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SETTING: Two consecutive trials were conducted to evaluate the effectiveness of a public health approach to identify and correct problems in the care cascade for household contacts (HHCs) of TB patients in three Brazilian high TB incidence cities.METHODS: In the first trial, 12 clinics underwent standardised evaluation using questionnaires administered to TB patients, HHCs and healthcare workers, and analysis of the cascade of latent TB care among HHCs. Six clinics were then randomised to receive interventions to strengthen management of latent TB infection (LTBI), including in-service training provided by nurses, work process organisation and additional clinic-specific solutions. In the second trial, a similar but streamlined evaluation was conducted in two clinics, who then received initial and subsequent intensive in-service training provided by a physician.RESULTS: In the evaluation phase of both trials, many HHCs were identified, but few started LTBI treatment. After the intervention, the number of HHCs initiating treatment per 100 active TB patients increased by 10 (95%CI - 11 to 30) in the first trial, and by 44 (95%CI 26 to 61) in the second trial.DISCUSSION: A public health approach with standardised evaluation, local decisions for improvements, followed by intensive initial and in-service training appears promising for improved LTBI management.

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BACKGROUND: Despite improvements in treatment success rates for tuberculosis (TB), current six-month regimen duration remains a challenge for many National TB Programmes, health systems, and patients. There is increasing investment in the development of shortened regimens with a number of candidates in phase 3 trials. METHODS: We developed an individual-based decision analytic model to assess the cost-effectiveness of a hypothetical four-month regimen for first-line treatment of TB, assuming non-inferiority to current regimens of six-month duration. The model was populated using extensive, empirically-collected data to estimate the economic impact on both health systems and patients of regimen shortening for first-line TB treatment in South Africa, Brazil, Bangladesh, and Tanzania. We explicitly considered 'real world' constraints such as sub-optimal guideline adherence. RESULTS: From a societal perspective, a shortened regimen, priced at USD1 per day, could be a cost-saving option in South Africa, Brazil, and Tanzania, but would not be cost-effective in Bangladesh when compared to one gross domestic product (GDP) per capita. Incorporating 'real world' constraints reduces cost-effectiveness. Patient-incurred costs could be reduced in all settings. From a health service perspective, increased drug costs need to be balanced against decreased delivery costs. The new regimen would remain a cost-effective option, when compared to each countries' GDP per capita, even if new drugs cost up to USD7.5 and USD53.8 per day in South Africa and Brazil; this threshold was above USD1 in Tanzania and under USD1 in Bangladesh. CONCLUSION: Reducing the duration of first-line TB treatment has the potential for substantial economic gains from a patient perspective. The potential economic gains for health services may also be important, but will be context-specific and dependent on the appropriate pricing of any new regimen.

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RESUMO O presente estudo teve como objetivo avaliar a atividade antibacteriana, antioxidante e citotóxica da espécie Opuntia cochenillifera (L.) Mill. Foi realizada a prospecção fitoquímica e espectroscopia de absorção de infravermelho (IV) dos extratos etanólicos brutos e frações dos cladódios grande e pequeno. A atividade antioxidante foi avaliada pelo método da capacidade sequestradora de radicais livres utilizando o radical sintético 2,2-difenil-1-picrilhidrazila (DPPH). A atividade citotóxica foi obtida através do método colorimétrico do Metiltetrazolium (MTT). Já a atividade antibacteriana foi avaliada pelo método de microdiluição em caldo para determinar a concentração inibitória mínima (CIM) frente às estirpes bacterianas Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa e Escherichia coli. A prospecção fitoquímica revelou principalmente a presença de fenóis, esteroides livres, alcaloides, alcanos, além de outras classes químicas. O IV apresentou grupos funcionais como alcanos, carbonilas, grupos de metila, duplas ligações de carbono, grupamentos alquilamina, entre outros. Sobre a citotoxicidade na concentração de 100 μg/mL, os dois extratos brutos, todas as frações do cladódio grande e as frações de clorofórmio e metanol do cladódio pequeno não apresentaram toxicidade. Os extratos brutos e frações do cladódio grande e pequeno, não demonstraram atividade antibacteriana e nem antioxidante. Esses resultados podem fornecer suporte para pesquisas futuras, visando outras atividades biológicas da presente espécie vegetal.

ABSTRACT The purpose of this study was to evaluate the antibacterial, antioxidant, and cytotoxic activity of Opuntia cochenillifera (L.) Mill. A phytochemical screening and infrared (IR) absorption spectroscopy were performed in the crude ethanolic extracts and fractions of large and small cladodes. The antioxidant activity was evaluated through the qualitative method of free-radical scavenging capacity using the synthetic radical 2,2-diphenyl-1-picrylhydrazyl (DPPH). The cytotoxic activity was obtained by the cell viability assay using methyl thiazolyl tetrazolium (MTT). Antibacterial activity was evaluated by broth microdilution method to determine the minimum inhibitory concentration (MIC) against the bacterial strains Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, and Escherichia coli. The phytochemical screening mainly revealed the presence of phenols, flavonoids, free steroids, alkaloids, alkanes, and other chemical classes. The IR spectroscopy presented functional groups such as alkanes, carbonyls, methyl groups, carbon double bonds, and alkylamino groups, among others. Regarding cytotoxicity in the concentration of 100 μg/mL, neither the crude extracts, the fractions of the large cladode, nor the chloroform and methanol fractions of small cladode presented toxicity. The crude ethanolic extracts and fractions of large and small cladode showed no antibacterial or antioxidant activity. These results may provide support for future research aimed at other biological activities of this plant species.

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RESUMO Estudo experimental in vitro que objetivou investigar o potencial antimicrobiano e citotóxico de quatro frações e um extrato etanólico da espécie Pouteria venosa usada como planta medicinal. A atividade antimicrobiana foi determinada pelos testes de sensibilidade microbiana, como o método de difusão em disco e o método da microdiluição em caldo, para a determinação da Concentração Inibitória Mínima (CIM). Obteve-se a avaliação da citotoxicidade por meio do método colorimétrico do Metiltetrazolium. No estudo da atividade antimicrobiana, os principais resultados foram obtidos contra Staphylococus aureus para a fração AcOEt das cascas do caule, CIM de 125 µg/mL; Streptococcus pneumoniae e Proteus mirabilis para a fração AcOEt das cascas do caule, CIMde250 µg/mL; Staphylococus epidermidis, Pseudomonas aeruginosa para a fração AcOEt das folhas e cascas do caule, CIM de 250 µg/mL. Todas as amostras foram inativas para os fungos testados. A fração AcOEt das cascas do caule foi considerada atóxica, podendo ser utilizada em testes pré-clínicos in vivo

ABSTRACT Study of antimicrobial and cytotoxic potential of Pouteria venosa species (Sapotaceae). This experimental in vitro study aimed to investigate the antimicrobial and cytotoxic potential of four fractions and one ethanolic extract of the specie Pouteria venosa used as a medicinal plant. The antimicrobial activity was determined by microbial sensitivity tests, as the method of disk diffusion and the broth microdilution method for determination of Minimum Inhibitory Concentration (MIC). The evaluation of the cytotoxicity was obtained by the Metiltetrazolium colorimetric method. In the antimicrobial activity research, the main results were obtained against the Staphylococcus aureus for the AcOEt fraction of the stem bark MIC 125 µg/mL, Streptococcus pneumoniae and Proteus mirabilis for the AcOEt fraction from the stem bark, CIM 250 µg/mL, Staphylococcus epidermidis, Pseudomonas aeruginosa to the AcOEt fraction of the leaves and stem bark, MIC 250 µg/mL. All samples did not react for the fungi tested. The AcOEt fraction of the stem bark was considered non-toxic and can be used at in vivo pre-clinical testing

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RESUMO As espécies da família Bignoniaceae e do gênero Tabebuia são amplamente utilizadas na medicina tradicional e possuem um forte potencial terapêutico. Diante disso, objetivou-se avaliar o potencial biológico da Tabebuia aurea, determinando a atividade antimicrobiana; por meio do método da microdiluição em caldo, para a determinação da Concentração Inibitória Mínima (CIM); antiedematogênica, pelo ensaio de edema de orelha induzido por capsaicina; e antirradicalar, frente ao radical DPPH. Os extratos etanólicos de T. aurea não evidenciaram citotoxicidade, exceto o extrato etanólico da flor nas concentrações > 0,5 mg mL-1. O extrato etanólico da flor foi ativo com ação bactericida frente a S. epidermidis (CIM de 0,06 mg mL-1) enquanto o extrato etanólico da folha foi moderadamente ativo frente a S. epidermidis (CIM: 0,25 mg mL-1) e S. aureus (CIM: 0,50 mg mL-1) sugerindo ação bacteriostática para ambas as linhagens. Os dois extratos apresentaram ação antiedematogênica, com inibição do edema de 40,50% pelo extrato etanólico da flor e de 41,73% pelo extrato da folha. T. aurea não apresentou atividade antirradicalar. Os resultados comprovam o perfil antibacteriano e antiedematogênico com ausência de citotoxidade pela T. aurea. Sugere-se a continuação dos testes com frações e substâncias isoladas das flores e folhas da referida espécie vegetal, bem como de experimentos in vivo, como forma de agregar evidências visando à busca de novos fitoterápicos.

ABSTRACT The species of Bignoniaceae family and genus Tabebuia are widely used in the traditional medicine and have a great therapeutic potential. The aim of the current research was to evaluate the biological potential of the Tabebuia aurea, determining its antimicrobial activity by the microdilution broth method, to predict the anti-edematogenic Minimum Inhibitory Concentration (MIC) by ear edema assay induced by capsaicin; and the antiradical one, towards DPPH. The ethanol extracts of T. aureashowed no cytotoxicity, except for the flower ethanol extract in concentrations above > 0.5 mg mL-1. The ethanol extract of the flower was active, with bactericidal action, against S. epidermidis (MIC 0.06 mg ml-1) and the ethanol extract of moderately active recto S. epidermidis (CIM: 0.25 mg mL-1) and S. aureus (MIC: 0.50 mg mL-1) were bacteriostatic for both strains. Both extracts had antiedematogenic action on the inhibition of edema of 40.50% by the ethanol extract of the flower and 41.73% by leaf extract. T. aurea did not show antiradical activity. The results indicate the antibacterial and antiedematogenic profile with no cytotoxicity by the T. aurea. It suggests the continuation of tests with isolated fractions and substances of flowers and leaves of that plant species as well as in vivo trials, in order to enhance the evidences targeted on finding new herbal medicines.

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SETTING: Randomised trial comparing 9 months of isoniazid with 4 months of rifampicin for the treatment of high-risk tuberculin skin test positive subjects in Rio de Janeiro, Brazil. OBJECTIVES: To compare QuantiFERON®-TB Gold In-Tube (QFT-GIT) responses before and 1, 4 and 9 months after starting treatment for latent tuberculous infection (LTBI) according to adherence to one of the two regimens. DESIGN: Participants in the trial were invited to undergo serial QFT-GIT. Within-subject differences at different time points were analysed as quantitative responses and categorised as positive or negative using different cut-off points. RESULTS: Of 215 participants, 118 completed treatment, of whom 58 underwent all three tests; and 97 did not complete treatment, of whom 10 underwent all tests. After 1 month of treatment, there was no significant difference in QFT-GIT response between the groups. After 4 and 9 months, reversions were more frequent in non-adherent subjects. Marked within-subject fluctuations were observed. No cut-off point could be established at which QFT-GIT responses were consistently positive or associated with adherence or type of treatment. CONCLUSION: Frequent within-subject variability in QFT-GIT responses, not associated with LTBI treatment, makes it difficult for clinicians to interpret QFT-GIT conversions and reversions.

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Endophytic microorganisms represent promising alternatives for obtaining new drugs of biotechnological importance. In this study, the endophytic species Acremonium cavaraeanum (A1a) isolated from Cocos nucifera was cultivated for the production of secondary metabolites, and its extracts and fractions were evaluated by the dilution method (MIC). The EtOAc extracts and MeOH fractions were tested against Gram-positive and -negative bacteria, and had an MIC of 125 µg/mL when evaluated in the EtOAc extract (EBI). The EtOAc extract (EBII) had an MIC of 62.25 µg/mL for Staphylococcus aureus and an MIC between 125 and 250 µg/mL for Gram-negative bacteria. The methanolic fractions showed activity with MIC between 125 and 250 µg/mL for all bacteria tested. The IGS region of the rDNA repeat unit of genomic DNA was analyzed by PCR/RFLPs, including endonucleases PstI, BamHII, HinfI, and EcoRI. The physical maps showed different restriction sites for the 6 Acremonium sp isolates, and revealed 5 RFLP patterns. The results showed that isolates of the same Acremonium species exhibited variation in this specific region. The sequences of ITS1-5.8S-ITS2 regions were aligned by Clustal W using the neighbor joining method, which grouped the isolates into 5 distinct clusters. This study aimed to evaluate the genetic diversity of A. cavaraeanum crops exhibiting antibacterial activity. The results of this study indicate that different fungal genetic isolates have biotechnological potential for the production of active bio-compounds against several human pathogens.

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Hepatitis C, Dengue and West Nile virus are some of the most important flaviviruses, that share one important serine protease enzyme. Serine proteases are the most studied class of proteolytic enzyme and, in these cases, a primary target for drug discovery. In this paper, we describe the synthesis and preliminary molecular modeling studies of a novel class of N- t-Boc amino acid esters derived of isomannide as potential serine proteases inhibitors.

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This article outlines the trajectory of the Brazilian Association of Nursing (ABEn) in Alagoas and its influence in the organization of the nursing profession in this federal state. It points out that ABEn-AL was the first institution to organize nursing in Alagoas, since it was founded prior to any nursing graduation course or even any nursing syndicate. Therefore, ABEn is considered a decisive landmark in the political and professional organization of nursing in the state of Alagoas.

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