A nifedipina atua como bloqueador de canais de cálcio inibindo o fluxo transmembrânico de ions Ca2+ no interior das células do músculo cardíaco e células do músculo liso vascular, o qual induz ao relaxamento do músculo liso e diminuição da resistência vascular periférica. É utilizado no Brasil no tratamento de hipertensão arterial sistêmica (HAS), faz parte da Relação Nacional de Medicamentos Essenciais do Ministério da Saúde e vem sendo distribuída pela Secretaria da Saúde do Estado de São Paulo. Uma vez que a determinação plasmática do fármaco contribui para maior segurança de seu uso, o objetivo deste trabalho se prendeu em padronizar e validar um método analítico em cromatografia em fase gasosa com detecção por captura de elétrons, sensível, específico e reprodutível para a quantificação das concentrações plasmáticas com a finalidade de avaliar a relação entre a dose diária de 60mg e a concentração plasmática versus a resposta da pressão arterial sistêmica, observando a ocorrência de possíveis reações adversas, alterações bioquímicas e hematológicas, em pacientes portadores de HAS, submetidos à farmacoterapia. O método apresentou linearidade na faixa de 10 a 200 ng.mL-1 , com coeficiente de correlação (r) igual a 0,9977. Coeficientes de variação de precisão intra e interensaio menor que 10% e recuperação absoluta da nifedipina de 74,47 a 75,97%. Os limites de detecção e quantificação do método foram de 1,0 e 2,0 ng.mL-1, respectivamente e o fármaco demonstrou ser estável por 90 dias quando armazenado a -70°C ao abrigo da luz. Os dados observados no presente estudo permitiram evidenciar que os pacientes apresentaram concentrações plasmáticas no intervalo terapêutico preconizado, as quais foram efetivas na redução da pressão arterial sistólica e diastólica. Estas concentrações não acarretaram efeitos adversos em nível do sistema hematológico e bioquímico estatisticamente significativos e em relação às reações adversas relacionadas ao medicamento, tais como: cefaléia, edema periférico vascular, tontura, hipotensão arterial, rubor, tosse e cãibras, apesar de relatadas de forma significativa pelos pacientes no inicio do tratamento, foram ao longo do mesmo minimizadas e pouco relatadas. / Nifedipine, a compound of dihydropyridine class, is a calcium-channel antagonists drug that inhibits the transmembrane influx of Ca+2 into cardiac muscle cells and vasculas smooth muscle cells throught specific ion channels. It induces smooth muscle relaxation and decreases peripheral vascular resistance. It is widely used for the treatment of high blood pressure, and is considered as a essencial medicine by the Brazilian government. In Sao Paulo state, this drug has been distributed to hypertensive patients in treatment. Since the drug quantification in plasma contributes for a drug safety use, the objective of the present study was to develop and validate a accurate, specific and reproducible method for the determination of nifedipine in plasma by gas chromatography with eletron capture detection. The validated method was applied in samples of hipertensive patients on 60 mg daily dose of nifedipine with the purpose to evaluate the relation between drug plasma concentration and it\'s daily dose versus the hemodymamic effects, possible side effects and biochemical and hematologic alterations. The method was linear over a concentration range of 10 -200 ng.mL-1 (r2>0,99). The coefficient of variation of intra- and inter-assay precision less than 10% and the recovery was higher than 74%. The limit of detection and quantification were 1,0 and 2,0 ng.mL-1, respectively. Nifedipine was found to be stable in samples stored at -70ºC for 90 days and protect from light. The result showed that patients with drug plasma concentration within therapeutics levels also showed systolic and diastolic blood pressure succesfully controled. Therefore, these patients do not manifested any adverse effects specially in biochemical and hematologic systems. Other adverse efects of nifedipine such as headache, peripheral edema, hypotension, redness, cramp and cough reported by the patients at the beggining of thetreatment, were gradually diminishing and rarely related.

A nifedipina atua como bloqueador de canais de cálcio inibindo o fluxo transmembrânico de ions Ca2+ no interior das células do músculo cardíaco e células do músculo liso vascular, o qual induz ao relaxamento do músculo liso e diminuição da resistência vascular periférica. É utilizado no Brasil no tratamento de hipertensão arterial sistêmica (HAS), faz parte da Relação Nacional de Medicamentos Essenciais do Ministério da Saúde e vem sendo distribuída pela Secretaria da Saúde do Estado de São Paulo. Uma vez que a determinação plasmática do fármaco contribui para maior segurança de seu uso, o objetivo deste trabalho se prendeu em padronizar e validar um método analítico em cromatografia em fase gasosa com detecção por captura de elétrons, sensível, específico e reprodutível para a quantificação das concentrações plasmáticas com a finalidade de avaliar a relação entre a dose diária de 60mg e a concentração plasmática versus a resposta da pressão arterial sistêmica, observando a ocorrência de possíveis reações adversas, alterações bioquímicas e hematológicas, em pacientes portadores de HAS, submetidos à farmacoterapia. O método apresentou linearidade na faixa de 10 a 200 ng.mL-1 , com coeficiente de correlação (r) igual a 0,9977. Coeficientes de variação de precisão intra e interensaio menor que 10% e recuperação absoluta da nifedipina de 74,47 a 75,97%. Os limites de detecção e quantificação do método foram de 1,0 e 2,0 ng.mL-1, respectivamente e o fármaco demonstrou ser estável por 90 dias quando armazenado a -70°C ao abrigo da luz. Os dados observados no presente estudo permitiram evidenciar que os pacientes apresentaram concentrações plasmáticas no intervalo terapêutico preconizado, as quais foram efetivas na redução da pressão arterial sistólica e diastólica. Estas concentrações não acarretaram efeitos adversos em nível do sistema hematológico e bioquímico estatisticamente significativos e em relação às reações adversas relacionadas ao medicamento, tais como: cefaléia, edema periférico vascular, tontura, hipotensão arterial, rubor, tosse e cãibras, apesar de relatadas de forma significativa pelos pacientes no inicio do tratamento, foram ao longo do mesmo minimizadas e pouco relatadas. / Nifedipine, a compound of dihydropyridine class, is a calcium-channel antagonists drug that inhibits the transmembrane influx of Ca+2 into cardiac muscle cells and vasculas smooth muscle cells throught specific ion channels. It induces smooth muscle relaxation and decreases peripheral vascular resistance. It is widely used for the treatment of high blood pressure, and is considered as a essencial medicine by the Brazilian government. In Sao Paulo state, this drug has been distributed to hypertensive patients in treatment. Since the drug quantification in plasma contributes for a drug safety use, the objective of the present study was to develop and validate a accurate, specific and reproducible method for the determination of nifedipine in plasma by gas chromatography with eletron capture detection. The validated method was applied in samples of hipertensive patients on 60 mg daily dose of nifedipine with the purpose to evaluate the relation between drug plasma concentration and it\'s daily dose versus the hemodymamic effects, possible side effects and biochemical and hematologic alterations. The method was linear over a concentration range of 10 -200 ng.mL-1 (r2>0,99). The coefficient of variation of intra- and inter-assay precision less than 10% and the recovery was higher than 74%. The limit of detection and quantification were 1,0 and 2,0 ng.mL-1, respectively. Nifedipine was found to be stable in samples stored at -70ºC for 90 days and protect from light. The result showed that patients with drug plasma concentration within therapeutics levels also showed systolic and diastolic blood pressure succesfully controled. Therefore, these patients do not manifested any adverse effects specially in biochemical and hematologic systems. Other adverse efects of nifedipine such as headache, peripheral edema, hypotension, redness, cramp and cough reported by the patients at the beggining of thetreatment, were gradually diminishing and rarely related.

Background. The study objective was to determine how the population located in five remote rural areas responded to HIV testing offered by mobile clinics operating under Family Health International, an international NGO that provides health services, especially HIV prevention and family planning. The study sought to identify how different segments of the population, classified according to their socio-demographic characteristics, responded to HIV testing. The analysis is based on secondary data, collected between October 2009 and September 2010, on clients who came to seek health services at mobile clinics. The population is geographically located in five districts: OR Tambo in Eastern Cape, Amajuba in KwaZulu-Natal, Gert Sibande and Ehlanzeni in Mpumalanga, and Sekhukhune in Limpopo. Although these mobile clincs provided comprehensive health services, HIV prevention and family planning were the main focus of attention. Methods. A total number of 9015 individuals aged 18 years and older visited the mobile clinics during the period October 2009 to September 2010. Eight socio-demographic characteristics were collected and used to determine the association between HIV testing and the aforementioned eight variables. The association between the independent variables (sex, age, level of education, marital status, occupation, number of living children, district of residence and area of residence) and HIV testing (the dependent variables) was first investigated using a descriptive analysis and then performing a logistic regression. Results. More than 88% of individuals aged 18 years and older who visited the mobile clinics in the areas covered by the FHI project are from rural areas. HIV testing is still low in these areas, even though the services are provided close to their homes by the mobile clinics. It was found that only 34.7% of the mobile clinic’s clients tested for HIV during the period from October 2009 to September 2010. Out of eight independent variables included in the logistic regression model, five were found to have a statistically significant association with HIV testing, being: sex, age, education, occupation and area of residence Although the majority of these mobile clinics’ clients are females (77.1%), males tested in higher proportion than females accross all areas. The results showed that HIV testing decreases with age, with the age category 18 - 24 years testing for HIV in higher proportion than the age group 25 - 34 years and decreasing further when people become older. Individuals are more likely to take an HIV test when their level of education is higher than matric and tend to respond the same to a HIV testing offer when they have no education, primary or secondary level. Employment was found to be an enabling factor to test for HIV. People who are employed tested for HIV in a higher proportion than people who were unemployed or still in school. The area of residence (classified as rural, semi-urban and urban) showed that HIV testing is higher in urban than in semi-urban areas, and low in rural areas. The analysis by sex showed that education is important for women because women who had either primary, secondary or a higher level of education tested for HIV better than women who do not have any level of education. For males, education was not statistically significant regarding HIV testing. The different age groups showed the same pattern for both sexes regarding HIV testing, but young males in the category 18-24 years showed higher odds of testing for HIV than females in the same age category. With occupation variable, females who are either students or employed tested for HIV almost in the same proportion and their odds of testing for HIV were double that of unemployed females. Employed males showed a notably higher difference in testing for HIV than males who were either in school or unemployed. The area of residence showed the same pattern for males and females, with both testing in higher proportions in urban and semi-urban areas than in rural areas. Conclusion. Women from rural areas, with no education, were found to test for HIV less than any other individual in the areas under study. Women tested better when they had been exposed to any form of education. The provision of education to women in the form of an extensive and aggressive door to door HIV awareness campaign should therefore make a difference in increasing the uptake of HIV testing in the five areas covered by the mobile clinics. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2012.

Indiana University-Purdue University Indianapolis (IUPUI) / Forensic DNA profiling is widely used as an identification tool for associating an individual with evidence of a crime. Analysis of a DNA sample involves observation of data in the form of an electropherogram, and subsequently annotating a DNA “profile” from an individual or from the evidence. The profile obtained from the evidence can be compared to reference profiles deposited in a national DNA database, which may include the potential contributor. Following a match, a random match probability is calculated to determine how common that genotype is in the population. This is the probability of obtaining that same DNA profile by sampling from a pool of unrelated individuals. Each state has adopted various laws requiring suspects and/or offenders to submit a DNA sample for the national database (such as California’s law that all who are arrested must provide a DNA sample). These profiles can then be associated with past unsolved crimes, and remain in the database to be searched in the event of future crimes. In the case of database samples, a physical sample of the offender’s DNA must be kept on file in the laboratory indefinitely so that in the event of a database hit, the sample is able to be retested. Current methods are to collect a buccal swab or blood sample, and store the DNA extracts under strict preservation conditions, i.e. cold storage, typically -20° C. With continually increasing number of samples submitted, a burden is placed on crime labs to store these DNA extracts. A solution was required to help control the costs of properly storing the samples. FTA™ paper was created to fulfill the need for inexpensive, low maintenance, long term storage of biological samples, which makes it ideal for use with convicted offender DNA samples. FTA™ paper is a commercially produced, chemically treated paper that allows DNA to be stored at room temperature for years with no costly storage facilities or conditions. Once a sample is required for DNA testing, a small disc is removed and is to be used directly in a PCR reaction. A high quality profile is important for comparing suspect profiles to unknown or database profiles. A single difference between a suspect and evidentiary sample can lead to exclusion. Unfortunately, the DNA profile results yielded from the direct addition have been unfavorable. Thus, most crime laboratories will extract the DNA from the disc, leading to additional time and cost to analyze a reference sample. Many of the profiles from the direct addition of an FTA™ disc result in poor quality profiles, likely due to an increase in PCR inhibitors and high concentrations of DNA. Currently, standardized protocols regarding the recommended locations for removal of a sample disc from a bloodspot on an FTA™ card does not exist. This study aims to validate the optimal location by comparing DNA profiles obtained from discs removed from the center, halfway, and edge locations of a bloodspot from 50 anonymous donors. Optimal punch location was first scored on the number of failed, partial or discordant profiles. Then, profile quality was determined based on peak characteristics of the resulting DNA profiles. The results for all three disc locations were 5.3% failed amplifications, 4.2% partial amplifications, and one case of a discordant profile. Profile quality for the majority of the samples showed a high incidence of stutter and the absence of non-template adenylation. Of the three disc locations, the edge of the blood stain was ideal, due to a presumably lower concentration of DNA and likely more dilute amount of the PCR inhibitor heme. Therefore, based on the results of this study, there is a greater probability of success using a sample from the edge of a blood stain spotted in FTA™ paper than any other location of the FTA™ card.