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RATIONALE: End-expiratory lung volume (EELV) is reduced in mechanically ventilated patients, especially in pathologic conditions. The resulting heterogeneous distribution of ventilation increases the risk for ventilation induced lung injury. Clinical measurement of EELV however, remains difficult. OBJECTIVE: Validation of a novel continuous capnodynamic method based on expired carbon dioxide (CO2) kinetics for measuring EELV in mechanically ventilated critically-ill patients. METHODS: Prospective study of mechanically ventilated patients scheduled for a diagnostic computed tomography exploration. Comparisons were made between absolute and corrected EELVCO2 values, the latter accounting for the amount of CO2 dissolved in lung tissue, with the reference EELV measured by computed tomography (EELVCT). Uncorrected and corrected EELVCO2 was compared with total CT volume (density compartments between - 1000 and 0 Hounsfield units (HU) and functional CT volume, including density compartments of - 1000 to - 200HU eliminating regions of increased shunt. We used comparative statistics including correlations and measurement of accuracy and precision by the Bland Altman method. MEASUREMENTS AND MAIN RESULTS: Of the 46 patients included in the final analysis, 25 had a diagnosis of ARDS (24 of which COVID-19). Both EELVCT and EELVCO2 were significantly reduced (39 and 40% respectively) when compared with theoretical values of functional residual capacity (p < 0.0001). Uncorrected EELVCO2 tended to overestimate EELVCT with a correlation r2 0.58; Bias - 285 and limits of agreement (LoA) (+ 513 to - 1083; 95% CI) ml. Agreement improved for the corrected EELVCO2 to a Bias of - 23 and LoA of (+ 763 to - 716; 95% CI) ml. The best agreement of the method was obtained by comparison of corrected EELVCO2 with functional EELVCT with a r2 of 0.59; Bias - 2.75 (+ 755 to - 761; 95% CI) ml. We did not observe major differences in the performance of the method between ARDS (most of them COVID related) and non-ARDS patients. CONCLUSION: In this first validation in critically ill patients, the capnodynamic method provided good estimates of both total and functional EELV. Bias improved after correcting EELVCO2 for extra-alveolar CO2 content when compared with CT estimated volume. If confirmed in further validations EELVCO2 may become an attractive monitoring option for continuously monitor EELV in critically ill mechanically ventilated patients. TRIAL REGISTRATION: clinicaltrials.gov (NCT04045262).
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Capnografia , Estado Terminal , Medidas de Volume Pulmonar , Humanos , Masculino , Feminino , Estado Terminal/terapia , Estudos Prospectivos , Pessoa de Meia-Idade , Idoso , Medidas de Volume Pulmonar/métodos , Capnografia/métodos , Respiração Artificial/métodos , COVID-19 , Tomografia Computadorizada por Raios X/métodos , AdultoRESUMO
Inter-simple sequence repeats markers were used to determinate the genetic variability of Fasciola hepatica populations recovered from sheep and cattle from Spain (Sp1, Sp2, Sp3 and Sp4), UK (Eng), Ireland (Ir) and Mexico (Mex). Twenty five primers were tested but only five produced 39 reproducible bands, being 71.79% polymorphic bands. This percentage ranged from 10.26% in Sp4 to 48.72% in Sp1, and per host between 28.21 and 48.72% in sheep and between 10.26 and 38.46% in cattle. This relatively low range of genetic diversity within populations, with a mean of 34.40%, implies that a large proportion of variation resided among populations. The population differentiation (Gst = 0.547) indicated that 54.7% of variation is due to differences between populations and 45.3% due to differences within population. The Nei's distance ranged between 0.091 and 0.230 in sheep and between 0.150 and 0.337 in cattle. The genetic relationships between populations and individuals were shown by a UPGMA dendrogram and a principal coordinate analysis; both grouped all populations separately from Sp4, a population of from the Midwest of Spain with the lowest level of diversity. Small genetic distances were observed between Eng and Ir, on the one hand, and Sp1, Sp2, Sp3, from the Northwest of Spain, together with Mex, on the other.
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Doenças dos Bovinos/parasitologia , Fasciola hepatica/genética , Fasciolíase/veterinária , Variação Genética , Doenças dos Ovinos/parasitologia , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Primers do DNA/genética , Fasciola hepatica/classificação , Fasciolíase/epidemiologia , Fasciolíase/parasitologia , Marcadores Genéticos , Irlanda/epidemiologia , Fígado/parasitologia , México/epidemiologia , Reação em Cadeia da Polimerase/métodos , Reação em Cadeia da Polimerase/veterinária , Ovinos , Doenças dos Ovinos/epidemiologia , Espanha/epidemiologia , Reino Unido/epidemiologiaRESUMO
This work studies the effects of the partial substitution of NaCl with potassium and calcium chloride salts on the fermentation profile of Spanish-style green Manzanilla olives. For this purpose, response surface methodology based in an enlarged simplex centroid mixture design with constrain (∑salts = 100 g/L) was used. Regarding to physicochemical characteristics, pH decreased when CaCl2 increased, titratable acidity was lower in presence of KCl while combined acidity increased as the contents of KCl and CaCl2 were close to the barycentre of the experiment (â¼33.33% each salt). Regarding to microbiological profile, Enterobacteriaceae growth was slight stimulated in presence of high CaCl2 contents, yeast patterns were not linked to the initial brine compositions, while the maximum lactic acid bacteria population decreased slightly as KCl and CaCl2 increased in the proportion 1:1, although a moderate (equilibrated) content of both may be stimulating. Results obtained in this work show that Spanish-style green Manzanilla cv. can be fermented in diverse mixtures of chloride salts, albeit the initial CaCl2 should be limited to 20-30 g/L to prevent excessive Enterobacteriaceae growth; combining it with a similar proportion of KCl may also improve LAB predominance.
Assuntos
Olea/microbiologia , Sais/análise , Cloreto de Sódio/análise , Enterobacteriaceae/crescimento & desenvolvimento , Enterobacteriaceae/metabolismo , Fermentação , Microbiologia de Alimentos , Frutas/química , Frutas/microbiologia , Lactobacillaceae/crescimento & desenvolvimento , Lactobacillaceae/metabolismo , Olea/química , Cloreto de Sódio/metabolismo , Espanha , Leveduras/crescimento & desenvolvimento , Leveduras/metabolismoRESUMO
This work evaluates the use of two multifunctional starters of Lactobacillus pentosus species (TOMC LAB2 and TOMC LAB4) during elaboration of Manzanilla olive fruits processed according to the Spanish-style. Data show that the use of inocula at the onset of fermentation led to a proper acidification and sugar consumption of brines compared to the spontaneous process, obtaining in a shorter period of time the maximum population for lactic acid bacteria. Both inoculated L. pentosus strains were recovered at high frequencies at the end of fermentation on the olive surface, which was corroborated by RAPD-PCR analysis. In situ observation of olive epidermis slices by scanning electron microscopy revealed a strong aggregation and adhesion between microorganisms, which reached population levels of approximately 6 and 7 log10 cfu/cm(2) for yeasts and lactic acid bacteria, respectively. Enterobacteriaceae on the olive surface were also found at the onset of fermentation (â¼9 log10 cfu/cm(2)), but they declined during the process and were below the detection limit at the end of fermentation. Results obtained in this study show the advantage of using multifunctional starters with the ability to adhere to the olive epidermis because, ultimately, the fruits are the food ingested by consumers.
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Lactobacillus/metabolismo , Olea/microbiologia , Probióticos/química , Fermentação , Microbiologia de Alimentos , Frutas/química , Frutas/microbiologia , Lactobacillus/classificação , Lactobacillus/genética , Olea/química , EspanhaRESUMO
INTRODUCTION: The use of abdominal radiography (AXR) apparently continues to be widespread despite its limited indications, the potential radiation and unnecessary costs associated. In addition, the interpretation and its report seem variable and not always performed by a radiologist. Our objective is to analyze the use, adequacy and usefulness of AXR in the emergency of a tertiary referral hospital. MATERIAL AND METHODS: We retrospectively reviewed all the AXR performed in January 2020 in the emergency of our centre, as well as the patient's demographics and medical records, technical quality of the radiographs, indications according to the SERAM (Spanish Society of Radiology) Appropriateness Guidelines, presence of a formal radiology report, and impact on the clinical management of the patient. Of all non-appropriated AXR we calculated the radiation received by the patients and its extra costs. RESULTS: In January 2020, 429 AXR (9.1% of all radiographies) were performed in the emergency of our centre. The most frequent indication was abdominal pain (40%, nâ¯=â¯176), followed by low back pain (21.4%, nâ¯=â¯92). 12.4% of AXR requested did not include any clinical information. Most of the AXR (79.6%) had sufficient technical quality. 61.3% (nâ¯=â¯263) of the AXR performed were not indicated, assuming an average unjustified radiation dose per patient of 0.50⯱â¯0.33â¯mSv, and a total additional cost of 6575;. Only 6% of the inadequate AXRs led to a change in the clinical management of the patient, compared to 29% of the adequate AXR (pâ¯<â¯0.001). Only 3% of the AXR had a formal radiology report. CONCLUSIONS: AXR is still common in the emergency setting, although most of them might be inadequate according to the SERAM Appropriateness Guidelines. Its use should be optimized to avoid unnecessary radiation and costs. Radiologists must have a more active participation in the management of AXR.
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Serviço Hospitalar de Emergência , Radiografia Abdominal , Humanos , Estudos Retrospectivos , Serviço Hospitalar de Emergência/economia , Radiografia Abdominal/economia , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Proteção Radiológica/economia , Idoso , Idoso de 80 Anos ou mais , Utilização de Procedimentos e Técnicas , Adolescente , Adulto JovemRESUMO
Statistical modelling techniques were used in the present study to assess the individual effects of temperature and NaCl concentration on the growth of 10 lactic acid bacteria and 6 yeast strains mostly isolated from different forms of table olive processing and belonging to the species Lactobacillus pentosus, Lactobacillus plantarum, Saccharomyces cerevisiae, Wickerhamomyces anomalus and Candida boidinii. The mathematical models obtained in synthetic laboratory media show that yeasts, except for C. boidinii, were more resistant to a high salt concentration than lactic acid bacteria, with an MIC value ranging from 163.5 (S. cerevisiae) to 166.9 g/L (W. anomalus); while for L. pentosus and L. plantarum this parameter ranged from 110.6 to 117.6 g/L, respectively. With regards to temperature, lactic acid bacteria showed a slight trend towards supporting higher temperature values than yeasts, with the exception of S. cerevisiae. The maximum temperatures for growth of L. pentosus and L. plantarum were 41.9 and 43.0 °C, respectively; while for W. anomalus and C. boidinii they were 38.2 and 36.5 °C. The optimum temperatures for growth were also higher for L. pentosus and L. plantarum (35.5 and 32.9 °C), compared to W. anomalus and C. boidinii (29.3 and 26.9 °C, respectively). Additional experiments carried out in natural olive brines confirmed previous results, showing that high NaCl concentrations clearly favoured yeast growth and that at high temperatures LAB slightly overcame yeasts. Results obtained in this paper could be useful for industry for a better control of both table olive fermentation and packaging.
Assuntos
Lactobacillus/crescimento & desenvolvimento , Olea/microbiologia , Cloreto de Sódio/metabolismo , Leveduras/metabolismo , Fermentação , Microbiologia de Alimentos , Lactobacillus/genética , Lactobacillus/isolamento & purificação , Lactobacillus/metabolismo , Temperatura , Leveduras/genética , Leveduras/crescimento & desenvolvimento , Leveduras/isolamento & purificaçãoRESUMO
This work examines the formation of poly-microbial communities adhered to the surface of Manzanilla olive fruits processed according to the Spanish style. The experimental design consisted of four pilot fermenters inoculated with four Lactobacillus pentosus strains, plus another fermenter which was not inoculated and fermented spontaneously. Lactic acid bacteria and yeasts were analysed in depth on olive epidermis throughout fermentation by plate count, molecular techniques and scanning electron microscopy. Data show that in all cases high population levels (above 8 log(10) CFU per olive) were reached for both groups of microorganisms at the second week of fermentation and that these counts never fell below 6 log(10) CFU per olive during the 3 months that fermenters were monitored. In situ observation of olive epidermis slices revealed a strong aggregation and adhesion between bacteria and yeasts by the formation of a matrix which embedded the microorganisms. Geotrichum candidum, Pichia galeiformis and Candida sorbosa were the main yeast species isolated from these biofilms at the end of fermentation (confirmed by RFLP analysis of the 5.8S-ITS region), while molecular characterization of lactobacilli isolates by means of RAPD-PCR with primer OPL(5) showed in many cases a high similarity in their banding profiles with the inoculated strains. Results obtained in this survey show the importance of studying the olive epidermis throughout fermentation, because ultimately, olives are ingested by consumers.
Assuntos
Lactobacillaceae/metabolismo , Olea/microbiologia , Leveduras/metabolismo , Aderência Bacteriana , Qualidade de Produtos para o Consumidor , Fermentação , Contaminação de Alimentos/prevenção & controle , Lactobacillaceae/classificação , Lactobacillaceae/genética , Lactobacillaceae/crescimento & desenvolvimento , Olea/metabolismo , Espanha , Leveduras/classificação , Leveduras/genética , Leveduras/crescimento & desenvolvimentoRESUMO
There are currently several commercialized products approved by the Food and Drug Administration and the European Medicines Agency based on the use of recombinant human BMP-2 for the treatment of non-unions long fractures and spinal fusion. However, the adverse effects recorded with the use of BMPs suggest the need for drug delivery carriers that allow reducing the required doses and improve their cost-effectiveness. Herein, we have developed a new osteoconductive scaffold that reduces the required doses of BMP-2 for promoting bone regeneration in an osteoporotic defect model. The composite is, in brief, a gelatin-based 3D scaffold reinforced with either calcium sulfate or hydroxyapatite as an inorganic osteoconductive biomaterial. To this end, the organic/inorganic composite systems showed high hydration capacity and good in vitro degradability. The incorporation of 7.5% (m/v) ceramic compounds resulted in scaffolds with stiffer Young modulus (179 and 75 kPa for CaSO4_7 and HA_7, respectively) than bare gelatin hydrogels (48 kPa). Studies with human bone-marrow derived mesenchymal stem cells (hBM-MSCs) revealed that the 3D scaffolds promote cell adhesion and proliferation along with osteogenic differentiation capabilities. Specifically, downregulation of stemness (Nanog, Oct4) genes and upregulation of osteogenic markers (ALP, Col1a1, Fmod) by two fold were observed over 10 days under basal culture conditions. Promisingly, the sustained in vitro release of BMP-2 observed from the porous reinforced scaffolds allowed us to address the critical-sized osteoporotic mice calvarial defects with a relatively low growth factor doses (600 ng BMP-2/scaffold) compared to conventional doses at 2-15 micrograms. Overall, this study demonstrates the promising potential of osteoconductive gelatin/calcium bioceramics composites as osteogenic growth factors delivery carriers for bone-regeneration via ultra-low growth factor doses.
Assuntos
Proteína Morfogenética Óssea 2 , Portadores de Fármacos , Osteogênese , Osteoporose , Animais , Proteína Morfogenética Óssea 2/farmacologia , Cerâmica/química , Portadores de Fármacos/química , Gelatina/química , Humanos , Camundongos , Osteoporose/tratamento farmacológico , Alicerces TeciduaisRESUMO
This work studies the effects of different sodium (in the range of 4-10%), potassium (0-4%) and calcium (0-6%) chloride salt mixtures on the fermentation profile of Gordal olives processed according to the Spanish style. For this purpose, response surface methodology based on a simplex centroid mixture design with constrain (sum of salt percentages = 10%) was used. All treatments reached appropriate titratable acidity levels, but this parameter could not be related to the initial chloride salt concentration. The presence of CaCl(2) led to lower initial and after-fermentation pHs, delayed sugar diffusion into the brine, its maximum concentration and titratable acidity formation. CaCl(2) also delayed Enterobacteriaceae and yeast sprang, decreasing their overall growth. This chloride salt also showed a tendency to reduce overall lactic acid bacteria growth. KCl had a similar behaviour to NaCl but, in general, increased overall microbial growth. Thus, a partial substitution of NaCl in Spanish-style green olives with KCl and CaCl(2) does not substantially modify the fermentation profile but does produce some changes, which, when properly managed, could help to improve product processing.
Assuntos
Cloretos/farmacologia , Fermentação , Olea/metabolismo , Enterobacteriaceae/isolamento & purificação , Fermentação/efeitos dos fármacos , Concentração de Íons de Hidrogênio , Análise Multivariada , Olea/microbiologia , Leveduras/isolamento & purificaçãoRESUMO
Before the National Socialist party came to power, the German pharmaceutical industry constituted an international reference as far as the development of new medicines was concerned, having been responsible for synthetic analgesics (phenacetin, phenazones, acetylsalicylic acid), arsphenamine, barbiturates and sulfonamides. The year 1925 saw the founding of I.G. Farben (Interessen-Gemeinschaft Farbenindustrie AG), a conglomerate of companies that would monopolize the country's chemical production and come to own all its major pharmaceutical industries. During the World War II, I.G. Farben participated in numerous operations associated with the criminal activities of the Nazi executive, including the use of slave labour in plants built close to concentration camps, such as that at Auschwitz. With regard to medical and pharmacological research projects, I.G. Farben became involved in experimental programmes using patients from the Nazi regime's euthanasia programmes and healthy subjects recruited without their consent from concentration camps, on whom various pharmacological substances were tested, including sulfamide and arsenical derivatives and other preparations whose composition is not precisely known (B-1012, B-1034, 3382 or Rutenol, 3582 or Acridine), generally in relation to the treatment of infectious diseases, such as typhus, erysipelas, scarlet fever or paratyphoid diarrhoea. Furthermore, I.G. Farben played a decisive role in the German army's chemical warfare programme, contributing to the development of the first two neurotoxic substances, later known as 'nerve agents', tabun and sarin. Some of these activities came to light as a result of the one the famous Nuremberg Trials in 1947, which saw 24 executives and scientists from I.G. Farben brought to justice for, among other offences, the use of slave labour in the concentration camps and forced experimentation with drugs on prisoners.
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Pesquisa Biomédica/história , Substâncias para a Guerra Química/história , Indústria Farmacêutica/história , Ética Médica , Socialismo Nacional , Preparações Farmacêuticas/história , Substâncias para a Guerra Química/toxicidade , Campos de Concentração/história , Alemanha , História do Século XX , Experimentação Humana/história , Humanos , Doenças do Sistema Nervoso/induzido quimicamente , Doenças do Sistema Nervoso/história , II Guerra MundialRESUMO
The plasma cell dyscrasias (PCDs) include a number of entities such as multiple myeloma, primary amyloidosis, and monoclonal immunoglobulin deposition disease. Hematopoietic cell transplant (HCT) is the only cure for a variety of hematologic and oncologic diseases. Clinically significant renal impairment is a common feature in plasma cell myeloma, affecting 20% to 55% of patients at initial diagnosis; 2% to 3% of patients present with failure sufficiently severe to require hemodialysis. This circumstance is associated with a high early mortality. The necessity for immunosuppression after HCT could complicate its management and may precipitate the development of complications. In some patients an effective alternative could be kidney transplant (KT); however, the presence of 2 transplants will require optimal adjustment of immunosuppression and management of complications. At present, there are few published cases of KT after HCT, and the experience of managing 2 transplants is limited. We would like to describe our experience with 4 patients who had a PCD and initially received HCT and received subsequent KT. In our experience the progress and outcome of KT after HCT were optimal. We would like to address that a higher incidence of cytopenia associated with the combination of immunosuppression (lenalidomide, tacrolimus, mycophenolate, etc.) and other drugs (ie, valganciclovir) should be considered together with an increased risk of opportunistic infections and PCD relapse.
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Transplante de Células-Tronco Hematopoéticas , Transplante de Rim , Paraproteinemias/complicações , Paraproteinemias/cirurgia , Insuficiência Renal/cirurgia , Adulto , Idoso , Feminino , Humanos , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Insuficiência Renal/etiologiaRESUMO
BACKGROUND: Our purpose was to examine the use of classification and diagnostic systems in the field of psychiatry (CDSP) from a bibliometric perspective, over the period 1980-2005. METHODS: We selected (in EMBASE and MEDLINE databases) documents that contained, in any of their sections, the descriptors 'psychiatr*', 'DSM*', 'ICD*', or 'diagnostic criteria',as well as other more specific descriptors. As a bibliometric indicator of production we applied Price's law. We also calculated the national participation index (PI) and correlated it with overall PI in biomedical and health sciences, and with PI in the discipline of psychiatry. RESULTS: We obtained 20,564 original documents; 15,743 referred to the Diagnostic and Statistical Manual of Mental Disorders (DSM) and 3,106 to the International Classification of Diseases (ICD). Our results indicate non-fulfilment of Price's law, since scientific production on CDSP does not undergo exponential growth (correlation coefficient r = 0.9651, vs. r = 0.9927 after linear adjustment). Of the 10 journals with the highest impact factor in the field of psychiatry, the Journal of Clinical Psychiatry has the highest PI in the DSM subgroup (PI = 14.77), and the British Journal of Psychiatry in the ICD subgroup (PI = 1.54). The principal producer country is the United States (PI = 37.9), though in proportion to its production in the psychiatric field the ranking is headed by Finland. Only 10 countries, of the 20 major producers in health sciences, surpass their own PI in the field of psychiatry (Brazil, Italy, Japan, Austria, Spain, Germany, France, India, Switzerland, and China). CONCLUSIONS: Over recent years, the use of CDSP (basically the DSM or ICD) in the scientific literature has increased. Nevertheless, the abstracts to these studies, included in the principal databases, should always specify the diagnostic criteria employed, with a view to increasing information levels and reliability for the reader.
Assuntos
Bibliometria , Manual Diagnóstico e Estatístico de Transtornos Mentais , Classificação Internacional de Doenças/estatística & dados numéricos , Transtornos Mentais/diagnóstico , Humanos , Transtornos Mentais/classificação , Transtornos Mentais/tratamento farmacológico , Publicações Periódicas como Assunto/classificação , Psiquiatria/estatística & dados numéricosRESUMO
Disposition of green table olives alkaline solutions (GTOS) remains a major task for the industry with serious environmental implications. The presence of high concentrations of polyphenols in olives also presents a problem for direct brining and successful fermentation step. In this study we evaluated the effect of ozone treated GTOS on the growth of Saccharomyces cerevisiae and Lactobacillus pentosus. GTOS were treated with ozone for 24 and 72 h. The treatment caused a rapid destruction of polyphenols but did not affect sugar concentration. S. cerevisiae grew in the original and treated liquids, although its maximum specific growth rate (mu(m)) and its population size increased as the ozone treatment was longer. L. pentosus was completely inhibited in the original and 24 h ozone treated GTOS, but grew in 72 h treated solutions. Co-culture with S. cerevisiae improved L. pentosus performance. Diluting the original GTOS with distilled water in several ratios, and adding MRS medium (50 g/L) to ensure nutrient availability, showed that a complete inhibition on L. pentosus did never occur; however, its mu(m) progressively increased, and the lag phase period (lambda) decreased linearly, with increasing dilutions levels. The inhibition effect was lower in 24 h ozone treated GTOS and disappeared completely in those treated for 72 h. Furthermore, treatment of GTOS with ozone always improved microbial growth.
Assuntos
Flavonoides/análise , Lactobacillus/crescimento & desenvolvimento , Olea , Oxidantes Fotoquímicos/farmacologia , Ozônio/farmacologia , Fenóis/análise , Saccharomyces cerevisiae/crescimento & desenvolvimento , Fermentação , Manipulação de Alimentos/métodos , Microbiologia de Alimentos , Humanos , Cinética , Olea/química , Olea/microbiologia , Polifenóis , Fatores de TempoRESUMO
OBJECTIVES: To ascertain the correlation between the partial pressure of oxygen (PaO2) and oxyhaemoglobin saturation by pulse oximetry (SpO2) in patients who were admitted to the emergency department with suspected acute respiratory failure. MATERIAL AND METHODS: A prospective, observational multicentre study was conducted in the emergency departments of 3 Spanish hospitals. RESULTS: The study included 166 patients who presented mean±standard deviation PaO2, SpO2 and fraction of inspired oxygen (FiO2) values of 61.64±17.3mmHg, 87.61±8.8% and 0.28±0.15%, respectively. The median PaO2/FiO2 and SpO2/FiO2 ratios were 256.6 and 359.2, respectively. The correlation between PaO2/FiO2 and the SpO2/FiO2 was 0.745 (P<.001). CONCLUSIONS: The SpO2/FiO2 ratio can be used to calculate PaO2/FiO2 and determine the oxygenation state of patients with acute respiratory failure.
RESUMO
OBJECTIVE: To assess the course of sexual function in epilepsy patients treated with lamotrigine. MATERIAL AND METHODS: This open study included 141 patients treated with lamotrigine for a period of 8 months: 79 patients initiated treatment with lamotrigine monotherapy, and 62 were switched to lamotrigine because of lack of efficacy or adverse events to a previous antiepileptic drug (AED). Patients were assessed at baseline and after 4 and 8 months of treatment. In the baseline and final visits the Changes in Sexual Functioning Questionnaire (CSFQ) was applied. Analysis was performed in an intent-to-treat population. RESULTS: In women who started treatment with lamotrigine, a significant improvement was observed, both in total CSFQ score (increase of 5.39 +/- 6.95 points; p < 0.05), and in the five dimensions of the scale (desire/frequency, desire/interest, pleasure, arousal/excitement and orgasm). In men, a significant improvement was only observed in the pleasure dimension. In the group of patients in whom a previous AED was substituted by lamotrigine, significant improvement was recorded in the dimensions of pleasure and orgasm in men and desire/frequency in women, whilst in women the desire/interest dimension showed a decrease. CONCLUSIONS: In this observational study, an improvement in sexual dysfunction was observed in association with lamotrigine. This could have been the result of improvement of the epilepsy, changes in quality of life, elimination of side effects from other AEDs, or a mood-stabilizing effect of lamotrigine.
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Anticonvulsivantes/uso terapêutico , Epilepsia/tratamento farmacológico , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Triazinas/uso terapêutico , Adulto , Anticonvulsivantes/efeitos adversos , Epilepsia/complicações , Feminino , Humanos , Lamotrigina , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Disfunções Sexuais Fisiológicas/etiologia , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Treatment adherence is a factor that is affecting the effectiveness of antiepileptic drugs. Levetiracetam is a drug whose effectiveness and safety is well established and is available in different oral formulations (granulates in sachets, tablets, oral solution), but information on treatment adherence/compliance with these oral formulations is limited. AIM: To determine treatment adherence with levetiracetam formulations (granulates in sachets, tablets) in adult and elderly people. PATIENTS AND METHODS: Retrospective observational non-interventionist study. During the three months before the study patients should be treated with levetiracetam (granulates in sachets or tablets), either alone or in combination. Compliance tests (Green-Morisky modified test) as well as a satisfaction questionnaire investigator and patient/caregiver is assessed. Data were analyzed using SPSS v. 21.0 program. RESULTS: A total of 466 patients completed the study. The average age was 52.75 ± 19.17 years old and the average over 65 years of 72.79 ± 6.15. 55.4% were men. Compliance is related to the variable 'pharmaceutical formulation' and with age (p = 0.031). The risk of non-compliance was 86.4% higher among those taking tablets versus granulates in sachets of levetiracetam (odds ratio: 1.864). Likewise, the non-compliance was greater among patients over 65 years. The non-compliance was related to attributing of memory failures. CONCLUSIONS: Patients older are more difficult to compliance. The granulates levetiracetam in sachets improves compliance.
TITLE: Adhesion al tratamiento con levetiracetam: estudio observacional retrospectivo no intervencionista.Introduccion. La adhesion al tratamiento es un factor que esta repercutiendo en la eficacia de los farmacos antiepilepticos. El levetiracetam es un principio activo cuya eficacia y seguridad estan ampliamente demostradas y que esta disponible en diferentes formulaciones orales (sobres, comprimidos y solucion oral), pero la informacion sobre la adhesion/cumplimiento del tratamiento con estas formulaciones orales es escasa. Objetivo. Conocer la adhesion al tratamiento con formulaciones de levetiracetam (granulado en sobre y comprimidos) en adultos y ancianos. Pacientes y metodos. Estudio observacional retrospectivo no intervencionista. Durante los tres meses previos al estudio debia estar en tratamiento con levetiracetam (granulado en sobre o comprimidos), bien en monoterapia o en combinacion. Se valoraron los tests de cumplimiento (cuestionario de Morisky-Green modificado), asi como un cuestionario de satisfaccion del investigador y del paciente/cuidador. Los datos se analizaron con el programa SPSS v. 21.0. Resultados. Un total de 466 pacientes completaron el estudio. La edad media fue de 52,75 ± 19,17 años, y la media en los mayores de 65 años fue de 72,79 ± 6,15 años. Un 55,4% eran hombres. El cumplimiento se relaciona con la variable 'formulacion galenica' y con la edad (p = 0,031). El riesgo de incumplimiento es un 86,4% mayor entre los que toman comprimidos frente a granulado de levetiracetam (odds ratio: 1,864). Asimismo, el incumplimiento es mayor entre los pacientes mayores de 65 años. El incumplimiento se relaciona con la atribucion de fallos de memoria. Conclusiones. Los pacientes mas mayores presentan mas dificultades en el cumplimiento. El granulado de levetiracetam en sobres favorece el cumplimiento.
Assuntos
Anticonvulsivantes/uso terapêutico , Adesão à Medicação , Piracetam/análogos & derivados , Adulto , Idoso , Feminino , Humanos , Levetiracetam , Masculino , Pessoa de Meia-Idade , Piracetam/uso terapêutico , Estudos RetrospectivosRESUMO
This article refers to the paper "Assessment of table olive fermentation by functional data analysis" (Ruiz-Bellido et al., 2016) [1]. The dataset include pH, titratable acidity, yeast count and area values obtained during fermentation process (380 days) of Aloreña de Málaga olives subjected to five different fermentation systems: i) control of acidified cured olives, ii) highly acidified cured olives, iii) intermediate acidified cured olives, iv) control of traditional cracked olives, and v) traditional olives cracked after 72 h of exposure to air. Many of the Tables and Figures shown in this paper were deduced after application of Functional Data Analysis to raw data using a routine executed under R software for comparison among treatments by the transformation of raw data into smooth curves and the application of a new battery of statistical tools (functional pointwise estimation of the averages and standard deviations, maximum, minimum, first and second derivatives, functional regression, and functional F and t-tests).
RESUMO
For the first time, functional data analysis (FDA) was used to assess the effects of different treatments on Protection Denomination of Origin Aloreña de Málaga table olive fermentations, focusing on the evolution of yeast population. The analysis of fermentation by a conventional approach led to scarce information. However, the transformation of microbial (and also physicochemical) data into smooth curves allowed the application of a new battery of statistical tools for the analysis of fermentations (functional pointwise estimation of the averages and standard deviations, maximum, minimum, first and second derivatives, functional regression, and functional F and t-tests). FDA showed that all the treatments assayed led to similar trends in yeast population while changes in pH and titratable acidity profiles led to several significant differences. Therefore, FDA represents a promising and valuable tool for studying table olive fermentations and for food microbiology in general.