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1.
Transpl Int ; 37: 12579, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38605938

RESUMO

Inhaled tobramycin treatment has been associated with nephrotoxicity in some case reports, but limited data are available about serum levels and its possible systemic absorption in lung transplant recipients (LTR). We conducted a single-center, observational and retrospective study of all adult (>18 years old) LTR treated with inhaled tobramycin for at least 3 days between June 2019 and February 2022. Trough serum levels were collected and >2 µg/mL was considered a high drug level. The primary outcome assessed the presence of detectable trough levels, while the secondary outcome focused on the occurrence of acute kidney injury (AKI) in individuals with detectable trough levels. Thirty-four patients, with a median age of 60 years, were enrolled. The primary indications for treatment were donor bronchial aspirate bacterial isolation (18 patients) and tracheobronchitis (15 patients). In total, 28 patients (82%) exhibited detectable serum levels, with 9 (26%) presenting high levels (>2 µg/mL). Furthermore, 9 patients (26%) developed acute kidney injury during the treatment course. Median trough tobramycin levels were significantly elevated in invasively mechanically ventilated patients compared to non-ventilated individuals (2.5 µg/mL vs. 0.48 µg/mL) (p < 0.001). Inhaled tobramycin administration in LTRs, particularly in those requiring invasive mechanical ventilation, may result in substantial systemic absorption.


Assuntos
Injúria Renal Aguda , Tobramicina , Humanos , Pessoa de Meia-Idade , Injúria Renal Aguda/induzido quimicamente , Administração por Inalação , Antibacterianos/efeitos adversos , Estudos de Coortes , Pulmão , Estudos Retrospectivos , Tobramicina/efeitos adversos , Transplantados
2.
Br J Clin Pharmacol ; 89(9): 2843-2850, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37170398

RESUMO

AIMS: Several cases of ertapenem-related neurotoxicity have been published in the current literature. However, studies evaluating the ertapenem blood concentration (EBC) as a risk of these adverse events are scarce. We aimed to evaluate the relationship between the trough EBC and the risk of neurological toxicity. METHODS: This was a retrospective study, including patients who underwent ertapenem treatment between October 2019 and February 2021. We excluded patients in the critical care unit and those whose blood samples were not properly taken in order to analyse ertapenem trough concentration. We also excluded patients whose clinical follow-up was not properly realized for the entire period of ertapenem treatment. The main outcome was the presence of any suspicious neurological side effect owing to ertapenem administration and its relationship with the plasma concentration. Secondary outcomes were to identify clinical and analytical data contributing to a higher risk of neurotoxicity. RESULTS: The initial cohort comprised 158 individuals. For the final analysis we evaluated 102 patients, reporting a neurological alteration in 13/102 (12.7%). Mean trough EBC was significantly higher in patients showing neurotoxicity in comparison with those who did not (37.8 mcg mL-1 , standard deviation [SD] ± 35.7 vs. 14.6 mcg mL-1 , SD ± 15.2; P = .002). In multivariable logistic regression analysis, EBC (odds ratio [OR] = 1.07; P = .006), a moderate renal insufficiency (OR = 9.2; P = .02) and a history of previous neurologic disease (OR = 9.9; P = .02) were identified as risk factors of neurological alteration during ertapenem treatment. CONCLUSIONS: In patients at risk, determining the ertapenem plasma concentration may help to minimize the risk of neurotoxicity.


Assuntos
Antibacterianos , Síndromes Neurotóxicas , Humanos , Ertapenem/efeitos adversos , Antibacterianos/efeitos adversos , Estudos Retrospectivos , Síndromes Neurotóxicas/epidemiologia , Síndromes Neurotóxicas/etiologia , Síndromes Neurotóxicas/tratamento farmacológico , Fatores de Risco
3.
Phys Chem Chem Phys ; 25(29): 19626-19632, 2023 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-37435932

RESUMO

Organic chromophores and semiconductors, like anthracene, pentacene, perylene, and porphyrin, are prone to aggregation, and their packing in the solid state is often hard to predict and difficult to control. As the condensed phase structures of these chromophores and semiconductors are of crucial importance for their optoelectronic functionality, strategies to control their assembly and provide new structural motifs are important. One such approach uses metal-organic frameworks (MOFs); the organic chromophore is converted into a linker and connected by metal ions or nodes. The spatial arrangement of the organic linkers can be well-defined in a MOF, and hence optoelectronic functions can be adjusted accordingly. We have used such a strategy to assemble a phthalocyanine chromophore and illustrated that the electronic inter-phthalocyanine coupling can be rationally tuned by introducing bulky side grounds to increase steric hindrance. We have designed new phthalocyanine linkers and using a layer-by-layer liquid-phase epitaxy strategy thin films of phthalocyanine-based MOFs have been fabricated and their photophysical properties explored. It was found that increasing the steric hindrance around the phthalocyanine reduced the effect of J-aggregation in the thin film structures.

4.
Angew Chem Int Ed Engl ; 62(35): e202306764, 2023 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-37402213

RESUMO

The evaluation of the pentafluorocyclopropyl group as a chemotype in crop protection and medicinal chemistry has been hampered in the past by the lack of suitable methodologies that enable the practical incorporation of this moiety into advanced synthetic intermediates. Herein, we report the gram-scale synthesis of an unprecedented sulfonium salt, 5-(pentafluorocyclopropyl)dibenzothiophenium triflate, and its use as a versatile reagent for the photoinduced C-H pentafluorocyclopropylation of a broad series of non-previously functionalized (hetero)arenes through a radical mediated mechanism. The scope and potential benefits of the protocol developed are further demonstrated by the late-stage introduction of the pentafluorocyclopropyl unit into biologically relevant molecules and widely used pharmaceuticals.

5.
Artigo em Inglês | MEDLINE | ID: mdl-33722884

RESUMO

Scopulariopsis/Microascus isolates cause infections with high mortality in lung transplant recipients. Treatment is challenging due to antimicrobial resistance. We describe two cases of Scopulariopsis/Microascus tracheobronchitis in lung transplant recipients successfully treated with nebulized micafungin. This antifungal was well tolerated and achieved high concentrations in epithelial lining fluid up to 14 h after nebulization without significant plasma concentrations. Nebulized micafungin may be a safe and effective option for the treatment of fungal tracheobronchitis.


Assuntos
Micoses , Scopulariopsis , Antifúngicos/uso terapêutico , Humanos , Pulmão , Micafungina , Micoses/tratamento farmacológico , Transplantados
6.
Chemphyschem ; 21(20): 2254-2262, 2020 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-33448590

RESUMO

The effect of donor-acceptor distance in controlling the rate of electron transfer in axially linked silicon phthalocyanine-C60 dyads has been investigated. For this, two C60-SiPc-C60 dyads, 1 and 2, varying in their donor-acceptor distance, have been newly synthesized and characterized. In the case of C60-SiPc-C60 1 where the SiPc and C60 are separated by a phenyl spacer, faster electron transfer was observed with kcs equal to 2.7×109 s-1 in benzonitrile. However, in the case of C60-SiPc-C60 2, where SiPc and C60 are separated by a biphenyl spacer, a slower electron transfer rate constant, kcs=9.1×108 s-1, was recorded. The addition of an extra phenyl spacer in 2 increased the donor-acceptor distance by ∼4.3 Å, and consequently, slowed down the electron transfer rate constant by a factor of ∼3.7. The charge separated state lasted over 3 ns, monitoring time window of our femtosecond transient spectrometer. Complimentary nanosecond transient absorption studies revealed formation of 3SiPc* as the end product and suggested the final lifetime of the charge separated state to be in the 3-20 ns range. Energy level diagrams established to comprehend these mechanistic details indicated that the comparatively high-energy SiPc.+-C60.- charge separated states (1.57 eV) populated the low-lying 3SiPc* (1.26 eV) prior returning to the ground state.

7.
Chemphyschem ; 21(20): 2232, 2020 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-33462920

RESUMO

The front cover artwork is provided by the groups of Prof. Sastre-Santos, Prof. D'Souza, and Prof. Karr. The effect of donor-acceptor distance in governing the kinetics of electron transfer is demonstrated using different linkers between silicon phthalocyanines and C60. The cover shows the molecules playing soccer. Read the full text of the Article at 10.1002/cphc.202000578.

8.
J Strength Cond Res ; 34(5): 1400-1408, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-29140910

RESUMO

Del Coso, J, Salinero, JJ, Lara, B, Gallo-Salazar, C, Areces, F, Herrero, D, and Puente, C. Polygenic profile and exercise-induced muscle damage by a competitive half-ironman. J Strength Cond Res 34(5): 1400-1408, 2020-To date, it is still unknown why some individuals develop higher levels of muscle damage than other individuals, despite participating in exercise with comparable levels of physical intensity. The aim of this investigation was to analyze 7 single-nucleotide polymorphisms (SNPs) that are candidates to explain individual variations in the level of muscle damage attained during a half-ironman competition. Using the model of Williams and Folland (2, 1, and 0 points for optimal, intermediate, and suboptimal genotype), we determined the total genotype score from the accumulated combination of 7 SNPs (ACE = 287bp Ins/Del; ACTN3 = p.R577X; creatine kinase, muscle type = NcoI; insulin-like growth factor 2 = C13790G; interleukin-6 = 174G>C; myosin light chain kinase = C37885A; and tumor necrosis factor-α = 308G>A) in 22 experienced triathletes. Before and after the race, a sample of venous blood was obtained to measure serum markers of muscle damage. Two groups of triathletes were established according to their postcompetition serum CK concentration: low CK responders (n = 10; 377 ± 86 U·L) vs. high CK responders (n = 12; 709 ± 136 U·L). At the end of the race, low CK responders had lower serum myoglobin concentrations (384 ± 243 vs. 597 ± 293 ng·ml, p = 0.04). Although the groups were similar in age, anthropometric characteristics, and training habits, total genotype score was higher in low CK responders than in high CK responders (7.7 ± 1.1 vs. 5.5 ± 1.1 point, p < 0.01). A favorable polygenic profile can contribute to reducing the level of muscle damage developed during endurance exercise.


Assuntos
Creatina Quinase/sangue , Exercício Físico/fisiologia , Músculo Esquelético/fisiologia , Actinina/sangue , Actinina/genética , Adulto , Biomarcadores , Pesos e Medidas Corporais , Feminino , Genótipo , Humanos , Fator de Crescimento Insulin-Like II/análise , Fator de Crescimento Insulin-Like II/genética , Interleucina-6/sangue , Interleucina-6/genética , Masculino , Pessoa de Meia-Idade , Mioglobina/sangue , Polimorfismo de Nucleotídeo Único , Fator de Necrose Tumoral alfa/sangue , Fator de Necrose Tumoral alfa/genética , Adulto Jovem
9.
Eur J Appl Physiol ; 117(1): 151-158, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27913923

RESUMO

PURPOSE: Alpha-actinin-3, encoded by the ACTN3 gene, is an actin-binding protein with an important role in myofibril contraction and muscle force output. In humans, there is a relatively common deficiency of the α-actinin-3 due to homozygosity in a polymorphism of the ACTN3 gene (R577X, rs1815739), that has been related to decreased resistance to strain during voluntary muscle contractions. The purpose of this study was to investigate the influence of the ACTN3 genotype on the level of exercise-induced muscle damage attained by 23 experienced triathletes during an official half-ironman competition. METHODS: Before and after the race, a sample of venous blood was obtained and jump height was measured during a countermovement jump. The changes in serum creatine kinase (CK-MM isoform) were measured in the blood samples and muscle pain was measured with a visual analogue scale (0-10 cm). Data from RX heterozygotes and XX mutant homozygotes were grouped as X-allele carriers (n = 13) and compared to RR homozygotes (n = 10). RESULTS: Race time was very similar between groups (313 ± 31 vs. 313 ± 25 min; P = 0.45); however, pre-to-post-competition reduction in jump height was greater in X-allele carriers than RR homozygotes (-18.4 ± 11.4 vs. -8.2 ± 6.9%; P = 0.04). At the end of the race, X-allele carriers presented higher serum CK-MM concentrations (682 ± 144 vs. 472 ± 269 U/L; P = 0.03), and there was also a tendency for higher self-reported values of lower limb muscle pain (7.7 ± 1.1 vs. 6.3 ± 2.3 cm; P = 0.06). CONCLUSIONS: X-allele triathletes in the ACTN3 R577X polymorphism presented greater signs of exercise-induced muscle damage during a half-ironman race than RR homozygotes.


Assuntos
Actinina/genética , Exercício Físico , Heterozigoto , Fadiga Muscular/genética , Polimorfismo de Nucleotídeo Único , Adolescente , Adulto , Alelos , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
10.
Farm Hosp ; 48(1): 29-33, 2024.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37612182

RESUMO

OBJECTIVE: Pulmonary administration of voriconazole involves advantages, including optimization of lung penetration and reduction of adverse effects and interactions. However, there is scarce evidence about its use and there are no commercial presentations for nebulization. We aim to characterize a compounded voriconazole solution for nebulization and describe its use in our center. METHOD: This is a retrospective observational study including patients who received nebulized voriconazole to treat fungal lung diseases (infection or colonization). Voriconazole solution was prepared from commercial vials for intravenous administration. RESULTS: The pH and osmolarity of voriconazole solutions were adequate for nebulization. Ten patients were included, 9 adults and a child. The dosage was 40 mg in adults and 10 mg in the pediatric patient, diluted to a final concentration of 10 mg/ml, administered every 12-24 h. The median duration of treatment was 139 (range: 26-911) days. There were no reported adverse effects and the drug was not detected in plasma when nebulized only. CONCLUSION: Voriconazole nebulization is well-tolerated and it is not absorbed into the systemic circulation; further research is needed to assess its efficacy.


Assuntos
Aspergilose , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Adulto , Humanos , Criança , Voriconazol/efeitos adversos , Antifúngicos/efeitos adversos , Aspergilose/induzido quimicamente , Aspergilose/tratamento farmacológico , Triazóis/efeitos adversos
11.
Farm Hosp ; 48(1): T29-T33, 2024.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37858518

RESUMO

OBJECTIVE: Pulmonary administration of voriconazole involves advantages, including optimization of lung penetration and reduction of adverse effects and interactions. However, there is scarce evidence about its use and there are no commercial presentations for nebulization. We aim to characterize a compounded voriconazole solution for nebulization and describe its use in our center. METHOD: This is a retrospective observational study including patients who received nebulized voriconazole to treat fungal lung diseases (infection or colonization). Voriconazole solution was prepared from commercial vials for intravenous administration. RESULTS: The pH and osmolarity of voriconazole solutions were adequate for nebulization. Ten patients were included, nine adults and a child. The dosage was 40 mg in adults and 10 mg in the pediatric patient, diluted to a final concentration of 10 mg/ml, administered every 12-24 hours. The median duration of treatment was 139 (range: 26-911) days. There were no reported adverse effects and the drug was not detected in plasma when nebulized only. CONCLUSION: Voriconazole nebulization is well tolerated and it is not absorbed into the systemic circulation; further research is needed to assess its efficacy.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Pneumopatias Fúngicas , Adulto , Criança , Humanos , Administração Intravenosa , Antifúngicos/efeitos adversos , Voriconazol/efeitos adversos , Estudos Retrospectivos
12.
Eur Arch Otorhinolaryngol ; 270(8): 2327-32, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23315185

RESUMO

The Zuckerkandl tubercle is a residue from the embryological development of the thyroid gland. Although it is undeniably well known in surgery, this is not so among otolaryngologists. Our objective is to highlight the importance of the Zuckerkandl tubercle, as it has proven to be a reliable point of reference to locate the upper parathyroid, the lower thyroid artery and the recurrent nerve. In order to study the Zuckerkandl tubercle, we made a prospective analysis of the posterolateral border of the thyroid lobes in 107 thyroidectomies (88 total thyroidectomies and 19 hemithyroidectomies) carried out by the same surgeon; in total, 195 thyroid lobes were analysed. The Zuckerkandl tubercle was certainly detected in 155 thyroid lobes (79.48%). The Zuckerkandl tubercle was most frequent in the right thyroid lobe (P = 0.06). When the Zuckerkandl tubercle was present, we localised the upper parathyroid due to its relationship with the tubercle in 80 right thyroid lobes (95.23%) and in 65 left (91.54%). On 147 occasions (94.83%), the recurrent nerve was directed towards the cricothyroid membrane beneath the Zuckerkandl tubercle, laterally to the tracheal surface in relation with the Berry ligament. The lower thyroid artery and some of the distal branches, such as the recurrent nerve, also ran under the Zuckerkandl tubercle. The areolar tissue underlying the Zuckerkandl tubercle is difficult to dissect, and so this protuberance constitutes a surgical difficulty but it is fundamentally helpful to find those important structures that must be preserved in thyroid surgery.


Assuntos
Glândulas Paratireoides/anatomia & histologia , Nervo Laríngeo Recorrente/anatomia & histologia , Glândula Tireoide/anormalidades , Tireoidectomia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Glândula Tireoide/cirurgia
13.
Am J Phys Med Rehabil ; 102(12): e162-e164, 2023 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-37669074

RESUMO

ABSTRACT: Osteonecrosis after COVID-19 infection is a complex pathology with multifactorial origin. Factors such as infection itself with associated coagulopathy, as well as genetic mechanisms, and medications used for its treatment such as corticosteroids, may also be involved. The variability in the presentation makes diagnosis difficult, which, if done soon, can help delay progression and reduce morbidity and the need for surgery.This report presents a case of knee osteonecrosis in a female patient who did not have previous knee pathology on imaging tests. She was diagnosed by magnetic resonance imaging months after hospital admission for SARS-CoV-2 pneumonia, which required high-dose corticosteroid treatment.


Assuntos
COVID-19 , Osteonecrose , Humanos , Feminino , COVID-19/complicações , SARS-CoV-2 , Corticosteroides , Osteonecrose/diagnóstico por imagem , Osteonecrose/etiologia
14.
Med Clin (Engl Ed) ; 158(7): 301-307, 2022 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-35531306

RESUMO

Introduction and objectives: Tocilizumab is an interleukin-6 receptor-blocking agent proposed for the treatment of severe COVID-19; however, limited data are available on their efficacy. The aim of this study was to assess the effect of tocilizumab on the outcomes of patients with COVID-19 pneumonia by using propensity-score-matching (PSM) analysis. Methods: A retrospective observational analysis of hospitalized COVID-19 adult patients admitted to the Vall d'Hebron Hospital was performed between March and April 2020. We used the logistic regression to analyze the effect of tocilizumab on mortality, as main outcome, and PSM analysis to further validate their effect. Secondary outcomes were length-of-stay (LOS) and intensive-care-unit (ICU) stay. Same outcomes were also assessed for early tocilizumab administration, within 72 h after admission. Patients were selected by matching their individual propensity for receiving therapy with tocilizumab, conditional on their demographic and clinical variables. Results: A total of 544 COVID-19 patients were included, 197 (36.2%) were treated with tocilizumab of whom 147 were treated within the first 72 h after admission; and 347 were included in the control group. After PSM analyses, the results showed no association between tocilizumab use and overall mortality (OR = 1.03, 95%CI: 0.63-1.68). However, shorter ICU-stay in the tocilizumab group was found compared to the control group (Coefficient -4.27 95%CI: -6.63 to -1.92). Similar results were found in the early tocilizumab cohort. Conclusions: The administration of tocilizumab in patients with moderate to severe COVID-19 did not reduce the risk of mortality in our cohort of patients, regardless of the time of administration.


Introducción y objetivos: El tocilizumab es un agente bloqueador del receptor de la interleucina 6 propuesto para el tratamiento de la COVID-19 grave; sin embargo, se dispone de datos limitados sobre su eficacia. El objetivo de este estudio fue evaluar el efecto de tocilizumab en los resultados de los pacientes con neumonía por COVID-19 mediante un análisis de emparejamiento por propensity-score-matching (PSM, «puntuación de propensión¼). Métodos: Se realizó un análisis observacional retrospectivo de los pacientes adultos con COVID-19 ingresados en el Hospital Vall d'Hebron entre marzo y abril de 2020. Se utilizó la regresión logística para analizar el efecto de tocilizumab en la mortalidad, como resultado principal, y el análisis PSM para validar aún más su efecto. Los resultados secundarios fueron la duración de la estancia y la estancia en la unidad de cuidados intensivos (UCI). También se evaluaron los mismos resultados para la administración temprana de tocilizumab, dentro de las 72 h posteriores al ingreso. Los pacientes se seleccionaron mediante el emparejamiento de su propensión individual a recibir tratamiento con tocilizumab, condicionado a sus variables demográficas y clínicas. Resultados: Se incluyeron 544 pacientes de COVID-19, 197 (36,2%) fueron tratados con tocilizumab, de los cuales 147 fueron tratados dentro de las primeras 72 h tras el ingreso; y 347 fueron incluidos en el grupo control. Tras los análisis PSM, los resultados no mostraron ninguna asociación entre el uso de tocilizumab y la mortalidad global (OR = 1,03; IC del 95%: 0,63-1,68). Sin embargo, se encontró una menor estancia en la UCI en el grupo de tocilizumab en comparación con el grupo de control (coeficiente −4,27; IC del 95%: −6,63 − −1,92). Se encontraron resultados similares en la cohorte de tocilizumab temprano. Conclusiones: La administración de tocilizumab en pacientes con COVID-19 moderada a grave no redujo el riesgo de mortalidad en nuestra cohorte de pacientes, independientemente del momento de la administración.

15.
Med Clin (Barc) ; 158(7): 301-307, 2022 04 08.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34147248

RESUMO

INTRODUCTION AND OBJECTIVES: Tocilizumab is an interleukin-6 receptor-blocking agent proposed for the treatment of severe COVID-19; however, limited data are available on their efficacy. The aim of this study was to assess the effect of tocilizumab on the outcomes of patients with COVID-19 pneumonia by using propensity-score-matching (PSM) analysis. METHODS: A retrospective observational analysis of hospitalized COVID-19 adult patients admitted to the Vall d'Hebron Hospital was performed between March and April 2020. We used the logistic regression to analyze the effect of tocilizumab on mortality, as main outcome, and PSM analysis to further validate their effect. Secondary outcomes were length-of-stay (LOS) and intensive-care-unit (ICU) stay. Same outcomes were also assessed for early tocilizumab administration, within 72h after admission. Patients were selected by matching their individual propensity for receiving therapy with tocilizumab, conditional on their demographic and clinical variables. RESULTS: A total of 544 COVID-19 patients were included, 197 (36.2%) were treated with tocilizumab of whom 147 were treated within the first 72h after admission; and 347 were included in the control group. After PSM analyses, the results showed no association between tocilizumab use and overall mortality (OR=1.03, 95%CI: 0.63-1.68). However, shorter ICU-stay in the tocilizumab group was found compared to the control group (Coefficient -4.27 95%CI: -6.63 to -1.92). Similar results were found in the early tocilizumab cohort. CONCLUSIONS: The administration of tocilizumab in patients with moderate to severe COVID-19 did not reduce the risk of mortality in our cohort of patients, regardless of the time of administration.


Assuntos
Tratamento Farmacológico da COVID-19 , Adulto , Anticorpos Monoclonais Humanizados , Humanos , Estudos Retrospectivos , SARS-CoV-2 , Padrão de Cuidado
16.
Artigo em Inglês | MEDLINE | ID: mdl-36361080

RESUMO

Walkability is determined the presence or absence of factors such as quality sidewalks, pedestrian crossings, traffic, etc. The ability to walk to the school environment may be one of the variables that promotes active commuting levels. The aim of this study was to examine the walkability of school environments using the Delphi method. This study used the Delphi method to measure the walkability. A total of 18 experts were selected. First, a list of variables was designed by the control group and sent three times to the experts. Later, the items were analyzed qualitatively and quantitatively to test the consensus of the experts. The list of variables that influence walkability showed a good consensus among the experts at the end of the process. This list was formed by 48 items and organized in six factors: traffic and safety (eleven items), signage (eight items), sidewalk (ten items), transport consistency (five items), activity (five items), and finally, urban planning (nine items). The experts agreed on the need to analyze the environments of educational centers and measure the variables that affect walkability. This study has identified the most important barriers. In the future, a measurement instrument should be developed that allows centers to be compared with others in terms of their levels of walkability. Moreover, it might be a resource for more policies to be developed with the aim to promote active commuting to school.


Assuntos
Planejamento Ambiental , Características de Residência , Técnica Delphi , Meios de Transporte , Caminhada , Instituições Acadêmicas
17.
Microbiol Spectr ; 10(1): e0178421, 2022 02 23.
Artigo em Inglês | MEDLINE | ID: mdl-35171022

RESUMO

Isavuconazole (ISA) is an alternative treatment for Aspergillus spp. and other fungal infections, but evidence regarding its use in solid organ transplant recipients (SOTR) is scarce. All SOTR who received ISA for treatment of a fungal infection (FI) at our center from December 2017 to January 2021 were included. The duration of the treatment depended on the type of infection. All patients were followed up to 3 months after treatment. Fifty-three SOTR were included, and the majority (44, 83%) were lung transplant recipients. The most frequently treated FI was tracheobronchitis (25, 46.3%). Aspergillus spp. (43, 81.1%); specially A. flavus (16, 37.2%) and A. fumigatus (12, 27.9%), was the most frequent etiology. Other filamentous fungi including one mucormycosis, and four yeast infections were treated. The median duration of treatment was 81 days (IQR 15-197). Mild gamma-glutamyltransferase elevation was the most frequent adverse event (34%). ISA was prematurely discontinued in six patients (11.3%) due to mild hepatotoxicity (2), fatigue (2), gastrointestinal intolerance (1) and myopathy (1). The mean tacrolimus dose decrease was 30% after starting ISA. Seven patients received ISA with mTOR inhibitors with good tolerability. Two patients developed breakthrough FI (3.8%). Among patients who completed the treatment, 27 (50.9%) showed clinical cure and 15 (34.1%) presented fungal persistence. Three patients (6%) died while on ISA due to FI. ISA was well tolerated and appeared to be an effective treatment for FI in SOTR. IMPORTANCE We describe 53 solid organ transplant recipients treated with isavuconazole for fungal infections. Because its use in clinical practice, there is scarce data of its use in solid organ transplant recipients, where interactions with calcineurin inhibitors and mTOR and adverse drug events have limited the use of other triazoles. To the best of our knowledge, this is the first article describing the safety regarding adverse events and drug interactions of isavuconazole for the treatment of fungal infections in a cohort of solid organ transplant recipients. Also, although this is a noncomparative study, we report some real world effectivity data of these patients, including treatment of non-Aspergillus fungal infections.


Assuntos
Micoses/tratamento farmacológico , Nitrilas/uso terapêutico , Piridinas/uso terapêutico , Transplantados , Triazóis/uso terapêutico , Idoso , Antifúngicos/uso terapêutico , Aspergilose/tratamento farmacológico , Aspergillus/efeitos dos fármacos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transplante de Órgãos
18.
Sensors (Basel) ; 11(11): 10820-39, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22346673

RESUMO

This work presents the development and experimental evaluation of a method based on fuzzy logic to locate mobile robots in an Intelligent Space using wireless sensor networks (WSNs). The problem consists of locating a mobile node using only inter-node range measurements, which are estimated by radio frequency signal strength attenuation. The sensor model of these measurements is very noisy and unreliable. The proposed method makes use of fuzzy logic for modeling and dealing with such uncertain information. Besides, the proposed approach is compared with a probabilistic technique showing that the fuzzy approach is able to handle highly uncertain situations that are difficult to manage by well-known localization methods.

19.
J Occup Environ Med ; 63(6): e318-e322, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33769332

RESUMO

OBJECTIVE: To evaluate the cardiorespiratory fitness and other fitness-related measures, and to analyze the differences among age groups. METHODS: This study was conducted on 104 firefighters. Maximal oxygen uptake (VO2 max) was assessed using the Shuttle Test and fitness was evaluated using appropriate physical tests. RESULTS: Mean VO2 max was 45.7 mL/kg/min and 60.6% of firefighters were over the minimum accepted standpoint to do effective work, however, the VO2 max decreased with increasing age. 35.6% of the firefighters were overweight. Age, weight, and total body fat were found to be significant predictors of VO2 max level in this population, with total body fat as strongest predictor. CONCLUSIONS: Healthy habits-based interventions tailored by age groups should be promoted, to improve cardiorespiratory fitness and body composition for safe work and to improve firefighters' health.


Assuntos
Aptidão Cardiorrespiratória , Bombeiros , Teste de Esforço , Humanos , Consumo de Oxigênio , Aptidão Física
20.
Artigo em Inglês | MEDLINE | ID: mdl-33504002

RESUMO

During the lockdown declared in Spain to fight the spread of COVID-19 from 14 March to 3 May 2020, a context in which health information has gained relevance, the agenda-setting theory was used to study the proportion of health advertisements broadcasted during this period on Spanish television. Previous and posterior phases were compared, and the period was compared with the same period in 2019. A total of 191,738 advertisements were downloaded using the Instar Analytics application and analyzed using inferential statistics to observe the presence of health advertisements during the four study periods. It was observed that during the lockdown, there were more health advertisements than after, as well as during the same period in 2019, although health advertisements had the strongest presence during the pre-lockdown phase. The presence of most types of health advertisements also changed during the four phases of the study. We conclude that, although many differences can be explained by the time of the year-due to the presence of allergies or colds, for instance-the lockdown and the pandemic affected health advertising. However, the effects were mostly visible after the lockdown, when advertisers and broadcasters had had time to adapt to the unexpected circumstances.


Assuntos
Publicidade/tendências , COVID-19 , Pandemias , Televisão , Controle de Doenças Transmissíveis , Promoção da Saúde , Humanos , Espanha
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