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1.
Notas enferm. (Córdoba) ; 25(43): 62-65, jun.2024.
Artigo em Espanhol | LILACS, BDENF - Enfermagem, UNISALUD, InstitutionalDB, BINACIS | ID: biblio-1561284

RESUMO

El síndrome compartimental agudo requiere de la descompresión quirúrgica, mediante fasciotomía, esta técnica debe ser urgente y será clave para evitar la instauración de graves secuelas. El posterior abordaje de estas heridas de difícil y lenta cicatrización suponen un reto para los profesionales de la salud y un problema para la salud pública debido a los altos costes y elevada morbilidad. La terapia de presión negativa (TPN) o cura por vacío (VAC, "vacuum assisted closure") es un tratamiento no invasivo que consigue la curación de las heridas favoreciendo la vascularización, la aparición del tejido de granulación y eliminación del exceso de exudado[AU]


Acute compartment syndrome requires surgical decompression by fasciotomy, this technique must be urgent and will be key to avoid the establishment of serious sequels. The subsequent approach to these wounds, which are difficult and slow to heal, is a challenge for health professionals and a problem for public health due to high costs and high morbidity. Negative pressure therapy (NPWT) or vacuum assisted closure (VAC) is a non-invasive treatment that achieves wound healing by promoting vascularization, the appearance of granulation tissue and elimination of excess exudate[AU]


A síndrome compartimental aguda requer descompressão cirúrgica, por fasciotomia, esta técnica deve ser urgente e será fundamental para evitar o estabelecimento de sequelas graves. O tratamento subsequente destas feridas difíceis e de cicatrização lenta é um desafio para os profissionais de saúde e um problema desaúde pública devido aos elevados custos e à elevada morbilidade. A terapia por pressão negativa (NPWT) ou o encerramento assistido por vácuo (VAC) é um tratamento não invasivo que permite a cicatrização de feridas através da promoção da vascularização, do aparecimento de tecido de granulação e da remoção do excesso de exsudado[AU]


Assuntos
Humanos , Fasciotomia
2.
Am J Orthopsychiatry ; 2024 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-39298244

RESUMO

In the aftermath of Hurricane María's devastating impact on Puerto Rico in September 2017, a wave of migration to the continental United States followed. Despite Puerto Rico's territorial association with the United States, its distinct culture and language often render its migrants as cultural minorities who are often treated as foreigners. Prior research has indicated that natural disasters can have a profound effect on the family unit, so examining the experiences of displacement and resettlement of Puerto Rican parents can shed light on the challenges faced by these families. Using cultural stress theory and psychological sense of community as guiding frameworks, this qualitative study aimed to explore the experience of Puerto Rican parents displaced to the United States following Hurricane María. A total of 42 Puerto Rican Hurricane María migrant parents agreed to participate in semistructured interviews. Our findings illuminate a trade-off in the lives of Puerto Rican migrants: As they departed their homeland, they exchanged social connections, support networks, and the vibrant social fabric of Puerto Rico for the promise of economic stability, reduced crime, and enhanced prospects for themselves and their children in the United States. This study represents a crucial contribution to the understanding of Puerto Ricans who have embarked on the challenging journey of relocating in the aftermath of Hurricane María. It underscores how they grapple with the multifaceted challenges and benefits inherent in their roles as cross-cultural climate migrants, transitioning from the predominantly Spanish-speaking, Latin American context of Puerto Rico to the diverse landscape of the United States. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

3.
Animals (Basel) ; 14(17)2024 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-39272325

RESUMO

Menbutone is a choleretic agent currently used in Europe to treat digestive disorders in livestock and dogs. Pharmacokinetic parameters were established in 4-month Holstein calves after intravenous (IV) and intramuscular (IM) administration. The drug was administered to 12 animals (10 mg/kg) for both IV and IM routes following a crossover design. Plasma samples were collected at various time points over 24 h and analyzed by reverse-phase high-performance liquid chromatography with a photodiode-array detector, following a method validated according to European Medicines Agency guidelines. Pharmacokinetic parameters were calculated using compartmental and non-compartmental methods. Menbutone followed a two-compartment open model after IV injection, with a total clearance (Cl) of 71.9 ± 13.5 mL/h/kg, an elimination half-life (t½ß) of 4.53 ± 2.45 h, and a volume of distribution at steady-state (Vss) of 310.4 ± 106.4 mL/kg. Non-compartmental elimination half-life (t½λ) was 4.2 ± 1.1 h. After IM administration, drug pharmacokinetics was best described by a one-compartment open model. The peak plasma concentration (Cmax) was 15.1 ± 4.3 µg/mL; the time to reach Cmax (tmax), 1.66 ± 0.55 h; and the mean absorption time (MAT), 2.50 ± 1.42 h. Absorption was high, with a fraction of the dose absorbed (F) of 83.5 ± 22.4%. Menbutone was rapidly eliminated from plasma for both routes of administration, with a fast and high IM bioavailability.

4.
Artigo em Inglês | MEDLINE | ID: mdl-39318212

RESUMO

INTRODUCTION: Computational methods are crucial for efficient and cost-effective drug toxicity prediction. Unfortunately, the data used for prediction is often imbalanced, resulting in biased models that favor the majority class. This paper proposes an approach to apply a hybrid class balancing technique and evaluate its performance on computational models for toxicity prediction in Tox21 datasets. METHODS: The process begins by converting chemical compound data structures (SMILES strings) from various bioassay datasets into molecular descriptors that can be processed by algorithms. Subsequently, Undersampling and Oversampling techniques are applied in two different schemes on the training data. In the first scheme (Individual), only one balancing technique (Oversampling or Undersampling) is used. In the second scheme (Hybrid), the training data is divided according to a ratio (e.g., 90-10), applying a different balancing technique to each proportion. We considered eight resampling techniques (four Oversampling and four Undersampling), six molecular descriptors (based on MACCS, ECFP, and Mordred), and five classification models (KNN, MLP, RF, XGB and SVM) over 10 bioassay datasets to determine the configurations that yield the best performance. RESULTS: We defined three testing scenarios: without balancing techniques (baseline), Individual, and Hybrid. We found that using the ENN technique in the MACCS-MLP combination resulted in a 10.01% improvement in performance. The increase for ECFP6-2048 was 16.47% after incorporating a combination of the SMOTE (10%) and RUS (90%) techniques. Meanwhile, using the same combination of techniques, MORDRED-XGB showed the most significant increase in performance, achieving a 22.62% improvement. CONCLUSION: Integrating any of the class balancing schemes resulted in a minimum of 10.01% improvement in prediction performance compared to the best baseline configuration. In this study, Undersampling techniques were more appropriate due to the significant overlap among samples. By eliminating specific samples from the predominant class that are close to the minority class, this overlap is greatly reduced.

5.
Artigo em Inglês | MEDLINE | ID: mdl-39302772

RESUMO

Melanoma is considered a global public health challenge and is responsible for more than 90% deaths related to skin cancer. Although the diagnosis of early melanoma is the main goal of dermoscopy, the discrimination between dermoscopic images of in situ and invasive melanomas can be a difficult task even for experienced dermatologists. Recent advances in artificial intelligence in the field of medical image analysis show that its application to dermoscopy with the aim of supporting and providing a second opinion to the medical expert could be of great interest. In this work, four datasets from different sources were used to train and evaluate deep learning models on in situ versus invasive melanoma classification and on Breslow thickness prediction. Supervised learning and semi-supervised learning using a multi-teacher ensemble knowledge distillation approach were considered and evaluated using a stratified 5-fold cross-validation scheme. The best models achieved AUCs of 0.6186 ±0.0410 and of 0.7501 ±0.0674 on the former and latter classification tasks, respectively. The best results were obtained using semi-supervised learning, with the best model achieving 0.7751 and 0.8164 AUC, respectively. The results obtained show that semi-supervised learning could improve the performance of trained models in different melanoma classification tasks compared to supervised learning. Automatic deep learning-based diagnosis systems could support medical professionals in their decision, serving as a second opinion or as a triage tool for medical centers.

6.
HSS J ; 20(2): 187-194, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-39281996

RESUMO

Background: Bundled payments for total joint arthroplasty (TJA) were instituted by the Centers for Medicare and Medicaid Services (CMS) to reimburse providers a lump sum for operative and 90-day postoperative costs. Gaining a better understanding of which TJA patients are at risk for early return to the operating room (OR) is critical in preoperative optimization of those with modifiable risks, which could improve bundled-payment performance. Purpose: We sought to identify the most common reason for readmissions, as well as patient characteristics and costs, associated with early return to the OR among TJA patients. Methods: This was a retrospective cohort study of Medicare patients who had undergone primary total hip or knee arthroplasty (THA or TKA) between 2013 and 2018 at a tertiary care hospital. We used the CMS research identifiable files database to identify the most common reasons for readmissions and revisions within 90 days of surgery. Total billing claims were used to determine the cost of early readmissions and revisions. Multivariate regression analysis was used to determine the characteristics associated with early readmission or revision. Results: Out of 20 166 primary TJA patients identified, we found 1349 readmissions (5.6%) and 163 (0.8%) revisions within 90 days of surgery. Dislocation was the most common indication for readmission, and periprosthetic joint infection was the most common indication for revision. Early return to the OR was associated with a mean $105,988 (standard deviation [SD] = $76,865) in CMS claims for the inpatient stay. Factors associated with a higher risk of early reoperation were female sex, THA, longer length of stay, and discharge to long-term care facility. Conclusions: This retrospective cohort study found that early return to the OR after TJA increased overall 90-day costs by 260%, suggesting that early reoperation might have a significant impact on bundled payments. Further study is warranted.

7.
Rev Esp Enferm Dig ; 2024 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-39324615

RESUMO

Inflammatory cloacogenic polyp is an unusual anorectal lesion associated with benign polyp with malignant appearance. This pathology is associated with mucosal prolapse syndrome and inflammatory intestinal disease. The surgery is the gold standard treatment if malignancy cannot be excluded or the patient is symptomatic.

8.
Front Public Health ; 12: 1410932, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39296829

RESUMO

Background: Nomophobia is a specific phobia characterized by the appearance of anxiety, nervousness, discomfort and distress when the mobile phone is not used and is considered an emerging public health problem because of the negative consequences on the physical and mental health of young people and adolescents, especially women. Neurofeedback-Assisted Mindfulness Training Programs may prove beneficials for improving self-control abilities, a key ability in addressing addictive behaviors. The main objective of this study is to evaluate the impact, in a young population aged 18-35 years, of an intervention based on Neurofeedback-Assisted Mindfulness Training Program (NAMTP) on disorders associated with problematic use of mobile phones. The effect of the intervention on the total score in the nomophobia test and habits of internet and social network use, as well as on signs of depression, anxiety and stress will be analyzed. As a secondary objective, the effect of the intervention on signs of insomnia will be analyzed. Methods and design: Randomized, controlled clinical-trial with two-parallel groups. 40 young adults (18-35 years) will be included and randomly assigned to Intervention Group-NAMTP or Control Group (CG). The NAMTP will include a total of 25 sessions (2-3/week) during 3-months. Each session will have a duration of 10/15 min. The instrument to be used for the neurofeedback sessions is MUSE® (InteraXon Inc.). Study variables will be collected at the baseline visit and at the final visit (3-months after randomization). During these visits, questionnaires will be administered to evaluate the main and secondary variables that will include the Smartphone Addiction Scale-Short Version, Nomophobia Questionnaire, Depression, Anxiety and Stress Scale 21-item (DASS-21) and Athens Insomnia Scale. Discussion: This trial will make an important contribution to the need for evidence of effective education programs and other primary care interventions through new non-invasive interventions in reducing the risk of developing addictions to new technologies and alleviating the symptoms of discomfort associated with this problem. Ethics and dissemination: The project was approved by the Clinical Research Ethics Committee of the Salamanca Health Area (CEIm Code: PI 2023 071340). Clinical trial registration: ClinicalTrials.gov, http://www.Clinicaltrials.gov/ct2/show/NCT06188910.


Assuntos
Ansiedade , Atenção Plena , Neurorretroalimentação , Angústia Psicológica , Smartphone , Humanos , Atenção Plena/métodos , Adulto , Adolescente , Adulto Jovem , Feminino , Neurorretroalimentação/métodos , Masculino , Ansiedade/prevenção & controle , Inquéritos e Questionários , Estresse Psicológico/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto
9.
Eur Geriatr Med ; 2024 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-39227556

RESUMO

BACKGROUND: Muscle ultrasound is increasingly popular thanks to its advantages over other techniques. However, its usefulness in the diagnosis of sarcopenia in older adults with aortic stenosis (AS) has not been studied to date. OBJECTIVES: to analyze the prevalence of sarcopenia using muscle ultrasound and its impact on the health outcomes in older patients with AS. METHODS: The single-center FRESAS (FRailty-Evaluation-in-Severe-Aortic-Stenosis) registry was used to study patients over 75 years with severe AS susceptible to valve replacement. Sarcopenia was suspected in those individuals with diminished grip strength, and the diagnosis was confirmed in the presence of reduced ultrasound quadriceps muscle thickness, following the recommendations of the EWGSOP2 (European-Working-Group-on-Sarcopenia-in-Older-People). The primary composite endpoint was urgent hospital admission and mortality of cardiac cause 6 months after the diagnosis. RESULTS: Of the 150 patients studied, 55.3% were females, and only 17.3% were frail; the mean age was 83.4 years. Sarcopenia was diagnosed in 42 patients (28%). The overall survival rate at 6 months was 92%. The primary endpoint was recorded in 23.2% of the cases and was more frequent in the sarcopenic patients (33.3%) than in the non-sarcopenic individuals (17.6%) (p = 0.01). The regression analysis found that sarcopenia was associated with an increased risk of the primary endpoint (HR: 2.25; 95% CI 1.19-4.45; p = 0.02), adjusting for potential confounding factors. CONCLUSIONS: The incidence of serious cardiac complications in older patients with sarcopenia and severe AS is significant. The present study describes a noninvasive, ultrasound-guided diagnostic technique that may prove efficient in its predictive capacity.

10.
J Sport Rehabil ; : 1-5, 2024 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-39244193

RESUMO

CONTEXT: Adductor longus muscle strains are one of the most common injuries occurring in intermittent sports such as soccer. OBJECTIVE: The purpose of this study was to know the effect of a specific rehabilitation and reconditioning program, which was previously validated, after adductor longus injury in professional soccer players. METHODS: A specific rehabilitation and reconditioning program was applied to 11 injured male professional soccer players. PARTICIPANTS: Eleven male professional soccer players (age = 29.18 [4.45] y; height = 179.64 [4.97] cm; mass = 75.33 [3.84] kg). INTERVENTIONS: In the first place, the days taken to return to full team training and to return to competition (RTP) was analyzed; second, the most important performance parameters were analyzed and compared in the preinjury match (PRE) and after the return to competition at 2 different points in time (RTP1-RTP2). RESULTS: The return to full team training recorded was 11.91 (1.92) days and the RTP was 15.36 (3.04) days. Match performance parameters showed significant improvements after injury. Significant improvements were observed during RTP2, in the variables of high-speed running (P = .002), very high-speed running (P = .006), acceleration (>3 m/s2; P = .048), and high metabolic load distance (P = .009). CONCLUSION: The results allow us to conclude that this program was very effective, as it allowed the players to obtain similar and/or higher performance values in a reduced period of time after the injury.

12.
PRiMER ; 8: 42, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39238487

RESUMO

Peer review is primarily thought of as the process used to determine whether manuscripts are published in medical or other academic journals. While a publication may be one outcome of peer review, this article shares a model of 4 Ps to remind faculty of some important additional applications of peer review. The 4 Ps are publication, presentation, promotion, and practice. The medical literature offers few reasons why faculty should get involved in peer review. In this article, we define peer review, illustrate the role of peer review in four important processes, describe how the volume of material to review has changed over time, and share how participation in these processes promotes career advancement. Understanding the peer review process and its benefits can encourage professionals to participate in peer review in any of the four Ps as they recognize the benefits to their discipline and their career.

13.
Front Med (Lausanne) ; 11: 1439338, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39247640

RESUMO

Introduction: Non-infectious inflammatory ocular diseases pose significant challenges in diagnosis and management, often requiring systemic immunosuppressive therapy. Since Janus kinase (JAK) inhibitors may represent a novel therapeutic option for these disorders, the present study aimed to expand current knowledge about their efficacy and safety in patients with these conditions. Methods: This prospective cohort study included 12 adult patients from the international AutoInflammatory Disease Alliance (AIDA) Network registries dedicated to non-infectious ocular inflammatory conditions. We assessed ocular flares, visual acuity, disease course, and complications before and after initiating JAK inhibitor therapy. Results: Ocular inflammation was related to a systemic disease in 8 (66.7%) patients as follows: spondyloarthritis (n = 3), peripheral psoriatic arthritis (n = 1), rheumatoid arthritis (n = 1), antinuclear antibodies (ANA) positive juvenile idiopathic arthritis (n = 1), Behçet's syndrome (n = 1), Vogt-Koyanagi-Harada syndrome (n = 1). In total, 4 patients received baricitinib, 1 patient received tofacitinib, and 7 patients underwent upadacitinib treatment. The overall average duration of JAK inhibitors treatment was 8.6 ± 5.5 months (ranging from 3 to 20 months). At the last assessment, ocular disease control was complete in 12/12 patients. One patient discontinued baricitinib due to poor compliance after a 12-month relapse-free period. The incidence of ocular flares was 125 episodes/1.000 person-months prior to the initiation of JAK inhibitors and 28.6 episodes/1.000 person-months thereafter. The incidence rate ratio for experiencing a relapse before starting a JAK inhibitor compared to the following period was 4.37 (95% CI 1.3-14.7, p-value: 0.02). Conclusion: JAK inhibitors demonstrate efficacy and safety in controlling ocular inflammatory relapses, confirming that they represent a valuable treatment option for patients with non-infectious inflammatory ocular diseases resistant to conventional treatments.

14.
Pediatr Dermatol ; 2024 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-39258307

RESUMO

5q14.3 microdeletion syndrome is a rare condition involving multiple genes such as MEF2C and RASA1 and is potentially classified as a neurocutaneous syndrome. Deletion of the MEF2C gene accounts for the majority of clinical manifestations, including global developmental delay, intellectual disability, seizures, and behavioral disorders. RASA1 deletion is linked to capillary malformations with arteriovenous malformations (CM-AVM). Until now, only 17 cases have been described with deletions of both genes. We present the first case described in Spain with the microdeletion in the 5q14.3 cytoband simultaneously affecting both MEF2C and RASA1, exhibiting the typical manifestations of this entity, and review the published cases to date.

15.
Int J Neural Syst ; 34(11): 2450057, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39155691

RESUMO

Typically, deep learning models for image segmentation tasks are trained using large datasets of images annotated at the pixel level, which can be expensive and highly time-consuming. A way to reduce the amount of annotated images required for training is to adopt a semi-supervised approach. In this regard, generative deep learning models, concretely Generative Adversarial Networks (GANs), have been adapted to semi-supervised training of segmentation tasks. This work proposes MaskGDM, a deep learning architecture combining some ideas from EditGAN, a GAN that jointly models images and their segmentations, together with a generative diffusion model. With careful integration, we find that using a generative diffusion model can improve EditGAN performance results in multiple segmentation datasets, both multi-class and with binary labels. According to the quantitative results obtained, the proposed model improves multi-class image segmentation when compared to the EditGAN and DatasetGAN models, respectively, by [Formula: see text] and [Formula: see text]. Moreover, using the ISIC dataset, our proposal improves the results from other models by up to [Formula: see text] for the binary image segmentation approach.


Assuntos
Aprendizado Profundo , Processamento de Imagem Assistida por Computador , Redes Neurais de Computação , Semântica , Humanos , Processamento de Imagem Assistida por Computador/métodos , Aprendizado de Máquina Supervisionado
16.
Microbiol Resour Announc ; 13(9): e0019024, 2024 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-39162459

RESUMO

Nanopore sequencing of the infectious pancreatic necrosis virus (IPNV) vp2 gene from Andean trout cultures in Peru reveals genogroups 1 and 5. This insight aids in understanding strain diversity and pathogenicity, vital for effective disease surveillance, and control measures in aquaculture.

17.
J Am Chem Soc ; 146(38): 25986-25999, 2024 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-39145676

RESUMO

In the pursuit of selective conversion of methane directly to methanol in the liquid-phase, a common challenge is the concurrent formation of undesirable liquid oxygenates or combustion byproducts. However, we demonstrate that monometallic Pd-CeO2 catalysts, modified by carbon, created by a simple mechanochemical synthesis method exhibit 100% selectivity toward methanol at 75 °C, using hydrogen peroxide as oxidizing agent. The solvent free synthesis yields a distinctive Pd-iC-CeO2 interface, where interfacial carbon (iC) modulates metal-oxide interactions and facilitates tandem methane activation and peroxide decomposition, thus resulting in an exclusive methanol selectivity of 100% with a yield of 117 µmol/gcat at 75 °C. Notably, solvent interactions of H2O2 (aq) were found to be critical for methanol selectivity through a density functional theory (DFT)-simulated Eley-Rideal-like mechanism. This mechanism uniquely enables the direct conversion of methane into methanol via a solid-liquid-gas process.

18.
Brain ; 2024 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-39101570

RESUMO

The potential of combining serum neurofilament light chain (sNfL) and glial fibrillary acidic protein (sGFAP) levels to predict disability worsening in multiple sclerosis (MS) remains underexplored. We aimed to investigate whether sNfL and sGFAP values identify distinct subgroups of patients according to the risk of disability worsening and their response to disease-modifying treatments (DMTs). This multicentre study, conducted across thirteen European hospitals, spanned from July 15, 1994, to August 18, 2022, with follow-up until September 26, 2023. We enrolled MS patients who had serum samples collected within 12 months from disease onset and before initiating DMTs. Multivariable regression models were used to estimate the risk of relapse-associated worsening (RAW), progression independent of relapse activity (PIRA), and Expanded Disability Status Scale (EDSS) score of 3. Of the 725 patients included, median age was 34.2 years (IQR, 27.6-42.4), and 509 patients (70.2%) were female. Median follow-up duration was 6.43 years (IQR, 4.65-9.81). Higher sNfL values associated with an elevated risk of RAW (HR of 1.45; 95% CI 1.19-1.76; P < 0.001), PIRA (HR of 1.43; 95% CI 1.13-1.81; P = 0.003), and reaching an EDSS of 3 (HR of 1.55; 95% CI 1.29-1.85; P < 0.001). Moreover, higher sGFAP levels were linked to a higher risk of achieving an EDSS score of 3 (HR of 1.36; 95% CI 1.06-1.74; P = 0.02) and, in patients with low sNfL values, to PIRA (HR of 1.86; 95% CI 1.01-3.45; P = 0.04). We further examined the combined effect of sNfL and sGFAP levels. Patients with low sNfL and sGFAP values (NLGL) exhibited a low risk of all outcomes and served as reference. Untreated patients with high sNfL levels showed a higher risk of RAW, PIRA, and reaching an EDSS of 3. Injectable or oral DMTs reduced the risk of RAW in these patients but failed to mitigate the risk of PIRA and reaching an EDSS of 3. Conversely, high-efficacy DMTs counteracted the heightened risk of these outcomes, except for the risk of PIRA in patients with high sNfL and sGFAP levels. Patients with low sNfL and high sGFAP values (NLGH) showed an increased risk of PIRA and achieving an EDSS of 3, which remained unchanged with either high-efficacy or other DMTs. In conclusion, evaluating sNfL and sGFAP levels at disease onset in MS may identify distinct phenotypes associated with diverse immunological pathways of disability acquisition and therapeutic response.

19.
Healthcare (Basel) ; 12(16)2024 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-39201118

RESUMO

In the healthcare field, the effective implementation of clinical protocols is crucial to ensuring patient safety and well-being. In this context, this study evaluates nurses' adherence to the maintenance and replacement protocol of peripheral venous catheters (PVCs) in a university hospital in Spain, examining the impact of compliance with the protocol on the loss of PVCs and on patient safety in addition to analyzing the related costs. A retrospective observational study was conducted with 590 patients who were admitted in 2018 and 2019. The chi-square test or Fisher's exact test, as appropriate, was used to see the association between the study variables; with the dependent variable being the loss of PVCs (including, as a dependent variable, the loss of PVCs before 48 h). The patients' electronic and physical medical records were reviewed to analyze nursing interventions related to the management of PVCs. A total of 24% of patients experienced PVC loss within the first 24 h after insertion. Failure to comply with the protocol resulted in 80% more catheter loss and increased the cost of cannulation by 46.84%. Low compliance with PVC care protocols significantly increases the risk of catheter loss, suggesting the need for increased training and strict protocol implementation. The findings emphasize the critical role of nursing in ensuring patient safety through adherence to evidence-based protocols. Continuing education and diligent protocol implementation are essential to reducing healthcare costs and improving patient outcomes.

20.
Org Lett ; 26(33): 6944-6949, 2024 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-39116344

RESUMO

Microcrystal electron diffraction (microED) is an emerging technique for rapid crystallographic analysis of small molecule micro- and nanocrystals. In this report, we evaluate the applicability of microED to pharmaceutical compounds through the analysis of 30 samples obtained from the process and medicinal chemistry groups at Amgen Inc. Using only 40 h of microscope time, 15 of 30 crystal structures were elucidated. From these crystal structures, all chiral compounds had the correct absolute stereochemistry assigned by dynamical refinement of continuous rotation electron diffraction data, confirming dynamical refinement as a promising tool for the absolute stereochemistry determination of pharmaceutically relevant compounds.


Assuntos
Nanopartículas , Estereoisomerismo , Estrutura Molecular , Preparações Farmacêuticas/química , Cristalografia por Raios X , Nanopartículas/química , Modelos Moleculares
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