Um estudo transversal foi conduzido no perÃodo de janeiro de 1996 a janeiro de 1998 para investigar os conhecimentos e atitudes das mÃes e pediatras em relaÃÃo à febre e as formas de tratamento que os mesmos adotam. O estudo foi realizado junto: A) 212 mÃes de crianÃas menores de seis anos com episÃdios de febre levadas a duas emergÃncias pediÃtricas de Fortaleza, uma pÃblica e outra privada; B) 317 mÃes em seus domicÃlios; C) 96 pediatras em seus locais de trabalho. Das mÃes entrevistadas no domicilio 34,0% delas consideram a febre um sintoma e 20,2% uma doenÃa. No entanto, para 34% dos pediatras a febre à um sinal de alerta e para 302% deles a febre à sà uma elevaÃÃo da temperatura do corpo. A grande maioria das mÃes do domicilio e dos pediatras acreditam que a febre pode causar algum problema na crianÃa, principalmente convulsÃo (60,5% e 82,4%, respectivamente. As principais razÃes que os levam a tratar a febre à a temperatura superior a 38,0ÂC (38,5%) e o risco de convulsÃo febril (19,2%). O metamizol e o paracetamol foram os antitÃrmicos mais usados pelas mÃes das emergÃncias (51,0% e 29,5%, respectivamente) e pelas mÃes no domicilio (62,9% e 21 ,4%, respectivamente). Estes antitÃrmicos, tambÃm foram os mais recomendados pelos pediatras, sendo o metamizol mais prescrito no serviÃo pÃblico (58,8%) e enquanto o preferido no serviÃo privado foi o paracetamol (52,4%). A prevalÃncia de antitÃrmicos (57%) nas prescriÃÃes pediÃtricas nas duas emergÃncias pediÃtricas foi considerada elevada. O estudo mostra o uso indiscriminado de antitÃrmicos pelas mÃes à reforÃado pela orientaÃÃo dos pediatras e ainda, indica um conflito entre conhecimentos e percepÃÃes das mÃes e dos pediatras sobre a febre e seu manejo. Isto indica a necessidade de uma intervenÃÃo educacional para as mÃes que inclua os aspectos culturais para contribuir para a reduÃÃo do uso de antitÃrmicos. AlÃm disso hà a necessidade de atualizaÃÃo dos pediatras para que se atinja entre os mesmos um consenso no manejo da febre baseado no conhecimento cientÃfico atual sobre o assunto no momento. / A cross-sectional study was carried out from January 1996 to January 1998 to investigate the perception, attitude and knowledge of mothers and paediatrics about fever, their harmful and their treatment. Data were collected for the study by interviewing: A) 212 mothers who brought their children under 6 years of age to two emergencies services (private and public); B) 317 mothers in their households: C) 96 paediatricians who work in Fortaleza. Out of the 212 mothers interviewed in domicile some 34.0% defined fever as a symptom and some 20.2% of them considered fever a disease. However, to be some 34.0% of the paediatricians define fever as a sign whilst some 30.2% of them stated that fever is a increase of the body temperature Most of the mothers interviewed in domicile (97.8%) and paediatricians (83.0%) believe that fever may cause some health problem, mainly convulsion (60.5% and 82.4%, respectively). The mothers in domicile (26.7%) start some kind of treatment to reduce the body temperature when it reached 38.5ÂC. The paediatricians opinion differ from the mothers opinions. The main reasons to treat the fever is the temperatures above 38.0ÂC (38.5%) and risk of febrile convulsion. Metamizole and paracetamol are the antithermics more commonly used by mothers in domicile (51.0% and 29.5%, respectively) and by the mothers who came to emergencies (62.9% and 21.4%.respectively). In the two emergencies the metamizole and paracetamol were more prescribed (52.0%). Metamizole is more often prescribed in public service and paracetamol in private. The study indicates that there is a need to define an educational intervention for mothers in order to reduce the indiscriminate use of antithermics. it also points out need of up dating paediatricians knowledge so that a consensus can be achieved on the fever treatment, based on current scientific knowledge.

Abstract Febrile seizures (FS) occur in 2-5% of children. Their pathogenesis is unknown. Elevated levels of prostaglandins (PG) have been found in cerebrospinal fluid after such seizures, and a third of all patients have recurrences. No safe ways of reducing the risk of recurrences have been found. The outcome has been shown in prospective studies to be good, by they have been linked to mesial temporal sclerosis (MTS) in patients with severe temporal lobe epilepsy (TLE). The aim was to analyze the records on the role of PGs in the pathogenesis of FS, to find risk factors for recurrences that are amenable to intervention and to evaluate the prevention of recurrences and the connection of FSs with MTS. We performed a systematic review of the effect of PGs and their synthetase inhibitors on seizures and a meta-analysis of the prevention of recurrences. The prophylactic effect of diazepam and acetaminophen on recurrences was evaluated in a placebo-controlled trial with 180 FS patients, and risk factors for recurrences were analysed from these data. To find MTS, MRI volumetry was performed after 12 years of follow-up on 64 cases chosen out of 329 unselected FS patients: twenty-four with a prolonged initial seizure, eight with a later unprovoked seizure and 32 age, sex and handedness-matched controls. PGD2, PGE1 and PGE2 had mainly anticonvulsive effects and PGF2alfa proconvulsive ones. NSAIDs had seizure-modulating effects in adult animals ranging from attenuation to provocation. Each degree of increase in fever doubled the recurrence risk, and each febrile episode increased it by 18%. The meta-analysis showed phenobarbital and valproate to prevent recurrences, but they cannot be recommended for FS as they have severe side-effects. The meta-analysis nullified the alleged effect of diazepam, and neither this nor acetaminophen prevented recurrences in a clinical trial. No MTS was found in any patient group. PGs may be involved in the pathogenesis of FS. No safe prophylaxis for recurrences is available, although the effect of antipyretics needs further evaluation. Measures to reduce feverish infections in order to prevent FS recurrences seem logical. MTS is uncommon even after prolonged FS.

Pterocarpus erinaceus Poir. (Fabaceae) est une plante médicinale utilisée dans la prise en charge de nombreuses pathologies dont les maladies à composante inflammatoire au Burkina Faso. Les feuilles, le tronc, et les racines sont utilisés comme remède dans le traitement des dermatoses, de l’inflammation, de l’ulcère, du rhumatisme, de la dysenterie, le paludisme, etc. L’objectif de ce travail était de mener des études phytochimiques et pharmacologiques sur des extraits de Pterocarpus erinaceus Poir. (Fabaceae) afin d’évaluer l’innocuité et l’efficacité de cette plante en vue d’obtenir des pré-requis pour le développement d’un phytomédicament. L’étude phytochimique a été réalisée en utilisant des méthodes chromatographiques (CCM, SPE, CC, VLC, MPLC, CLHP) et spectroscopiques (RMN 1D et 2D). Cette étude a permis d’isoler 18 molécules dont 14 identifiées à savoir la friedeline (2 fois), le lupeol, l’épicatechine, la rutine, la lutéoline, la quercétine-3-O-sophoroside, le kaempferol-3-Osophoroside, la quercétine-3-O-β-glucose, le stigmastérol, la friedeline, le 3α-hydroxyfriedelan-2-one, l’α-sophoradiol et le maltol 6-O-apiofuranoside-glucopyranoside. L’étude sur la toxicité aiguë a montré que les décoctés des feuilles (DECFEU), d’écorces de tronc (DECEC), d’écorces de racines (DECRA) et les extraits méthanoliques des feuilles (MeOH K), d’écorces du tronc (MeOH B) sont considérés comme des substances faiblement toxiques selon l’échelle de toxicité de Hodge et Sterner et de l’OMS. Les effets antiinflammatoires, analgésiques et antipyrétiques des extraits issus des écorces de tronc, des feuilles et des racines ont été validés sur des modèles animaux. Les résultats obtenus dans les tests in vitro (antioxydant, tests sur l’inhibition de la production de TNF α et de nitrite cellulaires, de la peroxydation lipidique et de la lipoxygénase) montrent que les extraits manifestent des effets intéressants; plus particulièrement l’extrait méthanolique des écorces du tronc (MeOH B) qui a le meilleur pouvoir antioxydant (ARP = 5 ; TEAC = 0,9) et la forte inhibition sur la peroxydation lipidique (37,25 %) et sur la lipoxygénase (97,69 %). Par contre l’extrait méthanolique des feuilles (MeOH K) a présenté la forte inhibition à la concentration de 50 μg/mL sur la production de TNF α (37,35 % et 30 %) et de NO (95 % et 50%) dans la culture de macrophages activés par LPS et LPS/IFN γ / Pterocarpus erinaceus Poir. (Fabaceae) is a medicinal plant used in the treatment of several diseases including diseases inflammatory component in Burkina Faso. The leaves, stem and roots are used as a drug in the treatment of skin diseases, inflammation, ulcer, rheumatism, dysentery, malaria. The aim of this study was to carry out phytochemical and pharmacological studies on extracts of Pterocarpus erinaceus Poir. (Fabaceae) to evaluate the safety and efficacy of this plant to obtain the data for the development of a drug. Phytochemical study has been performed using chromatographic methods (TLC, SPE, CC, VLC, MPLC, HPLC) and spectroscopic (1D and 2D NMR). This study has been leading to isolated 18 molecules including 14 identified namely friedelin, lupeol, epicatechin, rutin, luteolin, quercetin-3-O-sophorosid, kaempferol-3-O-sophorosid, quercetin-3-O-β-glucose, stigmasterol, 3α-hydroxyfriedelan-2-on, α-sophoradiol, maltol-6-O-apiofuranosideglucopyranoside. The test on acute toxicity showed that the decoction of the leaves (DECFEU), stem (DECEC), roots (DECRA) and methanol extracts of leaves (MeOH K), stem bark (MeOH B) are considered slightly toxic substances according to the toxicity scale of Hodge and Sterner and WHO. The anti-inflammatory, analgesic and antipyretic extracts from the stem bark, leaves and roots have been validated en animal models. The results obtained in vitro test (antioxidant test, tests on the inhibition of the production of cellular TNF α and nitrite, lipid peroxidation and lipoxygénase) showed that the extracts exhibited effects, especially the methanol extract stem bark (MeOH B) which has the best antioxidant power (ARP = 5; TEAC = 9) and the strongest inhibition of lipid peroxidation (37.25 %) and lipoxygénase (97.69 %). However the methanol extract of leaves (MeOH K) presented strong inhibition at a concentration of 50 μg/mL on the production of TNF α (37.35 % and 30 %) and NO (95 % and 50 %) in the macrophages cultures active by LPS and LPS/INF-γ

Made available in DSpace on 2016-08-10T10:29:40Z (GMT). No. of bitstreams: 1 Rotherdan Mecenas Cruz.pdf: 792136 bytes, checksum: faeb20a9b08befcbc642b86e796bc369 (MD5) Previous issue date: 2009-09-25 / Medicinal plants have always been used by man to solve health problems. This treatment is based mainly on observation of behavior of animals and plants in the front passage of the customs of its use from generation to generation. Many herbal medicines are currently used in therapy after his action proved scientifically, validating its use and effectiveness. Considering the high investments implemented by large conglomerates in the development of new pharmaceutical drugs and the discovery of these relatively slow, the plants are certainly sources little used for this purpose since there are few studies compared the number of species of flora. The aim of this study was to evaluate the activities antiinflammatory, antipyretic and antinociceptive of the crude extract of Alternanthera brasiliana (EAB) in the model of paw edema induced by carrageenan, in the model of fever induced by substance pirogência, lipopolysaccharide-LPS and the type of pain induced by formalin in rats, respectively. The testing of antipyretic activity, inhibition of EAB in the concentration of 40mg/kg occurred in two intervals: 4.5 h, inhibition of 31.4% and 6h, 35.7% reduction. Already at a concentration of 80 mg / kg was only the 6th time, 42.8%. The dose of 160mg/kg significantly inhibited the fever, 30.6%, only around 4.5 h after injection of LPS. The doses of 640 and 1280 mg / kg shown to be effective in reducing fever mainly between the 2nd and 6th hours, where the peak of inhibition at the 3rd hour (47% for lower dose and 35.2% for a dose of 1280 mg) . In results for the inhibition of edema caused by carrageenan was observed that doses of 640 and 1280mg/kg were effective in reducing the swelling between the 3rd and 5th hours, with peak inhibition of 36.8% in the 3rd time for the dose of 1280 mg and a decrease of 36.2% in the 4th h for the lower dose, showing results similar to antiinflammatory drug used as positive control, the indomethacin. The administration of the EAB test nociception at doses of 640 and 1280mg, showed significant inhibition on the number of shaken to paw in rats, both the neurogenic phase, between 0 and 5 min, and in the inflammatory phase, 15- 20 min, where the range of maximum inhibition occurred between 15-19 min for a dose of 640 mg, 70.6% and between 20-24 min for a dose of 1280 mg, 54.4%. This study indicates that the plant studied presented anti-inflammatory activity, antinociceptive and antipyretic. / As plantas medicinais sempre foram utilizadas pelo homem para sanar problemas de saúde. Este tratamento é baseado principalmente na observação do comportamento dos animais frente as plantas e na passagem dos costumes de sua utilização de geração em geração. Muitos medicamentos fitoterápicos são atualmente utilizados na terapêutica depois de sua ação comprovada cientificamente, validando seu uso e eficácia. Tendo em vista os altos investimentos aplicados pelos grandes conglomerados farmacêuticos no desenvolvimento de novos fármacos e a descoberta relativamente lenta destes, as plantas são sem dúvida fontes pouco exploradas para esse fim já que existem poucos estudos quando comparado ao grande número de espécies da flora. O objetivo deste estudo foi avaliar as atividades antiinflamatória, antipirética e antinociceptiva do extrato bruto de Alternanthera brasiliana (EAB) no modelo de edema de pata induzido por carragenina, no modelo de febre induzida por substância pirogência, Lipopolissacarídeo- LPS e no modelo de dor induzida por formalina em ratos, respectivamente. No teste de atividade antipirética, a inibição do EAB na concentração de 40mg/kg ocorreu em dois intervalos: 4,5h, inibição de 31,4% e 6h, 35,7% de redução. Já na concentração de 80 mg/Kg só ocorreu na 6ª hora, 42,8%. A dose de 160mg/kg inibiu a febre significativamente, 30,6%, apenas em torno de 4,5h após a injeção do LPS. As doses de 640 e 1280 mg/kg demonstraram ser eficientes em reduzir a febre principalmente entre a 2ª e 6ª horas, onde o pico de inibição na 3ª hora (47% para a menor dose e 35,2% para dose de 1280 mg). Nos resultados referentes a inibição do edema provocado por carragenina observa-se que as doses de 640 e 1280mg/kg foram eficazes na redução do edema entre as 3ª e 5ª horas, com pico de inibição de 36,8% na 3ª hora para a dose de 1280 mg e diminuição de 36,2% na 4ªh para a menor dose, demonstrando resultado semelhante a droga antiinflamatória utilizada como controle positivo, a indometacina. A administração do EAB no teste de nocicepção, nas doses de 640 e 1280mg, mostrou inibição significativa sobre o número de sacudida de pata nos ratos, tanto na fase neurogênica, entre 0 e 5 min, quanto na fase inflamatória, 15-20 min, onde o intervalo de inibição máxima aconteceu entre 15-19 min para a dose de 640 mg, 70,6% e entre 20-24 min para dose de 1280 mg, 54,4%. Este estudo indica que a planta estudada apresenta atividades antiinflamatória, antinociceptiva e antipirética.

Made available in DSpace on 2016-08-10T10:29:44Z (GMT). No. of bitstreams: 1 Marcelino Santos Neto.pdf: 764118 bytes, checksum: 7cbbd02d693a4818acfb7123e08c89ca (MD5) Previous issue date: 2009-08-07 / The use of plants for prevention or treatment of diseases have been carried out by mankind from earliest times and transmitted over generations. Scientific studies have been conducted to validate the information concerning the popular use of medicinal plants. From surveys ethnopharmacology you can reduce the time and expense in research and development of new drugs. In 2003, Andrade and colleagues identified plants with medicinal use in the state of Tocantins, Brazil, pre-selected by means of data obtained by the Forest Biodiversity Project, conducted by UNITINS / Ministry of Health / Ministry of the Environment and made available by the FMT / UNITINS. From this survey we selected Cochlospermum regium (Mart & Schrank) Pilger, known commonly as Algodãozinho-do-campo , which promotes, in the studied population, anti-inflammatory (main), analgesic and antipyretic activity. Thus, this study aimed to investigate the antinociceptive, anti-inflammatory and antipyretic activity of a crude hydroalcoholic extract (EHA) of the roots of Cochlospermum regium (Mart & Schrank) Pilger in rats by means of the formalin test, the paw edema induced by carrageenan and fever induced by lipopolysaccharide (LPS). The oral administration of EHA produced significant antinociceptive effect in a dose-dependent for both phases of nociception induced by formalin, and yet more effective in the first phase of this model (inhibition of 36% and 57% for doses of 640 and 1280 mg / kg, respectively). The antiinflammatory activity of EHA was confirmed in the model of paw edema induced by carrageenan since our results showed that the EHA reduced dose-dependent manner of the edema of paw induced by intraplantar administration of carrageenan in rats. The doses of 640 and 1280 mg / kg of extract inhibited 22.5% and 36.2%, respectively, the formation of edema three hours after the injection of inflammatory stimulus. It was possible to verify that the EHA, the dose of 1280 mg / kg, inhibited the febrile response induced by LPS. The inhibition occurred from the 2nd hour after administration of LPS and continued throughout the observation period, with maximum inhibition of 0.7 º C between 2 h and 3 h. These results contribute to the scientific validation of its use popular, and show real possibilities for this plant as a source of principle (s) active (s), the search depth can lead to the discovery of a new and better therapeutic alternative to the pathological states of inflammation , pain and fever. Thus it is necessary to carry out additional experiments to isolate and characterize the chemical constituents and especially to better clarify the mechanisms of action involved in activities analgesic, antipyretic and antiinflammatory as well as studies of toxicity and safety. / A utilização de plantas para prevenção ou tratamento de doenças tem sido realizada pela humanidade desde os tempos mais remotos e transmitida ao longo de gerações. Estudos científicos vêm sendo realizados no sentido de validar as informações populares referentes ao uso de plantas medicinais. A partir de levantamentos etnofarmacológicos pode-se reduzir o tempo e os gastos na pesquisa e no desenvolvimento de um novo medicamento. Em 2003, Andrade e colaboradores identificaram as plantas com uso medicinal no Estado do Tocantins, pré-selecionadas por meio de dados obtidos pelo Projeto Bosque da Biodiversidade, realizado pela UNITINS/Ministério da Saúde/Ministério do Meio Ambiente e disponibilizado pela FMT/UNITINS. Deste levantamento foi selecionada Cochlospermum regium (Mart & Schrank) Pilger, conhecida vulgarmente como Algodãozinho-do-campo , que promove, segundo a população pesquisada, ação antiinflamatória (principal), analgésica e antipirética. Desta forma, o presente estudo objetivou investigar as atividades antinociceptiva, antiinflamatória e antipirética do extrato hidroalcoólico bruto (EHA) da raiz de Cochlospermum regium (Mart & Schrank) Pilger em ratos por meio dos testes da formalina, edema de pata induzido por carragenina e febre induzida por lipopolissacarídeo (LPS). A administração oral do EHA produziu efeito antinociceptivo significativo de forma dose-dependente em relação a ambas as fases da nocicepção induzida pela formalina, sendo, contudo, mais efetivo na primeira fase desse modelo (inibição de 36% e 57% para as doses de 640 e 1280 mg/kg, respectivamente). A atividade antiinflamatória do EHA foi confirmada no modelo de edema de pata induzido por carragenina uma vez que nossos resultados demonstraram que o EHA reduziu de maneira dose-dependente o edema de pata induzido pela administração intraplantar de carragenina em ratos. As doses de 640 e 1280 mg/kg do extrato inibiram 22,5 % e 36,2 %, respectivamente, a formação do edema três horas após a injeção do estimulo inflamatório. Foi possível verificar ainda que o EHA, na dose de 1280 mg/kg, inibiu a resposta febril induzida pelo LPS. A inibição ocorreu a partir da 2ª hora após a administração de LPS e perdurou durante todo o período de observação, com pico máximo de inibição de 0,7ºC entre a 2 h e 3 h. Tais resultados colaboram para a validação científica de seu uso popular, e indicam possibilidades reais para esta planta como fonte de princípio(s) ativo(s), cuja pesquisa aprofundada pode levar à descoberta de uma nova e melhor alternativa terapêutica aos estados patológicos de inflamação, dor e febre. Para tanto é necessária a realização de experimentos adicionais para isolamento e caracterização dos constituintes químicos e, sobretudo, para o melhor esclarecimento dos mecanismos de ação envolvidos nas atividades analgésica, antiinflamatória e antipirética, bem como estudos de toxicidade e segurança.