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1.
Acta Ortop Mex ; 38(2): 73-81, 2024.
Article in Spanish | MEDLINE | ID: mdl-38782471

ABSTRACT

INTRODUCTION: surgical site infections (SSI) remain a significant cause of morbidity and mortality and one of the most representative causes of nosocomial infections. The use of intrawound vancomycin in lumbar spine surgery is a potential prophylactic measure against SSI; however, evidence regarding its efficacy is contradictory. Our study was designed to research if intrawound vancomycin significantly prevents SSI in lumbar spine surgery. MATERIAL AND METHODS: this is a randomized, double-blinded, controlled clinical trial; 233 patients who underwent lumbar spine surgery, were randomly assigned to a group in which intrawound vancomycin was instilled in the incision before closure (109), or to a control group (114). The main outcome is the presence of SSI; we determined its prevalence and searched for difference between groups for association between SSI and independent variables. RESULTS: global SSI prevalence was 1.8%, in the experimental group was 0.9%, in the control group was 2.6%. There was no significant difference between these values, p = 0.622. The relative risk of SSI in the experimental group was 0.35 (95% CI 0.037-3.30), that of the control group was 2.87 (95% CI 0.30-27.16). The number needed to treat is 58.3. We did not find a significant association between the independent variables studied and the appearance of SSI. CONCLUSIONS: we did not find a significant difference in the prevalence of SSI between groups nor a significant association between SSI and independent variables.


INTRODUCCIÓN: las infecciones postoperatorias del sitio quirúrgico son una importante causa de morbimortalidad y una de las formas más comunes de infecciones nosocomiales. La aplicación de vancomicina al terminar una intervención de columna lumbar es una potencial práctica profiláctica de infecciones del sitio quirúrgico (ISQ). La evidencia que sostiene su uso es controversial. Nuestro estudio investiga si la aplicación de vancomicina disminuye en forma significativa la prevalencia de ISQ. MATERIAL Y MÉTODOS: ensayo clínico aleatorizado, controlado, cegado; 223 pacientes intervenidos de la columna lumbar fueron aleatoriamente asignados a un grupo experimental de 109 pacientes en quienes se colocó vancomicina y a un grupo control de 114 pacientes que no recibió vancomicina. El principal desenlace del estudio es la aparición de ISQ; se estudió la prevalencia de ISQ en ambos grupos y se buscó si existe diferencia significativa. Se analizó la existencia de factores predictores de ISQ. RESULTADOS: la prevalencia global de infección fue 1.8%; en el grupo experimenta 0.09% y en el grupo control 2.6%. No hubo diferencia significativa entre estas cifras, p = 0.622. El riesgo relativo de ISQ en el grupo experimental fue 0.35 (IC95% 0.037-3.30), el del grupo control fue 2.87 (IC95% 0.30-27.16). El número necesario para tratar es 58.3. No encontramos asociación significativa entre las variables independientes estudiadas y la aparición de ISQ. CONCLUSIONES: no encontramos evidencia suficiente de que la aplicación de vancomicina disminuya significativamente la prevalencia de ISQ ni asociación significativa de ISQ con las variables independientes estudiadas.


Subject(s)
Administration, Topical , Anti-Bacterial Agents , Lumbar Vertebrae , Surgical Wound Infection , Vancomycin , Humans , Surgical Wound Infection/prevention & control , Surgical Wound Infection/epidemiology , Male , Female , Vancomycin/administration & dosage , Vancomycin/therapeutic use , Middle Aged , Double-Blind Method , Lumbar Vertebrae/surgery , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Aged , Adult
2.
Waste Manag ; 168: 167-178, 2023 Aug 01.
Article in English | MEDLINE | ID: mdl-37301089

ABSTRACT

Around 143,000 chemicals find their fate in wastewater treatment plants in the European Union. Low efficiency on their removal at lab-based studies and even poorer performance at large scale experiments have been reported. Here, a coupled biological technology (bioaugmentation and composting) is proposed and proved for pharmaceutical active compounds degradation and toxicity reduction. The optimization was conducted through in situ inoculation of Penicillium oxalicum XD 3.1 and an enriched consortium (obtained from non-digested sewage sludge), into pilot scale piles of sewage sludge under real conditions. This bioaugmentation-composting system allowed a better performance of micropollutants degradation (21 % from the total pharmaceuticals detected at the beginning of the experiment) than a traditional composting process. Particularly, inoculation with P. oxalicum allowed the degradation of some recalcitrant compounds like carbamazepine, cotinine and methadone, and also produced better stabilization features in the mature compost (significant passivation of copper and zinc, higher macronutrients value, adequate physicochemical conditions for soil direct application and less toxic effect on germination) compared to the control and the enriched culture. These findings provide a feasible, alternative strategy to obtain a safer mature compost and a better removal of micropollutants performance at large scale.


Subject(s)
Composting , Sewage , Sewage/chemistry , Soil/chemistry , Zinc , Pharmaceutical Preparations
3.
Georgian Med News ; (330): 99-105, 2022 Sep.
Article in English | MEDLINE | ID: mdl-36427851

ABSTRACT

Coronavirus disease 2019 (Covid-19) active cases continue to demand the development of safe and effective treatments. This is the first clinical trial to evaluate the safety and efficacy of oral thymic peptides. ; We conducted a nonrandomized phase 2 trial with a historic control group to evaluate the safety and efficacy of a daily 250-mg oral dose of thymic peptides in the treatment of hospitalized Covid-19 patients. Comparisons based on standard care from registry data were performed after propensity score matching. The primary outcomes were survival, time to recovery, and number of participants with treatment-related adverse events or side effects by day 20. ; A total of 44 patients were analyzed in this study: 22 in the thymic peptide group and 22 in the standard care group. There were no deaths in the intervention group compared to 24% mortality in standard care by day 20 (log-rank P=0.02). Kaplan-Meier analysis showed a significantly shorter time to recovery by day 20 in the thymic peptide group than in the standard care group (median, 6 days vs. 12 days; hazard ratio for recovery, 2.75 [95% confidence interval, 1.34 to 5.62]; log-rank P=0.002). No side effects or adverse events were reported. ; In patients hospitalized with Covid-19, the use of thymic peptides resulted in no side effects, adverse events, or deaths by day 20. Compared with the registry data, a significantly shorter time to recovery and mortality reduction were measured.


Subject(s)
COVID-19 Drug Treatment , Peptides , Humans , Honduras , Kaplan-Meier Estimate , Peptides/adverse effects , Proportional Hazards Models
4.
Actas urol. esp ; 46(1): 41-48, ene.-feb. 2022. ^tab
Article in Spanish | IBECS | ID: ibc-203534

ABSTRACT

Objetivo Estudiar el grado de concordancia diagnóstica entre vejiga hiperactiva (VH) e hiperactividad del detrusor (HD) en varones con síntomas del tracto urinario inferior (STUI) predominantemente de llenado, y el perfil clínico y urodinámico según presencia de HD y grado de obstrucción del tracto urinario inferior (OTUI).Material y métodos Estudio epidemiológico, transversal, multicéntrico y nacional. Se cumplimentaron: diario miccional de 3 días (DM3d), International Prostate Symptom Score (IPSS) y Cuestionario de Autoevaluación del Control de la Vejiga (CACV). Se determinó el volumen prostático (Vp) por ecografía y se realizó estudio urodinámico (EUD). Se analizó la prevalencia de VH y HD y la concordancia (kappa). Se realizó un análisis descriptivo de características clínicas y urodinámicas; posteriormente se comparó su frecuencia según presencia de HD y OTUI.ResultadosSe evaluaron 445 pacientes con edad media±DE de 54,8±9,9 años. Según el DM3d, un 89,8% presentaba frecuencia miccional aumentada, un 87,9% nicturia, un 72,8% urgencia y un 31,9% incontinencia urinaria de urgencia (IUU). Un 36,8% tenía OTUI. El 54,5% presentaba VH y HD. La concordancia diagnóstica entre HD y VH fue baja (κ=0,1702). Más pacientes con HD que sin ella presentaron urgencia (DM3d y CACV; p<0,001), IUU (DM3d; p=0,008) y nicturia (CACV; p<0,001). Hubo diferencias en IPSS-vaciado, flujo máximo (Qmax) y residuo posmiccional (p<0,05) según el grado de obstrucción.ConclusionesEn pacientes varones de 18 a 65 años con STUI predominantemente de llenado derivados a unidades especializadas, aproximadamente la mitad tienen coexistencia de VH y HD y un tercio tenía obstrucción. Hay baja concordancia diagnóstica entre VH y HD (AU)


Objective To assess the diagnostic concordance of overactive bladder (OAB) and detrusor overactivity (DO) in male patients with predominant storage lower urinary tract symptoms (LUTS) and evaluate their clinical and urodynamic profile according to DO presence and degree of obstruction.Material and methods Epidemiological, cross-sectional multicenter study. A 3-day bladder diary (3dBD), International Prostate Symptom Score (IPSS) and Bladder Control Self-Assessment Questionnaire (B-SAQ) questionnaires were analyzed. Prostate volume was determined by ultrasound. Urodynamic study (UDS) tests were performed. The prevalence of OAB and DO and the degree of clinical concordance (kappa index) were investigated. Descriptive analysis of clinical variables and UDS results was performed, followed by comparisons based on the presence of DO and degree of obstruction.ResultsA total of 445 patients were included. The mean age was (SD) 54.8 (9.9) years. According to 3dBD, 89.9% presented increased urinary frequency, 87.9% nocturia, 72.1% urgency, and 31.9% urge urinary incontinence (UUI). Obstruction was present in 36.8%. Concomitant OAB and DO were present in 54.5%. The degree of diagnostic concordance between OAB and DO was low (κ=0.1772). There were more patients with DO presenting urgency (3dBD and B-SAQ; p<0.001), UUI (3dBD; p=0.008) and nocturia (B-SAQ; p<0.001). Differences were found in terms of prostate volume, IPSS-voiding, maximum flow (Qmax) and post-void residual (p<0.05) according to the obstruction degree.ConclusionsApproximately 50% of male patients aged 18-65 years old with predominant storage LUTS, referred to specialized units, have both OAB and DO. Obstruction is present on 1/3. Diagnostic concordance between OAB and DO is poor (AU)


Subject(s)
Humans , Male , Adolescent , Young Adult , Adult , Middle Aged , Aged , Urinary Bladder, Overactive/diagnosis , Urinary Incontinence, Urge/diagnosis , Urinary Bladder, Overactive/epidemiology , Urinary Incontinence, Urge/epidemiology , Cross-Sectional Studies , Urodynamics , Prevalence
5.
Actas Urol Esp (Engl Ed) ; 46(1): 41-48, 2022.
Article in English, Spanish | MEDLINE | ID: mdl-34848162

ABSTRACT

OBJECTIVES: To assess the diagnostic concordance of overactive bladder (OAB) and detrusor overactivity (DO) in male patients with predominant storage lower urinary tract symptoms (LUTS) and evaluate their clinical and urodynamic profile according to DO presence and degree of obstruction. MATERIAL AND METHODS: Epidemiological, cross-sectional multicenter study. A 3-day bladder diary (3dBD), International Prostate Symptom Score (IPSS) and Bladder Control Self-Assessment Questionnaire (B-SAQ) questionnaires were analyzed. Prostate volume was determined by ultrasound. Urodynamic study (UDS) tests were performed. The prevalence of OAB and DO and the degree of clinical concordance (kappa index) were investigated. Descriptive analysis of clinical variables and UDS results was performed, followed by comparisons based on the presence of DO and degree of obstruction. RESULTS: A total of 445 patients were included. The mean age was (SD) 54.8 (9.9) years. According to 3dBD, 89.9% presented increased urinary frequency, 87.9% nocturia, 72.1% urgency, and 31.9% urge urinary incontinence (UUI). Obstruction was present in 36.8%. Concomitant OAB and DO were present in 54.5%. The degree of diagnostic concordance between OAB and DO was low (κ = 0.1772). There were more patients with DO presenting urgency (3dBD and B-SAQ; p < 0.001), UUI (3dBD; p = 0.008) and nocturia (B-SAQ; p < 0.001). Differences were found in terms of prostate volume, IPSS-voiding, maximum flow (Qmax) and post-void residual (p < 0.05) according to the obstruction degree. CONCLUSIONS: Approximately 50% of male patients aged 18-65 years old with predominant storage LUTS, referred to specialized units, have both OAB and DO. Obstruction is present on 1/3. Diagnostic concordance between OAB and DO is poor.


Subject(s)
Urinary Bladder, Overactive , Urology , Adolescent , Adult , Aged , Cross-Sectional Studies , Humans , Male , Middle Aged , Urinary Bladder, Overactive/diagnosis , Urinary Bladder, Overactive/epidemiology , Urinary Incontinence, Urge/diagnosis , Urinary Incontinence, Urge/epidemiology , Urodynamics , Young Adult
6.
Article in English, Spanish | MEDLINE | ID: mdl-34332808

ABSTRACT

OBJECTIVE: To assess the diagnostic concordance of overactive bladder (OAB) and detrusor overactivity (DO) in male patients with predominant storage lower urinary tract symptoms (LUTS) and evaluate their clinical and urodynamic profile according to DO presence and degree of obstruction. MATERIAL AND METHODS: Epidemiological, cross-sectional multicenter study. A 3-day bladder diary (3dBD), International Prostate Symptom Score (IPSS) and Bladder Control Self-Assessment Questionnaire (B-SAQ) questionnaires were analyzed. Prostate volume was determined by ultrasound. Urodynamic study (UDS) tests were performed. The prevalence of OAB and DO and the degree of clinical concordance (kappa index) were investigated. Descriptive analysis of clinical variables and UDS results was performed, followed by comparisons based on the presence of DO and degree of obstruction. RESULTS: A total of 445 patients were included. The mean age was (SD) 54.8 (9.9) years. According to 3dBD, 89.9% presented increased urinary frequency, 87.9% nocturia, 72.1% urgency, and 31.9% urge urinary incontinence (UUI). Obstruction was present in 36.8%. Concomitant OAB and DO were present in 54.5%. The degree of diagnostic concordance between OAB and DO was low (κ=0.1772). There were more patients with DO presenting urgency (3dBD and B-SAQ; p<0.001), UUI (3dBD; p=0.008) and nocturia (B-SAQ; p<0.001). Differences were found in terms of prostate volume, IPSS-voiding, maximum flow (Qmax) and post-void residual (p<0.05) according to the obstruction degree. CONCLUSIONS: Approximately 50% of male patients aged 18-65 years old with predominant storage LUTS, referred to specialized units, have both OAB and DO. Obstruction is present on 1/3. Diagnostic concordance between OAB and DO is poor.

8.
Nanotechnology ; 32(5): 055604, 2021 Jan 29.
Article in English | MEDLINE | ID: mdl-33065556

ABSTRACT

Nanostructured hybrid materials (NHMs) are promising candidates to improve the performance of several materials in different applications. In the case of optoelectronic technologies, the ability to tune the optical absorption of such NHMs is an appealing feature. Along with the capacity to transform the absorbed light into charge carriers (CC), and their consequently efficient transport to the different electrodes. In this regard, NHM based on graphene-like structures and semiconductor QDs are appealing candidates, assuming the NHMs retain the light absorption and CC photogeneration properties of semiconductor QDs, and the excellent CC transport properties displayed by graphene-like materials. In the current work a solution-processed NHM using PbS quantum dots (QDs) and graphene oxide (GO) was fabricated in a layer-by-layer configuration by dip-coating. Afterwards, these NHMs were reduced by thermal or chemical methods. Reduction process had a direct impact on the final optoelectronic properties displayed by the NHMs. All reduced samples displayed a decrement in their resistivity, particularly the sample chemically reduced, displaying a 107 fold decrease; mainly attributed to N-doping in the reduced graphene oxide (rGO). The optical absorption coefficients also showed a dependence on the rGO's reduction degree, with reduced samples displaying higher values, and sample thermally reduced at 300 °C showing the highest absorption coefficient, due to the combined absorption of unaltered PbS QDs and the appearance of sp2 regions within rGO. The photogenerated current increased in most reduced samples, displaying the highest photocurrent the sample reduced at 400 °C, presenting a 2500-fold increment compared to the NHM before reduction, attributed to an enhanced CC transfer from PbS QDs to rGO, as a consequence of an improved band alignment between them. These results show clear evidence on how the optoelectronic properties of NHMs based on semiconductor nanoparticles and rGO, can be tuned based on their configuration and the reduction process parameters.

9.
Nat Comput Sci ; 1(12): 830-842, 2021 Dec.
Article in English | MEDLINE | ID: mdl-38217181

ABSTRACT

Pattern separation is a fundamental brain computation that converts small differences in input patterns into large differences in output patterns. Several synaptic mechanisms of pattern separation have been proposed, including code expansion, inhibition and plasticity; however, which of these mechanisms play a role in the entorhinal cortex (EC)-dentate gyrus (DG)-CA3 circuit, a classical pattern separation circuit, remains unclear. Here we show that a biologically realistic, full-scale EC-DG-CA3 circuit model, including granule cells (GCs) and parvalbumin-positive inhibitory interneurons (PV+-INs) in the DG, is an efficient pattern separator. Both external gamma-modulated inhibition and internal lateral inhibition mediated by PV+-INs substantially contributed to pattern separation. Both local connectivity and fast signaling at GC-PV+-IN synapses were important for maximum effectiveness. Similarly, mossy fiber synapses with conditional detonator properties contributed to pattern separation. By contrast, perforant path synapses with Hebbian synaptic plasticity and direct EC-CA3 connection shifted the network towards pattern completion. Our results demonstrate that the specific properties of cells and synapses optimize higher-order computations in biological networks and might be useful to improve the deep learning capabilities of technical networks.

10.
Rev. chil. ter. ocup ; 20(2): 149-153, dic. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1366951

ABSTRACT

La epidemia de COVID-19 ha llevado a la necesidad de decisiones sin precedentes. Esta sistematización aborda la toma de decisiones operativas que el equipo de Terapia Ocupacional del Hospital estatal San José de Santiago ha trabajado durante la epidemia.


The COVID-19 epidemic has led to the need for unprecedented decisions. This systematization addresses the operational decision-making that the Occupational Therapy team of the San José de Santiago State Hospital has worked on during the epidemic.


Subject(s)
Humans , Occupational Therapy/organization & administration , COVID-19/rehabilitation , Intensive Care Units/organization & administration , Pandemics
11.
Endodoncia (Madr.) ; 37(2): 30-38, sept. 2019. tab, graf
Article in Spanish | IBECS | ID: ibc-186297

ABSTRACT

Objetivo: El objetivo de este estudio ha sido valorar cómo el hidróxido de calcio y la pasta triantibiótica (3-ATB) con agua destilada o propilenglicol actúan frente a una de las principales bacterias anaerobias facultativas presentes en dientes permanentes jóvenes con pulpa necrótica. Material y Método: Se llevó a cabo la siembra de la cepa bacteriana E.Coli (ATCC(R) 25922) en placas Petri para probar la susceptibilidad de los materiales mediante el método de difusión en agar. Se realizó la lectura de los resultados a las 48 horas mediante la medición de los halos de inhibición (mm) presentes en las placas. Resultados: La pasta tri-antibiótica mostró mayor inhibición que el hidróxido de calcio. Respecto a los solventes, la pasta 3-ATB ofreció mejor resultado combinada con propilenglicol, mientras que la respuesta del hidróxido de calcio fue más favorable al mezclar con agua destilada. Conclusiones: La pasta 3-ATB es más efectiva contra microorganismos anaerobios facultativos que el hidróxido de calcio, independientemente del solvente utilizado. En cuanto al solvente, el propilenglicol es más efectivo con pasta tri-antibiótica y el hidróxido de calcio lo es con agua destilada


Objective: The objective of this study was to assess how calcium hydroxide and triple antibiotic paste (3-ATB) with distilled water or propylene glycol act against one of the main facultative anaerobic bacteria present in young permanent teeth with necoritc pulp. Material and Methods: The seeding of the E.Coli (ATCC(R) 25922) was carried out in Petri dishes to test the susceptibility of the materials by the agar diffusion method. The results were read at 48 hours by measuring the inhibition zones (mm) present in the plates. Results: 3-ATB paste showed greater inhibition than calcium hydroxide. Regarding the solvents, 3-ATB paste offered better re-sults with propylene glycol, while the calcium hydroxide response was more favorable mixed with distilled water. Conclusions: 3-ATB paste is more effective against facultative anaerobic microorganisms than calcium hydroxide, regardless of the solvent used. As for the solvent, propylene glycol is more effective with 3-ATB paste while calcium hydroxide with distilled water


Subject(s)
Humans , Anti-Infective Agents/therapeutic use , Calcium Hydroxide/metabolism , Ointments/therapeutic use , Bacteria, Anaerobic/drug effects , Dentition, Permanent , Propylene Glycol/therapeutic use , Distilled Water , Spectrophotometry , Analysis of Variance , 28599
12.
Nanotechnology ; 30(39): 395601, 2019 Sep 27.
Article in English | MEDLINE | ID: mdl-31234156

ABSTRACT

In the present study core-shell PEDOT:PSS-polyvinylpirrolidone nanofibers were synthesized by coaxial electrospinning. These fibers were doped with different solvents (dimethylsulphoxide, dimethyl sulfoxide (DMSO), isopropyl alcohol (IPA), and ethylene glycol), and PbS nanoparticles at different concentrations; additionally, the coaxial electrospinning setup process was inverted in order to exchange the phases comprising the core-shell morphology. Experimental results showed that DMSO and IPA solvents produced a change in the PEDOT:PSS phase from its benzoid structure to a more conjugated (quinoid) one. The synthesized samples displayed an increment in the conductance of the composite nanofibers, based on a more conjugated structure of the PEDOT:PSS phase, and a better dispersion of the PbS nanoparticles within the nanofibers; this increment was, under certain synthesis conditions, up to three orders of magnitude higher than in the case of the nanofibers with no solvent, nor nanoparticles, added. Photoresponse also showed a clear increment in the value of the photogenerated current as the concentration of the nanoparticles increased. Inverting the arrangement of the core-shell phases in the nanofibers increased the conductance and the photogenerated current in the cases analyzed. These results show novel evidence on the capability of tuning the conductance and photoresponse of composite core-shell nanofibers, based on the doping of the PEDOT:PSS phase with different solvents and PbS nanoparticles, and the arrangement of the core-shell phases. Tailoring the optoelectronic properties of conductive, flexible nanofibers is a desirable competence in technological areas such as transparent flexible conductors, biosensors and tissue engineering.

13.
Actas urol. esp ; 43(3): 143-150, abr. 2019. tab, graf
Article in Spanish | IBECS | ID: ibc-181173

ABSTRACT

Introducción y objetivos: Los pacientes mayores con vejiga hiperactiva bajo tratamiento antimuscarínico son especialmente susceptibles al deterioro cognitivo. El objetivo fue evaluar los cambios a corto plazo en la función cognitiva de pacientes de edad avanzada con vejiga hiperactiva tratados con oxibutinina transdérmica. Materiales y métodos: Estudio observacional retrospectivo multicéntrico en pacientes entre 65 y 80 años de edad, con vejiga hiperactiva, que reciben tratamiento con oxibutinina transdérmica. Antes y después de un mes de tratamiento, se evaluó la función cognitiva mediante el test de alteración de memoria y el test del dibujo del reloj, los cambios en los síntomas con cuestionarios validados, la percepción del paciente ante su respuesta al tratamiento utilizando la escala de beneficio del tratamiento y la adherencia al tratamiento con el test de Morisky-Green modificado. Resultados: De 85 pacientes elegibles, 70 completaron la evaluación (promedio de edad: 71,4 ± 4,5; IMC: 28,7 ± 3,1 kg/m2). No se observó deterioro cognitivo tras un mes de tratamiento con oxibutinina transdérmica: Test de alteración de memoria (+1 punto; IC 95%: 0-1,5), test del dibujo del reloj (0 puntos; IC 95%: 0-0). Se observó una mejoría estadísticamente significativa (p < 0,001) en todos los síntomas de almacenamiento urinario, excepto en la incontinencia de esfuerzo. Hubo una mejora en el cuestionario de autoevaluación de control de la vejiga (grado de los síntomas: -2,27; IC 95%: -2,8, -1,7; p < 0,001; grado de molestias: -2,73; IC 95%: -3,3, -2,1; p < 0,001). El 70% de los pacientes informaron una condición de vejiga estable o mejorada según el cuestionario de Percepción de la Condición de la Vejiga del Paciente. El 72,8% de los pacientes informó que sus problemas urinarios habían mejorado o mejorado notablemente con un 84,3% de adherencia al tratamiento. Conclusiones: No se observó deterioro cognitivo en pacientes de edad avanzada tras de un mes de tratamiento con oxibutinina transdérmica. Los síntomas de incontinencia urinaria mejoraron y hubo una adecuada adherencia al tratamiento


Introduction and objectives: Older patients with overactive bladder under antimuscarinic treatment are especially susceptible to cognitive impairment. The aim was to assess short term changes in cognitive function in elderly patients with overactive bladder treated with transdermal oxybutynin. Materials and methods: Observational, retrospective, multicentre study in patients with overactive bladder aged 65-80 years undergoing treatment with transdermal oxybutynin. Before and after one month of treatment, cognitive function using the Memory Alteration Test and Clock-Drawing Test, changes in symptoms with validated questionnaires, patient perception of treatment response using Treatment Benefit Scale and treatment adherence with the modified Morisky-Green test, were assessed. Results: From 85 eligible patients, 70 completed the assessment (mean age: 71.4 ± 4.5; BMI: 28.7 ± 3.1 kg/m2). No cognitive impairment was observed after one month with transdermal oxybutynin: Memory Alteration Test (+1 point; 95%CI: 0.0-1.5), Clock-Drawing Test (0 points; 95%CI: 0.0-0.0). A statistically significant improvement (p < 0.001) was observed in all urinary storage symptoms, except stress urinary incontinence. There was an improvement in the Bladder Control Self-Assessment Questionnaire (symptom score: -2.27; 95%CI: -2.8, -1.7; p < 0.001; bother score: -2.73; 95%CI: -3.3, -2.1; p < 0.001). 70% of patients reported either a stable or improved bladder condition according to the Patient Perception of Bladder Condition questionnaire. 72.8% of patients reported that their urinary problems had improved or greatly improved with an 84.3% treatment adherence. Conclusions: No cognitive impairment was observed in elderly patients after one month of treatment with transdermal oxybutynin; urinary urgency symptoms improved and there was adequate treatment adherence


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Urinary Bladder, Overactive/complications , Muscarinic Antagonists/adverse effects , Cognition/drug effects , Treatment Adherence and Compliance/psychology , Urinary Bladder, Overactive/drug therapy , Transdermal Patch , Aged , Cognition/physiology , Retrospective Studies , Surveys and Questionnaires
14.
Actas urol. esp ; 43(2): 62-70, mar. 2019. graf, tab
Article in Spanish | IBECS | ID: ibc-178333

ABSTRACT

Introducción y objetivos: El síndrome de dolor vesical (SDV) está catologado como enfermedad rara y su diagnóstico representa un desafío debido al solapamiento de sus síntomas con los asociados al síndrome de vejiga hiperactiva. El objetivo fue estimar la prevalencia del SDV y conocer el perfil de síntomas y la práctica clínica en pacientes que acuden a unidades de Urología Funcional y Urodinámica. Material y métodos: Estudio epidemiológico en el cual participaron 37 unidades de Urología Funcional y Urodinámica de España. La prevalencia se estudió considerando ambos sexos. Se evaluó la práctica clínica en 319 mujeres con SDV (nuevo diagnóstico o en revisión). Se recogieron retrospectivamente datos clínicos y sociodemográficos. Se analizaron los resultados de análisis de orina, cistoscopia, biopsia, exploración física, diario miccional, así como de los 4 cuestionarios disponibles: Patient Perception of Bladder Condition; Bladder Pain/Interstitial Cystitis Symptom Score; EuroQoL-5 Dimensions-5L y Patient Global Impression of Severity. Resultados: El 5,4% (503) de los pacientes que acudieron a estas unidades (9.312) tenían diagnóstico de SDV (90% [453] mujeres). Las pruebas más realizadas según historia clínica y anamnesis fueron: análisis de orina, ecografía vesical y cistoscopia. Los síntomas/comorbilidades más frecuentes fueron: dolor en la región vesical, frecuencia miccional aumentada, nicturia, ansiedad y depresión. La evaluación diagnóstica determinó dolor en hidrodistensión (86,9%), biopsia positiva (59,2%), dolor miofascial pélvico (28,4%), fenotipo urológico (97,8%) y frecuencia miccional aumentada (88,7%). Los cuestionarios reflejaron el elevado grado de afectación de la calidad de vida de estos pacientes. Conclusiones: La prevalencia del SDV en las unidades de Urología Funcional y Urodinámica en España es baja. No se observa homogeneidad en cuanto al diagnóstico entre los diferentes centros participantes. Por ello, sería necesario establecer una metodología común de manejo de pacientes con SDV en estas unidades, con herramientas específicas para esta patología


Introduction and objectives: Bladder pain syndrome (BPS) is classified as a rare chronic debilitating disease and its diagnosis presents a challenge because its symptoms overlap with those associated with overactive bladder syndrome. The aim of the routine study was to estimate the prevalence of BPS and discover to study the profile of symptoms and clinical practice for patients attending functional urology and urodynamics units. Material and methods: An epidemiological study in which 37 functional urology and urodynamics units in Spain participated. The prevalence was studied in both sexes. Clinical practice was evaluated for 319 women with BPS (new diagnosis or under review). Clinical and sociodemographic data were collected retrospectively. The results were studied of urine tests, cystoscopy, biopsy, physical examination, bladder diary, and those of the four available questionnaires: Patient Perception of Bladder Condition; Bladder Pain/Interstitial Cystitis Symptom Score; EuroQoL-5 Dimensions-5L and Patient Global Impression of Severity. Results: Five point four percent (503) of the patients who attended these units (9,312) had a diagnosis of BPS (90% [453] females). The tests that were performed most according to the clinical history and anamnesis were: urine test, bladder ultrasound and cystoscopy. The most common symptoms/comorbidities were: pain in the bladder region, increased urinary frequency, nocturia, anxiety and depression. Diagnostic assessment determined pain on hydrodistension (86.9%), positive biopsy (59.2%), myofascial pelvic pain (28.4%), urological phenotype (97.8%), and increased urinary frequency (88.7%). The questionnaires reflected how much the quality of life of these patients was affected. Conclusions: The prevalence of BPS in functional urology and urodynamics units in Spain is low. No homogeneity was observed in terms of diagnosis between the different participating centres. Therefore, a common methodology is required for the management of patients with BPS in these units, with tools specific to this disorder


Subject(s)
Humans , Female , Middle Aged , Cystitis, Interstitial/complications , Cystitis, Interstitial/diagnosis , Chronic Pain/complications , Chronic Pain , Urodynamics , Urology Department, Hospital/statistics & numerical data , Retrospective Studies , Spain/epidemiology , Observational Study , Practice Management, Medical , Severity of Illness Index , Surveys and Questionnaires
16.
J Hazard Mater ; 370: 196-202, 2019 May 15.
Article in English | MEDLINE | ID: mdl-29776703

ABSTRACT

Removal of hexavalent chromium was accomplished by using photocatalyst materials of TiO2 doped with tungsten oxide, environmental air as oxygen supply and white light as irradiation source. Dichromate anions in concentration ranges of 50 to 1000 µg/L were removed by means of aqueous dispersions of TiO2 doped with tungsten. The aqueous chromium analyses were performed by Differential Pulse Voltammetry technique. Additionally, mineralization of CO2 gas was promoted by the photocatalysis process, as was clearly shown by Raman spectroscopy and X-ray Photoelectron Spectroscopy (XPS) analyses obtained from the TiO2 samples recovered after photocatalytic experiments. Results of sample analyses by Scanning Electron Microscopy (SEM) and High Resolution Transmission Electron Microscopy (HRTEM) are presented and discussed.

17.
Actas Urol Esp (Engl Ed) ; 43(2): 62-70, 2019 Mar.
Article in English, Spanish | MEDLINE | ID: mdl-30262204

ABSTRACT

INTRODUCTION AND OBJECTIVES: Bladder pain syndrome (BPS) is classified as a rare chronic debilitating disease and its diagnosis presents a challenge because its symptoms overlap with those associated with overactive bladder syndrome. The aim of the routine study was to estimate the prevalence of BPS and discover to study the profile of symptoms and clinical practice for patients attending functional urology and urodynamics units. MATERIAL AND METHODS: An epidemiological study in which 37 functional urology and urodynamics units in Spain participated. The prevalence was studied in both sexes. Clinical practice was evaluated for 319 women with BPS (new diagnosis or under review). Clinical and sociodemographic data were collected retrospectively. The results were studied of urine tests, cystoscopy, biopsy, physical examination, bladder diary, and those of the four available questionnaires: Patient Perception of Bladder Condition; Bladder Pain/Interstitial Cystitis Symptom Score; EuroQoL-5 Dimensions-5L and Patient Global Impression of Severity. RESULTS: Five point four percent (503) of the patients who attended these units (9,312) had a diagnosis of BPS (90% [453] females). The tests that were performed most according to the clinical history and anamnesis were: urine test, bladder ultrasound and cystoscopy. The most common symptoms/comorbidities were: pain in the bladder region, increased urinary frequency, nocturia, anxiety and depression. Diagnostic assessment determined pain on hydrodistension (86.9%), positive biopsy (59.2%), myofascial pelvic pain (28.4%), urological phenotype (97.8%), and increased urinary frequency (88.7%). The questionnaires reflected how much the quality of life of these patients was affected. CONCLUSIONS: The prevalence of BPS in functional urology and urodynamics units in Spain is low. No homogeneity was observed in terms of diagnosis between the different participating centres. Therefore, a common methodology is required for the management of patients with BPS in these units, with tools specific to this disorder.


Subject(s)
Cystitis, Interstitial/diagnosis , Cystitis, Interstitial/epidemiology , Adult , Aged , Cystitis, Interstitial/physiopathology , Diagnostic Self Evaluation , Female , Humans , Male , Middle Aged , Prevalence , Retrospective Studies , Spain , Urodynamics
18.
Nanotechnology ; 30(2): 025601, 2019 Jan 11.
Article in English | MEDLINE | ID: mdl-30387444

ABSTRACT

Polyacrylonitrile nonwovens intercalated with graphene oxide (GO) sheets were prepared by a simultaneous electrospinning-spray deposition system. These hybrid nonwovens were carbonized in a two-stage process to obtain a mesostructured hybrid carbon containing carbon nanofibers (CNF) and reduced GO sheets (CNF/RGO). During the carbonization process, the CNF act as spacers between the RGO layers to prevent their compactation and restacking resulting in a three-dimensional structure. The presence of RGO increases the electrical conductivity in the CNF/RGO material. The resulting hybrid carbon is nitrogen-doped as indicated by x-ray photoelectron spectroscopy and Fourier transformed infrared spectroscopy. This N-doped porous carbon was used to prepare electrodes with improved sensitivity for the electrochemical detection of L-cysteine.

19.
Actas Urol Esp (Engl Ed) ; 43(3): 143-150, 2019 Apr.
Article in English, Spanish | MEDLINE | ID: mdl-30470585

ABSTRACT

INTRODUCTION AND OBJECTIVES: Older patients with overactive bladder under antimuscarinic treatment are especially susceptible to cognitive impairment. The aim was to assess short term changes in cognitive function in elderly patients with overactive bladder treated with transdermal oxybutynin. MATERIALS AND METHODS: Observational, retrospective, multicentre study in patients with overactive bladder aged 65-80 years undergoing treatment with transdermal oxybutynin. Before and after one month of treatment, cognitive function using the Memory Alteration Test and Clock-Drawing Test, changes in symptoms with validated questionnaires, patient perception of treatment response using Treatment Benefit Scale and treatment adherence with the modified Morisky-Green test, were assessed. RESULTS: From 85 eligible patients, 70 completed the assessment (mean age: 71.4±4.5; BMI: 28.7±3.1kg/m2). No cognitive impairment was observed after one month with transdermal oxybutynin: Memory Alteration Test (+1 point; 95%CI: 0.0-1.5), Clock-Drawing Test (0 points; 95%CI: 0.0-0.0). A statistically significant improvement (P<.001) was observed in all urinary storage symptoms, except stress urinary incontinence. There was an improvement in the Bladder Control Self-Assessment Questionnaire (symptom score: -2.27; 95%CI: -2.8, -1.7; P<.001; bother score: -2.73; 95%CI: -3.3, -2.1; P<.001). 70% of patients reported either a stable or improved bladder condition according to the Patient Perception of Bladder Condition questionnaire. 72.8% of patients reported that their urinary problems had improved or greatly improved with an 84.3% treatment adherence. CONCLUSIONS: No cognitive impairment was observed in elderly patients after one month of treatment with transdermal oxybutynin; urinary urgency symptoms improved and there was adequate treatment adherence.


Subject(s)
Cognition , Mandelic Acids/administration & dosage , Muscarinic Antagonists/administration & dosage , Urinary Bladder, Overactive/drug therapy , Urinary Bladder, Overactive/psychology , Administration, Cutaneous , Aged , Aged, 80 and over , Female , Humans , Male , Psychological Tests , Retrospective Studies
20.
Carbohydr Polym ; 181: 642-649, 2018 Feb 01.
Article in English | MEDLINE | ID: mdl-29254018

ABSTRACT

Agave is recognized as a low recalcitrant material, which makes it a potential source to obtain nanocellulose. Aqueous dispersions (in water, H2O2, H2O2/H2SO4) of agave powder were heated at 120°C under vapor pressure (1kg/cm2). The resultant materials were observed with an optical microscope (OM), a laser scanning microscope (LSM) to obtain the thickness measurement and a scanning electron microscope (SEM) to observe morphology. Raman spectroscopy, X-ray diffraction (XRD) and X-ray photoelectron spectroscopy (XPS) were used to obtain the chemical structure. Cellulose nanoplatelets (CNPs) from Agave salmiana were successfully isolated under mild conditions. Physicochemical analysis indicates that lignin was removed in a single step oxidation with hydrogen peroxide in presence of sulfuric acid at low concentration (0.17M). The CNPs images revealed the presence of entangled cellulose nanofibrils (Ø≈14nm) along the nanoplatelets (thickness ≈80nm).

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