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1.
J Psychosoc Oncol ; : 1-16, 2024 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-39126398

RESUMO

BACKGROUND: Traditional MBSR or MBTC programs do not delve deeply enough into emotional regulation, which is especially relevant in oncological patients. The aim of this study was to analyze the benefits of a mindfulness-based emotion regulation program in adult oncological patients. METHOD: Psycho-oncologists from the AECC developed a mindfulness-based emotion regulation program. The Five Facet Mindfulness Questionnaire (FFMQ), Trait Meta-Mood Scale (TMMS), and Hospital Anxiety and Depression Scale (HADS) were administered before and after the program. A single-group pre-post test design with repeated measures was employed, utilizing the General Linear Model. RESULTS: Ninety-seven adult cancer patients completed the pre- and post-program assessments. Statistically significant improvements were observed in all FFMQ subscales, increased clarity of emotional discrimination, mood repair, and statistically significant reductions in anxiety and depressive symptoms. CONCLUSIONS: Regardless of the phase of the disease, the results of this study suggest that emotional regulation may improve and anxiety and depressive symptomatology decrease after a mindfulness-based emotion regulation program in oncological patients.

2.
Molecules ; 29(10)2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38792264

RESUMO

The study aimed to utilize MoO3 catalysts, produced on a pilot scale via combustion reaction, to produce biodiesel from residual oil. Optimization of the process was conducted using a 23 experimental design. Structural characterization of the catalysts was performed through X-ray diffraction, fluorescence, Raman spectroscopy, and particle size distribution analyses. At the same time, thermal properties were examined via thermogravimetry and differential thermal analysis. Catalytic performance was assessed following process optimization. α-MoO3 exhibited a monophasic structure with orthorhombic phase, whereas α/h-MoO3 showed a biphasic structure. α-MoO3 had a larger crystallite size and higher crystallinity, with thermal stability observed up to certain temperatures. X-ray fluorescence confirmed molybdenum oxide predominance in the catalysts, with traces of iron oxide. Particle size distribution analyses revealed polymodal distributions attributed to structural differences. Both catalysts demonstrated activity under all conditions tested, with ester conversions ranging from 93% to 99%. The single-phase catalyst had a long life cycle and was reusable for six biodiesel production cycles. The experimental design proved to be predictive and significant, with the type of catalyst being the most influential variable. Optimal conditions included α-MoO3 catalyst, oil/alcohol ratio of 1/15, and a reaction time of 60 min, resulting in high biodiesel conversion rates and showcasing the viability of MoO3 catalysts in residual oil biodiesel production.

3.
Eur Respir J ; 61(4)2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-37012080

RESUMO

BACKGROUND: Severe community-acquired pneumonia (sCAP) is associated with high morbidity and mortality, and while European and non-European guidelines are available for community-acquired pneumonia, there are no specific guidelines for sCAP. MATERIALS AND METHODOLOGY: The European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Latin American Thoracic Association (ALAT) launched a task force to develop the first international guidelines for sCAP. The panel comprised a total of 18 European and four non-European experts, as well as two methodologists. Eight clinical questions for sCAP diagnosis and treatment were chosen to be addressed. Systematic literature searches were performed in several databases. Meta-analyses were performed for evidence synthesis, whenever possible. The quality of evidence was assessed with GRADE (Grading of Recommendations, Assessment, Development and Evaluation). Evidence to Decision frameworks were used to decide on the direction and strength of recommendations. RESULTS: Recommendations issued were related to diagnosis, antibiotics, organ support, biomarkers and co-adjuvant therapy. After considering the confidence in effect estimates, the importance of outcomes studied, desirable and undesirable consequences of treatment, cost, feasibility, acceptability of the intervention and implications to health equity, recommendations were made for or against specific treatment interventions. CONCLUSIONS: In these international guidelines, ERS, ESICM, ESCMID and ALAT provide evidence-based clinical practice recommendations for diagnosis, empirical treatment and antibiotic therapy for sCAP, following the GRADE approach. Furthermore, current knowledge gaps have been highlighted and recommendations for future research have been made.


Assuntos
Doenças Transmissíveis , Pneumonia , Humanos , Pneumonia/diagnóstico , Pneumonia/terapia , Cuidados Críticos , Unidades de Cuidados Respiratórios
4.
Int J Mol Sci ; 24(19)2023 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-37833855

RESUMO

In this work, polyhydroxybutyrate (PHB) was maleic anhydride (MA)-grafted in the molten state, using dicumyl peroxide (DCP) as a reaction initiator. Tin(II) 2-ethylhexanoate (Sn(Oct)2) and styrene monomer (St.) were used to maximize the maleic anhydride grafting degree. When PHB was modified with MA/DCP and MA/DCP/Sn(Oct)2, viscosity was reduced, suggesting chain scission in relation to pure PHB. However, when the styrene monomer was added, the viscosity increased due to multiple grafts of MA and styrene into the PHB chain. In addition, the FTIR showed the formation of a new band at 1780 cm-1 and 704 cm-1, suggesting a multiphase copolymer PHB-g-(St-co-MA). The PHB (MA/DCP) system showed a grafting degree of 0.23%; however, the value increased to 0.39% with incorporating Sn(Oct)2. The highest grafting efficiency was for the PHB (MA/DCP/St.) system with a value of 0.91%, while the PHB (MA/DCP/St./Sn(Oct)2) hybrid mixture was reduced to 0.73%. The chemical modification process of PHB with maleic anhydride increased the thermal stability by about 20 °C compared with pure PHB. The incorporation of 0.5 phr of the Sn(Oct)2 catalyst increased the efficiency of the grafting degree in the PHB. However, the St./Sn(Oct)2 hybrid mixture caused a deleterious effect on the maleic anhydride grafting degree.


Assuntos
Anidridos Maleicos , Estireno , Polímeros , Fenômenos Químicos
5.
Int J Mol Sci ; 24(8)2023 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-37108198

RESUMO

Tuning and controlling the magnetic properties of nanomaterials is crucial to implement new and reliable technologies based on magnetic hyperthermia, spintronics, or sensors, among others. Despite variations in the alloy composition as well as the realization of several post material fabrication treatments, magnetic heterostructures as ferromagnetic/antiferromagnetic coupled layers have been widely used to modify or generate unidirectional magnetic anisotropies. In this work, a pure electrochemical approach has been used to fabricate core (FM)/shell (AFM) Ni@(NiO,Ni(OH)2) nanowire arrays, avoiding thermal oxidation procedures incompatible with integrative semiconductor technologies. Besides the morphology and compositional characterization of these core/shell nanowires, their peculiar magnetic properties have been studied by temperature dependent (isothermal) hysteresis loops, thermomagnetic curves and FORC analysis, revealing the existence of two different effects derived from Ni nanowires' surface oxidation over the magnetic performance of the array. First of all, a magnetic hardening of the nanowires along the parallel direction of the applied magnetic field with respect their long axis (easy magnetization axis) has been found. The increase in coercivity, as an effect of surface oxidation, has been observed to be around 17% (43%) at 300 K (50 K). On the other hand, an increasing exchange bias effect on decreasing temperature has been encountered when field cooling (3T) the oxidized Ni@(NiO,Ni(OH)2) nanowires below 100 K along their parallel lengths.


Assuntos
Nanoporos , Nanofios , Nanofios/química , Óxido de Alumínio , Níquel/química , Nanotecnologia/métodos
6.
Crit Care ; 26(1): 141, 2022 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-35581612

RESUMO

BACKGROUND: The role of neuromuscular blocking agents (NMBAs) in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) is not fully elucidated. Therefore, we aimed to investigate in COVID-19 patients with moderate-to-severe ARDS the impact of early use of NMBAs on 90-day mortality, through propensity score (PS) matching analysis. METHODS: We analyzed a convenience sample of patients with COVID-19 and moderate-to-severe ARDS, admitted to 244 intensive care units within the COVID-19 Critical Care Consortium, from February 1, 2020, through October 31, 2021. Patients undergoing at least 2 days and up to 3 consecutive days of NMBAs (NMBA treatment), within 48 h from commencement of IMV were compared with subjects who did not receive NMBAs or only upon commencement of IMV (control). The primary objective in the PS-matched cohort was comparison between groups in 90-day in-hospital mortality, assessed through Cox proportional hazard modeling. Secondary objectives were comparisons in the numbers of ventilator-free days (VFD) between day 1 and day 28 and between day 1 and 90 through competing risk regression. RESULTS: Data from 1953 patients were included. After propensity score matching, 210 cases from each group were well matched. In the PS-matched cohort, mean (± SD) age was 60.3 ± 13.2 years and 296 (70.5%) were male and the most common comorbidities were hypertension (56.9%), obesity (41.1%), and diabetes (30.0%). The unadjusted hazard ratio (HR) for death at 90 days in the NMBA treatment vs control group was 1.12 (95% CI 0.79, 1.59, p = 0.534). After adjustment for smoking habit and critical therapeutic covariates, the HR was 1.07 (95% CI 0.72, 1.61, p = 0.729). At 28 days, VFD were 16 (IQR 0-25) and 25 (IQR 7-26) in the NMBA treatment and control groups, respectively (sub-hazard ratio 0.82, 95% CI 0.67, 1.00, p = 0.055). At 90 days, VFD were 77 (IQR 0-87) and 87 (IQR 0-88) (sub-hazard ratio 0.86 (95% CI 0.69, 1.07; p = 0.177). CONCLUSIONS: In patients with COVID-19 and moderate-to-severe ARDS, short course of NMBA treatment, applied early, did not significantly improve 90-day mortality and VFD. In the absence of definitive data from clinical trials, NMBAs should be indicated cautiously in this setting.


Assuntos
Tratamento Farmacológico da COVID-19 , Bloqueadores Neuromusculares , Síndrome do Desconforto Respiratório , Idoso , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Bloqueadores Neuromusculares/uso terapêutico , Pontuação de Propensão , Respiração Artificial , Síndrome do Desconforto Respiratório/tratamento farmacológico
7.
Echocardiography ; 39(11): 1450-1454, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36266746

RESUMO

We present the case of a 53-year-old patient with a giant floating thrombus in the aortic arch associated with proximal stenosis of the left subclavian artery diagnosed by multimodal imaging. Left carotid-subclavian shunt and thoracic endovascular aortic repair (TEVAR) were successful. Transesophageal echocardiography (TEE) played a substantial role in the safety and efficacy of the endovascular procedure and should be considered as an additional guide to fluoroscopy for this type of procedure.


Assuntos
Aneurisma da Aorta Torácica , Dissecção Aórtica , Implante de Prótese Vascular , Trombose , Humanos , Pessoa de Meia-Idade , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/cirurgia , Dissecção Aórtica/cirurgia , Implante de Prótese Vascular/métodos , Ecocardiografia Transesofagiana , Stents , Trombose/diagnóstico por imagem , Trombose/cirurgia , Resultado do Tratamento , Prótese Vascular , Estudos Retrospectivos
8.
Int J Mol Sci ; 23(16)2022 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-36012282

RESUMO

Nylon 6/acrylonitrile-butadiene-styrene nanocomposites were prepared by mixing in a molten state and injection molded for application in electromagnetic interference shielding and antistatic packaging. Multi-wall carbon nanotubes (MWCNT) and maleic anhydride-grafted ABS compatibilizer were incorporated to improve the electrical conductivity and mechanical performance. The nanocomposites were characterized by oscillatory rheology, Izod impact strength, tensile strength, thermogravimetry, current-voltage measurements, shielding against electromagnetic interference, and scanning electron microscopy. The rheological behavior evidenced a severe increase in complex viscosity and storage modulus, which suggests an electrical percolation phenomenon. Adding 1 to 5 phr MWCNT into the nanocomposites produced electrical conductivities between 1.22 × 10-6 S/cm and 6.61 × 10-5 S/cm. The results make them suitable for antistatic purposes. The nanocomposite with 5 phr MWCNT showed the highest electromagnetic shielding efficiency, with a peak of -10.5 dB at 9 GHz and a value around -8.2 dB between 11 and 12 GHz. This was possibly due to the higher electrical conductivity of the 5 phr MWCNT composition. In addition, the developed nanocomposites, regardless of MWCNT content, showed tenacious behavior at room temperature. The results reveal the possibility for tailoring the properties of insulating materials for application in electrical and electromagnetic shielding. Additionally, the good mechanical and thermal properties further widen the application range.


Assuntos
Acrilonitrila , Nanocompostos , Nanotubos de Carbono , Butadienos , Caprolactama/análogos & derivados , Condutividade Elétrica , Polímeros , Estireno
9.
Crit Care ; 25(1): 199, 2021 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-34108029

RESUMO

BACKGROUND: Heterogeneous respiratory system static compliance (CRS) values and levels of hypoxemia in patients with novel coronavirus disease (COVID-19) requiring mechanical ventilation have been reported in previous small-case series or studies conducted at a national level. METHODS: We designed a retrospective observational cohort study with rapid data gathering from the international COVID-19 Critical Care Consortium study to comprehensively describe CRS-calculated as: tidal volume/[airway plateau pressure-positive end-expiratory pressure (PEEP)]-and its association with ventilatory management and outcomes of COVID-19 patients on mechanical ventilation (MV), admitted to intensive care units (ICU) worldwide. RESULTS: We studied 745 patients from 22 countries, who required admission to the ICU and MV from January 14 to December 31, 2020, and presented at least one value of CRS within the first seven days of MV. Median (IQR) age was 62 (52-71), patients were predominantly males (68%) and from Europe/North and South America (88%). CRS, within 48 h from endotracheal intubation, was available in 649 patients and was neither associated with the duration from onset of symptoms to commencement of MV (p = 0.417) nor with PaO2/FiO2 (p = 0.100). Females presented lower CRS than males (95% CI of CRS difference between females-males: - 11.8 to - 7.4 mL/cmH2O p < 0.001), and although females presented higher body mass index (BMI), association of BMI with CRS was marginal (p = 0.139). Ventilatory management varied across CRS range, resulting in a significant association between CRS and driving pressure (estimated decrease - 0.31 cmH2O/L per mL/cmH20 of CRS, 95% CI - 0.48 to - 0.14, p < 0.001). Overall, 28-day ICU mortality, accounting for the competing risk of being discharged within the period, was 35.6% (SE 1.7). Cox proportional hazard analysis demonstrated that CRS (+ 10 mL/cm H2O) was only associated with being discharge from the ICU within 28 days (HR 1.14, 95% CI 1.02-1.28, p = 0.018). CONCLUSIONS: This multicentre report provides a comprehensive account of CRS in COVID-19 patients on MV. CRS measured within 48 h from commencement of MV has marginal predictive value for 28-day mortality, but was associated with being discharged from ICU within the same period. Trial documentation: Available at https://www.covid-critical.com/study . TRIAL REGISTRATION: ACTRN12620000421932.


Assuntos
COVID-19/complicações , COVID-19/terapia , Complacência Pulmonar/fisiologia , Respiração Artificial/métodos , Síndrome do Desconforto Respiratório/etiologia , Síndrome do Desconforto Respiratório/terapia , Adulto , Estudos de Coortes , Cuidados Críticos/métodos , Europa (Continente) , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença
10.
Ann Vasc Surg ; 72: 196-204, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33388408

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) infection can cause alterations in the coagulation mechanism conditioning thrombotic phenomena such as acute limb ischemia (ALI) as the only manifestation of the infection. The aim of the study was to describe clinical and surgical characteristics of a group of patients infected with severe acute respiratory syndrome coronavirus 2 who presented ALI in the context of the COVID-19 pandemic at Lima, Peru. METHODS: A multicenter, observational, and retrospective study was performed in six general hospitals, from March to July 2020. The variables considered were the pathological history and associated habits, laboratory tests, the severity of COVID-19 infection and ALI, the anatomic location of the lesion, treatment, evolution, and discharge conditions. RESULTS: Thirty patients with ALI infected with COVID-19 were evaluated. Their mean age was 60 ± 15 years, the condition being more frequent in men (76.6%). The main comorbidities were arterial hypertension (33.3%), obesity (33.3%), and diabetes mellitus 2 (26.6%). There were 23.3% asymptomatic patients, and their only manifestation was ALI. Rutherford IIA and IIB stage included 93.2% of patients. The most frequent location of the thrombosis was the lower limbs (73.3% vs. 26.6%). Thrombectomy was performed in 76.6% of the patients, and amputation (primary and secondary) was performed in 30% of the patients. The mortality rate was 23.3%, all of it because of acute respiratory distress syndrome. CONCLUSIONS: ALI is a vascular pathology associated with embolic and thrombotic processes. COVID-19 infection can cause severe alterations in coagulation mechanisms, leading some patients to present severe acute arterial complications such as thrombosis, as the only associated manifestation. We report a younger cohort than those described in other studies and with a high frequency of amputations despite adequate surgical treatment.


Assuntos
COVID-19/complicações , Isquemia/etiologia , Isquemia/cirurgia , Extremidade Inferior/irrigação sanguínea , Doença Aguda , Amputação Cirúrgica , COVID-19/epidemiologia , COVID-19/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Peru/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Pneumonia Viral/virologia , Estudos Retrospectivos , SARS-CoV-2 , Trombectomia
11.
Ann Vasc Surg ; 74: 520.e1-520.e9, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33556505

RESUMO

Lumbar artery pseudoaneurysm (LAPA) is a pathology infrequently described in the literature. The most frequent complications are the expansion and rupture of the pseudoaneurysm. Reports of association between PE with LAPA have not yet been described. We present a 53-year-old male patient with LAPA whose expansion caused compression of the inferior vena cava and subsequently PE. He underwent mechanical thrombectomy and inferior cava vein filter placement associated with embolization of the LAPA. Despite the severe clinical profile, the patient was discharged with a favorable postoperative course without complications. This case report also includes a review of the literature.


Assuntos
Falso Aneurisma/complicações , Artérias , Vértebras Lombares/irrigação sanguínea , Embolia Pulmonar/etiologia , Veia Cava Inferior , Trombose Venosa/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/terapia , Anticoagulantes/uso terapêutico , Artérias/diagnóstico por imagem , Embolização Terapêutica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/diagnóstico por imagem , Embolia Pulmonar/terapia , Trombectomia , Resultado do Tratamento , Filtros de Veia Cava , Veia Cava Inferior/diagnóstico por imagem , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/terapia , Adulto Jovem
12.
Sensors (Basel) ; 21(17)2021 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-34502842

RESUMO

Mimblewimble (MW) is a privacy-oriented cryptocurrency technology that provides security and scalability properties that distinguish it from other protocols of its kind. We present and discuss those properties and outline the basis of a model-driven verification approach to address the certification of the correctness of the protocol implementations. In particular, we propose an idealized model that is key in the described verification process, and identify and precisely state the conditions for our model to ensure the verification of the relevant security properties of MW. Since MW is built on top of a consensus protocol, we develop a Z specification of one such protocol and present an excerpt of the {log} prototype after its Z specification. This {log} prototype can be used as an executable model. This allows us to analyze the behavior of the protocol without having to implement it in a low level programming language. Finally, we analyze the Grin and Beam implementations of MW in their current state of development.


Assuntos
Privacidade
13.
BMC Microbiol ; 20(1): 132, 2020 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-32450809

RESUMO

BACKGROUND: Mortality due to tuberculosis (TB) has increased due to the development of drug resistance, the mechanisms of which have not been fully elucidated. Our research group identified a low expression of lipF gene in Mycobacterium tuberculosis clinical isolates with drug resistance. The aim of this work was to evaluate the effect of lipase F (LipF) expression on mycobacterial drug resistance. RESULTS: The effects of expressing lipF from Mycobacterium tuberculosis in Mycobacterium smegmatis on resistance to antituberculosis drugs were determined with resazurin microtiter assay plate and growth kinetics. Functionality of ectopic LipF was confirmed. LipF expression reduced the rifampicin (RIF) and streptomycin (STR) minimum inhibitory concentration (MIC) from 3.12 µg/mL to 1.6 µg/mL and 0.25 µg/mL to 0.06 µg/mL respectively, moreover a reduced M. smegmatis growth in presence of RIF and STR compared with that of a control strain without LipF expression (p < 0.05 and p < 0.01) was shown. CONCLUSIONS: LipF expression was associated with increased RIF and STR sensitivity in mycobacteria. Reduced LipF expression may contribute to the development of RIF and STR resistance in Mycobacterium species. Our findings provide information pertinent to understanding mycobacterial drug resistance mechanisms.


Assuntos
Farmacorresistência Bacteriana Múltipla , Lipase/genética , Mycobacterium tuberculosis/enzimologia , Rifampina/farmacologia , Estreptomicina/farmacologia , Proteínas de Bactérias/genética , Clonagem Molecular , Regulação para Baixo , Regulação Bacteriana da Expressão Gênica/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Mycobacterium smegmatis/efeitos dos fármacos , Mycobacterium smegmatis/genética , Mycobacterium smegmatis/crescimento & desenvolvimento , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/genética
14.
Molecules ; 25(12)2020 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-32630602

RESUMO

The present paper investigates the feasibility of using acetone (ACE) in triple blends with fossil diesel (D) and straight vegetable oils (SVOs) as alternative fuel for diesel engines. In this respect, ACE is selected as an oxygenated additivedue to its favorable propertiesto be mixed with vegetable oils and fossil diesel. In fact, the very low kinematic viscosity allows reduces the high viscosity of SVOs. ACE's oxygen content, low autoignition temperature, and very low cloud point and pour point values highlight its possibilities as an additive in D/ACE/SVO triple blends. Moreover, ACE can be produced through a renewable biotechnological process, an acetone-butanol-ethanol (ABE) fermentation from cellulosic biomass. The SVOs tested were castor oil (CO), which is not suitable for human consumption, and sunflower oil (SO), used as a standard reference for waste cooking oil. The viscosity measurement of the ACE/SVO double blend was considered crucial to choose the optimum proportion, which better fulfilled the specifications established by European standard EN 590. Moreover, some of the most significant physicochemical properties of D/ACE/SVO triple blends, such as kinematic viscosity, cloud point, pour point, and calorific value, were determined to assess their suitability as fuels. The blends were evaluated in a conventional diesel generator through the study of the following parameters: engine power, smoke emissions, and fuel consumption. Despite the low calorific value of ACE limits its ratio in the mixtures due to engine knocking problems, the experimental results reveal an excellent performance for the blends containing up to 16-18% of ACE and 22-24% of SVO. These blends produce similar engine power as to fossil diesel, but with slightly higher fuel consumption. Considerable reductions in emissions of air pollutants, as well as excellent cold flow properties are also obtained with these triple blends. In summary, the use of these biofuels could achieve a substitution of fossil diesel up to 40%, independently on the SVO employed.


Assuntos
Acetona/química , Biocombustíveis/análise , Óleo de Rícino/química , Gasolina/análise , Óleos de Plantas/química , Óleo de Girassol/química , Emissões de Veículos/análise , Humanos
15.
Clin Infect Dis ; 69(11): 1912-1918, 2019 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-30722013

RESUMO

BACKGROUND: Randomized clinical trials (RCTs) in hospital-acquired and ventilator-associated bacterial pneumonia (HABP and VABP, respectively) are important for the evaluation of new antimicrobials. However, the heterogeneity in endpoints used in RCTs evaluating treatment of HABP/VABP may puzzle clinicians. The aim of this work was to reach a consensus on clinical endpoints to consider in future clinical trials evaluating antimicrobial treatment efficacy for HABP/VABP. METHODS: Twenty-six international experts from intensive care, infectious diseases, and the pharmaceutical industry were polled using the Delphi method. RESULTS: The panel recommended a hierarchical composite endpoint including, by priority order, (1) survival at day 28, (2) mechanical ventilation-free days through day 28, and (3) clinical cure between study days 7 and 10 for VABP; and (1) survival (day 28) and (2) clinical cure (days 7-10) for HABP. Clinical cure was defined as the combination of resolution of signs and symptoms present at enrollment and improvement or lack of progression of radiological signs. More than 70% of the experts agreed to assess survival and mechanical ventilation-free days though day 28, and clinical cure between day 7 and day 10 after treatment initiation. Finally, the hierarchical order of endpoint components was reached after 3 Delphi rounds (72% agreement). CONCLUSIONS: We provide a multinational expert consensus on separate hierarchical composite endpoints for VABP and HABP, and on a definition of clinical cure that could be considered for use in future HABP/VABP clinical trials.


Assuntos
Antibacterianos/uso terapêutico , Pneumonia Bacteriana/microbiologia , Pneumonia Associada à Ventilação Mecânica/tratamento farmacológico , Consenso , Cuidados Críticos/métodos , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Humanos , Pneumonia Bacteriana/tratamento farmacológico , Pneumonia Associada à Ventilação Mecânica/microbiologia , Resultado do Tratamento
16.
Curr Opin Infect Dis ; 32(5): 426-434, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31313714

RESUMO

PURPOSE OF REVIEW: To discuss available information on the effectiveness of anti-toxoplasma therapy for ocular toxoplasmosis and to provide clinicians with a practical approach to the disease. RECENT FINDINGS: Only eleven randomized studies were identified. In the three studies for acute retinitis, there was a clear trend in favor of treatment. In the two studies for the prevention of recurrences, trimethoprim-sulfamethoxazole prophylaxis was superior to placebo. In the six studies comparing different regimens, there was no statistically significant difference between the regimens. In the setting of acute posterior uveitis suspected to be caused by toxoplasma, serological testing should always be obtained, and anti-toxoplasma drug treatment, and corticosteroids should be instituted for at least 6 weeks. Toxoplasmic chorioretinitis during pregnancy represents a particular challenge. SUMMARY: Treatment with at least two drugs and corticosteroids should be offered to patients with active toxoplasmic chorioretinitis. Pregnant women with confirmed acute infection and concomitant acute retinitis should be treated for the ocular lesion(s) and to prevent vertical transmission. Pregnant women with chronic Toxoplasma infection acquired prior to gestation and concomitant retinitis by reactivation should be treated for the retinitis and monitored for vertical transmission.


Assuntos
Antiprotozoários/uso terapêutico , Gerenciamento Clínico , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Toxoplasmose Ocular/diagnóstico , Toxoplasmose Ocular/tratamento farmacológico , Corticosteroides/uso terapêutico , Adulto , Anti-Inflamatórios/uso terapêutico , Testes Diagnósticos de Rotina/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Gestantes , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
17.
Cytokine ; 123: 154784, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31344596

RESUMO

Cutaneous leishmaniasis (CL) caused by Leishmania braziliensis is the most spread clinical form of leishmaniasis in Brazil. However, only a few part of the people infected develop clinically perceptive disease, suggesting the influence of human genetic components in the CL pathogeny. The rs2275913 SNP is the nucleotide variant of the IL17A gene. The A allele is associated with a vast number of infectious and non-infectious diseases. Here, we investigated the association of the rs2275913 SNP (G/A) from IL-17A and two forms of susceptibility to CL in Brazil by case-control study. Furthermore, we evaluated the functional relevance of this SNP during the immune response of the host and analyzed its impact in the parasite elimination. Weak associations of A allele with susceptibility to L. braziliensis infection or to symptomatic CL were observed, and a tendency of A allele carriers to be more susceptible to infection and cutaneous disease. Functional analysis of the Th17 cell phenotypes revealed lower frequencies of CD4+ IL-17+ cells in samples of infected people with AA/AG genotypes. Furthermore, people carrying the A allele maintain higher parasite loads, reinforcing the genetic susceptibility findings. This study adds knowledge about the influence of a significant genetic variation on IL-17 promoter on CL pathogenesis, and may contribute to enhance the knowledge about the role of IL-17 in the L. braziliensis infections.


Assuntos
Predisposição Genética para Doença , Genótipo , Interleucina-17 , Leishmania braziliensis/imunologia , Leishmaniose Cutânea , Polimorfismo de Nucleotídeo Único , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Interleucina-17/genética , Interleucina-17/imunologia , Leishmaniose Cutânea/genética , Leishmaniose Cutânea/imunologia , Leishmaniose Cutânea/patologia , Masculino , Pessoa de Meia-Idade , Células Th17/imunologia , Células Th17/patologia
18.
Langmuir ; 35(44): 14291-14299, 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31565937

RESUMO

The synthesis of organic-solvent-dispersible gold nanoparticles in reverse micelles of didodecyldimethylammonium bromide (DDAB) is revisited in the present investigation. Some parameters of synthesis, specifically the reaction volume and the concentration of the reducing agent, were slightly modified obtaining directly monodisperse gold nanocrystals (AuNCs) without the need to use additional active surfactants or additional treatments such as digestive ripening. Interestingly, most of the obtained AuNCs display the same exposed crystalline faces composed of six bounding facets (four {111} faces and two {002} faces), corresponding to single-crystalline face-centered cubic nanoparticles with a cuboctahedron shape. When these AuNCs are subsequently functionalized with 1-decanethiol (C10H21SH) or 1-dodecanethiol (C12H25SH), they don't experience significant changes in their size or crystalline texture, however, they self-aggregate directly in the suspension at room temperature into faceted supramolecular structures and exhibit collective plasmonic excitations. Such self-organization is reversible under heating treatments allowing the observation of the influence of the AuNCs aggregation state on their plasmonic properties. Fourier transform infrared spectroscopy reveals that thiols only replace partially the DDAB molecules, and thus, DDAB molecules remain present in the thiol-capped AuNCs. To turn the thiol-capped nanocrystals into water-dispersible nanocrystals and extend their technological potential, they are stabilized with poloxamer 407 obtaining highly stable purple colloids in water.

19.
Microb Cell Fact ; 18(1): 200, 2019 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-31727078

RESUMO

The global rise in urbanization and industrial activity has led to the production and incorporation of foreign contaminant molecules into ecosystems, distorting them and impacting human and animal health. Physical, chemical, and biological strategies have been adopted to eliminate these contaminants from water bodies under anthropogenic stress. Biotechnological processes involving microorganisms and enzymes have been used for this purpose; specifically, laccases, which are broad spectrum biocatalysts, have been used to degrade several compounds, such as those that can be found in the effluents from industries and hospitals. Laccases have shown high potential in the biotransformation of diverse pollutants using crude enzyme extracts or free enzymes. However, their application in bioremediation and water treatment at a large scale is limited by the complex composition and high salt concentration and pH values of contaminated media that affect protein stability, recovery and recycling. These issues are also associated with operational problems and the necessity of large-scale production of laccase. Hence, more knowledge on the molecular characteristics of water bodies is required to identify and develop new laccases that can be used under complex conditions and to develop novel strategies and processes to achieve their efficient application in treating contaminated water. Recently, stability, efficiency, separation and reuse issues have been overcome by the immobilization of enzymes and development of novel biocatalytic materials. This review provides recent information on laccases from different sources, their structures and biochemical properties, mechanisms of action, and application in the bioremediation and biotransformation of contaminant molecules in water. Moreover, we discuss a series of improvements that have been attempted for better organic solvent tolerance, thermo-tolerance, and operational stability of laccases, as per process requirements.


Assuntos
Biocatálise , Poluentes Ambientais/metabolismo , Lacase , Biodegradação Ambiental , Ecossistema , Fungos/enzimologia , Lacase/química , Lacase/metabolismo , Plantas/enzimologia , Água/análise , Água/química , Purificação da Água
20.
J Antimicrob Chemother ; 73(1): 212-222, 2018 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-29045648

RESUMO

BACKGROUND: Substantial heterogeneity in the epidemiology and management of Staphylococcus aureus bacteraemia (SAB) occurs in Latin America. We conducted a prospective cohort study in 24 hospitals from nine Latin American countries. OBJECTIVES: To assess the clinical impact of SAB in Latin America. PATIENTS AND METHODS: We evaluated differences in the 30 day attributable mortality among patients with SAB due to MRSA compared with MSSA involving 84 days of follow-up. Adjusted relative risks were calculated using a generalized linear model. RESULTS: A total of 1030 patients were included. MRSA accounted for 44.7% of cases with a heterogeneous geographical distribution. MRSA infection was associated with higher 30 day attributable mortality [25% (78 of 312) versus 13.2% (48 of 363), adjusted RR: 1.94, 95% CI: 1.38-2.73, P < 0.001] compared with MSSA in the multivariable analysis based on investigators' assessment, but not in a per-protocol analysis [13% (35 of 270) versus 8.1% (28 of 347), adjusted RR: 1.10, 95% CI: 0.75-1.60, P = 0.616] or in a sensitivity analysis using 30 day all-cause mortality [36% (132 of 367) versus 27.8% (123 of 442), adjusted RR: 1.09, 95% CI: 0.96-1.23, P = 0.179]. MRSA infection was not associated with increased length of hospital stay. Only 49% of MSSA bloodstream infections (BSI) received treatment with ß-lactams, but appropriate definitive treatment was not associated with lower mortality (adjusted RR: 0.93, 95% CI: 0.70-1.23, P = 0.602). CONCLUSIONS: MRSA-BSIs in Latin America are not associated with higher 30 day mortality or longer length of stay compared with MSSA. Management of MSSA-BSIs was not optimal, but appropriate definitive therapy did not appear to influence mortality.


Assuntos
Bacteriemia/epidemiologia , Infecção Hospitalar/epidemiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/epidemiologia , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Bacteriemia/microbiologia , Hemocultura , Estudos de Coortes , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Feminino , Humanos , América Latina/epidemiologia , Masculino , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Pessoa de Meia-Idade , Estudos Prospectivos , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/mortalidade , Vancomicina/uso terapêutico
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