extremely important for the development of innovative drugs. However, it is unstable in the pharmaceutical industry, which seriously hinders the development of innovative drugs in the World. China is the country with the biggest population, and therefore problems in this country are ones of the most important. In this context, we studied the influence of strengthening correlation degree on synergetic innovation between pharmaceutical enterprises and scientific research institutions by using quantum game. Through the establishment of quantum game model, we obtain the optimal strategy of both players in different case. The results show that the quantum game can solve the problem of “prisoner's dilemma” existing in the game between pharmaceutical enterprises and scientific research institutions; it is easier for the two players to choose complete synergy when they are entangled state and quantum strategy has been adopted; when pharmaceutical enterprises and scientific research institutions are not in a state of entanglement, the quantum game has no difference with classical game in this case.
Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by neuronal loss and dysfunction of dopaminergic neurons located in the substantia nigra, which contain a variety of misfolded α-synuclein (α-syn). Medications that increase or substitute for dopamine can be used for the treatment of PD. Recently, numerous studies have shown gut microbiota plays a crucial role in regulating and maintaining multiple aspects of host physiology including host metabolism and neurodevelopment. In this review article, the role of gut microbiota in the etiological mechanism of PD will be reviewed. Furthermore, we discussed current pharmaceutical medicine-based methods to prevent and treat PD, followed by describing specific strains that affect the host brain function through the gut-brain axis. We explained in detail how gut microbiota directly produces neurotransmitters or regulate the host biosynthesis of neurotransmitters. The neurotransmitters secreted by the intestinal lumen bacteria may induce epithelial cells to release molecules that, in turn, can regulate neural signaling in the enteric nervous system and subsequently control brain function and behavior through the brain-gut axis. Finally, we proved that the microbial regulation of the host neuronal system. Endogenous α-syn can be transmitted long distance and bidirectional between ENS and brain through the circulatory system which gives us a new option that the possibility of altering the community of gut microbiota in completely new medication option for treating PD.
ZL-004, a promising small molecule that increases white blood cell counts, was developed for extended-release nanosuspensions to improve low solubility and compliance of patients. In vivo pharmacokinetic studies of nanosuspensions with different particle sizes and administration volumes were conducted. Unexpectedly, C<sub>max</sub> of NS-PC-L (1156 nm) was 1.3 fold higher than NS-PB-L (836 nm), and area under plasma concentration-time curve (AUC) was similar. It suggested that in vivo behavior of nanosuspensions was influenced significantly by the original dissolved drug, which did not only rely on the particle size but also the amount of the free stabilizers. In addition, smaller administration volume (0.1 mL) achieved significantly lower C<sub>max</sub> and AUC than the higher volume (0.5 mL), due to the reduced amount of dissolved drug. DSC and XPRD demonstrated that the crystal forms of nanosuspensions prepared by the precipitation method and high-pressure homogenization were similar; therefore, in vivo behaviors did not show significant differences. An additional 0.15% PEG 4000 enhanced the redispersity and maintained the particle size for 3 months. Finally, a nanosuspensions with the desired initial release was achieved, which lasted approximately 32 days steadily after a single dose. AUC and t<sub>1/2</sub> were 161.2 fold and 22.9 fold higher than oral administration.
Mahmoud Mohamed Mokhtar, Hesham Mohamed Shaban, Mohamed El-amir F. Hegazy
et al.
Cancer is the second leading cause of death world-wide. One of the most important medical practices of the 21st century is the chemoprevention of cancer. For a long history, it has been accepted that plants could prevent and exert suitable anti-carcinogenic effects for multiple types of cancers. Seriphidium herba-alba family Asteraceae has been used in the folk medicine by many cultures for treatment of various ailments since ancient times. In the current research we were aimed to evaluate the cancer chemopreventive activity of two crude extracts of S. herba-alba, methylene chloride extract and methanol extract on two cell lines: Human breast cancer cells (MCF-7) and human hepatocellular carcinoma cells (Hep-G2). Assessment of cytotoxicity using methyl thiazole tetrazolium (MTT assay) indicated that both extracts exhibit poor cytotoxicity with half maximal inhibitory concentration (IC50) >20 µg/mL. Assessment of glutathione-S-transferases (GSTs) activity (spectrophotometrically) showed statistically significant enhancement of enzyme activity after treatment with three different doses of methylene chloride extract and glutathione (GSH) concentrations were decreased. Analysis of cell mode of death by Ethidium bromide/Acridine orange (EB/AO) staining revealed that the dominant mode of death in MCF-7 cells was apoptosis. Assessment of vascular endothelial growth factor (VEGF) and platelets derived growth factor (PDGFBB) using ELISA showed that VEGF and PDGFBB levels were statistically significant decreased. In Conclusion: both extracts may be cancer chemopreventive agents since they had tumor anti-initiating, and anti-promoting activity.
Therapeutics. Pharmacology, Pharmacy and materia medica
Yongzhong Wang,1 Zhen Fan,2 Lei Shao,3 Xiaowei Kong,1 Xianjuan Hou,1 Dongrui Tian,1 Ying Sun,1 Yazhong Xiao,1 Li Yu4 1School of Life Sciences, Collaborative Innovation Center of Modern Bio-manufacture, Anhui University, Hefei, People’s Republic of China; 2Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA; 3State Key Laboratory of New Drugs and Pharmaceutical Process, Shanghai Institute of Pharmaceutical Industry, Shanghai, 4Department of Microbiology and Parasitology, Anhui Provincial Laboratory of Microbiology and Parasitology, Anhui Key Laboratory of Zoonoses, Anhui Medical University, Hefei, People’s Republic of China Abstract: Owing to peculiar properties of nanobody, including nanoscale size, robust structure, stable and soluble behaviors in aqueous solution, reversible refolding, high affinity and specificity for only one cognate target, superior cryptic cleft accessibility, and deep tissue penetration, as well as a sustainable source, it has been an ideal research tool for the development of sophisticated nanobiotechnologies. Currently, the nanobody has been evolved into versatile research and application tool kits for diverse biomedical and biotechnology applications. Various nanobody-derived formats, including the nanobody itself, the radionuclide or fluorescent-labeled nanobodies, nanobody homo- or heteromultimers, nanobody-coated nanoparticles, and nanobody-displayed bacteriophages, have been successfully demonstrated as powerful nanobiotechnological tool kits for basic biomedical research, targeting drug delivery and therapy, disease diagnosis, bioimaging, and agricultural and plant protection. These applications indicate a special advantage of these nanobody-derived technologies, already surpassing the “me-too” products of other equivalent binders, such as the full-length antibodies, single-chain variable fragments, antigen-binding fragments, targeting peptides, and DNA-based aptamers. In this review, we summarize the current state of the art in nanobody research, focusing on the nanobody structural features, nanobody production approach, nanobody-derived nanobiotechnology tool kits, and the potentially diverse applications in biomedicine and biotechnology. The future trends, challenges, and limitations of the nanobody-derived nanobiotechnology tool kits are also discussed. Keywords: nanobody, VHH, V-NAR, HCAbs, IgNAR, nanobiotechnology