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1.
Telemed J E Health ; 29(6): 936-942, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36264193

RESUMO

Objective: To analyze the impact of applying criteria for patient selection and interruption of dispensation in a telepharmacy program. Secondary objective: to conduct a socioeconomic analysis of requests for telepharmacy after applying the criteria. Methods: A retrospective observational study was conducted. We applied the criteria from September 1, 2021 to December 31, 2021 and reviewed the impact of their application by comparing the prior period (October 14, 2020-August 31, 2021) with the period when the criteria were applied. We analyzed the evolution of applications over time, the number of users, the evolution over time of rejected applications, and the associated reasons. Finally, we studied how the average income and distance to hospital are related to the number of requests. This study was reviewed by the authors' institutional ethics committee and was considered exempted from further review. Results: We applied the criteria to 2,379 patients. Dispensations by telepharmacy increased progressively. We provided telepharmacy services to 41.7% of all outpatients and rejected 962 applications (65% after the criteria were applied). The main pre- and postcriteria reasons for rejecting applications were refusal without express reason and the patient having sufficient medication, respectively. All patients corrected the situation that caused rejection. Telepharmacy requests and distance to hospital were not related, although the number of requests and average income were related. Conclusions: We provided pharmaceutical care with this protocol and encouraged patients to correct the reasons for interrupted dispensations. The new criteria render telepharmacy available to all patients, regardless of where they live or their purchasing power. Lower-income individuals use telepharmacy more often.


Assuntos
Assistência Farmacêutica , Telemedicina , Humanos , Telemedicina/métodos , Seleção de Pacientes , Pacientes Ambulatoriais , Estudos Retrospectivos
2.
Int J Clin Pharmacol Ther ; 60(7): 311-316, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35343431

RESUMO

Hereditary transthyretin amyloidosis (hATTR) is an ultra-rare illness. Inotersen is a 2'-O-methoxyethyl (2'MOE)-modified antisense oligonucleotides (ASO) approved in 2018 as a polyneuropathy treatment for adults with hereditary transthyretin amyloidosis stages 1 or 2. Inotersen can produce grade 4 thrombocytopenia as a severe adverse reaction that can lead to potentially fatal hemorrhage complications. We describe our experience in the management of severe thrombocytopenia with inotersen. The onset of the thrombocytopenia and the incidences described in the cases in our hospital are different from that described in the literature. Also, recovery of platelet levels was faster in our patient who was administered human immunoglobulin G, which suggests that there is an immunological component.


Assuntos
Neuropatias Amiloides Familiares , Trombocitopenia , Adulto , Humanos , Oligonucleotídeos/efeitos adversos , Trombocitopenia/induzido quimicamente , Trombocitopenia/terapia
3.
Proc Natl Acad Sci U S A ; 113(36): 10121-6, 2016 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-27551065

RESUMO

Attine ants evolved farming 55-60 My before humans. Although evolutionarily derived leafcutter ants achieved industrial-scale farming, extant species from basal attine genera continue to farm loosely domesticated fungal cultivars capable of pursuing independent reproductive interests. We used feeding experiments with the basal attine Mycocepurus smithii to test whether reproductive allocation conflicts between farmers and cultivars constrain crop yield, possibly explaining why their mutualism has remained limited in scale and productivity. Stoichiometric and geometric framework approaches showed that carbohydrate-rich substrates maximize growth of both edible hyphae and inedible mushrooms, but that modest protein provisioning can suppress mushroom formation. Worker foraging was consistent with maximizing long-term cultivar performance: ant farmers could neither increase carbohydrate provisioning without cultivars allocating the excess toward mushroom production, nor increase protein provisioning without compromising somatic cultivar growth. Our results confirm that phylogenetically basal attine farming has been very successful over evolutionary time, but that unresolved host-symbiont conflict may have precluded these wild-type symbioses from rising to ecological dominance. That status was achieved by the evolutionarily derived leafcutter ants following full domestication of a coevolving cultivar 30-35 Mya after the first attine ants committed to farming.


Assuntos
Agaricales/efeitos dos fármacos , Formigas/fisiologia , Evolução Biológica , Proteínas/farmacologia , Simbiose/fisiologia , Agaricales/fisiologia , Animais , Formigas/classificação , Metabolismo dos Carboidratos , Carboidratos/farmacologia , Filogenia , Proteínas/metabolismo
4.
Sensors (Basel) ; 17(5)2017 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-28467357

RESUMO

Humidity sensors have been widely used in areas such as agriculture, environmental conservation, medicine, instrumentation and climatology. Hydrophobicity is one of the important factors in capacitive humidity sensors: recent research has shown that the inclusion of graphene (G) in polyvinylidene fluoride (PVDF) improves its hydrophobicity. In this context, a methodology to fabricate electrospun membranes of PVDF blended with G was developed in order to improve the PVDF properties allowing the use of PVDF/G membrane as a capacitive humidity sensor. Micrographs of membranes were obtained by scanning electron microscopy to analyze the morphology of the fabricated samples. Subsequently, the capacitive response of the membrane, which showed an almost linear and directly proportional response to humidity, was tested. Results showed that the response time of PVDF/G membrane was faster than that of a commercial DHT11 sensor. In summary, PVDF/G membranes exhibit interesting properties as humidity sensors.

5.
Aging Clin Exp Res ; 28(3): 567-71, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26423565

RESUMO

BACKGROUND AND AIMS: Osteoporosis leads to high fracture risk and evidence suggests that genetic factors play an important role in this disease. The aim was to evaluate the association of two polymorphisms (-1997G/T, +1245G/T) in the collagen type1 alpha 1 gene (COL1A1) with fracture or with low bone mineral density (BMD) at the hip in postmenopausal Mexican women. METHODS: BMD was determined by bone densitometry and the risk factors were collected with a questionnaire. Genotyping was performed by real-time PCR. RESULTS: The polymorphisms were in Hardy-Weinberg equilibrium. The -1997G/+1245T haplotype showed, after adjustment for confounders, a fourfold increased risk of hip fracture [OR 4.32; p = 0.041 (95 % CI 1.07-17.43)]; while in the women with low BMD at the hip, the risk was increased threefold [OR 3.36; p = 0.022 (95 % CI 1.20-9.40)]. CONCLUSIONS: The results support the association of COL1A1 gene polymorphisms with fracture and with low BMD at the hip in Mexican population.


Assuntos
Densidade Óssea , Colágeno Tipo I/genética , Fraturas do Quadril/genética , Polimorfismo Genético , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea/genética , Cadeia alfa 1 do Colágeno Tipo I , Feminino , Genótipo , Haplótipos , Humanos , México , Pessoa de Meia-Idade , Osteoporose/genética , Pós-Menopausa
6.
Sensors (Basel) ; 16(3)2016 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-26959026

RESUMO

An ear prosthesis was designed in 3D computer graphics software and fabricated using a 3D printing process of polyvinylidene fluoride (PVDF) for use as a hearing aid. In addition, the prosthesis response to pressure and temperature was observed. Pyroelectric and piezoelectric properties of this ear prosthesis were investigated using an astable multivibrator circuit, as changes in PVDF permittivity were observed according to variations of pressure and temperature. The results show that this prosthesis is reliable for use under different conditions of pressure (0 Pa to 16,350 Pa) and temperature (2 °C to 90 °C). The experimental results show an almost linear and inversely proportional behavior between the stimuli of pressure and temperature with the frequency response. This 3D-printed ear prosthesis is a promising tool and has a great potentiality in the biomedical engineering field because of its ability to generate an electrical potential proportional to pressure and temperature, and it is the first time that such a device has been processed by the additive manufacturing process (3D printing). More work needs to be carried out to improve the performance, such as electrical stimulation of the nervous system, thereby extending the purpose of a prosthesis to the area of sensory perception.


Assuntos
Orelha/fisiopatologia , Polivinil/química , Impressão Tridimensional , Próteses e Implantes , Desenho Assistido por Computador , Humanos , Polivinil/uso terapêutico , Pressão , Desenho de Prótese , Temperatura
7.
Sensors (Basel) ; 14(11): 21523-34, 2014 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-25405510

RESUMO

Respiratory and heart rates are among the most important physiological parameters used to monitor patients' health. It is important to design devices that can measure these parameters without risking or altering the subject's health. In this context, a novel sensing method to monitor simultaneously the heartbeat and respiratory rate signals of patients within an electrically safety environment was developed and tested. An optical fiber-based sensor was used in order to detect two optical phenomena. Photo-plethysmography and the relation between bending radius and attenuation of optical fiber were coupled through a single beam light traveling along this fiber.


Assuntos
Traumatismos por Eletricidade/prevenção & controle , Tecnologia de Fibra Óptica/instrumentação , Frequência Cardíaca/fisiologia , Segurança do Paciente , Fotopletismografia/instrumentação , Testes de Função Respiratória/instrumentação , Taxa Respiratória/fisiologia , Condutividade Elétrica , Desenho de Equipamento , Análise de Falha de Equipamento , Humanos , Processamento de Sinais Assistido por Computador/instrumentação , Integração de Sistemas , Transdutores
8.
Pharmacol Res Perspect ; 12(3): e1195, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38644566

RESUMO

Recent systematic reviews suggest that pharmacists' interventions in asthma patients have a positive impact on health-related outcomes. Nevertheless, the association is not well established, and the role of clinical pharmacists is poorly represented. The aim of this overview of systematic reviews is to identify published systematic reviews assessing the impact of pharmacists' interventions on health-related outcomes measured in asthma patients. PubMed, Embase, Scopus, and Cochrane Library were searched from inception to December 2022. Systematic reviews of all study designs and settings were included. Methodological quality was assessed using AMSTAR 2. Two investigators performed study selection, quality assessment and data collection independently. Nine systematic reviews met the inclusion criteria. Methodological quality was rated as high in one, low in two, and critically low in six. Reviews included 51 primary studies reporting mainly quality of life, asthma control, lung capacity, and therapeutic adherence. Only four studies were carried out in a hospital setting and only two reviews stated the inclusion of severe asthma patients. The quality of the systematic reviews was generally low, and this was the major limitation of this overview of systematic reviews. However, solid evidence supports that pharmaceutical care improves health-related outcomes in asthma patients.


Assuntos
Asma , Farmacêuticos , Qualidade de Vida , Asma/tratamento farmacológico , Humanos , Adesão à Medicação/estatística & dados numéricos , Assistência Farmacêutica , Papel Profissional , Antiasmáticos/uso terapêutico , Antiasmáticos/administração & dosagem , Revisões Sistemáticas como Assunto
9.
Am Nat ; 181(4): 571-82, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23535621

RESUMO

Multipartner mutualisms have potentially complex dynamics, with compensatory responses when one partner is lost or relegated to a minor role. Fungus-growing ants (Attini) are mutualistic associates of basidiomycete fungi and antibiotic-producing actinomycete bacteria; the former are attacked by specialized fungi (Escovopsis) and diverse generalist microbes. Ants deploy biochemical defenses from bacteria and metapleural glands (MGs) and express different behaviors to control contaminants. We studied four Trachymyrmex species that differed in relative abundance of actinomycetes to understand interactions among antimicrobial tactics that are contingent on the nature of infection. MG grooming rate and actinomycete abundance were negatively correlated. The two species with high MG grooming rates or abundant actinomycetes made relatively little use of behavioral defenses. Conversely, the two species with relatively modest biochemical defenses relied heavily on behavior. Trade-offs suggest that related species can evolutionarily diverge to rely on different defense mechanisms against the same threat. Neither bacterial symbionts nor MG secretions thus appear to be essential for mounting defenses against the specialized pathogen Escovopsis, but reduced investment in one of these defense modes tends to increase investment in the other.


Assuntos
Formigas/fisiologia , Basidiomycota/fisiologia , Comportamento Animal , Actinobacteria/metabolismo , Animais , Antibacterianos/metabolismo , Especificidade da Espécie
10.
Transpl Int ; 26(9): 893-902, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23841527

RESUMO

Kidney transplantation (KT) outcomes in human immunodeficiency virus (HIV)-infected recipients are under continuous research. High incidence of early post-transplant complications such as acute rejection has been observed. A multicenter study including HIV-infected patients who underwent KT in Spain, from 2001 to 2011, was performed. The study population included 108 recipients, 36 HIV-infected, and 72 matched HIV-negative KT recipients. HIV-infected recipients developed more delayed graft function (DGF) (52% vs. 21%, P < 0.001). One- and 3-year graft survival was 91.6% and 86.2% in HIV-infected patients, and 97.1% and 94.7% in HIV-negative patients (P = 0.052). In two-variate Cox analysis, HIV infection was not a predictor of graft loss after adjusting for time on dialysis, acute rejection, and DGF. Multivariate analysis for DGF revealed HIV-positive status as independent risk factor. We analyzed the evolution of immunosuppressive and antiretroviral therapy (ART). In HIV-infected patients tacrolimus trough levels were very high in the first week and significantly lower in the second week post-transplant (P = 0.042). Post-transplant ART was significantly changed: protease inhibitors use decreased (P = 0.034) and integrase inhibitor use increased (P < 0.001). DGF is another frequent early complication in HIV-infected recipients that can affect graft survival. Strategies to prevent DGF and antiretroviral regimes with less drug interactions could improve outcomes.


Assuntos
Função Retardada do Enxerto/epidemiologia , Infecções por HIV/cirurgia , Transplante de Rim/efeitos adversos , Insuficiência Renal/cirurgia , Infecções Oportunistas Relacionadas com a AIDS/prevenção & controle , Adulto , Antirretrovirais/administração & dosagem , Estudos de Coortes , Feminino , Rejeição de Enxerto/epidemiologia , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Humanos , Imunossupressores/uso terapêutico , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Espanha/epidemiologia
11.
Farm Hosp ; 47(4): T175-T179, 2023.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37394378

RESUMO

INTRODUCTION: Recent systematic reviews and meta-analyses suggest that pharmacists' interventions in asthma patients have a positive impact on health-related outcomes. Nevertheless, the association is not well established and the role of clinical pharmacists is poorly represented, as well as severe asthma patients. The aim of this overview of systematic reviews is to identify published systematic reviews assessing the impact of pharmacists' interventions on health-related outcomes measured in asthma patients, as well as to describe key components of the interventions, the outcomes assessed and any associations between pharmacists' interventions and health-related outcomes. METHODS: PubMed, Embase, Scopus and the Cochrane Library will be searched from inception to December 2022. Systematic reviews of all study designs, severity of asthma and level of care that measured health-related outcomes will be considered. Methodological quality will be assessed using A Measurement Tool to Assess Systematic Reviews 2. Two independent investigators will perform the study selection, quality assessment and data collection, any discrepancy will be solved by a third investigator. Both narrative findings and meta-analysis of primary study data included in the systematic reviews will be synthesized. If data are appropriate for quantitative synthesis, the measures of association will be expressed as the risk ratio and difference in means. DISCUSSION: The first results on the establishment of a multidisciplinary network for the management of asthmatic patients have shown the benefits of integrating different levels of care in disease control and morbidity reduction. Further studies showed benefits in hospital admissions, patients' basal oral corticosteroid dose, exacerbations and quality of life of asthma patients. A systematic review is the most appropriate design in order to summarize the literature and identify the evidence of the benefits of interventions performed by clinical pharmacists in asthma patients, especially those with severe uncontrolled asthma, and encourage future studies to stablish the role of clinical pharmacists in asthma units. REGISTRATION DETAILS: Systematic review registration number: CRD42022372100.


Assuntos
Asma , Assistência Farmacêutica , Humanos , Asma/tratamento farmacológico , Hospitalização , Metanálise como Assunto , Qualidade de Vida , Revisões Sistemáticas como Assunto , Literatura de Revisão como Assunto
12.
Farm Hosp ; 47(4): 175-179, 2023.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37173184

RESUMO

INTRODUCTION: Recent systematic reviews and meta-analyses suggest that pharmacists' interventions in asthma patients have a positive impact on health-related outcomes. Nevertheless, the association is not well established and the role of clinical pharmacists is poorly represented, as well as severe asthma patients. The aim of this overview of systematic reviews is to identify published systematic reviews assessing the impact of pharmacists' interventions on health-related outcomes measured in asthma patients, as well as to describe key components of the interventions, the outcomes assessed and any associations between pharmacists' interventions and health-related outcomes. METHODS: PubMed, Embase, Scopus and the Cochrane Library will be searched from inception to December 2022. Systematic reviews of all study designs, severity of asthma and level of care that measured health-related outcomes will be considered. Methodological quality will be assessed using A Measurement Tool to Assess Systematic Reviews 2. Two independent investigators will perform the study selection, quality assessment and data collection, any discrepancy will be solved by a third investigator. Both narrative findings and meta-analysis of primary study data included in the systematic reviews will be synthesised. If data are appropriate for quantitative synthesis, the measures of association will be expressed as the risk ratio and difference in means. DISCUSSION: The first results on the establishment of a multidisciplinary network for the management of asthmatic patients have shown the benefits of integrating different levels of care in disease control and morbidity reduction. Further studies showed benefits in hospital admissions, patients' basal oral corticosteroid dose, exacerbations and quality of life of asthma patients. A systematic review is the most appropriate design in order to summarise the literature and identify the evidence of the benefits of interventions performed by clinical pharmacists in asthma patients, especially those with severe uncontrolled asthma, and encourage future studies to stablish the role of clinical pharmacists in asthma units. REGISTRATION DETAILS: Systematic review registration number: CRD42022372100.


Assuntos
Asma , Assistência Farmacêutica , Humanos , Qualidade de Vida , Revisões Sistemáticas como Assunto , Asma/tratamento farmacológico , Hospitalização , Metanálise como Assunto
13.
Theriogenology ; 209: 202-212, 2023 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-37423044

RESUMO

Ejaculates present their own microbiota, and a link between ejaculates' microbiota and sperm quality and fertility exists. With the development of artificial insemination in animal breeding, ejaculates must be manipulated by diluting them with extenders and storing them at temperatures below body temperature. The effects that these processes have on the original semen microbiota have never been studied. This study explores the effects of the protocol for preparing refrigerated goat buck semen doses and storing on seminal microbiota. Semen from six adult goat bucks of the Murciano-Granadina breed (24 ejaculates) was used, cooled to 4 °C in a skimmed milk-based extender, and stored at this temperature for 24 h. Samples were taken in different steps: in the raw ejaculates (ejaculates), after dilution with the refrigeration extender (diluted), immediately after reaching 4 °C (chilled 0 h) and the samples refrigerated at 4 °C and stored at this temperature for 24 h (chilled 24 h). Sperm quality (motility and integrity of plasma and acrosomal membrane, and mitochondrial functionality) was also evaluated. Bacterial 16S rRNA sequencing was used to study the seminal microbiota. Our results indicated that both refrigeration and storage at 4 °C negatively affected sperm quality parameters. Preparing semen doses and their subsequent conservation caused a significant change in the bacterial community structure. Raw ejaculates showed a lower Pielou's evenness index than the other samples (diluted, chilled 0 h and chilled 24 h). Ejaculates also had a lower Shannon's diversity index (3.44) than the diluted semen (4.17) and the semen chilled for 24 h (4.43). Regarding beta diversity, significant differences were detected between ejaculates and the other treatments. Differences were also found in unweighted UniFrac distances between the semen chilled for 0 h and that chilled for 24 h. At the genus level, marked effects of preparing doses and their subsequent conservation were also evident: 199 genera that were absent in ejaculates were found in the semen chilled and stored for 24 h; 177 genera that were present in ejaculates disappeared after 24-h refrigeration. In conclusion, the extender and protocol for preparing refrigerated goat buck semen doses considerably modify microbial ejaculate composition.


Assuntos
Preservação do Sêmen , Sêmen , Masculino , Animais , Preservação do Sêmen/veterinária , Preservação do Sêmen/métodos , Cabras , RNA Ribossômico 16S , Motilidade dos Espermatozoides , Espermatozoides
14.
Front Vet Sci ; 9: 867671, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35647092

RESUMO

Changes in semen microbiota are associated with alterations to sperm quality and fertility. However, the microbiota from most livestock species has not yet been studied. Goats are seasonal breeders, but semen microbiota has never been described in this species, and it is unknown how seasonality affects it. Our study objective is 2-fold: to describe the microbiota in goat buck ejaculates and to determine if it differs between breeding and non-breeding seasons. Semen from six males of the Murciano-Granadina breed was collected during both seasons. Two replicates were performed per male and season on different days. The microbiota was characterized by genomic sequencing technology. Sperm quality was also evaluated. Repetition was not significant for the studied variables. Sperm velocities were higher for the breeding than for the non-breeding season. The ejaculates from both seasons also differed in the proportion of apoptotic spermatozoa. The five dominant phyla were Firmicutes, Proteobacteria, Fusobacteria, Actinobacteria, and Bacteroidetes during the breeding season and Firmicutes, Proteobacteria, Actinobacteria, Bacteroidetes, and Cyanobacteria during the non-breeding season. The dominant genus during both seasons was Ureaplasma. Differences in microbial community structure (the beta diversity) were found. A decrease in the relative abundance of the genus Faecalibacterium and an increase in the genera Sphingomonas and Halomonas were observed in the ejaculates collected during the breeding season. Sphingomonas and Faecalibacterium abundance favorably and unfavorably correlated with sperm quality, respectively. In conclusion, the semen microbiota from goat bucks varies between breeding and non-breeding seasons, and the microbiota remains stable for 7 days within a season. In addition, the genera Sphingomonas and Faecalibacterium could be possible biomarkers of semen quality in goat bucks. These results contribute to an in-depth understanding of the effects of reproductive seasonality on goat buck ejaculates.

15.
Nephrol Dial Transplant ; 26(4): 1401-7, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20858765

RESUMO

BACKGROUND: Some aspects of kidney transplant outcome in human immunodeficiency virus (HIV)-infected patients are still controversial. Besides, published experience is scarce in Europe. METHODS: A multicentre case-control study was designed to analyse the outcome of renal transplant in HIV + patients in Spain. Twenty HIV + patients were compared with a matched cohort of 40 HIV - recipients. RESULTS: Post-transplant follow-up period was 39.98 ± 36.51 months. Pre-transplant dialysis duration and the incidence of pre-transplant opportunistic infections were significantly higher for HIV + patients. Following transplantation, HIV + recipients presented lower incidence of immediate renal function and more acute rejection. Graft survival was lower although the difference was not significant (1 year: 85 vs 97.5%; 5 years: 74.4 vs 91%; log-rank P = 0.058). There was no difference in patient survival rates. Eight patients in each group presented hepatitis C (HCV) infection. Coinfected patients were compared with HIV +/HCV - and HIV -/HCV + recipients. Coinfected patients presented more time on dialysis, greater duration of delayed graft function and lower graft survival (HIV +/HCV + vs HIV +/HCV -: log-rank P = 0.009; HIV +/HCV + vs HIV -/HCV +: log-rank P = 0.02). Conversely, when excluding HCV + patients in both groups, graft survival in HIV + and HIV - patients was similar. CONCLUSIONS: The outcome was good, particularly in non-coinfected patients. Coinfected patients constitute an especially high-risk group for kidney transplantation.


Assuntos
Infecções por HIV/complicações , HIV/patogenicidade , Falência Renal Crônica/etiologia , Transplante de Rim , Fármacos Anti-HIV/efeitos adversos , Estudos de Casos e Controles , Feminino , Sobrevivência de Enxerto , Infecções por HIV/tratamento farmacológico , Humanos , Imunossupressores/uso terapêutico , Falência Renal Crônica/mortalidade , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento , Carga Viral
16.
BMC Anesthesiol ; 11: 2, 2011 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-21324200

RESUMO

BACKGROUND: Postoperative hypothermia is a common cause of complications in patients who underwent laparoscopic cholecystectomy. Hypothermia is known to elicit electrophysiological, biochemical, and cellular alterations thus leading to changes in the active and passive membrane properties. These changes might influence the bioelectrical impedance (BI). Our aim was to determine whether the BI depends on the core temperature. METHODS: We studied 60 patients (52 female and 8 male) age 40 to 80 years with an ASA I-II classification that had undergone laparoscopic cholecystectomy under balanced inhalation anesthesia. The experimental group (n = 30) received active core rewarming during the transanesthetic and postanesthesic periods. The control group (n = 30) received passive external rewarming. The BI was recorded by using a 4-contact electrode system to collect dual sets of measurements in the deltoid muscle. The body temperature, hemodynamic variables, respiratory rate, blood-gas levels, biochemical parameters, and shivering were also measured. The Mann-Whitney unpaired t-test was used to determine the differences in shivering between each group at each measurement period. Measurements of body temperature, hemodynamics variables, respiratory rate, and BI were analyzed using the two-way repeated-measures ANOVA. RESULTS: The gradual decrease in the body temperature was followed by the BI increase over time. The highest BI values (95 ± 11 Ω) appeared when the lowest values of the temperature (35.5 ± 0.5°C) were reached. The active core rewarming kept the body temperature within the physiological range (over 36.5°C). This effect was accompanied by low stable values (68 ± 3 Ω) of BI. A significant decrease over time in the hemodynamic values, respiratory rate, and shivering was seen in the active core-rewarming group when compared with the controls. The temporal course of shivering was different from those of body temperatue and BI. The control patients showed a significant increase in the serum-potassium levels, which were not seen in the active-core rewarming group. CONCLUSIONS: The BI analysis changed as a function of the changes of core temperature and independently of the shivering. In addition, our results support the beneficial use of active core rewarming to prevent accidental hypothermia.

17.
Animals (Basel) ; 11(4)2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33915961

RESUMO

The aim of this work was to improve the growth characteristics of Murciano-Granadina (MG) kids through terminal crossbreeding of MG goats to Boer bucks. Four experiments were carried out, using a total of 354 MG goats, half of which were mated with MG bucks (n = 12) and the other half with Boer bucks (n = 12). The kids were raised in artificial rearing until slaughter weight (9 kg). The birth weight and average daily gain were recorded in crossed kids (n = 197 and 145, respectively) and purebred kids (n = 257 and 169, respectively). Crossed kids presented significant differences (p < 0.001) compared to MG purebred kids in birth weight (+ 24%), mortality in artificial rearing (-37%), average daily gain (+32%) and milk powder conversion rate (-16%). However, the reproductive performance rates of MG goats mated with Boer bucks were slightly worse (pregnancy rate: 78.5% vs. 86.6%, p < 0.05; kidding rate: 62.0% vs. 75.7%; p < 0.01; prolificacy: 1.9 vs. 2.1 kids/parturition), especially when the matings took place in non-breeding season (experiments conducted at latitude 38-39° N). It is concluded that the terminal crossbreeding of MG goats to Boer bucks (those not used to produce replacement kids) could be an interesting option for ethical goat production.

18.
Eur J Hosp Pharm ; 28(Suppl 2): e120-e123, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33115800

RESUMO

INTRODUCTION: During the COVID-19 pandemic, measures have been put in place to adapt to patients' needs during home quarantine, such as "telehealthcare". With this service, hospital pharmacists develop a distinct role via the implementation of pharmacovigilance services and pharmaceutical care plans for patients with comorbidities, and for special populations as immunosuppressed patients.MethodsCross-sectional study involving hospital and community pharmacists actively practising during the COVID-19 pandemic. Patients who could not come to the hospital pharmacy department were provided with a delivery service to the community pharmacy of their choice. RESULTS: A total of 1186 patients requested this service. Erythropoiesis-stimulating agents were the most in-demand medication, followed by rheumatoid arthritis and antiretroviral drugs. 125 patients responded to the telephone survey, most of whom stated that they would use the delivery service again, and expressed their desire to continue doing so. DISCUSSION: Without a doubt, telepharmacy and medication delivery services have provided multiple benefits during home quarantine. The delivery service enabled us to provide drugs to patients in their immediate environment through a service that was free for both the patient and the hospital pharmacy service. However, at present, the available evidence of the impact of telepharmacy models is sparse. CONCLUSIONS: This medication delivery service has provided multiple benefits to patients during home quarantine. Although the users of this service seem to be satisfied with the current model, in the future, we should consider which patients would benefit most from this service and shape it to individual needs.


Assuntos
COVID-19 , Serviço de Farmácia Hospitalar , Humanos , Pandemias , Farmacêuticos , SARS-CoV-2
19.
Nat Ecol Evol ; 5(1): 122-134, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33106603

RESUMO

During crop domestication, human farmers traded greater productivity for higher crop vulnerability outside specialized cultivation conditions. We found a similar domestication trade-off across the major co-evolutionary transitions in the farming systems of attine ants. First, the fundamental nutritional niches of cultivars narrowed over ~60 million years of naturally selected domestication, and laboratory experiments showed that ant farmers representing subsequent domestication stages strictly regulate protein harvest relative to cultivar fundamental nutritional niches. Second, ants with different farming systems differed in their abilities to harvest the resources that best matched the nutritional needs of their fungal cultivars. This was assessed by quantifying realized nutritional niches from analyses of items collected from the mandibles of laden ant foragers in the field. Third, extensive field collections suggest that among-colony genetic diversity of cultivars in small-scale farms may offer population-wide resilience benefits that species with large-scale farming colonies achieve by more elaborate and demanding practices to cultivate less diverse crops. Our results underscore that naturally selected farming systems have the potential to shed light on nutritional trade-offs that shaped the course of culturally evolved human farming.


Assuntos
Formigas , Agricultura , Animais , Domesticação , Fazendas , Fungos , Humanos , Filogenia , Simbiose
20.
Annu Int Conf IEEE Eng Med Biol Soc ; 2021: 1399-1402, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34891546

RESUMO

The magnitude of harmful effects on dental structures, periodontium, masticatory muscles, and the temporomandibular joint, derived from temporomandibular disorders, specifically from sleep Bruxism, generates evidence that needs to be objectively collected. This paper introduces a portable device aiming at extracting and analyzing parameters (like timestamp, duration, or latency) from recordings obtained from the monitoring of occlusal activity, throughout a complete sleep cycle. An electronic device embedded in a mid-density medical grade silicon occlusal splint detects the moment in which the subject exerts sustained force, and records the time and length of the event, keeping the device on hold until a new event arises. The electronic device, based on a microcontroller, identifies occlusive events from an array of two piezo-resistive sensors and has a storage capacity of up to 36 hours of continuous activity. The collected data is wirelessly transmitted to an external module that is connected via USB to a PC. In the PC, the data is decoded, processed, analyzed, displayed, and stored in ordered files for case subjects, updating every recorded test for a complete history review. The proposed Bruxist Activity Monitor System (BAMS) was tested in one subject for more than 40 hours (5 sessions in 7 days). Preliminary results show the oral appliance endure without any significant damage over its surface nor undermining its functionality.


Assuntos
Bruxismo do Sono , Monitores de Aptidão Física , Humanos , Placas Oclusais , Bruxismo do Sono/diagnóstico
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