RESUMO
Although nebulized liposomal amphotericin B (NLAB) is being used in invasive pulmonary aspergillosis (IPA) prophylaxis, no clinical trial has shown its efficacy as a therapeutic strategy. NAIFI is the inaugural randomized, controlled clinical trial designed to examine the safety and effectiveness of NLAB (dosage: 25 mg in 6 mL, three times per week for 6 weeks) against a placebo, in the auxiliary treatment of IPA. Throughout the three-year clinical trial, thirteen patients (six NLAB, seven placebo) were included, with 61% being onco-hematological with less than 100 neutrophils/µL. There were no significant differences noted in their pre- and post-nebulization results of forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and oxygen saturation between the groups. Neither bronchospasm nor serum amphotericin B levels were reported in any patients given NLAB. 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET-TC) was carried out at the baseline and after 6 weeks. A notable decrease in median SUV (standardized uptake value) was observed in NLAB patients after 6 weeks (-3.6 vs. -0.95, p: 0.039, one tail). Furthermore, a reduction in serum substance galactomannan and beta-D-Glucan was identified within NLAB recipients. NLAB is well tolerated and safe for patients with IPA. Encouraging indirect efficacy data have been derived from image monitoring or biomarkers. However, further studies involving more patients are necessary.
RESUMO
La adolescencia es una etapa de la vida que se caracteriza por un marcado y difícil desarrollo físico, psicológico y social, durante el que el joven deberá enfrentarse a distintos problemas cotidianos y estresores vitales. Conocer y clasificar los conflictos que más preocupan al adolescente puede servir para dirigir los proyectos educativos o las intervenciones terapéuticas más eficaces. En el presente trabajo, se han codificado y cuantificado, a través del Sistema de Codificación y Análisis Diferencial de los Problemas de los Adolescente, los problemas percibidos como más estresantes por una muestra de menores residentes en un centro de acogida. Una comparación entre los adolescentes acogidos y aquellos que viven con sus padres, muestra que los menores acogidos (entre 11 y 17 años) plantean situaciones vitales diferentes en todas las categorías, destacando el alto porcentaje de problemas interpersonales con compañeros y relacionados con el deporte o el tiempo de ocio. Palabras clave autoresAdolescencia, conflictos, percepción de problemas, estresores...
Adolescence is a stage of life characterized by a marked and dififficult psysical, psychological and social development in which the young must face different daily problems and vital stressors. Knowing and classifying the conflicts that most worry the teenager might be used to direct the educative projects or therapeutic intervention more efficients. In this paper, problems perceived as more stressing have been codified and quantified through Adolescents Problems Differential Analysis and Coding System using a sample of minors leaving in a residential child care. A comparison between housed teenagers and those who live with their parents show that housed minors (between 11 and 17 years old) rise different vital situations in every single category. An outstanding fact is the high percentage of interpersonal problems with other house mates and related to sports and leisure time...