En dépit du nombre croissant d’études cliniques sur le canal artériel (CA), des failles méthodologiques entretiennent plusieurs incertitudes concernant l’efficacité et la sécurité des traitements chez les bébés nés prématurés. L’objectif de cette recherche était de comparer les concentrations de prostaglandine E2 (PGE2) et les mesures du flux mésentérique par échographie Doppler chez les enfants nés prématurément et ayant un canal artériel traité à l’ibuprofène par voie intraveineuse ou entérale, en utilisant la méthodologie randomisée contrôlée et à double insu. Dans notre étude pilote, 20 nouveau-nés prématurés de moins de 34 semaines ayant un CA symptomatique confirmé par échocardiographie, furent randomisés au traitement à l’ibuprofène par voie intraveineuse ou entérale. La voie d’administration fut maintenue à l’insu de l’équipe traitante, des cardiologues et des investigateurs. Des dosages des prostaglandines plasmatiques ont été mesurés avant le début du traitement ainsi que 3, 24 et 48 h après le début du traitement. Les mesures du flux mésentérique ont été effectuées avant le traitement à l’ibuprofène ainsi que 1 h et 3 h après le traitement. Nous avons démontré à partir de nos observations que les niveaux plasmatiques de prostaglandines E2 diminuent chez les patients ayant répondu au traitement à l’ibuprofène, indépendamment de la voie d’administration. Nous n’avons pas observé de changement dans l’évolution des dosages de PGE2 chez les patients qui n’ont pas répondu au traitement. Les paramètres mesurés par échographie Doppler au niveau de l’artère mésentérique supérieure n’étaient pas affectés par la voie d’administration du traitement à l’ibuprofène, intraveineuse ou entérale. La présente étude suggère ainsi que le traitement du CA par ibuprofène intraveineux ou entéral n’influe pas sur le flux sanguin mesuré par échographie Doppler. La baisse de la prostaglandine E2 coïncide avec la fermeture du CA, et son dosage pourrait jouer un rôle dans la gestion du traitement. Nous avons démontré la faisabilité d’une étude clinique randomisée à double insu dans le traitement du canal artériel; une méthodologie qui devrait désormait être employé dans la recherche clinique sur les traitements de la persistance du CA. / Despite the growing body of research on the patent ductus arteriosus (PDA), issues with clinical research methodology impairs much of our understanding regarding treatment efficacy and safety in the preterm population. The purpose of this study was to determine plasma prostaglandin E2 (PGE2) concentrations in preterm infants with symptomatic persistence of the ductus arteriosus treated with IV and oral ibuprofen, and measure Doppler flow parameters in the superior mesenteric artery, utilizing randomized controlled and double-blind methodology. Twenty patients age < 34 wks with a symptomatic PDA confirmed by echocardiography randomized to oral vs intravenous ibuprofen regimen. Treating physician, cardiologists and study investigators were blinded to treatment allocation. Plasma PGE2 levels were measured prior to ibuprofen treatment and at 3, 24 and 48 h after treatment. Mesenteric Doppler measurements were taken prior to ibuprofen treatment, and 1 h and 3 h after treatment. Our results showed that plasma PGE2 levels decreased over time in patients that exhibited ductal closure after IV or oral ibuprofen treatment; no time-dependent changes in PGE2 were seen in subjects that failed to respond to ibuprofen. Superior mesenteric artery Doppler flow measurements were not affected by ibuprofen treatment (IV or oral), regardless of efficacy on ductal closure and of PGE2 changes. We conclude that treatment with oral or intravenous ibuprofen does not impact on superior mesenteric artery blood flow measured by Doppler ultrasound. Decreases in plasma PGE2 concentrations coincide with ibuprofen efficacy, and may be more cost-effective to monitor than ultrasound. This study also demonstrated the successful use of double blinded randomized controlled research methodology, which should be more strictly applied in future clinical research on PDA treatment.

Prostanoids are oxygenated derivatives of arachidonic acid with a wide range of physiological effects in vertebrates including modulation of inflammation and innate immune responses. Nonsteroidal anti-inflammatory drugs (NSAIDs) act through inhibition of cyclooxygenase (COX) conversion of arachidonic acid to prostanoids. In order to better understand the potential of environmental NSAIDS for interruption of normal levels COX products in fishes, we developed an LC/MS/MS-based approach for tissue analysis of 7 prostanoids. Initial studies examining muscle, gut and gill demonstrated that prostaglandin E2 (PGE2) was the most abundant of the measured prostanoids in all tissues and that gill tissue had the highest and most consistent concentrations of PGE2. After short-term 48-h laboratory exposures to concentrations of 5, 25, 50 and 100 ppb ibuprofen, 50.0ppb and 100.0 ppb exposure concentrations resulted in significant reduction of gill tissue PGE2 concentration by approximately 30% and 80% respectively. The lower exposures did not result in significant reductions when compared to unexposed controls. Measured tissue concentrations of ibuprofen indicated that this NSAID had little potential for bioaccumulation (BCF 1.3) and the IC50 of ibuprofen for inhibition of PGE2 production in gill tissue was calculated to be 0.4 µM. Short-term laboratory exposure to ibuprofen did not result in significant alteration of concentrations of PGE2 at environmentally relevant concentrations.

A análise estereosseletiva tem um lugar de destaque em várias áreas e, dentre elas, a farmacêutica, pois diversos fármacos quirais são comercializados como misturas racêmicas. A análise estereosseletiva empregando a cromatografia líquida de alta eficiência e a eletroforese capilar é prática e bastante eficaz para aplicações que envolvem a determinação de enantiômeros ao nível de traços em matrizes complexas, como por exemplo, em estudos de disposição cinética. Entretanto, devido à complexidade das matrizes biológicas, há necessidade da preparação da amostra antes de sua análise. Entre as diversas técnicas existentes, as mais utilizadas são a extração líquido-líquido e a extração em fase sólida. Contudo, essas técnicas apresentam algumas desvantagens,sendo a principal delas o uso de grandes quantidades de solventes. Portanto, técnicas que requerem pouco ou nenhum consumo de solventes orgânicos são bastante desejáveis. Entre essas técnicas destacam-se a microextração em fase sólida (SPME) e a microextração em fase líquida (LPME). Essas técnicas relativamente recentes têm como vantagens a utilização de quantidades mínimas de solventes orgânicos, o alto poder de concentração, a remoção dos interferentes da matriz biológica e a simplicidade de automação. Nesse trabalho propusemos a utilização da SPME e LPME como técnicas de preparação de amostras de urina, visando o desenvolvimento de métodos estereosseletivos com detectabilidade e seletividade adequadas para aplicação em estudos posteriores de disposição cinética. A SPME foi empregada para análise estereosseletiva do ibuprofeno e de seus principais metabólitos, carboxiibuprofeno e 2-hidroxiibuprofeno e da hidroxicloroquina e seus principais metabólitos, enquanto que a LPME foi usada para a análise estereosseletiva da hidroxicloroquina e seus metabólitos. Inicialmente, foi realizada a otimização da separação dos fármacos e metabólitos em diversas colunas quirais,a otimização da separação da hidroxicloroquina e seus metabólitos por eletroforese capilar e,em seguida, a otimização dos procedimentos de extração e a validação dos métodos desenvolvidos. Utilizando a coluna Chiralpak AD-RH® e fase móvel composta por solução de ácido fosfórico 1 mol L-1 pH 3 : metanol (75 : 25, v/v), foi validado um método para análise enantiosseletiva do ibuprofeno em urina. A SPME foi empregada para extração do ibuprofeno das amostras de urina utilizando a fibra PDMS-DVB 60 6;m. O método mostrou ser linear na faixa de concentração de 0,25 a 25 &#956;g mL–1 para cada enantiômero. Para a análise do 2-hidroxiibuprofeno e carboxiibuprofeno, foi utilizada a coluna Chiralpak AS® e fase móvel composta por hexano: isopropanol (94 : 6, v/v) + 0,05% de ácido trifluoracético. A extração desses metabólitos foi feita empregando a fibra de CW-TPR 50 µm. O método mostrou ser linear na faixa de concentração de 5 a 50 µg mL -1. Já para a análise da hidroxicloroquina e seus principais metabólitos, DHCQ e DCQ, foi utilizada a coluna Chiralcel OD-H® e fase móvel composta por hexano : etanol : metanol (96 : 2 : 2, v/v/v) + 0,2% de dietilamina. A extração desses metabólitos foi feita empregando a fibra de PDMSDVB 60 &#956;m. O método mostrou ser linear na faixa de concentração de 50 a 1000 ng mL -1para HCQ e 42 - 416 ng mL-1 para os metabólitos. A microextração em fase líquida foi avaliada na análise da hidroxicloroquina e seus metabólitos, BDCQ, DHCQ e DCQ e separação por eletroforese capilar. Para tanto foi utilizado um capilar de sílica fundida nãorecoberto com um comprimento efetivo de 42 cm, e 30 mmol L-1 de HP-b-CD + 1% de CD-b- sulfatada dissolvida em tampão tris(hidroxiaminometano) 100 mmol L-1 pH 9 como tampão de análise. O método mostrou ser linear na faixa de concentração de 10 - 1000 ng mL-1 para HCQ e 21-333 ng mL-1 para os metabólitos. Obteve-se precisão com coeficientes de variação inferiores a 15% e exatidão com erros relativos menores que 15% para todos os métodos desenvolvidos. Após validação, os métodos foram empregados na determinação da quantidade excretada acumulada do do ibuprofeno, da hidroxicloroquina e de seus metabólitos após administração de de rac-ibuprofeno e rac-hidroxicloroquina a voluntários sadios. Em suma, as duas técnicas foram eficientes na extração dos fármacos e metabólitos estudados. A SPME mostrou ser uma técnica de mais fácil manuseio, porém com baixos valores de recuperação. Por outro lado, a LPME apresentou valores de recuperação maiores, porém o manuseio do sistema de extração foi mais difícil, necessitando de um tempo maior para o domínio da técnica. / The stereoselective analysis has been standing out in several areas, and it is mainly present in the pharmaceutical industry, since many drugs are marketed as racemic mixtures. The stereoselective analysis employing high-performance liquid chromatography (HPLC) and capillary electrophoresis (CE) is very useful for the determination of enantiomers at very low concentrations, as the ones found in biological matrices, for instance, in pharmacokinetic studies. The first step in the analysis of drugs in biological fluids is the extraction procedure. The most common extraction procedures employed are liquid-liquid extraction and solidphase extraction. These techniques show several drawbacks, such as the high amount of organic solvent consumed. So, based on this fact, techniques that consume small amounts of organic solvents are desirable. Among these techniques, solid-phase microextraction (SPME) and liquid-phase microextraction (LPME) have been stood out. The main advantages of these techniques are the small amount of organic solvent consumed and its high capacity in drug concentration. In this work, our purpose was to employ the SPME and the LPME as sample preparation techniques to develop stereoselective methods to be further applied in pharmacokinetic studies. SPME was employed for the stereoselective analysis of ibuprofen, hydroxychloroquine and their major metabolites.On the other hand,LPME was employed only for the enantioselective analysis of hydroxychloroquine and its metabolites. The first step was the separation optimization of the drugs and their metabolites by HPLC using several chiral columns, and the separation optimization of hydroxychloroquine and its metabolites by CE. Next, the extraction optimizations and method validations were performed. The enantioselective analysis of ibuprofen in human urine was carried out in the Chiralpak AD-RH® column, using methanol-pH 3.0 phosphoric acid solution (75 : 25 v/v) as mobile phase. The method was linear over the 0.5 - 25 µg mL-1 concentration range for both enantiomers. The fiber used in this method was PDMS-DVB 60 µm.The analysis of 2-hydroxyibuprofen and carboxyibuprofen was performed on a Chiralpak AS® column using hexane:isopropanol (95 : 5 v/v) plus 0.05% trifluoroacetic acid as the mobile phase. The method was linear over the 5 - 50 µg mL-1 concentration range. To perform the extractions, a CW-TPR 50 µm coated fiber was employed. The analysis of hydroxychloroquine and its major metabolites (DCQ and DHCQ) was done on a Chiralcel OD-H® column using hexane-methanol-ethanol (96 : 2 : 2, v/v/v) plus 0.2% diethylamine as mobile phase. The extraction was performed using a PDMS-DVB 60 µm coated fiber. The method was linear over the range of 50 - 1000 ng mL-1 for HCQ enantiomers and over the range of 42 - 416 ng mL-1 for DCQ and DHCQ enantiomers. LPME and CE were applied for the chiral determination of hydroxychloroquine and its metabolites (DCQ, DHCQ, BDCQ) in human urine. The electrophoretic separations were carried out in 100 mmol L-1tris(hydroxymethyl)aminomethane buffer (pH adjusted to 9.0 with phosphoric acid) containing 1% (w/v) S-b-CD and 30 mg mL-1 HP-?-CD, with a constant voltage of +18 kV. The method was linear over the concentration range of 10-1000 ng mL -1 for each HCQ stereoisomer and 21-333 ng mL -1 for each metabolite stereoisomer. Within-day and between-day assay precision and accuracy for all described methods were lower than 15%. The developed methods were applied for the determination of the cumulative urinary excretion of ibuprofen metabolites and hydroxychloroquine and its metabolites after oral administration of racibuprofen and rac-hydroxychloroquine to health volunteers. Comparing the techniques, both SPME and LPME were efficient to extract the drugs and their metabolites from human urine. iv SPME showed to be an easier technique to handle, however, the drug amount recovered by this technique was too small. On the contrary, LPME was a more difficulty technique to be handled, but better recovery values were obtained with this technique.

Submitted by Angela Maria de Oliveira (amolivei@uepg.br) on 2018-05-22T12:11:55Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Giselle Ariana.pdf: 971489 bytes, checksum: 5abfc7a704112e83f259ad38f6544f1e (MD5) / Made available in DSpace on 2018-05-22T12:11:55Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Giselle Ariana.pdf: 971489 bytes, checksum: 5abfc7a704112e83f259ad38f6544f1e (MD5) Previous issue date: 2018-03-26 / A prescrição de anti-inflamatórios e antibióticos é uma prática comum na Odontologia. Interações medicamentosas podem ocorrer quando diferentes fármacos são administrados ao mesmo tempo. O objetivo desta pesquisa foi avaliar a influência do ibuprofeno, sobre a concentração da amoxicilina no plasma e no tecido periapical de ratos com periodontite apical induzida. Foram utilizados 28 ratos Wistar, machos, com 45 dias, divididos em 4 grupos: PL: placebo (salina); AM: amoxicilina (100 mg/kg); IB: ibuprofeno (100 mg/kg); e AM+IB: amoxicilina (100 mg/kg) + ibuprofeno (100 mg/kg). Os animais foram submetidos à exposição pulpar do primeiro molar inferior esquerdo que permaneceu aberto por 15 dias e, então, fechado com resina composta, permanecendo por mais 07 dias. Os animais foram tratados com dose única dos medicamentos (gavagem) conforme o grupo ao qual pertenciam, 01 hora antes da eutanásia. Foram coletados 2 mL de sangue da artéria aorta para a obtenção do plasma sanguíneo e amostras do tecido periapical que foram homogeneizadas para a obtenção do sobrenadante. A partir das amostras (plasma e sobrenadante do tecido periapical) realizou-se o antibiograma para análise da concentração plasmática e tecidual de amoxicilina. Os resultados mostraram no plasma do grupo AM maiores concentrações da droga que os demais grupos (p<0,05, ANOVA com Tukey). O ibuprofeno interferiu na concentração plasmática de amoxicilina, no entanto, a concentração de amoxicilina no grupo AM+IB foi maior que nos grupos PL e IB (p<0,05, ANOVA com Tukey). A análise do sobrenadante do tecido periapical não mostrou diferença significativa entre os grupos (p>0,05, Kruskal-Wallis). A partir dos resultados é possível concluir que o ibuprofeno interfere com a concentração plasmática de amoxicilina, porém não interferiu na concentração da amoxicilina no tecido periapical. / The prescription of anti-inflammatories and antibiotics is a common practice in dentistry. Drug interactions can occur when medicines are administered at the same time. The objective of this present research was to evaluate the influence of ibuprofen on plasma and periapical tissue amoxycillin concentration in induced apical periodontitis in rats. 28 Wistar male rats (45 days) were divided into 4 groups: PL: placebo (saline); AM: amoxycillin (100 mg / kg); IB ibuprofen (100 mg / kg); and AM+IB amoxycillin (100 mg / kg) + ibuprofen (100 mg / kg). The animals were submitted to pulp exposure in the first lower left molar, which remained open for 15 days and then closed with composite resin, maintained for more 07 days. The rats were treated with a single dose (gavage) according to each group, 01 hour before euthanasia.Two milliliters of blood was collected from the aorta to obtain blood plasma samples and the periapical tissue were homogenised to obtain the supernatant. From the samples (plasma and the supernatant periapical tissue) was carried out antibiogram for analysis of plasma and tissue amoxycillin levels. Results showed that AM group showed plasma higher amoxycillin concentrations than the other groups (p <0.05, ANOVA with Tukey). Ibuprofen interferes with the amoxycillin plasma concentration, however, AM+IB group had a higher amoxycillin concentration than the PL and IB groups (p<0.05, ANOVA with Tukey test). The analysis of the periapical tissue supernatant showed no significant difference among groups (p> 0.05, Kruskal-Wallis). In conclusion, ibuprofen can interfere with amoxycillin plasm concentration, but had noinfluence on amoxycillin periapical tissue concentration.

O ibuprofeno é um antiinflamatório não esteróide, com baixa solubilidade em água, que apresenta diversos efeitos colaterais, incluindo lesão gástrica e intestinal. Esses efeitos podem depender da interação com a membrana celular, o que nos motivou a investigar, na primeira parte deste trabalho, a incorporação do ibuprofeno em monocamadas de Langmuir como modelos de membrana celular. Monocamadas de dipalmitoil fosfatidil glicerol (DPPG) e dipalmitoil fosfatidil colina (DPPC) co-espalhadas com o ibuprofeno ou depositadas sobre subfases contendo o fármaco foram estudadas por meio das isotermas de pressão e potencial de superfície. Foram observados efeitos significativos para monocamadas de DPPC, particularmente na transição de fase líquido-expandida para líquido-condensada, com modificações relevantes na elasticidade da monocamada. Esses efeitos aumentaram com a concentração do ibuprofeno. Para os dois tipos de fosfolipídios, o ibuprofeno pôde penetrar na região hidrofóbica, o que foi confirmado por espectroscopia de reflexão e absorção no infravermelho com modulação da polarização (PM-IRRAS), indicando assim a presença de interações hidrofóbicas. A análise por microscopia no ângulo de Brewster (BAM) mostrou que o ibuprofeno impede a formação de grandes domínios de DPPC, enquanto que não foram observadas alterações significativas para o DPPG. A interação entre o ibuprofeno e o DPPG também foi confirmada após a imobilização da monocamada mista em filmes LB com alterações na absorção no UV-Vis da molécula de ibuprofeno. No que diz respeito às implicações biológicas, a ação farmacológica que depende diretamente da interação com a membrana deve ocorrer primeiramente em regiões neutras via penetração do ibuprofeno na região hidrofóbica da membrana celular. A segunda parte deste trabalho foi dedicada à interação de capsaicinóides extraídos da pimenta malagueta com monocamadas de Langmuir constituídas de DPPG e DPPC. A capsaicina é um potente analgésico de uso tópico, que pode causar dessensibilização no local de aplicação dependendo da dose e, portanto há interesse na sua incorporação em sistemas de liberação controlada, como os lipossomos. A técnica de Langmuir foi empregada para verificar essa possibilidade. Os capsaicinóides expandiram as monocamadas de DPPG e aumentaram sua elasticidade. As isotermas de potencial de superfície indicaram que os capsaicinóides provocam aumento de 10% no momento de dipolo numa concentração de 30% em mol. Para os filmes mistos de DPPC e capsaicinóides, a área mínima diminuiu e a elasticidade da monocamada aumentou. De acordo com as isotermas de potencial, os momentos de dipolo diminuíram para as monocamadas de DPPC independentemente da concentração de capsaicinóides. Esses resultados sugerem que as moléculas de DPPC são solubilizadas para a subfase na presença do fármaco. A partir destes resultados, conclui-se que os capsaicinóides podem ser incorporados em estruturas lipídicas, constituídas principalmente de DPPG, o que é relevante para uso em sistemas de liberação de fármacos. / Ibuprofen is a nonsteroidal anti-inflammatory drug, with low solubility in water, which exhibits side effects including gastric and intestinal injury, often irreversible. Some of these effects may depend on the interaction with the cell membrane, which motivated us to investigate the incorporation of ibuprofen in Langmuir monolayers as cell membrane models, in the first part of this thesis. Dipalmitoyl phosphatidyl choline (DPPC) or dipalmitoyl phosphatidyl glycerol (DPPG) monolayers co-spread with ibuprofen or deposited on ibuprofen-containing aqueous subphases were studied using surface pressure and surface potential isotherms. Significant effects were observed for DPPC monolayers, particularly at the liquid-expanded to liquid-condensed phase transition, with relevant changes in the elasticity of the monolayer. These effects increased with the ibuprofen concentration. For both types of phospholipids, ibuprofen could penetrate into the hydrophobic part of the monolayer, which was confirmed with polarization-modulated infrared reflection absorption spectroscopy (PM-IRRAS), thus indicating the presence of hydrophobic interactions. BAM images showed that ibuprofen prevents the formation of large domains of DPPC, while no significant changes were observed for DPPG. The interaction between DPPG-ibuprofen was also confirmed for deposited layers in the form of LB films, with changes in the ibuprofen UV-Vis absorption. As for the biological implications, the pharmacological action depending directly on the membrane interaction should occur primarily with zwitterionic regions of the membrane via penetration of ibuprofen in the hydrophobic part of the monolayer. The second part of this thesis is dedicated to the interaction of capsaicinoids, extracted from malagueta pepper, with Langmuir monolayers of DPPC and DPPG. Capsaicin is a powerful analgesic of topical use, which can cause desensitization in the application site depending on the dose, and therefore there is interest in its incorporation in drug delivery systems, such as liposomes. The Langmuir technique was employed to verify this possibility. The capsaicinoids expanded the DPPG monolayer and increased its elasticity. Surface potential isotherms indicated that the capsaicinoids increased the average dipole moment by 10 % for 30 mol % of capsaicinoids. For the mixed films of DPPC and capsaicinoids, the minimum area decreased and the elasticity increased. According to the surface potential isotherms, the dipole moments decreased for DPPC monolayers regardless of the capsaicinoid concentrations. These results suggest that the DPPC molecules are solubilized into the subphase in the presence of the drug. From these results, it is concluded that the capsaicinoids can be incorporated into structures as the liposomes constituted mainly of DPPG, which is relevant for use in drug delivery systems.

Objetivo: Avaliar se o uso de Ibuprofeno associado a lorazepam, ou isoladamente, reduz a dor máxima associada à raspagem endometrial. Adicionalmente, analisou-se se reduz a dor logo após o procedimento e a rejeição a um novo procedimento. Material e Métodos: Estudo controlado, duplo-cego, com alocação aleatória de mulheres em três grupos paralelos, na proporção de 1:1:1. Foram convidadas a participar desta pesquisa mulheres com idade >=18 anos em tratamento para infertilidade no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo e que realizaram raspagem endometrial para aumentar as chances de gravidez. Foram inclusas 150 mulheres. As mulheres de todos os grupos receberam dois comprimidos: um grupo recebeu Ibuprofeno 600 mg + Lorazepam 1mg (I+L); outro grupo, Ibuprofeno 600 mg + placebo (I+P); e o último grupo recebeu dois placebos (P+P). A injúria endometrial foi realizada aproximadamente uma hora após essas intervenções. O principal parâmetro avaliado foi a dor máxima durante o procedimento, mensurado por meio de uma escala visual analógica (EVA) de 100 mm e outra escala verbal numérica (EVN) de 11 pontos (0 a 10). Os desfechos secundários foram a dor logo após a procedimento aplicando EVA e EVN e a aceitação de um novo procedimento avaliado por uma escala de Likert de cinco pontos sobre a afirmação \"Eu repetiria este procedimento\". Os valores obtidos entre os grupos foram comparados por meio de ANOVA e Kruskal-Wallis e por ?². Resultados: Cento e cinquenta mulheres aceitaram participar do estudo, sendo randomizadas 50 em cada grupo. Essas mulheres receberam a intervenção proposta (I+L, I+P ou P+P) e foram submetidas à injúria endometrial, aproximadamente uma hora após a administração da intervenção. Não se observou diferença significativa entre os grupos na dor máxima durante o procedimento, mensurada por EVA, EVN, ou pela média entre essas medidas EVA/EVN. Também não se verificou diferença significativa entre os grupos na dor mensurada logo após o procedimento ou na aceitação de um novo procedimento. Conclusões: Durante o procedimento de injúria endometrial não houve diferença na quantificação da dor entre os grupos estudados. O uso de Ibuprofeno isolado ou associado ao Lorazepam não foi eficaz em reduzir o nível da dor ou mudar a aceitação do procedimento, quando comparado com placebo. / Objectives: To assess whether the use of Ibuprofen associated with lorazepam or alone reduces the maximum pain associated with endometrial scraping. Additionally, we will evaluate if it reduces pain soon after the procedure and the rejection to a new procedure. Materials and Methods: A double-blind controlled study with random allocation of women in three parallel groups, at a ratio of 1: 1: 1. Women who were >= 18 years old who underwent infertility treatment at HC-FMRP-USP and who underwent endometrial scaling to increase their chances of pregnancy were invited to participate in this study. 150 women were included in the study Women of all groups received two tablets: one group received Ibuprofen 600 mg + lorazepam 1mg (I + L); the other group ibuprofen 600 mg + placebo (I + P); and the last group received two 2 placebos (P + P). The endometrial injury was performed approximately one hour after the use of these interventions. The main parameter evaluated was the maximum pain during the procedure, measured by a visual analogue scale (EVA) of 100 mm and a numerical verbal scale (EVN) of 11 points (0 to 10). Secondary outcomes were pain right after the procedure using EVA and EVN and acceptance of a new procedure rated by a 5-point Likert scale on the statement \"I would repeat this procedure.\" The values obtained between the groups were compared by ANOVA and Kruskal-Wallis and by ?². Results: One hundred and fifty women accepted to participate in the study, and 50 women in each group were randomized. These women received the proposed intervention (I + L, I + P or P + P) and were submitted to endometrial injury approximately one hour after the intervention. There was no significant difference between the groups in the maximum pain during the procedure measured by VAS, EVN, or by the mean between these VAS/EVN measures. We also did not observe a significant difference between the groups in the pain measured immediately after the procedure or in the acceptance of a new procedure. Conclusions: During the endometrial injury procedure, no difference was observed in the quantification of pain between the groups studied. Use of ibuprofen alone or in combination with lorazepam was not effective in reducing the level of pain or changing the acceptability of the procedure when compared to placebo.

<p>Studies have been performed to evaluate the use of micellar electrokinetic chromatography (MEKC), one mode of capillary electrophoresis (CE), as an analytical technique in industrial pharmaceutical analysis. The potential for using chemometrics for the optimisation of MEKC methods has also been studied as well as the possibilities of coupling MEKC with mass spectrometry (MS). </p><p>Two methods were developed, one for the determination of ibuprofen and codeine and another for pilocarpine, together with their degradation products and impurities in both cases. MEKC was found to be the most suitable mode of CE for the methods. Both methods were optimised by means of experimental design. Valuable information was gathered and optimum conditions were defined which resulted in fast systems with baseline-separated peaks. The ibuprofen-codeine method was validated according to the recommended validation procedures of the International Conference of Harmonisation. The validation was performed on a commercially available tablet formulation to verify the suitability of the method, i.e. for quantification of the two main compounds and to determine the degradation products and impurities in area% of each main peak. The following parameters were determined: selectivity, linearity, accuracy, precision, detection limit, quantitation limit, robustness and range. The results confirm that the method is highly suitable for its intended purpose, i.e. as a routine method for assay and impurity determination. The MEKC method for ibuprofen-codeine was coupled to a mass spectrometer in order to evaluate the potential of partial filling (PF)-MEKC-MS for identification of impurities in pharmaceutical substances and products. The so-called partial-filling technique was used to prevent the non-volatile micelles from entering the MS and was shown to fulfil its purpose of providing detection limits of about 10 pg. </p><p>The study clearly shows that micellar electrokinetic chromatography is well-suited as an analytical technique in industrial pharmaceutical analysis. </p>

Studies have been performed to evaluate the use of micellar electrokinetic chromatography (MEKC), one mode of capillary electrophoresis (CE), as an analytical technique in industrial pharmaceutical analysis. The potential for using chemometrics for the optimisation of MEKC methods has also been studied as well as the possibilities of coupling MEKC with mass spectrometry (MS). Two methods were developed, one for the determination of ibuprofen and codeine and another for pilocarpine, together with their degradation products and impurities in both cases. MEKC was found to be the most suitable mode of CE for the methods. Both methods were optimised by means of experimental design. Valuable information was gathered and optimum conditions were defined which resulted in fast systems with baseline-separated peaks. The ibuprofen-codeine method was validated according to the recommended validation procedures of the International Conference of Harmonisation. The validation was performed on a commercially available tablet formulation to verify the suitability of the method, i.e. for quantification of the two main compounds and to determine the degradation products and impurities in area% of each main peak. The following parameters were determined: selectivity, linearity, accuracy, precision, detection limit, quantitation limit, robustness and range. The results confirm that the method is highly suitable for its intended purpose, i.e. as a routine method for assay and impurity determination. The MEKC method for ibuprofen-codeine was coupled to a mass spectrometer in order to evaluate the potential of partial filling (PF)-MEKC-MS for identification of impurities in pharmaceutical substances and products. The so-called partial-filling technique was used to prevent the non-volatile micelles from entering the MS and was shown to fulfil its purpose of providing detection limits of about 10 pg. The study clearly shows that micellar electrokinetic chromatography is well-suited as an analytical technique in industrial pharmaceutical analysis.

The main focus of this project was to optimize a protocol for small molecule ligand co-purification from an in-vivo tissue source. For this purpose, I employed a transgenic zebrafish line called the pLT-gypsy, which expresses a fusion protein containing a tagged-NR LBD (Tiefenbach et al., 2010). The particular line I used to optimize the ligand identification protocol is the pLT-PPARγ zebrafish line, which expresses the tagged-PPARγ receptor's LBD (also called PPARγ-fusion protein). By using rosiglitazone (a known PPARγ ligand) as a positive control, I managed to optimize a protocol to purify the PPARγ-fusion protein and identify the co-purified ligand by mass spectrometry. This protocol can be used to identify the physiological/endogenous ligand for the PPARγ receptor as well as other orphan NRs. Compared to previous methods of ligand identification, this method allows for the identification of the ligand from the tissues where it is functional.

En dépit du nombre croissant d’études cliniques sur le canal artériel (CA), des failles méthodologiques entretiennent plusieurs incertitudes concernant l’efficacité et la sécurité des traitements chez les bébés nés prématurés. L’objectif de cette recherche était de comparer les concentrations de prostaglandine E2 (PGE2) et les mesures du flux mésentérique par échographie Doppler chez les enfants nés prématurément et ayant un canal artériel traité à l’ibuprofène par voie intraveineuse ou entérale, en utilisant la méthodologie randomisée contrôlée et à double insu. Dans notre étude pilote, 20 nouveau-nés prématurés de moins de 34 semaines ayant un CA symptomatique confirmé par échocardiographie, furent randomisés au traitement à l’ibuprofène par voie intraveineuse ou entérale. La voie d’administration fut maintenue à l’insu de l’équipe traitante, des cardiologues et des investigateurs. Des dosages des prostaglandines plasmatiques ont été mesurés avant le début du traitement ainsi que 3, 24 et 48 h après le début du traitement. Les mesures du flux mésentérique ont été effectuées avant le traitement à l’ibuprofène ainsi que 1 h et 3 h après le traitement. Nous avons démontré à partir de nos observations que les niveaux plasmatiques de prostaglandines E2 diminuent chez les patients ayant répondu au traitement à l’ibuprofène, indépendamment de la voie d’administration. Nous n’avons pas observé de changement dans l’évolution des dosages de PGE2 chez les patients qui n’ont pas répondu au traitement. Les paramètres mesurés par échographie Doppler au niveau de l’artère mésentérique supérieure n’étaient pas affectés par la voie d’administration du traitement à l’ibuprofène, intraveineuse ou entérale. La présente étude suggère ainsi que le traitement du CA par ibuprofène intraveineux ou entéral n’influe pas sur le flux sanguin mesuré par échographie Doppler. La baisse de la prostaglandine E2 coïncide avec la fermeture du CA, et son dosage pourrait jouer un rôle dans la gestion du traitement. Nous avons démontré la faisabilité d’une étude clinique randomisée à double insu dans le traitement du canal artériel; une méthodologie qui devrait désormait être employé dans la recherche clinique sur les traitements de la persistance du CA. / Despite the growing body of research on the patent ductus arteriosus (PDA), issues with clinical research methodology impairs much of our understanding regarding treatment efficacy and safety in the preterm population. The purpose of this study was to determine plasma prostaglandin E2 (PGE2) concentrations in preterm infants with symptomatic persistence of the ductus arteriosus treated with IV and oral ibuprofen, and measure Doppler flow parameters in the superior mesenteric artery, utilizing randomized controlled and double-blind methodology. Twenty patients age < 34 wks with a symptomatic PDA confirmed by echocardiography randomized to oral vs intravenous ibuprofen regimen. Treating physician, cardiologists and study investigators were blinded to treatment allocation. Plasma PGE2 levels were measured prior to ibuprofen treatment and at 3, 24 and 48 h after treatment. Mesenteric Doppler measurements were taken prior to ibuprofen treatment, and 1 h and 3 h after treatment. Our results showed that plasma PGE2 levels decreased over time in patients that exhibited ductal closure after IV or oral ibuprofen treatment; no time-dependent changes in PGE2 were seen in subjects that failed to respond to ibuprofen. Superior mesenteric artery Doppler flow measurements were not affected by ibuprofen treatment (IV or oral), regardless of efficacy on ductal closure and of PGE2 changes. We conclude that treatment with oral or intravenous ibuprofen does not impact on superior mesenteric artery blood flow measured by Doppler ultrasound. Decreases in plasma PGE2 concentrations coincide with ibuprofen efficacy, and may be more cost-effective to monitor than ultrasound. This study also demonstrated the successful use of double blinded randomized controlled research methodology, which should be more strictly applied in future clinical research on PDA treatment.