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1.
Ultrason Sonochem ; 99: 106548, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37556973

RESUMO

Phenols are recalcitrant compounds that constitute the majority of organic contaminants in industrial wastewaters. Their removal at large scales require a combination of various processes to reach the desired discharge quality. An extensive body of work has already been published in the area of phenol removal from wastewater, however none of them have focussed on a truly 'sensible' approach for coupling advanced oxidation processes (AOPs). Rather, a higher removal efficiency was targeted by unduly complicating the process by combining multiple AOPs. The most influential AOP as the primary method typically driven by the nature of the pollutant should form the basis for a hybrid AOP followed by a complementary AOP to intensify the oxidation process. This strategy is lacking in current literature. We address this knowledge gap directly by systematically identifying the best hybrid process for ZnO mediated photocatalysis of phenol. Either a cavitation mediated pre-treatment of ZnO or cavitation-photocatalysis-peroxide based hybrid AOP was investigated. While the pre-treatment approach led to >25% increase in phenol oxidation compared to bare ZnO photocatalysis, the hydrodynamic cavitation-photocatalysis-peroxide based system was found to have a cavitational yield 5 times higher than its acoustic cavitation counterpart. A new phenomenon known as the 'pseudo staggered effect' was also observed and established in hydrodynamic cavitation mediated photocatalysis-peroxide hybrid process for the first time. While we demonstrated that cavitation is a truly 'sensible' choice to enhance photocatalysis, the nature of the pollutant under investigation must always be the key driver when designing such hybrid AOPs.

2.
Food Chem ; 294: 384-389, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31126478

RESUMO

A new method for extraction and determination of trace and ultratrace impurities from edible oils via an ultrasound-assisted extraction using tetramethylammonium hydroxide (TMAH) and ethylenediaminetetraacetic acid (EDTA) has been described. Method is simple and sensitive. Extraction variables like pH, concentrations of TMAH and EDTA, ultrasonication and centrifugation times were all optimised for analytes using engine-oil. Under optimised conditions, extraction of spiked analytes from all the edible oils into aqueous-medium were investigated and found to be quantitative (89-101%). Using this method, concentrations of impurities in edible-oils were determined by graphite furnace atomic absorption spectrometer (GFAAS) using standard-addition calibration method and validated with microwave-digestion method. The method was successfully applied to edible oils extracted from various seeds such as mustard oil, sun flower oil, sesame oil, ground nut oil, coconut oil, rice bran oil and corn oil containing ultratrace impurities. Accuracy of developed method for edible-oils was checked with corresponding results obtained by microwave digestion method.


Assuntos
Ácido Edético/química , Grafite/química , Óleos de Plantas/química , Compostos de Amônio Quaternário/química , Espectrofotometria Atômica/métodos , Oligoelementos/análise , Cádmio/análise , Cádmio/isolamento & purificação , Cromo/análise , Cromo/isolamento & purificação , Cobre/análise , Cobre/isolamento & purificação , Concentração de Íons de Hidrogênio , Chumbo/análise , Chumbo/isolamento & purificação , Manganês/análise , Manganês/isolamento & purificação , Micro-Ondas , Sonicação , Temperatura , Oligoelementos/isolamento & purificação , Zinco/análise , Zinco/isolamento & purificação
3.
J Hazard Mater ; 333: 329-338, 2017 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-28376361

RESUMO

In this study, a bioelectrochemical system (BES) was used to treat acid mine drainage (AMD) from an abandoned coal mine in the cathode chamber under aerobic condition. Activated sludge from a local wastewater treatment plant was used in the anode chamber of the BES to supply electrons to the treatment. After 7days, the pH of the cathode solution enhanced from 2.5 to 7.3. More than 99% of Al, Fe and Pb were removed, and removal rates of 93%, 91%, 89% and 69% were achieved for Cd, Zn, Mn and Co respectively with biocathode. Energy-dispersive X-ray spectroscopy (EDS) study revealed the deposition of the various types of metals on the cathode surface, and some metals were detected in the precipitates of the cathode chamber. The bacteria for AMD treatment was identified to be Serratia spp. using 16s rRNA gene amplification and sequencing. Scanning electron microscopy showed attached growth of the bacteria on the cathode. The bioelectrochemical treatment of the AMD was also compared with the biological treatment in a continuously stirred batch reactor (CSBR).


Assuntos
Ácidos/química , Biodegradação Ambiental , Reatores Biológicos , Técnicas Eletroquímicas/métodos , Mineração , Serratia/metabolismo , Aerobiose , Técnicas Eletroquímicas/instrumentação , Eletrodos , Concentração de Íons de Hidrogênio , Metais Pesados/isolamento & purificação , Microscopia Eletrônica de Varredura , RNA Ribossômico 16S/genética , Serratia/genética , Serratia/crescimento & desenvolvimento , Serratia/ultraestrutura , Esgotos , Espectrometria por Raios X , Águas Residuárias
4.
Ecol Lett ; 19(9): 1150-8, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27465040

RESUMO

The impacts of climate change on forest net biomass change are poorly understood but critical for predicting forest's contribution to the global carbon cycle. Recent studies show climate change-associated net biomass declines in mature forest plots. The representativeness of these plots for regional forests, however, remains uncertain because we lack an assessment of whether climate change impacts differ with forest age. Using data from plots of varying ages from 17 to 210 years, monitored from 1958 to 2011 in western Canada, we found that climate change has little effect on net biomass change in forests ≤ 40 years of age due to increased growth offsetting increased mortality, but has led to large decreases in older forests due to increased mortality accompanying little growth gain. Our analysis highlights the need to incorporate forest age profiles in examining past and projecting future forest responses to climate change.


Assuntos
Biomassa , Mudança Climática , Taiga , Árvores/fisiologia , Alberta , Saskatchewan , Estações do Ano , Árvores/crescimento & desenvolvimento
5.
Talanta ; 159: 14-22, 2016 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-27474273

RESUMO

An improved matrix separation method has been described to characterize ultrapure germanium of 8N (99.999999%) purity. In this method, temperature of the reaction vessel in which in-situ generated chlorine gas reacts with germanium solid material directly is optimized to quantitatively remove Ge matrix from all its impurities. Optimized reaction temperature has been found to be 230±5°C. Recovery studies on more than 60 elements have been carried out at the optimized temperature. Recoveries of all the analytes except As, Se, Sn, Hg, Tl are found to be quantitative. The method has been examined for various amounts of Ge material and found to be suitable even for 10g of Ge sample and provides low parts per billion and trillion levels of process blanks. Determination of concentrations of impurities has been done by inductively coupled plasma quadrupole mass spectrometer (ICP-QMS) and high resolution continuum source graphite furnace atomic absorption spectrometer (HR-CS-GFAAS). In the absence of certified reference materials for ultrapure germanium, accuracy of the proposed method is established by spike recovery tests. Precision of this method is found to vary from 7% to 50% for concentrations between 4 and 0.004ngg(-1). Limits of detection (LOD) for the target analytes are found to be between 6 and 0.011ngmL(-1) or 1.8-0.003ngg(-1) for the proposed procedure. The method has been successfully applied for that characterization of ultrapure germanium material of 8N purity.

6.
Int J Clin Pract ; 69(6): 659-65, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25648886

RESUMO

AIMS: The objective of this study is to externally validate the SOAR stroke score (Stroke subtype, Oxfordshire Community Stroke Project Classification, Age and prestroke modified Rankin score) in predicting hospital length of stay (LOS) following an admission for acute stroke. METHODS: We conducted a multi-centre observational study in eight National Health Service hospital trusts in the Anglia Stroke & Heart Clinical Network between September 2008 and April 2011. The usefulness of the SOAR stroke score in predicting hospital LOS in the acute settings was examined for all stroke and then stratified by discharge status (discharged alive or died during the admission). RESULTS: A total of 3596 patients (mean age 77 years) with first-ever or recurrent stroke (92% ischaemic) were included. Increasing LOS was observed with increasing SOAR stroke score (p < 0.001 for both mean and median) and the SOAR stroke score of 0 had the shortest mean LOS (12 ± 20 days) while the SOAR stroke score of 6 had the longest mean LOS (26 ± 28 days). Among patients who were discharged alive, increasing SOAR stroke score had a significantly higher mean and median LOS (p < 0.001 for both mean and median) and the LOS peaked among patients with score value of 6 [mean (SD) 35 ± 31 days, median (IQR) 23 (14-48) days]. For patients who died as in-patient, there was no significant difference in mean or median LOS with increasing SOAR stroke score (p = 0.68 and p = 0.79, respectively). CONCLUSION: This external validation study confirms the usefulness of the SOAR stroke score in predicting LOS in patients with acute stroke especially in those who are likely to survive to discharge. This provides a simple prognostic score useful for clinicians, patients and service providers.


Assuntos
Tempo de Internação/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde/métodos , Índice de Gravidade de Doença , Acidente Vascular Cerebral , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Acidente Vascular Cerebral/mortalidade
7.
Curr HIV Res ; 10(6): 532-8, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22716105

RESUMO

There is limited information available about the prevalence and pattern of human immunodeficiency virus (HIV) drug resistance mutations (DRMs) among antiretroviral therapy (ART) experienced patients from northern India. Results of genotypic drug resistance testing were obtained from plasma samples of 128 patients, who had presented with clinical or immunological failure to treatment after at least six months of ART. Major DRMs associated with any of the three classes of antiretroviral (ARV) drugs, nucleoside reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRTI) and protease inhibitors (PI), were seen in 120 out of 128 patients (93.8% prevalence). NRTI and NNRTI DRMs were each seen in 115/128 (89.8%) patients, with M184V, M41L, D67N and T215Y being the most frequent among NRTI associated mutations, and K103N, G190A, Y181C and A98G among NNRTI associated ones. PI DRMs were observed in 14/128 (10.9%) patients, with L10I, V82A and L89V being the commonest. These results present a high prevalence of DRMs among ART experienced patients from northern India with clinical or immunological failure of therapy. It emphasizes the need for regular testing of plasma samples of such patients for DRMs in order to detect and replace a failing regimen early, and also the use of HIV drug resistance genotyping of ART naive individuals prior to initiating first line ART for possible transmitted resistance. It is very important to enhance the access of patients to ARV drugs so that their compliance could be improved and hence development of DRMs be minimized.


Assuntos
Síndrome da Imunodeficiência Adquirida/genética , Fármacos Anti-HIV/administração & dosagem , Farmacorresistência Viral/genética , HIV-1/genética , HIV-1/imunologia , Inibidores de Proteases/administração & dosagem , Inibidores da Transcriptase Reversa/administração & dosagem , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/epidemiologia , Adulto , Feminino , Genótipo , HIV-1/efeitos dos fármacos , Humanos , Índia/epidemiologia , Masculino , Filogenia , Prevalência , Falha de Tratamento
8.
AIDS Res Treat ; 2012: 905823, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22496972

RESUMO

Objective. The increased use of antiretroviral therapy (ART) has reduced the morbidity and mortality associated with HIV, adversely leading to the emergence of HIV drug resistance (HIVDR). In this study we aim to evaluate the prevalence of HIVDR mutations in ART-naive HIV-1 infected patients from northern India. Design. Analysis was performed using Viroseq genotyping system based on sequencing of entire protease and two-thirds of the Reverse Transcriptase (RT) region of pol gene. Results. Seventy three chronic HIV-1 infected ART naïve patients eligible for first line ART were enrolled from April 2006 to August 2008. In 68 patients DNA was successfully amplified and sequencing was done. 97% of HIV-1 strains belonged to subtype C, and one each to subtype A1 and subtype B. The overall prevalence of primary DRMs was 2.9% [2/68, 95% confidence interval (CI), 0.3%-10.2%]. One patient had a major RT mutation M184V, known to confer resistance to lamivudine, and another had a major protease inhibitor (PI) mutation D30N that imparts resistance to nelfinavir. Conclusion. Our study shows that primary HIVDR mutations have a prevalence of 2.9% among ART-naive chronic HIV-1 infected individuals.

9.
Talanta ; 93: 32-6, 2012 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-22483872

RESUMO

A method has been developed to improve the sensitivity of the electrolyte cathode discharge atomic emission spectrometry (ELCAD-AES) for mercury determination. Effects of various low molecular weight organic solvents at different volume percentages as well as at different acid molarities on the mercury signal were investigated using ELCAD-AES. The addition of few percent of organic solvent, acetic acid produced significant enhancement in mercury signal. Acetic acid of 5% (v/v) with the 0.2M acidity has been found to give 500% enhancement for mercury signal in flow injection mode. Under the optimized parameters the repeatability, expressed as the percentage relative standard deviation of spectral peak area for mercury with 5% acetic acid was found to be 10% for acid blank solution and 5% for 20 ng/mL mercury standard based on multiple measurements with a multiple sample loading in flow injection mode. Limit of detection of this method was determined to be 2 ng/mL for inorganic mercury. The proposed method has been validated by determining mercury in certified reference materials, Tuna fish (IAEA-350) and Aquatic plant (BCR-060). Accuracy of the method for the mercury determination in the reference materials has been found to be between 3.5% and 5.9%. This study enhances the utility of ELCAD-AES for various types of biological and environmental materials to quantify total mercury at very low levels.


Assuntos
Ácido Acético/química , Eletrólitos/química , Mercúrio/análise , Espectrofotometria Atômica/métodos , Animais , Eletrodos , Análise de Injeção de Fluxo , Mercúrio/química , Padrões de Referência , Solventes/química , Espectrofotometria Atômica/instrumentação , Espectrofotometria Atômica/normas
10.
Acute Med ; 10(4): 206-8, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22111101

RESUMO

Delirium is a common cause for hospital admission among elderly patients. Although infection is the most common explanation, there is a large number of other potential causes. We present a case of acute delirium due to serotonin syndrome, precipitated by concomitant prescription of clarithromycin and fluoxetine. The symptoms improved following treatment with a benzodiazepine and discontinuation of the fluoxetine. The diagnosis and management of serotonin syndrome is discussed.


Assuntos
Confusão/etiologia , Febre/etiologia , Síndrome da Serotonina/diagnóstico , Doença Aguda , Idoso de 80 Anos ou mais , Confusão/diagnóstico , Diagnóstico Diferencial , Técnicas de Diagnóstico Neurológico , Feminino , Febre/diagnóstico , Seguimentos , Humanos , Síndrome da Serotonina/complicações
11.
Biol Trace Elem Res ; 142(1): 29-35, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20552294

RESUMO

Diabetic nephropathy is a complication of diabetes mellitus. This present study investigates the status of copper and magnesium in diabetic nephropathy cases to establish a possible relation. Forty patients of diabetic nephropathy participated in the study as cases. Forty age- and sex-matched healthy individuals served as controls. Blood samples were collected from both cases and controls for determination of FBS, PPBS, HbA1c, microalbumin, copper, and magnesium levels. The mean concentrations of FBS, PPBS, HbA1c, and microalbumin of cases were significantly higher than that of controls. The mean magnesium levels of cases (1.60 ± 0.32 meq/L) were significantly lower than controls 2.14 ± 0.16 meq/L (p < 0.05). But the mean copper levels of cases, 165.42 ± 5.71 µg/dl, shows no significant difference with controls, 166.6 ± 5.48 µg/dl, (p > 0.05).The findings in the present study suggest that hypomagnesemia may be linked with development of diabetic nephropathy.


Assuntos
Cobre/sangue , Nefropatias Diabéticas/sangue , Magnésio/sangue , Idoso , Glicemia/análise , Estudos de Casos e Controles , Nefropatias Diabéticas/epidemiologia , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo , Albumina Sérica/análise , Oligoelementos/sangue
13.
J Clin Lipidol ; 4(6): 478-82, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-21122694

RESUMO

BACKGROUND: Dyslipidemia is a major risk factor for developing coronary artery disease. An increase in inflammatory cytokines may result in a decrease in lipoprotein lipase (LPL) enzyme activity, leading to a characteristic lipoprotein profile with increased triglycerides and decreased high-density lipoprotein (HDL) levels as seen in patients with systemic lupus erythematosus (SLE). Similar to SLE, patients with IBD have high circulatory levels of inflammatory cytokines. However, in these patients characteristic lipoprotein profiles have not been reported. OBJECTIVES: The purpose of this study is to identify and describe dyslipidemia and lipoprotein profiles in an IBD patient population. METHODS: Medical records of patients diagnosed with IBD (Crohn's disease [CD] and ulcerative colitis [UC]) at an academic medical center between 2000 and 2007 were retrospectively reviewed for lipoprotein lipid measurements, serum albumin levels, risk factors, and treatment to modify lipoprotein concentrations. The lipoprotein guidelines and risk factors are based on the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Only patients with documented IBD diagnosis and lipoprotein profiles are included in the study. National Health and Nutrition Examination Survey (NHANES) 2005-2006 population database was used for control values. RESULTS: A total of 393 patients (152 men and 241 women) diagnosed with IBD (188 CD and 205 UC) who were not on statins qualified for the study. Patients were grouped on the basis of gender (male and female) and IBD disease type (CD and UC). Compared with the male NHANES samples (with similar mean age and body mass index), total cholesterol and HDL-C were significantly lower and low-density lipoprotein cholesterol (LDL-C) and triglycerides were significantly greater in male patients with IBD. In female patients with IBD, the mean values for total cholesterol, HDL-C, and triglycerides were significantly lower and LDL-C significantly greater compared with the female NHANES samples. CONCLUSION: Given low levels of HDL-C and increased levels of LDL-C, a more aggressive approach in profiling and treating dyslipidemia seems warranted in patients with IBD.


Assuntos
Dislipidemias/sangue , Doenças Inflamatórias Intestinais/sangue , Adulto , Idoso , Dislipidemias/complicações , Feminino , Humanos , Doenças Inflamatórias Intestinais/complicações , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Triglicerídeos/sangue
15.
Ecology ; 91(1): 28-35, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20380192

RESUMO

Understanding disturbance effects on species diversity and functional diversity is fundamental to conservation planning but remains elusive. We quantified species richness, diversity, and evenness and functional richness, diversity, and evenness of riparian and upland plants along 24 small streams subjected to a range of anthropogenic disturbances in the boreal forest of northwestern Ontario, Canada. We included a total of 36 functional traits related to productivity, competitive ability, reproduction, disturbance tolerance, life history, and tolerance to habitat instability. Using nested ANOVA, we examined the response of diversity indices to disturbance and whether it followed the intermediate disturbance hypothesis (IDH) and varied with habitat stability. We found that, like species richness and diversity, functional richness and diversity reached peaks at moderate disturbance intensity; functional diversity followed the predictions of the IDH. Second, disturbance-habitat-stability coupling has very little effect on overall species and functional diversity, but the effect on particular life forms and functions may be significant. Since species richness and diversity patterns are context and system dependent, our findings should be most applicable to similar temperate riparian systems.


Assuntos
Biodiversidade , Plantas/classificação , Rios , Regiões Árticas , Canadá , Conservação dos Recursos Naturais
17.
Anal Chem ; 81(19): 8157-66, 2009 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-19715301

RESUMO

An open-to-air type electrolyte cathode discharge (ELCAD) has been developed with a new design. The present configuration leads to a stable plasma even at low flow rates (0.96 mL/min). Plasma fluctuations arising from the variations in the gap between solid anode and liquid cathode were eliminated by providing a V-groove to the liquid glass-capillary. Cathode (ground) connection is given to the solution at the V-groove itself. Interfaced to atomic emission spectrometry (AES), its analytical performance is evaluated. The optimized molarity of the solution is 0.2 M. The analytical response curves for Ca, Cu, Cd, Pb, Hg, Fe, and Zn demonstrated good linearity. The limit of detections of Ca, Cu, Cd, Pb, Hg, Fe, and Zn are determined to be 17, 11, 5, 45, 15, 28, and 3 ng mL(-1). At an integration time of 0.3 s, the relative standard deviation (RSD) values of the acid blank solutions are found to be less than 10% for the elements Ca, Cu, Cd, Hg, Fe, and Zn and 18% for Pb. The method is applied for the determination of the elemental constituents in different matrix materials such as tuna fish (IAEA-350), oyster tissue (NIST SRM 1566a), and coal fly ash (CFA SRM 1633b). The obtained results are in good agreement with the certified values. The accuracy is found to be between 7% and 0.6% for major to trace levels of constituent elements and the precision between 11% and 0.6%. For the injection of 100 microL of 200 ng mL(-1) mercury solution at the flow rate of 0.8 mL/min, the flow injection studies resulted in the relative standard deviation (RSD) of 8%, concentration detection limit of 10 ng/mL, and mass detection limit of 1 ng for mercury.

18.
Indian J Gastroenterol ; 28(1): 28-30, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19529899

RESUMO

Chronic inflammation with the presence of excess serum acute-phase proteins, cytokines and cell adhesion molecules is increasingly being implicated in atherosclerosis. The association between inflammatory bowel disease (IBD) and coronary artery disease (CAD) is unstudied. This is a preliminary, thesis-generating cross-sectional study aimed at evaluating the presence of traditional atherosclerotic risk factors in patients with IBD and CAD compared with the control population. The medical records of 42 consecutive IBD patients with CAD from 1999 to 2005 (27 men) were reviewed for the Framingham risk factors. The Framingham risk score (FRS) is calculated based on age, sex, hypertension, diabetes and hyperlipidemia. FRS of patients with IBD and CAD was compared with the FRS of 137 age- and sex-matched (102 men) consecutive patients with CAD (controls). When the Framingham risk score adjusted for group and gender with age as a covariate, the adjusted total FRS score was higher in patients with CAD alone (10.0 [3.75]) as compared to those with; IBD and CAD: (8.1 [3.47]; p = 0.001). FRS is lower in cases (patients with IBD and CAD) when compared with the controls (CAD alone).


Assuntos
Aterosclerose/etiologia , Doença da Artéria Coronariana/complicações , Inflamação/complicações , Doenças Inflamatórias Intestinais/complicações , Proteínas de Fase Aguda/imunologia , Proteínas de Fase Aguda/metabolismo , Aterosclerose/epidemiologia , Estudos de Casos e Controles , Doença da Artéria Coronariana/imunologia , Estudos Transversais , Citocinas/sangue , Citocinas/imunologia , Feminino , Humanos , Inflamação/sangue , Doenças Inflamatórias Intestinais/imunologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Fatores de Risco
20.
Gen Hosp Psychiatry ; 31(2): 194-5, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19269545

RESUMO

Quetiapine fumarate is an atypical antipsychotic with relatively benign side-effect profile. Here we report a rare side-effect of quetiapine use. This is the second reported case of peripheral edema with quetiapine use. Unaware of this rare side-effect, patient had to endure extensive investigations.


Assuntos
Antipsicóticos/efeitos adversos , Dibenzotiazepinas/efeitos adversos , Edema/induzido quimicamente , Transtornos Psicóticos/tratamento farmacológico , Antagonistas Adrenérgicos alfa/uso terapêutico , Adulto , Edema/complicações , Feminino , Humanos , Prazosina/uso terapêutico , Fumarato de Quetiapina , Distúrbios do Início e da Manutenção do Sono/complicações , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico
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