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1.
J Environ Manage ; 272: 111082, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-32854887

RESUMO

The remediation of a real textile wastewater aiming its reuse in the textile industry was carried out by integrating two processes: (i) a chemical or electrochemical advanced oxidation process (AOP or EAOP) based on Fenton's reaction for organics degradation, and (ii) a cation exchange process using marine macroalgae for removal of the iron acting in the Fenton's reaction based processes. Four AOPs/EAOPs at acidic pH 2.8 were tested: Fenton, photo-Fenton with ultraviolet A (UVA) radiation (PF/UVA), electro-Fenton (EF) and photoelectro-Fenton with UVA radiation (PEF/UVA). These processes provided very high color removals. After a running time of 45 min, the color removals were 68-95% for the Fenton process, 76-94% for the EF process, 80-98% for the PF/UVA process and 85-100% for the PEF/UVA process. In contrast, the mineralization was negligible for all the processes, indicating the generation/presence of persistent colorless compounds. The PF process was selected as first treatment stage due to its ability for color removal and related lower costs. A set of six marine macroalgae (Gracilaria caudata, Gracilaria cervicornis, Ascophyllum nodosum, Fucus spiralis, Laminaria hyperborea and Pelvetia canaliculata) were tested for iron uptake. Laminaria hyperborea showed the highest ion exchange capacity and affinity for iron species. Its application allowed the removal of all the iron acting in the PF process (3.4 mg/L). The textile wastewater resulting from the application of PF process followed by cation exchange with Laminaria hyperborea was successfully reused in scouring, bleaching and dyeing processes.


Assuntos
Águas Residuárias , Poluentes Químicos da Água/análise , Cátions , Peróxido de Hidrogênio , Oxirredução , Têxteis , Água
2.
Neurourol Urodyn ; 38(3): 958-967, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30762888

RESUMO

AIMS: To verify the incidence of urinary continence decline and the probability of maintaining urinary continence, as well as identify the prognostic factors of urinary continence decline in institutionalized older people. METHODS: A 2-year longitudinal study (with five 6-month waves) was conducted with subjects ≥60 years old who lived in 10 nursing homes in the city of Natal-RN (Brazil). Urinary incontinence was assessed by the Minimum Data Set version 3.0. Sociodemographic, institution-related and health-related variables were considered to establish the baseline. Time-dependent variables included cognitive decline, functional decline, and incidences of falls, hospitalizations, and fractures during the period. The actuarial method, the log-rank test, and Cox's regression were applied as statistical methods. RESULTS: Among the cohort of 196 older adults, 105 (53.6%) individuals maintained the continence status during the period, 21 (10.7%) improved it at one or more assessments, and 76 (38.8%) subjects declined. The cumulative probability of maintaining continence status was 82.6% (confidence interval [CI], 95%: 76.5%-87.3%), 74.7% (CI, 95%: 67.8%-80.4%), 66.9% (CI, 95%: 59.4%-73.2%), and 49.3% (CI, 95%: 40.1%-57.9%) at 6, 12, 18, and 24 months, respectively. Predicting factors for continence decline were: disability (hazard ratio [HR] = 4.03; P < 0.001), functional decline (HR = 3.02; P = 0.001) and potentially inappropriate medication (HR = 1.84; P = 0.008). CONCLUSIONS: The incidence of continence decline and the cumulative probability of maintaining continence status in institutionalized older adults was approximately 39% and 49%, respectively, at the 2-year follow-up. Disability and potentially inappropriate drugs at baseline and functional decline across the period predicted continence decline in this cohort.


Assuntos
Incontinência Urinária/fisiopatologia , Acidentes por Quedas , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Disfunção Cognitiva/psicologia , Estudos de Coortes , Avaliação da Deficiência , Pessoas com Deficiência , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Prescrição Inadequada , Incidência , Institucionalização , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Casas de Saúde , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Fatores Socioeconômicos , Incontinência Urinária/epidemiologia , Incontinência Urinária/psicologia
3.
Int J Mol Sci ; 17(11)2016 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-27869676

RESUMO

Landfill leachates result from the degradation of solid residues in sanitary landfills, thus presenting a high variability in terms of composition. Normally, these effluents are characterized by high ammoniacal-nitrogen (N-NH4⁺) concentrations, high chemical oxygen demands and low phosphorus concentrations. The development of effective treatment strategies becomes difficult, posing a serious problem to the environment. Phycoremediation appears to be a suitable alternative for the treatment of landfill leachates. In this study, the potential of Chlorella vulgaris for biomass production and nutrients (mainly nitrogen and phosphorus) removal from different compositions of a landfill leachate was evaluated. Since microalgae also require phosphorus for their growth, different loads of this nutrient were evaluated, giving the following N:P ratios: 12:1, 23:1 and 35:1. The results have shown that C. vulgaris was able to grow in the different leachate compositions assessed. However, microalgal growth was higher in the cultures presenting the lowest N-NH4⁺ concentration. In terms of nutrients uptake, an effective removal of N-NH4⁺ and phosphorus was observed in all the experiments, especially in those supplied with phosphorus. Nevertheless, N-NO3- removal was considered almost negligible. These promising results constitute important findings in the development of a bioremediation technology for the treatment of landfill leachates.


Assuntos
Amônia/isolamento & purificação , Chlorella vulgaris/metabolismo , Microalgas/metabolismo , Nitratos/isolamento & purificação , Poluentes Químicos da Água/isolamento & purificação , Biodegradação Ambiental , Chlorella vulgaris/crescimento & desenvolvimento , Microalgas/crescimento & desenvolvimento , Instalações de Eliminação de Resíduos
4.
Transplantation ; 108(1): 284-293, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-37638863

RESUMO

BACKGROUND: After kidney transplant, nonadherence to immunosuppressive therapy is the main cause of impaired kidney function and graft loss. The objective of this study was the development and internal validation of a clinical questionnaire for assessing the predisposition to adherence to immunosuppressive therapy in kidney pretransplant patients. METHODS: Multicenter prospective study conducted in 7 kidney hemodialysis and 6 kidney transplant centers of 3 Brazilian state capitals. Kidney transplant candidate patients of both sexes and >18-y-old were included. Retransplanted patients were excluded. A 72-item pilot version of the questionnaire, created through literature review complemented with a focus group of 8 kidney pretransplant patients, was administered to 541 kidney transplant candidate patients. Factor analysis with varimax rotation was used for questionnaire development. Internal validity evaluation used Cronbach's alpha and test-retest reliability. Construct validity was assessed by differentiation by known groups. RESULTS: The final questionnaire, named Kidney AlloTransplant Immunosuppressive Therapy Adherence (KATITA) Questionnaire, consisting of 25 items in 3 dimensions, presented good internal consistency reliability (Cronbach's alpha 0.81). The 3 dimensions and respective Cronbach's alpha were "Carelessness" (14 items, 0.81), "Skepticism" (6 items, 0.57), and "Concern" (5 items, 0.62). The interdimension correlation matrix showed low correlation coefficients (<0.35). Test-retest reliability, evaluated with 154 patients, showed an intraclass correlation coefficient of 0.62 (moderate agreement). The scale showed construct validity. CONCLUSIONS: The KATITA-25 questionnaire is the first psychometric instrument for evaluation of predisposition to nonadherence to immunosuppressive medication in candidate patients for kidney transplant in the pretransplant setting.


Assuntos
Transplante de Rim , Masculino , Feminino , Humanos , Reprodutibilidade dos Testes , Estudos Prospectivos , Transplante de Rim/efeitos adversos , Imunossupressores/efeitos adversos , Inquéritos e Questionários , Psicometria/métodos , Suscetibilidade a Doenças , Rim
5.
Transplantation ; 2024 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38548683

RESUMO

BACKGROUND: The self-administered Kidney AlloTransplant Immunosuppressive Therapy Adherence (KATITA-25) questionnaire is a multidimensional scale for use in the pretransplant setting that evaluates the predisposition to nonadherence of patients who are candidates to kidney transplant. The scale has shown adequate internal consistency and test-retest reliability. This study presents the results of an external validation study of the KATITA-25 scale. METHODS: Patients >18 y old scheduled for kidney transplant were included in this multicenter study. The KATITA-25 scale was administered before surgery and then at 3-mo posttransplantation for evaluation of scale sensitivity to change. At this time, 2 validated medication adherence scales were applied for assessment of concurrent validity. For evaluation of predictive validity, nonadherence to immunosuppressive medication was assessed at 6 and 12 mo after transplantation by 3 independent methods: patient self-report of nonadherence using the Morisky-Green-Levine Medication Assessment Questionnaire scale, serum trough levels of immunosuppressants, and pharmacy refills. RESULTS: Three twenty-two patients were available for evaluation of concurrent validity and 311 patients of predictive validity. After kidney transplant, the median KATITA-25 score decreased from 20 to 8 (P < 0.001), demonstrating scale sensitivity to change, and the KATITA-25 score showed correlation with the Basel Assessment of Adherence to Immunosuppressive Medication Scale score (Spearman's ρ 0.18, P = 0.002) and the Cuestionario para la Evaluación de la Adhesión al Tratamiento Antiretroviral scores (ρ -0.17, P = 0.002), confirming concurrent validity. The nonadherence rate was 57.6%. The scale predictive validity was demonstrated by the area under the receiver operating characteristics curve (0.68), sensitivity (59.8%), specificity (68.2%), and positive predictive value (71.8%). CONCLUSIONS: This external validation study of KATITA-25 scale provided evidence of sensitivity to change, and structural, criterion, and predictive validity.

6.
PLoS One ; 17(4): e0266776, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35476808

RESUMO

Blue and green ecosystems are considered a key for the improvement of cities sustainability, providing numerous ecosystem services and habitat for many species. However, urban streams are still neglected and degraded, specially in southern European countries. One important step towards the rehabilitation of these ecosystems is the awareness of their importance by citizens. This study aimed to assess the effect of 1-year of activities (field and laboratory) of an environmental education project on primary school children, in improving their knowledge on urban stream ecosystems and their problems. We analyzed students' questionnaires before and after field and laboratory activities, drawings and group interviews. Initially, most children had incipient contact with rivers and streams, showing fears and lack of knowledge about them. As the project progressed, their perceptions changed, with a clear increase in the proportion of students recognizing the biodiversity associated to rivers (e.g., names of riparian trees, aquatic plants and invertebrates). Also, their fears decreased significantly, while their awareness to the impacts of artificialization and lack of riparian vegetation increased. Our results show that direct contact with nature have a positive role in the way it is understood by children, as well as promoting responsible and sustainable behaviors, being effective from the early primary-school years.


Assuntos
Ecossistema , Rios , Animais , Biodiversidade , Criança , Pré-Escolar , Humanos , Invertebrados , Árvores
7.
Chemosphere ; 263: 128111, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33297104

RESUMO

This study focuses on the influence of major dissolved constituents naturally found in waters intended for human consumption on bromate (BrO3-) reduction by heterogeneous photocatalysis. The individual and combined effect of chloride (Cl-), bicarbonate/carbonic acid (HCO3-/H2CO3), nitrate (NO3-), sulphate (SO42-) and humic acids (HAs) on BrO3- reduction was evaluated in synthetic waters (SWs). Additionally, freshwaters (FWs) from a drinking water treatment plant (DWTP) were tested and directly compared to SWs. Cl- was beneficial for contents in the range 0.47-1.4 mM, with negligible influence for lower and higher contents. NO3- had a null effect regardless of its content (0.024-0.81 mM). HCO3-/H2CO3 (0.061/0.45 mM), SO42- (0.12-2.6 mM) and HAs (0.11-1.0 mM C) had a negative effect in the tested contents. The BrO3- reduction rate was 2.8 times lower in SW with a mixture of water constituents compared to SW without constituents addition. This decline on BrO3- reduction rate corresponded to the sum of the individual species contribution and so there was no evidence of synergetic effects. By contrast, the use of FWs provided BrO3- reduction rates only slightly lower than that found for SW without constituents addition (∼1.2-fold), which can be attributed to: (i) the distinct characteristics of the organic matter of FWs (HAs, fulvic acids and humins with distinct molecular weights and functional groups) compared to that of SW (pure HAs), and/or (ii) the presence in FWs of other inorganics in addition to those here addressed. The heterogeneous TiO2 photocatalysis proved to be a promising process for BrO3- reduction in DWTPs.


Assuntos
Poluentes Químicos da Água , Purificação da Água , Bromatos , Humanos , Nitratos , Água , Poluentes Químicos da Água/análise
8.
Sao Paulo Med J ; 139(1): 81-87, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33656132

RESUMO

BACKGROUND: The World Health Organization has declared that a pandemic situation exists in relation to the disease caused by the new coronavirus, COVID-19. So far, the absence of a vaccine against the new coronavirus has led people worldwide to seek various therapeutic alternatives, including use of cholecalciferol. DESIGN AND SETTING: Narrative review developed by a research group at a public university in Recife (PE), Brazil. METHODS: We searched the literature on the use of cholecalciferol for prevention or treatment of COVID-19, using the MEDLINE and LILACS databases, with the keywords "vitamin D", "cholecalciferol", "SARS-CoV-2", "COVID-19" and "coronavirus", from January 1, 2020, to June 10, 2020. Narrative reviews, cohort studies and ecological studies were selected. RESULTS: We retrieved 32 references, of which 8 were considered eligible for intensive review and critical analysis. These comprised five narrative reviews, two observational studies and one protocol proposal. Most of the studies selected reported positive effects from use of vitamin D for prevention or treatment of COVID-19. However, there was little quantitative data to assess the real impact of using this vitamin as an intervention against this disease. CONCLUSIONS: Current studies on vitamin D used for purposes other than bone health promotion cannot be taken as support to justify its use in a disease as recent as COVID-19. Studies of greater robustness, with higher levels of clinical evidence, need to be conducted. Rational use of this vitamin needs to be ensured, thereby minimizing the impacts on the patient and the public healthcare system.


Assuntos
Tratamento Farmacológico da COVID-19 , Colecalciferol/uso terapêutico , Humanos , Pandemias
9.
Cien Saude Colet ; 25(6): 2073-2082, 2020 Jun.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32520255

RESUMO

This study aimed to verify the prevalence of the use of Potentially Inappropriate Medications (PIM) for elderly living in Long-Term Care Institutions for the Elderly (LTCIE), as well as the types of medications and their associated factors. This is a cross-sectional study carried out in 10 LTCIEs in the city of Natal in the period October-December 2013. Potentially inappropriate medications were classified according to the 2015 American Geriatric Society Beers Criteria for Potentially Inappropriate Medication Use in Older Adults - 2015. Sociodemographic, LTCIE-related and health-related variables were considered. Univariate and multivariate analyses were performed between the primary variable (PIM use) and the independent variables using Poisson regression. The sample consisted of 321 older people, of whom 304 used medications. The prevalence of PIM use was 54.6% (95% CI: 48.9-60.2) and was associated with polypharmacy and dementia in the final model. The most common PIMs were antipsychotics and benzodiazepines. The study revealed a high prevalence of PIM use among the elderly of the LTCIEs, evidencing the need to adopt indicators on the use of these drugs and the implementation of strategies that make drug therapy safer and more adequate for older adults.


Este trabalho teve como objetivo verificar a prevalência do uso de medicamento potencialmente inapropriado (MPI) para idosos residentes em Instituições de Longa Permanência para Idosos (ILPI), assim como os tipos de medicamentos e seus fatores associados. Trata-se de estudo transversal realizado em 10 ILPI da cidade do Natal, entre outubro e dezembro de 2013. Os medicamentos inapropriados foram classificados de acordo com os Critérios de Beers da American Geriatric Society 2015. Foram analisadas variáveis sociodemográficas, relacionadas à ILPI e às condições de saúde. Para as análises univariada e multivariada entre a variável principal (uso de MPI) e as demais foi utilizada a regressão de Poisson. A amostra foi composta por 321 idosos e, destes, 304 utilizavam medicamentos. A prevalência de uso de MPI foi de 54,6% (IC 95%: 48,9-60,2) e no modelo final esteve associada à polifarmácia e à demência. As classes terapêuticas de MPI mais identificadas foram antipsicóticos e benzodiazepínicos. O estudo revelou alta prevalência de MPI entre os idosos das ILPI, configurando a necessidade de adoção de indicadores do uso destes medicamentos e a implantação de estratégias que tornem a farmacoterapia mais segura e adequada aos idosos.


Assuntos
Prescrição Inadequada , Lista de Medicamentos Potencialmente Inapropriados , Idoso , Estudos Transversais , Humanos , Polimedicação , Prevalência , Fatores de Risco
10.
Sci Total Environ ; 741: 140165, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32574920

RESUMO

This study focuses on the development of a treatment train for a leachate from a hazardous industrial waste landfill (HIWL) previously treated by: (i) catalytic oxidation with hydrogen peroxide (H2O2) for sulphide and sulphite conversion into oxidized sulphur species, including sulphate, and (ii) chemical precipitation of sulphate as barite. The complete treatment line counted on four more stages: (iii) 1st biological oxidation for removal of biodegradable organic compounds and nitrogen species, (iv) coagulation with ferric chloride (coagulant dose of 100 mg Fe L-1, pH 2.8) for removal of a fraction of recalcitrant organics and suspended solids, (v) photo-Fenton oxidation using ultraviolet A (UVA) radiation (PF-UVA) (pH 2.8, initial total dissolved iron content of 140 mg L-1, treatment time of ~4 h) for recalcitrant organics degradation and biodegradability improvement, and (vi) 2nd biological oxidation for removal of the biodegradable organic matter resulting from the PF-UVA process. The use of anodic oxidation or photoelectro-Fenton processes in stage (v) demonstrated to be unfeasible. A chemical oxygen demand (COD) below 1000 mg O2 L-1, a common limit imposed by municipal wastewater treatment plants (MWWTPs) to effluents discharged into the municipal sewer, was achieved after a feasible treatment time (~4 h) using the multistep approach. The remediation of the HIWL leachate proved to be a big challenge.


Assuntos
Poluentes Químicos da Água/análise , Análise da Demanda Biológica de Oxigênio , Resíduos Perigosos , Peróxido de Hidrogênio , Resíduos Industriais , Oxirredução , Eliminação de Resíduos Líquidos , Águas Residuárias
11.
Waste Manag ; 89: 114-128, 2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-31079725

RESUMO

This study aimed at developing an efficient multistage treatment strategy for a complex industrial landfill leachate: a leather tannery landfill leachate. Based on the leachate physicochemical characteristics, the following treatment train was delineated and tested: (i) initial biological process for removal of biodegradable organics, ammonium and alkalinity, (ii) coagulation/flocculation process for total removal of chromium and partial removal of recalcitrant organics and suspended solids, (iii) advanced oxidation process (AOP) or electrochemical AOP (EAOP) for degradation of recalcitrant organics and biodegradability enhancement, and (iv) final biological polishing step. Two initial biological treatment configurations were applied: one comprising nitrification and the other nitrification-denitrification. Coagulation/flocculation was optimized in terms of pH, coagulant dosage (iron(III) chloride) and flocculant nature and dosage. The following AOPs/EAOPs were tested: Fenton, photo-Fenton with UVA or UVC radiation (PF-UVA or PF-UVC), anodic oxidation (AO), electro-Fenton (EF) and photoelectro-Fenton with UVA radiation (PEF-UVA). The biological nitrification-denitrification was beneficial not only because it avoided the need for alkalinity addition during nitrification and decreased the amount of substrate added during denitrification, as expected. Over and above that, it reduced the acid consumption in the coagulation/flocculation, avoided the application of an additional stage comprising nitrites oxidation to nitrates prior to the AOP/EAOP, and improved the efficiency of Fenton's reaction based processes. Following nitrification-denitrification, the coagulation/flocculation was maximized at pH 3.0 and 400 mg Fe L-1 with no flocculant addition. The PEF-UVA process was the best AOP/EAOP. The final leachate fulfilled the discharge limits into waterbodies.


Assuntos
Poluentes Químicos da Água , Desnitrificação , Compostos Férricos , Peróxido de Hidrogênio , Ferro , Nitrificação , Oxirredução
12.
Sci Total Environ ; 655: 1249-1260, 2019 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-30577117

RESUMO

This study focused on the removal of sulphur compounds from a high-strength leachate of a hazardous industrial waste landfill. Firstly, sulphides (0.5 g L-1) and sulphites (2.5 g L-1) were catalytic oxidised at natural pH (8.7). Air or H2O2 were applied as oxidants and metals present in the leachate were used as catalysts. Distinct air flow rates and H2O2:sulphur molar ratios were tested. Concentrations of sulphide and sulphite lower than 1.0 mg L-1 (emission limit value - ELV) were obtained after 5-h oxygenation or 1-min peroxidation under the best conditions, i.e. air flow rate of 1 Lair Lleachate-1 min-1 and H2O2:sulphur stoichiometric ratio. Aeration was considered unsafe since >33 volatile organic compounds (VOCs) and hydrogen sulphide (H2S) were released to the atmosphere. Thus, only the H2O2-oxidised leachate pursued treatment. Sulphates (13 g L-1) were removed by chemical precipitation as ettringite or barite applying different reactants contents and pH values. Without pH correction, sulphate contents below 2.0 g L-1 (ELV) were achieved using a [Ca2+]:[Al3+]:[SO42-] molar ratio of 12:4:3 (2-fold stoichiometry) and a [Ba2+]:[SO42-] molar ratio of 1.0:1.0 (1-fold stoichiometry). The analysis of precipitates by X-ray diffraction (XRD) showed a three-phase ettringite (only 67% corresponding to ettringite itself) and single-phase barite. Barite precipitation proved to be more appealing since a value-added product was obtained and, furthermore, less reactants were required. After sulphur compounds removal using H2O2-driven catalytic oxidation and chemical precipitation through barite, the leachate was suitable for biological treatment, despite the high salinity, and a high fraction of the organic load (46%) could be biologically oxidised.

13.
Sci Total Environ ; 667: 821-832, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-30852436

RESUMO

This study is focused on the selection of the best piping arrangement for a pilot scale annular channel reactor intended for the remediation of waters and wastewaters. Two annular channel reactors composed of a single UV lamp and distinct piping arrangements were considered: (i) a novel reactor with tangential inlet/outlet pipes - the FluHelik reactor, and (ii) a conventional Jets reactor. These two reactors were manufactured at lab scale and characterized in terms of residence time distribution (RTD), radiant power and ability to degrade aqueous solutions spiked with a model compound - 3-amino-5-methylisoxazole (AMI) - by H2O2/UVC and UVC processes. Computational fluid dynamics (CFD) simulations were used to assess the hydrodynamics, RTD and UV radiation intensity distribution of both reactors at pilot scale. In general, experimental results at lab scale revealed quite similar RTDs, radiant powers and AMI degradation rates for both reactors. On the other hand, CFD simulations at pilot scale revealed the generation of a helical motion of fluid around the UVC lamp in the FluHelik reactor, inducing: (i) a longer contact time between fluid particles and UV light, (ii) more intense dynamics of macromixing as a result of larger velocity gradients, turbulent intensities and dispersion of RTD values around the peak, and (iii) a more homogeneous UV radiation distribution. In addition, the design of the FluHelik reactor can favor the implementation of various reactors in series, promoting its application at industrial scale. The FluHelik reactor was chosen for scaling-up. A pre-pilot scale treatment unit containing this reactor was constructed and its feasibility was proven.

14.
Pediatr Infect Dis J ; 38(9): e193-e198, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31220042

RESUMO

BACKGROUND: In 2015, the detection rate of leprosy in Santana do Ipanema municipality, Alagoas state, Brazil, was 39.3 cases per 100,000 inhabitants, and among young people below 15 years of age, it was 32.8 cases per 100,000 inhabitants. MATERIAL AND METHODS: A prospective study was carried out from 2015 to 2017, in Santana do Ipanema city, with 69 leprosy contacts in the age group of 4-15 years. Measurement of serum IgM, IgG, and IgA against phenolic glycolipid antigen-1 (PGL-1) was done by an indirect enzyme-linked immunosorbent assay. RESULTS: A high frequency of positive anti-PGL-1 IgM was found in both paucibacillary and multibacillary contacts. Twenty-three participants presented suspected lesions and 45 did not. In both groups a high frequency of positive IgM was found. In regard to anti-PGL-1 IgG, it was found a strong association between its positivity and the presence of lesions (relative risk of 3.25). Eight new cases of leprosy were diagnosed, five of which were seropositive for anti-PGL-1. Again, a striking association was found between positive IgG and leprosy (relative risk of 8.5). No significant association was found between IgM isotype and disease, nor between IgA and disease. CONCLUSIONS: The present study reinforces the importance of measuring the three anti-PGL-1 isotypes in follow-up studies of leprosy contacts. Moreover, positive anti-PGL-1 IgG is associated with a high associated risk of disease.


Assuntos
Anticorpos Antibacterianos/sangue , Antígenos de Bactérias/imunologia , Glicolipídeos/imunologia , Hanseníase/diagnóstico , Hanseníase/imunologia , Adolescente , Brasil , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Seguimentos , Humanos , Imunoglobulina A/sangue , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Estudos Prospectivos , Fatores de Risco
15.
Rev. Ciênc. Plur ; 9(2): 30628, 31 ago. 2023. tab
Artigo em Português | LILACS, BBO - odontologia (Brasil) | ID: biblio-1509333

RESUMO

Mesmo em emergências sanitárias, quando terapias experimentais são empregadas, é importante prezar pela segurança e eficácia no uso de medicamentos, e a análise de prescrições médicas é uma das maneiras de monitorar aspectos de segurança. Objetivo: Quantificar e classificar as interações medicamentosas potenciais com hidroxicloroquina de acordo com o riscoem prescrições de pacientes com COVID-19 em pacientes com COVID-19 em uso de hidroxicloroquina admitidos em uma unidade de terapia intensiva de um Hospital de Ensino.Metodologia:Este estudo transversal baseou-se na análise de 162 prescrições de 38 pacientes admitidos em uma unidade de terapia intensiva de um Hospital de ensino entre abril e junho de 2020.O Micromedex® e o UpToDate® foram as bases de dados de apoio à conduta clínica utilizadas para estabelecer as interações medicamentosas potenciais. Resultados:A média de dias de internamento foi de 16,1 ± 14,0 e a média de dias em uso de hidroxicloroquina foi de 4,26 ± 1,74. 87,14% das prescrições apresentaram interações medicamentosas potenciais e a mais comum foi entre hidroxicloroquina e azitromicina. 76,4% das prescrições analisadas apresentaram interações medicamentosas potenciais com hidroxicloroquina. 73,5% das prescrições tiverampelo menos uma interação medicamentosa potencial entre medicamentos que prolongam o intervalo QT. Conclusões: Tendo em vista os riscos da exposição de pacientes críticos às interações medicamentosas, este estudo demonstra a necessidade de fortalecer nas instituições hospitalares a cultura de monitoramento de parâmetros de segurança e eficáciano uso de medicamentos, inclusive em terapias experimentais com a utilização de medicamentos off-labelpara minimizar riscos e ampliar possíveis benefícios (AU).


Even in health emergencies, when experimental therapies are employed, it is important to ensure the safety and efficacy of medicines, and the analysis of medical prescriptions is one of the ways to monitor safety aspects.Objective: Quantify and rank potential drug interactions with hydroxychloroquine according to risk in prescriptions of COVID-19 patients taking hydroxychloroquine admitted to an intensive care unit of a TeachingHospital.Methodology: This cross-sectional study was based on the analysis of 162 prescriptions of 38 patients admitted to an intensive care unit of a teaching hospital between April and June 2020. Micromedex® and UpToDate® were the clinical practice support databases used to establish potential drug interactions. Results: The mean number of days of hospitalization was 16.1 ± 14.0 and the mean number of days of days on hydroxychloroquine was 4.26 ± 1.74. 87.14% of the prescriptions presented potential drug interactions and the most common was between hydroxychloroquine and azithromycin. 76.4% of the analyzed prescriptions had potential drug interactions with hydroxychloroquine. 73.5% of prescriptions had at least one potential drug interaction between drugs that prolong the QT interval. Conclusions: In view of the risks of exposure of critically ill patients to drug interactions, this study interactions, this study demonstrates the need to strengthen in hospital institutions the culture of institutions the culture of monitoring safety and efficacy parameters in the use of medicines, including experimental therapies with the use of off-label drugs to minimize risks and increase possible benefits (AU).


Aunque en médio aemergencias sanitarias, cuando son empleadas terapias experimentales, es importante estimar la seguridad y eficacia en el uso de los medicamentos, y el análisis de prescripciones es una de las formas de acompanhar los aspectos de seguridad. Objetivo:Cuantificar y clasificar las interaciones farmacologicas potenciales con hidroxicloroquina de acuerdo com el riesgo em prescripciones de pacientes com Covid-19 em uso de hidroxicloroquina andmitidos em unidad de terapia intensiva de um Hospital Docente. Metodología: Este estudio transversal se asienta en el análisis de 162 prescripciones de 38 pacientes admitidos em uma unidad de terapia intensiva de um Hospital Docente entre abril y junio de 2020. El Micromedex®ï¸y el UpToDate®ï¸fueron las bases de datos de apoyo a la actuación clínica utilizadas para establecer las interacciones farmacológicas potenciales. Resultados:El promedio de días de internamiento fue de 16,1 ± 14,0 y el promedio de días en uso hidroxicloroquina fuede 4,26 ± 1,74. 87,14% de las prescripciones presentaron interacciones farmacológicas potenciales y la más común fue entre hidroxicloroquina y azitromicina. 76,4% de las prescripciones analizadas presentaron interaciones farmacológicas com hidroxicloroquina. 73,5% de las prescripciones tuvierion por lo menos uma interacción farmacológica potencial entre medicamentos que prolongam el intervalo QT. Conclusiones:Tenendo a la vista los riesgos de la exposición de pacientes críticos a las interaciones farmacológicas, este estudio demuestra la necesidad de reforzar em las instituiciones hospitalarias la cultura de monitoreo de parâmetros de seguridade y eficacio em el uso de medicamentos, incluso en terapias experimentales con utilización de medicamentos off-label, para minorar riesgos y ampliar los posibles beneficios (AU).


Assuntos
Humanos , Masculino , Feminino , Uso de Medicamentos , Prescrições , COVID-19/transmissão , Hidroxicloroquina/análise , Unidades de Terapia Intensiva , Estudos Transversais/métodos , Interpretação Estatística de Dados , Interações Medicamentosas , Hospitais de Ensino
16.
J. Health Biol. Sci. (Online) ; 11(1): 1-7, Jan. 2023. tab
Artigo em Português | LILACS | ID: biblio-1524589

RESUMO

Objetivo: o presente trabalho teve como objetivo avaliar os fatores clínicos e medicamentosos relacionados com a redução da Taxa de Filtração Glomerular (TFG) em pacientes críticos em uso de vancomicina. Métodos: trata-se de um estudo transversal em que pacientes em uso de vancomicina, maiores de 18 anos, hospitalizados em terapia intensiva, foram selecionados no período de agosto a dezembro de 2019. Foram excluídos os pacientes que tiveram permanência inferior a 48h na unidade, aqueles com doença renal crônica e/ou que tiveram antimicrobiano suspenso nas primeiras 48h. Os dados clínicos e laboratoriais foram coletados do prontuário nas mesmas datas das coletas de amostras sanguíneas. As amostras de sangue foram coletadas no vale a partir do terceiro dia de tratamento. Os níveis de vancomicina foram medidos usando VANC VITROS ®. Os dados foram analisados através do software R. Resultados: 54 pacientes foram incluídos, sendo 68,5% do sexo masculino, 98,1% em ventilação mecânica, com foco respiratório (51,2%) e isolado Acinetobacter baumanni (38,0%). As concentrações de vancomicina variaram entre 5,0 e 50,0µg/mL, média 21,6 (DP: 10,6) µg/mL; 50% dos pacientes apresentaram concentração acima de 20µg/mL e 66,7% piora da TFG após o tratamento. A concentração de vancomicina foi a única variável diretamente relacionada com o desenvolvimento da alteração na função renal (p=0.0037). Não foi possível estabelecer a influência da comedicação na redução da taxa de filtração glomerular (TFG). Conclusão: as doses usuais de vancomicina ajustadas por meio da função renal não atingiram os níveis séricos terapêuticos recomendados de vancomicina, sendo relacionados à nefrotoxicidade.


Objective: we aimed to evaluate clinical and drug factors related to the Glomerular Filtration Rate (GFR) reduction in critically ill patients using vancomycin. Methods: This is a cross-sectional study where critically ill patients using vancomycin, aged over 18 years, were selected from August to December 2019. Patients were excluded when hospitalized for less than 48 hours in the unit, those with chronic kidney disease, and/or who had their antimicrobial suspended in the first 48 hours. Clinical and laboratory data were collected from the medical record on the same days as the blood sample collection. All blood samples were collected at the trough during the third day of vancomycin treatment. Vancomycin levels were measured using VANC VITROS ®. Data analysis was analyzed by R software. Results: 54 patients were included, 68.5% male, 98.1% mechanical ventilation, respiratory focus (51.2%), and isolation of Acinetobacter baumanni (38.0%). Vancomycin concentrations ranged between 5.0 and 50.0µg/mL, mean of 21.6 (SD: 10.6) µg/mL; 50% of patients with concentrations above 20µg/mL and 66.7% worsened GFR after vancomycin treatment. Vancomycin concentration was the only variable directly related to the development of renal malfunction (p=0.0037). It was not possible to establish the influence of co-medication in the reduction of the glomerular filtration rate (GFR). Conclusion: the usual doses of vancomycin adjusted by renal function did not reach the recommended therapeutic serum levels of vancomycin, being related to nephrotoxicity.


Assuntos
Adulto , Taxa de Filtração Glomerular , Vancomicina , Estudos Transversais
17.
Environ Sci Pollut Res Int ; 24(7): 6195-6204, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26555882

RESUMO

The present study aims to assess the removal of 3-amino-5-methylisoxazole (AMI), a recalcitrant by-product resulting from the biological breakdown of some pharmaceuticals, applying a solar photo-Fenton process assisted by ferrioxalate complexes (SPFF) (Fe3+/H2O2/oxalic acid/UVA-Vis) and classical solar photo-Fenton process (SPF) (Fe2+/H2O2/UVA-Vis). The oxidation ability of SPFF was evaluated at different iron/oxalate molar ratios (1:3, 1:6, and 1:9, with [total iron] = 3.58 × 10-2 mM and [oxalic acid] = 1.07 × 10-1, 2.14 × 10-1 and 3.22 × 10-1 mM, respectively) and pH values (3.5-6.5), using low iron contents (2.0 mg Fe3+ L-1). Additionally, the use of other organic ligands such as citrate and ethylenediamine-N,N'-disuccinic acid (EDDS) was tested. The oxidation power of the classical SPF was assessed at different pH values (2.8-4.0) using 2.0 mg Fe2+ per liter. Furthermore, the effect of AMI concentration (2-20 mg L-1), presence of inorganic ions (Cl-, SO42-, NO3-, HCO3-, NH4+), and radical scavengers (sodium azide and D-mannitol) on the SPF method at pH 3.5 was also assessed. Experiments were done using a lab-scale photoreactor with a compound parabolic collector (CPC) under simulated solar radiation. A pilot-scale assay was conducted using the best operation conditions. While at near neutral pH, an iron/oxalate molar ratio of 1:9 led to the removal of 72 % of AMI after 90 min of SPFF, at pH 3.5, an iron/oxalate molar ratio of 1:3 was enough to achieve complete AMI degradation (below the detection limit) after 30 min of reaction. The SPF process at pH 3.5 underwent a slower AMI degradation, reaching total AMI degradation after 40 min of reaction. The scale up of SPF process showed a good reproducibility. Oxalic and oxamic acids were identified as the main low-molecular-weight carboxylic acids detected during the pilot-scale SPF reaction. Graphical abstract ᅟ.


Assuntos
Resíduos de Drogas/química , Peróxido de Hidrogênio/química , Ferro/química , Isoxazóis/química , Processos Fotoquímicos , Concentração de Íons de Hidrogênio , Ácido Oxálico/química , Oxirredução
18.
Water Res ; 105: 251-263, 2016 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-27619501

RESUMO

This study focuses on the degradation of pharmaceuticals from a municipal wastewater after secondary treatment by applying various advanced oxidation processes (AOPs) and electrochemical AOPs (EAOPs) like UVC, H2O2/UVC, anodic oxidation (AO), AO with electrogenerated H2O2 (AO-H2O2), AO-H2O2/UVC and photoelectro-Fenton (PEF) using either UVC radiation (PEF-UVC) or UVA radiation (PEF-UVA). The municipal wastewater after secondary treatment was spiked with 5.0 mg L-1 of trimethoprim (TMP) antibiotic. The efficiency of processes to remove TMP followed the order UVC < AO-H2O2 < PEF-UVA << AO ≈ PEF-UVC < AO-H2O2/UVC < PEF-UVA (pH = 2.8) < H2O2/UVC ≈ PEF-UVC (pH = 2.8), using neutral pH, except when identified. While the UVC radiation alone led to a very low TMP removal, the H2O2/UVC process promoted a very high TMP degradation due to the production of hydroxyl radicals (OH) by H2O2 cleavage. In the AO-H2O2/UVC process, the electrogeneration of H2O2 can avoid the risks associated with the transportation, storage and manipulation of this oxidant and, furthermore, OH at the anode surface are also formed. Nevertheless, low contents of H2O2 were detected mainly at the beginning of the reaction, leading to a lower initial reaction rate when compared with the H2O2/UVC system. In the PEF-UVC, the addition of iron at neutral pH led to the visible formation of insoluble iron oxides that can filter the light. At pH 2.8, the iron remained dissolved, thereby promoting the Fenton's reaction and increasing the organics removal. The UVA-driven processes showed limited efficiency when compared with those using UVC light. For all processes with H2O2 electrogeneration, the active chlorine species can be scavenged by the H2O2, diminishing the efficiency of the processes. This can explain the lower efficiency of AO-H2O2 when compared with AO. Moreover, the degradation of the MWWTP effluent spiked with 18 pharmaceuticals in µg L-1 during AO process was assessed as well as the influence of the following operational variables on the process efficiency: (i) H2O2 concentration on H2O2/UVC, (ii) current density on AO, AO-H2O2, AO-H2O2/UVC, PEF-UVC and PEF-UVA, and (iii) pH on PEF-UVA.


Assuntos
Peróxido de Hidrogênio/química , Águas Residuárias/química , Ferro/química , Oxirredução , Poluentes Químicos da Água/química
19.
São Paulo med. j ; 139(1): 81-87, Jan.-Feb. 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1156972

RESUMO

ABSTRACT BACKGROUND: The World Health Organization has declared that a pandemic situation exists in relation to the disease caused by the new coronavirus, COVID-19. So far, the absence of a vaccine against the new coronavirus has led people worldwide to seek various therapeutic alternatives, including use of cholecalciferol. DESIGN AND SETTING: Narrative review developed by a research group at a public university in Recife (PE), Brazil. METHODS: We searched the literature on the use of cholecalciferol for prevention or treatment of COVID-19, using the MEDLINE and LILACS databases, with the keywords "vitamin D", "cholecalciferol", "SARS-CoV-2", "COVID-19" and "coronavirus", from January 1, 2020, to June 10, 2020. Narrative reviews, cohort studies and ecological studies were selected. RESULTS: We retrieved 32 references, of which 8 were considered eligible for intensive review and critical analysis. These comprised five narrative reviews, two observational studies and one protocol proposal. Most of the studies selected reported positive effects from use of vitamin D for prevention or treatment of COVID-19. However, there was little quantitative data to assess the real impact of using this vitamin as an intervention against this disease. CONCLUSIONS: Current studies on vitamin D used for purposes other than bone health promotion cannot be taken as support to justify its use in a disease as recent as COVID-19. Studies of greater robustness, with higher levels of clinical evidence, need to be conducted. Rational use of this vitamin needs to be ensured, thereby minimizing the impacts on the patient and the public healthcare system.


Assuntos
Humanos , Colecalciferol/uso terapêutico , COVID-19/tratamento farmacológico , Pandemias
20.
Water Res ; 75: 95-108, 2015 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-25765168

RESUMO

Apart from a high biodegradable fraction consisting of organic acids, sugars and alcohols, winery wastewaters exhibit a recalcitrant fraction containing high-molecular-weight compounds as polyphenols, tannins and lignins. In this context, a winery wastewater was firstly subjected to a biological oxidation to mineralize the biodegradable fraction and afterwards an electrochemical advanced oxidation process (EAOP) was applied in order to mineralize the refractory molecules or transform them into simpler ones that can be further biodegraded. The biological oxidation led to above 97% removals of dissolved organic carbon (DOC), chemical oxygen demand (COD) and 5-day biochemical oxygen demand (BOD5), but was inefficient on the degradation of a bioresistant fraction corresponding to 130 mg L(-1) of DOC, 380 mg O2 L(-1) of COD and 8.2 mg caffeic acid equivalent L(-1) of total dissolved polyphenols. Various EAOPs such as anodic oxidation with electrogenerated H2O2 (AO-H2O2), electro-Fenton (EF), UVA photoelectro-Fenton (PEF) and solar PEF (SPEF) were then applied to the recalcitrant effluent fraction using a 2.2 L lab-scale flow plant containing an electrochemical cell equipped with a boron-doped diamond (BDD) anode and a carbon-PTFE air-diffusion cathode and coupled to a photoreactor with compound parabolic collectors (CPCs). The influence of initial Fe(2+) concentration and current density on the PEF process was evaluated. The relative oxidative ability of EAOPs increased in the order AO-H2O2 < EF < PEF ≤ SPEF. The SPEF process using an initial Fe(2+) concentration of 35 mg L(-1), current density of 25 mA cm(-2), pH of 2.8 and 25 °C reached removals of 86% on DOC and 68% on COD after 240 min, regarding the biologically treated effluent, along with energy consumptions of 45 kWh (kg DOC)(-1) and 5.1 kWh m(-3). After this coupled treatment, color, odor, COD, BOD5, NH4(+), NO3(-) and SO4(2-) parameters complied with the legislation targets and, in addition, a total dissolved polyphenols content of 0.35 mg caffeic acid equivalent L(-1) was found. Respirometry tests revealed low biodegradability enhancement along the SPEF process.


Assuntos
Recuperação e Remediação Ambiental , Resíduos Industriais/análise , Eliminação de Resíduos Líquidos/métodos , Águas Residuárias/química , Poluentes Químicos da Água/química , Aerobiose , Biodegradação Ambiental , Técnicas Eletroquímicas , Oxirredução , Portugal
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