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1.
J Am Pharm Assoc (2003) ; 63(6): 1813-1820, 2023.
Article in English | MEDLINE | ID: mdl-37696492

ABSTRACT

BACKGROUND: Inpatient hypoglycemia is associated with increased morbidity and mortality. After a hypoglycemic event, the likelihood of additional episodes increases. The Joint Commission recommends evaluating all episodes of hypoglycemia for root-cause analysis. Studies have shown that pharmacists' involvement with glycemic control protocols can prevent hypoglycemia. OBJECTIVES: This study aimed to assess whether the implementation of pharmacists' real-time assessment of hypoglycemic events using an electronic alert messaging system contributes to the reduction of the number of recurrent hypoglycemia during hospitalization. PRACTICE DESCRIPTION: A community hospital that provides a wide range of health care services. The pharmacy department provides fully decentralized clinical services and team-based specialist services. PRACTICE INNOVATION: The pharmacist-led hypoglycemia stewardship initiative included a comprehensive review of hypoglycemic alerts received via an automated message. The alerts generated in the electronic health record (EHR) every time a patient's blood glucose resulted in less than 70 mg/dL if there was a documented administration of a hypoglycemic agent 48 hours before the hypoglycemia event. Once the alert was received by the pharmacists via an EHR in-basket, a real-time review was conducted to identify the potential causes of the event and opportunities for therapy modification. EVALUATION METHODS: A single-center retrospective observational study including a pre- and post-implementation phase from January 1 to June 3, 2020, and January 1 to June 30, 2021, respectively. Continuous data were analyzed using paired and equal variance t test. Noncontinuous data were analyzed using Fisher exact and chi-square test. Descriptive statistics were used to describe distribution and frequency of data. RESULTS: There was a 5.1% absolute reduction in recurrent hypoglycemic events (P < 0.001) and a 0.6% reduction of severe hypoglycemic days (P = 0.269) in the postimplementation group. The average time to pharmacist intervention was 4 (± 3.5) hours with a 92% acceptance rate. CONCLUSION: This study demonstrated the utility of pharmacist-led hypoglycemia reviews in the reduction of recurrent hypoglycemic events in the inpatient setting.


Subject(s)
Hypoglycemia , Pharmaceutical Services , Pharmacy , Humans , Blood Glucose , Hypoglycemia/prevention & control , Hypoglycemia/drug therapy , Hypoglycemic Agents/therapeutic use , Observational Studies as Topic , Pharmacists , Retrospective Studies
2.
J Am Pharm Assoc (2003) ; 62(4S): S47-S52, 2022.
Article in English | MEDLINE | ID: mdl-35773118

ABSTRACT

OBJECTIVES: The primary objective was to compare the percentage of Antiretroviral Therapy (ART) uncorrected errors during hospital admission before and after the implementation of an Antiretroviral Stewardship Program (ARVSP). PRACTICE DESCRIPTION: This was a 2-year single-center, pre-post quality improvement study. Included in the study were admitted patients at least 18 years of age, diagnosed with human immunodeficiency virus (HIV), and taking at least 1 antiretroviral. The baseline percentage of uncorrected ARV errors was retrospectively determined during the first year. The second year consisted of implementing an ARVSP that prospectively audited ART orders. The ARVSP consisted of a pharmacy resident, a medical resident, an infectious disease, HIV trained pharmacist, an infectious disease physician, and ancillary health care providers. The impact of the ARVSP was assessed by comparing the percentage of uncorrected errors between the 2 time periods. RESULTS: The number of uncorrected errors were 64.1% versus 31.1% before and after ARVSP implementation, respectively (P < 0.05). Delay in therapy errors were statistically significantly reduced (30.1% vs. 22.2%; P < 0.05). The time to overall correction of any error before ARVSP was 3.1 days, and after ARVSP, it was 1.8 days (P = 0.11). CONCLUSION: Implementation of an ARVSP reduces the number of uncorrected antiretroviral-related errors. Because health care resources are finite and focused on the acute care of hospitalized patients, this multidisciplinary practice model may provide a practical approach for similar institutions to improve antiretroviral stewardship surveillance in the inpatient setting.


Subject(s)
Anti-HIV Agents , HIV Infections , Anti-HIV Agents/therapeutic use , HIV Infections/drug therapy , Hospitals , Humans , Pharmacists , Retrospective Studies
3.
J Am Pharm Assoc (2003) ; 62(1): 264-269, 2022.
Article in English | MEDLINE | ID: mdl-34474965

ABSTRACT

OBJECTIVES: The primary objective was to compare the percentage of Antiretroviral Therapy (ART) uncorrected errors during hospital admission before and after the implementation of an Antiretroviral Stewardship Program (ARVSP). PRACTICE DESCRIPTION: This was a 2-year single-center, pre-post quality improvement study. Included in the study were admitted patients at least 18 years of age, diagnosed with human immunodeficiency virus (HIV), and taking at least 1 antiretroviral. The baseline percentage of uncorrected ARV errors was retrospectively determined during the first year. The second year consisted of implementing an ARVSP that prospectively audited ART orders. The ARVSP consisted of a pharmacy resident, a medical resident, an infectious disease, HIV trained pharmacist, an infectious disease physician, and ancillary health care providers. The impact of the ARVSP was assessed by comparing the percentage of uncorrected errors between the 2 time periods. RESULTS: The number of uncorrected errors were 64.1% versus 31.1% before and after ARVSP implementation, respectively (P < 0.05). Delay in therapy errors were statistically significantly reduced (30.1% vs. 22.2%; P < 0.05). The time to overall correction of any error before ARVSP was 3.1 days, and after ARVSP, it was 1.8 days (P = 0.11). CONCLUSION: Implementation of an ARVSP reduces the number of uncorrected antiretroviral-related errors. Because health care resources are finite and focused on the acute care of hospitalized patients, this multidisciplinary practice model may provide a practical approach for similar institutions to improve antiretroviral stewardship surveillance in the inpatient setting.


Subject(s)
HIV Infections , Pharmacy , HIV Infections/drug therapy , Hospitals , Humans , Pharmacists , Retrospective Studies
4.
Clin Infect Dis ; 73(7): e1436-e1442, 2021 10 05.
Article in English | MEDLINE | ID: mdl-33211794

ABSTRACT

BACKGROUND: Acute bacterial skin and skin structure infections (ABSSSIs) are common infectious diseases that cause a significant economic burden on the healthcare system. This study aimed to compare the cost-effectiveness of dalbavancin vs standard of care (SoC) in the treatment of ABSSSI in a community-based healthcare system. METHODS: This was a retrospective study of adult patients with ABSSSI treated with dalbavancin or SoC during a 27-month period. Patients were matched based on age and body mass index. The primary outcome was average net cost of care to the healthcare system per patient, calculated as the difference between reimbursement payments and the total cost to provide care to the patient. The secondary outcome was proportion of cases successfully treated, defined as no ABSSSI-related readmission within 30 days after the initiation of treatment. RESULTS: Of the 418 matched patients, 209 received SoC and 209 received dalbavancin. The average total cost of care per patient was greater with dalbavancin vs SoC ($4770 vs $2709, P < .0001). The average reimbursement per patient was $3084 with dalbavancin vs $2633 SoC (P = .527). The net cost, calculated as revenue minus total cost, was $1685 with dalbavancin vs $75 with SoC (P = .013). The overall treatment success rate was 74% with dalbavancin vs 85% with SoC (P = .004). CONCLUSIONS: Dalbavancin was more costly than SoC for the treatment of ABSSSI, with a higher 30-day readmission rate. Dalbavancin does not offer an economic or efficacy advantage.


Subject(s)
Skin Diseases, Bacterial , Standard of Care , Adult , Anti-Bacterial Agents/therapeutic use , Cost-Benefit Analysis , Delivery of Health Care , Humans , Retrospective Studies , Skin Diseases, Bacterial/drug therapy , Teicoplanin/analogs & derivatives , Teicoplanin/therapeutic use
5.
J Oncol Pharm Pract ; 27(4): 1033-1036, 2021 Jun.
Article in English | MEDLINE | ID: mdl-32955996

ABSTRACT

INTRODUCTION: The incidence of acyclovir-induced hypersensitivity is rare. To our knowledge, there are four published case reports of oral acyclovir desensitization in adults. Evidence-based guidelines prompt the use of acyclovir for herpes simplex virus (HSV) prophylaxis and treatment. Literature on the cross-reactivity of structurally similar antiviral agents is conflicting, presenting a clinical challenge when choosing an alternative agent. This is a case of successful acyclovir desensitization in an allogeneic stem cell transplant patient. CASE REPORT: A 69-year-old female patient, diagnosed with myelodysplastic/myeloproliferative neoplasm, presented to the hospital for donor mismatch allogeneic bone marrow transplant. The patient reported acyclovir-induced angioedema while receiving treatment for non-complicated herpes zoster (shingles) infection.Management & Outcome: After the acyclovir oral desensitization was conducted in an ICU setting with 1:1 patient-nurse ratio, the patient was successfully started on acyclovir therapy, 800mg by mouth twice daily for HSV prophylaxis with no further complications. Discussion: Oral acyclovir desensitization can provide an option for HSV therapy in patients reporting severe allergy.


Subject(s)
Acyclovir/adverse effects , Angioedema/chemically induced , Angioedema/diagnosis , Antiviral Agents/adverse effects , Bone Marrow Transplantation/adverse effects , Desensitization, Immunologic/methods , Aged , Bone Marrow Transplantation/trends , Drug Hypersensitivity/diagnosis , Drug Hypersensitivity/drug therapy , Female , Herpes Simplex/drug therapy , Humans
6.
J Strength Cond Res ; 35(4): 1082-1088, 2021 Apr 01.
Article in English | MEDLINE | ID: mdl-30325790

ABSTRACT

ABSTRACT: Andrade, DM, Fernandes, G, Miranda, R, Reis Coimbra, D, and Bara Filho, MG. Training load and recovery in volleyball during a competitive season. J Strength Cond Res 35(4): 1082-1088, 2021-The objective of this study was to analyze the training load (TL) and recovery status (RS) of a volleyball team in different periods of the season. Fifteen male athletes participated in the study. Training load was quantified through the rate of perceived exertion of session. The total weekly TL of the preparatory period (PP), competitive period I (CPI), and competitive period II (CPII) was calculated. Total quality recovery was used to evaluate the initial and final RS. Training load was higher (p < 0.05) in PP than in CPI and CPII. The final RS was lower (p < 0.05) in PP than in CPI and CPII. There was a difference (p < 0.05) between the initial and final RS in the analyzed periods. An inverse correlation (ρ: -0.62) was observed between the TL and the initial and final difference RS in PP. In conclusion, PP in volleyball presented the highest TL, related to a greater difference between the initial and final RS.


Subject(s)
Volleyball , Athletes , Humans , Male , Seasons
7.
J Phys Chem A ; 123(7): 1389-1398, 2019 Feb 21.
Article in English | MEDLINE | ID: mdl-30673243

ABSTRACT

An experimental and theoretical study of the photoinduced homolysis of the carbon-chlorine bond in an ice matrix of chlorobenzene is presented. A condensed chlorobenzene film has been grown in situ and near edge X-ray fine structure (NEXAFS) spectra were collected after exposing the condensed film to a monochromatic photon beam centered at the 2822 eV resonant excitation of chlorine and at 2850 eV. The photoabsorption to the Cl 1s → σ* and Cl 1s → π* states has been measured and the hypothesis of free radical coupling reactions was investigated via time-dependent density functional theory (TD-DFT) and complete active space self-consistent field (CASSCF) calculations. Also, potential energy pathways to the C-Cl cleavage have been obtained at the CASSCF level to the Cl 1s → σ*, 1s → π*, and 1s → ∞ states. A strong dissociative character was only found for the Cl 1s → σ* resonance.

8.
An Acad Bras Cienc ; 90(1): 3-16, 2018.
Article in English | MEDLINE | ID: mdl-29424394

ABSTRACT

Serra Pelada is the newest Brazilian eucrite and the first recovered fall from Amazonia (State of Pará, Brazil, June 29th 2017). In this paper, we report on its petrography, chemistry, mineralogy and its magnetic properties. Study of four thin sections reveals that the meteorite is brecciated, containing basaltic and gabbroic clasts, as well of recrystallized impact melt, embedded into a fine-medium grained matrix. Chemical analyses suggest that Serra Pelada is a monomict basaltic eucritic breccia, and that the meteorite is a normal member of the HED suite. Our results provide additional geological and compositional information on the lithological diversity of its parent body. The mineralogy of Serra Pelada consists basically of low-Ca pyroxene and high-Ca plagioclase with accessory minerals such as quartz, sulphide (troilite), chromite - ulvöspinel and ilmenite. These data are consistent with the meteorite being an eucrite, a basaltic achondrite and a member of the howardite-eucrite-diogenite (HED) clan of meteorites which most likely are from the crust asteroid 4 Vesta.

9.
Water Sci Technol ; 74(11): 2515-2522, 2016 Dec.
Article in English | MEDLINE | ID: mdl-27973356

ABSTRACT

Production of biogas from different organic materials is a most interesting source of renewable energy. The biomethane potential (BMP) of these materials has to be determined to get insight in design parameters for anaerobic digesters. Although several norms and guidelines for BMP tests exist, inter-laboratory tests regularly show high variability of BMPs for the same substrate. A workshop was held in June 2015, in Leysin, Switzerland, with over 40 attendees from 30 laboratories around the world, to agree on common solutions to the conundrum of inconsistent BMP test results. This paper presents the consensus of the intense roundtable discussions and cross-comparison of methodologies used in respective laboratories. Compulsory elements for the validation of BMP results were defined. They include the minimal number of replicates, the request to carry out blank and positive control assays, a criterion for the test duration, details on BMP calculation, and last but not least criteria for rejection of the BMP tests. Finally, recommendations on items that strongly influence the outcome of BMP tests such as inoculum characteristics, substrate preparation, test setup, and data analysis are presented to increase the probability of obtaining validated and reproducible results.


Subject(s)
Biofuels/analysis , Methane/analysis , Anaerobiosis , Biotechnology/standards , Laboratories/standards , Reproducibility of Results
10.
Int J Behav Nutr Phys Act ; 11: 153, 2014 Dec 10.
Article in English | MEDLINE | ID: mdl-25490946

ABSTRACT

BACKGROUND: Effective lifestyle interventions are needed to prevent noncommunicable diseases in low- and middle-income countries. We analyzed the effects of a school-based health promotion intervention on physical fitness after 28 months and explored if the effect varied with important school characteristics. We also assessed effects on screen time, physical activity and BMI. METHODS AND RESULTS: We performed a cluster-randomized pair matched trial in schools in urban Ecuador. The intervention included an individual and environmental component tailored to the local context and resources. Primary outcomes were physical fitness (EUROFIT battery), screen time (questionnaires) and physical activity (accelerometers). Change in BMI was a secondary outcome. A total of 1440 grade 8 and 9 adolescents (intervention: n = 700, 48.6%) and 20 schools (intervention: n = 10, 50%) participated. Data of 1083 adolescents (intervention: n = 550, 50.8%) from 20 schools were analyzed. CONCLUSIONS: A school-based intervention with an individual and environment component can improve physical fitness and can minimize the decline in physical activity levels from childhood into adolescence in urban Ecuador. TRIAL REGISTRATION: Clinicaltrials.gov identifier NCT01004367.


Subject(s)
Health Promotion/methods , Physical Fitness , School Health Services , Adolescent , Body Mass Index , Child , Diet , Ecuador , Female , Humans , Life Style , Male , Motor Activity , Schools , Sedentary Behavior , Socioeconomic Factors , Surveys and Questionnaires
11.
Int J Cardiol ; 408: 132106, 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-38705202

ABSTRACT

BACKGROUND: Ultramarathon running poses physiological challenges, impacting cardiac function. This systematic review and meta-analysis explore the acute effects of single-stage ultramarathon running on cardiac function. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations were followed. Searches covered Medline, Embase, CINAHL, SPORTDiscus, Web of Science, Central Cochrane, and Scopus. Random effects meta-analyses assessed left ventricular (LV) and right ventricular (RV) variables, expressed as mean differences (MD) with 95% confidence intervals (CI). RESULTS: Among 6972 studies, 17 were included. Post-ultramarathon reductions were found in LV end-diastolic diameter (LVEDD) (-1.24; 95% CI = -1.77, -0.71 mm), LV end-diastolic volume (LVEDV) (-9.92; 95% CI = -15.25, -4.60 ml), LV stroke volume (LVSV) (-8.96 ml, 95% CI -13.20, -4.72 ml), LV ejection fraction (LVEF) (-3.71; 95% CI = -5.21, -2.22%), LV global longitudinal strain (LVGLS) (-1.48; 95% CI = -2.21, -0.76%), E/A (-0.30; 95% CI = -0.38, -0.22 cm/s), .E' (-1.35 cm/s, 95% CI -1.91, -0.79 cm/s), RV fractional area change (RVFAC) (-3.34, 95% CI = -5.84, -0.84%), tricuspid annular plane systolic excursion (TAPSE) (-0.12, 95% CI = -0.22, -0.02 cm), RV global longitudinal strain (RVGLS) (-1.73, 95% CI = -2.87, -0.59%), with increases in RV end-diastolic area (RVEDA) (1.89, 95% CI = 0.63, 3.14 cm2), RV Peak A' (1.32 cm/s, 95% CI 0.20, 2.44), and heart rate (18.24, 95% CI = 15.16, 21.32). No significant differences were observed in LV end-systolic diameter (LVESD), LV end-systolic volume (LVESV), RV end-diastolic diameter (RVEDD), RV Peak E', and RV Peak S'. CONCLUSIONS: Evidence suggests immediate impairment of systolic and diastolic cardiac function post-ultramarathon running.


Subject(s)
Diastole , Systole , Humans , Diastole/physiology , Systole/physiology , Marathon Running/physiology , Stroke Volume/physiology , Ventricular Function, Left/physiology
12.
Am J Health Syst Pharm ; 78(1): 36-40, 2021 01 01.
Article in English | MEDLINE | ID: mdl-33037429

ABSTRACT

PURPOSE: Ledipasvir/sofosbuvir is an oral combination therapy containing fixed doses of direct-acting antiviral agents indicated for the treatment of hepatitis C virus (HCV) infection. Currently there are limited data on the clinical efficacy of crushed ledipasvir/sofosbuvir administered via feeding tube. SUMMARY: This case report discusses the successful treatment of chronic HCV genotype 1b infection with crushed ledipasvir/sofosbuvir administered through a percutaneous endoscopic gastrostomy (PEG) tube in a patient with human immunodeficiency virus (HIV) coinfection and high-grade sarcoma who had severe swallowing difficulties. The patient received crushed ledipasvir/sofosbuvir daily for a total of 12 weeks. At 12 weeks the patient had achieved a sustained virologic response. CONCLUSION: Currently, ledipasvir/sofosbuvir is available only as a tablet, with limited pharmacokinetic data available to guide clinicians on use of the fixed-dose combination medication in crushed form. This case report highlights our experience treating a patient with HCV/HIV coinfection through administration of crushed ledipasvir/sofosbuvir via PEG tube, which we found to be a safe and effective therapeutic option.


Subject(s)
Coinfection , HIV Infections , Hepatitis C, Chronic , Antiviral Agents/therapeutic use , Benzimidazoles , Coinfection/drug therapy , Drug Therapy, Combination , Fluorenes , Gastrostomy , Genotype , HIV Infections/complications , HIV Infections/drug therapy , Hepacivirus , Hepatitis C, Chronic/complications , Hepatitis C, Chronic/drug therapy , Humans , Sofosbuvir/therapeutic use , Treatment Outcome
13.
J Phys Chem A ; 114(26): 6917-26, 2010 Jul 08.
Article in English | MEDLINE | ID: mdl-20540546

ABSTRACT

Recent experimental results on negatively charged formic acid clusters generated by the impact of (252)Cf fission fragments on icy formic acid target are compared to quantum mechanical calculations. Structures for the clusters series, (HCOOH)nOH(-), where 2 < or = n < or = 4, are proposed based on ab initio electronic structure methods. The results show that cluster growth does not have a regular pattern of nucleation. A stability analysis was performed considering the commonly defined stability function. Temporal behavior of the clusters was evaluated by Born-Oppenheimer molecular dynamics to check the mechanism that provides cluster stability. The evaluated temporal profiles indicate the importance of hydrogen atom migration between the formic acid moieties in maintaining the stability of the structures and the water formation due to hydrogen abstraction by the hydroxyl approach.

14.
Pharmacy (Basel) ; 8(2)2020 Jun 11.
Article in English | MEDLINE | ID: mdl-32545231

ABSTRACT

Methicillin-resistant Staphylococcus aureus (MRSA) polymerase-chain-reaction nasal swabs (PCRNS) are a rapid diagnostic tool with a high negative predictive value. A PCRNS plus education "bundle" was implemented to inform clinicians on the utility of PCRNS for anti-MRSA therapy de-escalation in respiratory tract infections (RTI). The study included patients started on vancomycin with a PCRNS order three months before and after bundle implementation. The primary objective was the difference in duration of anti-MRSA therapy (DOT) for RTI. Secondary objectives included hospital length of stay (LOS), anti-MRSA therapy reinitiation, 30-day readmission, in-hospital mortality, and cost. We analyzed 62 of 110 patients screened, 20 in the preintervention and 42 in the postintervention arms. Mean DOT decreased after bundle implementation by 30.3 h (p = 0.039); mean DOT for patients with a negative PCRNS decreased by 39.7 h (p = 0.014). Median cost was lower after intervention [USD$51.69 versus USD$75.30 (p < 0.01)]. No significant difference in LOS, mortality, or readmission existed. The bundle implementation decreased vancomycin therapy and cost without negatively impacting patient outcomes.

15.
J Phys Chem A ; 113(42): 11161-6, 2009 Oct 22.
Article in English | MEDLINE | ID: mdl-19534497

ABSTRACT

Titan, the largest satellite of Saturn, has an atmosphere chiefly made up of N(2) and CH(4) and includes traces of many simple organic compounds. This atmosphere also partly consists of haze and aerosol particles which during the last 4.5 gigayears have been processed by electric discharges, ions, and ionizing photons, being slowly deposited over the Titan surface. In this work, we investigate the possible effects produced by soft X-rays (and secondary electrons) on Titan aerosol analogs in an attempt to simulate some prebiotic photochemistry. The experiments have been performed inside a high vacuum chamber coupled to the soft X-ray spectroscopy beamline at the Brazilian Synchrotron Light Source, Campinas, Brazil. In-situ sample analyses were performed by a Fourier transform infrared spectrometer. The infrared spectra have presented several organic molecules, including nitriles and aromatic CN compounds. After the irradiation, the brownish-orange organic residue (tholin) was analyzed ex-situ by gas chromatographic (GC/MS) and nuclear magnetic resonance ((1)H NMR) techniques, revealing the presence of adenine (C(5)H(5)N(5)), one of the constituents of the DNA molecule. This confirms previous results which showed that the organic chemistry on the Titan surface can be very complex and extremely rich in prebiotic compounds. Molecules like these on the early Earth have found a place to allow life (as we know) to flourish.


Subject(s)
Adenine/chemical synthesis , Adenine/radiation effects , Extraterrestrial Environment/chemistry , Saturn , Adenine/chemistry , Atmosphere/chemistry , Carbon Dioxide/chemical synthesis , Carbon Dioxide/chemistry , Carbon Monoxide/chemical synthesis , Carbon Monoxide/chemistry , Cyanates/chemical synthesis , Cyanates/chemistry , Gas Chromatography-Mass Spectrometry , Hydrocarbons, Aromatic/chemical synthesis , Hydrocarbons, Aromatic/chemistry , Magnetic Resonance Spectroscopy , Methane/chemical synthesis , Methane/chemistry , Nitriles/chemical synthesis , Nitriles/chemistry , Nitrogen/chemistry , Spectroscopy, Fourier Transform Infrared , Water/chemistry , X-Rays
16.
IDCases ; 18: e00657, 2019.
Article in English | MEDLINE | ID: mdl-31886130

ABSTRACT

Micrococcus species are typically considered contaminants from skin and mucous membranes. However, especially in severely immunocompromised patients, a blood culture with Micrococcus could be the cause of a significant infection. We report a 65-year-old female with non-Hodgkin's lymphoma who developed native valve infective endocarditis due to Micrococcus luteus. There is no defined therapeutic regimen for infective endocarditis due to Micrococcus luteus; however, our patient was successfully treated for six weeks with vancomycin and rifampin. To our knowledge, there is only one other case report of native valve endocarditis due to Micrococcus luteus.

17.
J Phys Chem A ; 112(51): 13382-92, 2008 Dec 25.
Article in English | MEDLINE | ID: mdl-19053548

ABSTRACT

Recent experimental results on positive charged formic acid clusters generated by the impact of (252)Cf fission fragments (FF) on icy formic acid target are examined in this paper by quantum mechanical calculations. Structures for the clusters series, (HCOOH)(n)H(+) and (HCOOH)(n)H(3)O(+), where 2 < or = n < or = 4, are proposed based on ab initio electronic structure methods. Results show that cluster growth does not present a regular pattern of nucleation. A stability analysis was performed considering the commonly defined stability function, where E is the total electronic energy plus the zero point vibrational energy correction, including the BSSE correction. The stability analysis leads to a picture that is compatible with experimental observations, indicating a decay of the stability with the increase of cluster mass. Temporal behavior of the clusters was evaluated by Born-Oppenheimer molecular dynamics to check the mechanism that provides cluster stability. The evaluated temporal profiles indicate the importance of hydrogen atom migration between the formic acid moieties to maintain the stability of the structures.


Subject(s)
Formates/chemistry , Algorithms , Cluster Analysis , Computer Simulation , Electrons , Hydrogen Bonding , Ions/chemistry , Models, Chemical , Quantum Theory , Thermodynamics , Water/chemistry
19.
Acta bioeth ; 28(2): 281-289, oct. 2022. tab
Article in English | LILACS | ID: biblio-1402935

ABSTRACT

Abstract: In the literature Informed consent (IC) assumptions is well established. However, the different stages and the conditions under which the IC for anesthetic practices is obtained, is scarce. The aim of the present study is to explore the phases and conditions of IC in anesthesiology. Anonymized clinical records of 325 patients submitted to anesthetic procedures at the Institute of Oncology of Porto were analyzed. A total agreement between the anesthetic techniques established in the IC and those performed, was reach with 270 patients. The importance of IC in clinical practice is discussed and an ideal process for IC is argued.


Resumen: El consentimiento informado (CI) está bien establecido en la literatura. Sin embargo, la información sobre las diferentes fases y condiciones en las que se obtiene el CI para las prácticas anestésicas es escasa. El objetivo del presente estudio es explorar las fases y condiciones de obtención de la CI en anestesiología. Se analizaron las historias clínicas anónimas de 325 pacientes sometidos a procedimientos anestésicos en el Instituto de Oncología de Oporto. Se alcanzó una concordancia total entre las técnicas de anestesia establecidas en el CI y las realizadas con 270 pacientes. Se defiende la importancia del CI en la práctica clínica y se discute un proceso ideal para obtenerlo.


Resumo: Na literatura o Consentimento Informado (CI) é bem estabelecido. Contudo, a informação sobre as diferentes fases e as condições em que o CI para práticas anestésicas é obtido, é escassa. O objetivo do presente estudo é explorar as fases e condições da obtenção do CI em anestesiologia. Foram analisados os registos clínicos anónimos de 325 pacientes submetidos a procedimentos anestésicos no Instituto de Oncologia do Porto. Foi alcançado um acordo total entre as técnicas anestésicas estabelecidas no CI e as realizadas, com 270 pacientes. A importância do CI na prática clínica é defendida e discute-se um processo ideal para a obtenção do CI.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Informed Consent/ethics , Anesthesia/methods , Anesthesia/ethics , Anesthesiology/ethics
20.
Rev. cuba. ortop. traumatol ; 36(1)abr. 2022. ilus, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1409050

ABSTRACT

Introducción: Una correcta evaluación fisioterapéutica permite direccionar una intervención idónea del paciente con amputación transfemoral. Objetivo: Describir clínicamente a los pacientes con amputación transfemoral unilateral en la ciudad de Pasto, Nariño, Colombia. Métodos: Se realiza estudio transversal de casos múltiples. Se selecciona una muestra de 13 pacientes que se encontraban en la base de datos del Instituto Departamental de Salud de Nariño, con amputación transfemoral unilateral, a los que se realizó una caracterización sociodemográfica y clínica, así como una evaluación fisioterapéutica. Se obtuvieron valores de frecuencias y porcentajes. El análisis de los datos recolectados se realizó mediante el software SPSS, versión 24. De manera descriptiva se dieron a conocer los resultados de la evaluación fisioterapéutica. Resultados: La edad media de los pacientes fue de 46 años, predominó el género masculino (77 por ciento), y la etiología traumática (69,23 por ciento). La sensación y dolor de miembro fantasma se presentó en el 69,23 por ciento y 53,84 por ciento de los pacientes, respectivamente. Se encontró una disminución marcada de fuerza muscular en los músculos pelvitrocantéreos, glúteo medio, menor y tensor de la fascia lata. El rango de movimiento estaba disminuido para los movimientos de rotación interna con una media de 27,8°/ 45°, rotación externa con una media de 29,8°/ 45° y aducción de cadera con una media de 31,2°/ 45°. Conclusiones: Las principales características clínicas y resultados de evaluación fisioterapéutica de los pacientes con amputación transfemoral unilateral son la presencia de sensación y dolor de miembro fantasma, diminución de fuerza, rangos de movimiento y presencia de escoliosis dorsales y/o lumbares. Realizar un adecuado proceso de evaluación fisioterapéutica, proporciona información sobre las necesidades individuales de cada paciente en cuanto a rehabilitación, para posteriormente, ejecutar un tratamiento idóneo(AU)


Introduction: Correct physiotherapeutic evaluation allows directing ideal intervention for the patient with transfemoral amputation. Objective: To clinically describe patients with unilateral transfemoral amputation in the city of Pasto, Nariño, Colombia. Methods: A cross-sectional study of multiple cases is carried out. A sample of 13 patients was selected. They were in the database of the Departmental Institute of Health of Nariño, with unilateral transfemoral amputation, they had underwent a sociodemographic and clinical characterization, as well as a physiotherapeutic evaluation. Frequency values and percentages were obtained. The analysis of the collected data was carried out using the SPSS software, version 24. The results of the physiotherapeutic evaluation were disclosed in a descriptive manner. Results: The mean age of the patients was 46 years, the male gender predominated (77 percent), and the traumatic etiology (69.23 percent). Phantom limb sensation and pain occurred in 69.23 percent and 53.84 percent of the patients, respectively. A marked decrease in muscle strength was found in the pelvitrochanteric, gluteus medius, minimus, and tensor fascia lata muscles. The range of motion was decreased for movements of internal rotation with a mean of 27.8°/45°, external rotation with a mean of 29.8°/45°, and hip adduction with a mean of 31.2°/ 45°. Conclusions: The main clinical characteristics and physiotherapeutic evaluation results of patients with unilateral transfemoral amputation are the presence of phantom limb sensation and pain, decreased strength, range of motion, and the presence of dorsal and/or lumbar scoliosis. An adequate physiotherapeutic evaluation process provides information on the individual needs of each patient in terms of rehabilitation, in order to subsequently execute an ideal treatment(AU)


Subject(s)
Humans , Adolescent , Amputation, Surgical/methods , Amputation, Surgical/psychology , Amputation, Surgical/rehabilitation , Epidemiology, Descriptive , Amputation, Traumatic
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