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1.
Int J Biol Macromol ; 253(Pt 7): 127488, 2023 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-37852395

RESUMO

Herein, biobased composite materials based on poly(lactic acid) (PLA) and poly(butylene adipate-co-terephthalate) (PBAT) as matrices, sodium hexametaphosphate microparticles (E452i, food additive microparticles, 1 and 5 wt%) as antimicrobial filler and acetyl tributyl citrate (ATBC, 15 wt%) as plasticizer, were developed for potential food packaging applications. Two set of composite films were obtained by melt-extrusion and compression molding, i) based on PLA matrix and ii) based on Ecovio® matrix (PLA/PBAT blend). Thermal characterization by thermogravimetric analysis and differential scanning calorimetry demonstrated that the incorporation of E452i particles improved thermal stability and crystallinity, while the mechanical test showed an increase in the Young's modulus. E452i particles also provide antimicrobial properties to the films against food-borne bacteria Listeria innocua and Staphylococcus aureus, with bacterial reduction percentages higher than 50 % in films with 5 wt% of particles. The films also preserved their disintegradability as demonstrated by an exhaustive characterization of the films under industrial composting conditions. Therefore, the results obtained in this work reveal the potential of these biocomposites as appropriated materials for antibacterial and compostable food packaging films.


Assuntos
Embalagem de Alimentos , Poliésteres , Poliésteres/química , Embalagem de Alimentos/métodos , Antibacterianos/farmacologia , Antibacterianos/química
2.
Sci Total Environ ; 905: 167183, 2023 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-37734597

RESUMO

The hydrological functioning of wetlands in S Spain is poorly understood. We perform a 22-years hydrological modelling of seven playa-lakes located in a semi-arid region of southern Spain, including dry and wet periods. To do that, we applied a hydrological balance model to reconstruct past lake water levels. In addition, we investigated the hydrochemistry of the water, the basin bathymetry, and the geological setting of the watersheds, acquiring new lithology and active structures data. Once the models were constrained, scenarios considering increases on temperature and human management were implemented, and discussed. The water balance is simplified to precipitation (water input) and basin discharge (evapotranspiration), as the lakes are disconnected from groundwater because of the low-permeability substrate. In addition, unlike in previous studies, we add overflows to the modelling. The results of the model agree with actual lake water monitoring data (R2 > 0.8). We observed that the hydroperiods of some of these lakes vary from permanent lakes to ephemeral, depending strongly on the basin bathymetry. Lakes with steeply margins show longer hydroperiods, whilst it is shorter for low-lying floor playa-lakes. In addition, we observed that steeply lake margins respond to active faults and/or lithological changes. To forecast the effects of climate change on the lake hydroperiods, we applied a 1 °C increase in average temperature in our hydrological modelling. The hydroperiod is significantly reduced for ephemeral playa-lakes, whilst is barely affected in permanent lakes. Moreover, we detected the high sensitivity of ephemeral playa-lakes to the anthropogenic management, including siltation, plant colonization and changes watershed surface.

3.
Carbohydr Polym ; 302: 120438, 2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36604094

RESUMO

In this work, chemical modification of chitosan using cationic thiazolium groups was investigated with the aim to improve water solubility and antimicrobial properties of chitosan. Enzymatic synthesis and ethyl-3-(3-dimethylaminopropyl) carbodiimide/N-hydroxysuccinimide (EDC/NHS) chemistry were employed to synthesize and attach to chitosan through the amine groups the molecule bearing thiazolium moieties, quaternized 4-(2-(4-methylthiazol-5-yl) ethoxy)-4-oxobutanoic acid (MTBAQ). On the basis of Fourier transform infrared spectroscopy (FTIR), elemental analysis and solid state nuclear magnetic resonance (ssNMR), around 95 % of the available amine groups of chitosan (of 25 % degree of acetylation) reacted. The resulting derivative was water soluble at physiological pH and exhibit excellent antimicrobial activity against Listeria innocua, Staphylococcus epidermidis, Staphylococcus aureus and Methicillin Resistant S. aureus Gram-positive bacteria (MIC = 8-32 µg/ mL), whereas its efficiency decreases against fungi Candida albicans and Eschericia coli Gram-negative bacterium. Subsequently, the thiazolium chitosan derivative was employed as antimicrobial component (up to 7 wt%) of chitosan/glycerol based films. The incorporation of the chitosan derivative does not modify significantly the characteristics of the film in terms of thermal and mechanical properties, while enhances considerably the antimicrobial activity.


Assuntos
Anti-Infecciosos , Quitosana , Staphylococcus aureus Resistente à Meticilina , Quitosana/química , Anti-Infecciosos/farmacologia , Anti-Infecciosos/química , Água , Aminas , Espectroscopia de Infravermelho com Transformada de Fourier , Antibacterianos/farmacologia , Antibacterianos/química
4.
Farm. comunitarios (Internet) ; 15(1): 41-55, ene. 2023. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-215167

RESUMO

Antecedentes: la falta de adherencia de los pacientes a sus tratamientos tiene un gran impacto tanto clínico como económico. Aunque existen diferentes métodos para medir la adherencia, los estudios retrospectivos son cada vez más utilizados por ser objetivos y menos sensibles a la percepción del paciente, interfiriendo menos en su vida. El sistema de receta electrónica proporciona a la farmacia comunitaria una herramienta útil para llevar a cabo esta investigación.Objetivos: utilizar el sistema de receta electrónica para medir la adherencia de los pacientes a su medicación crónica, analizando diferentes grupos terapéuticos y la salud mental de los pacientes.Métodos: se desarrolló un estudio observacional, ambispectivo y longitudinal. La adherencia se evaluó mediante la Proportion of Days Covered (PDC) por paciente y por tratamiento y con el test de Morisky Green Levine. A través del sistema de receta electrónica se obtuvieron datos sobre los medicamentos dispensados a los pacientes durante los últimos 12 meses. Los datos sobre la salud mental de los pacientes se recogieron mediante el cuestionario PHQ-2.Resultados: se reclutaron un total de 300 pacientes, pero sólo 290 se incluyeron en el análisis. El 25,5 % (IC: 20,6-30,9) se clasificó como polimedicado. El PDC por paciente tuvo una mediana de 0,90 (AI: 0,73-1). Según el cuestionario de Morisky Green Levine, el 57,9 % de los pacientes (IC: 52,0-63,6) eran adherentes a sus tratamientos. La concordancia entre el test de Morisky Green Levine y el PDC fue de kappa=0,086.Conclusiones: la receta electrónica resultó ser una herramienta útil para conocer la adherencia de la población a sus tratamientos crónicos medida con el PDC. (AU)


Assuntos
Humanos , Masculino , Feminino , Cooperação e Adesão ao Tratamento/estatística & dados numéricos , Serviços Comunitários de Farmácia , Prescrição Eletrônica/estatística & dados numéricos , Estudos Longitudinais , Inquéritos e Questionários
5.
Macromol Biosci ; 23(1): e2200401, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36443243

RESUMO

Antimicrobial fibers based on biodegradable polymers, poly(lactic acid) (PLA), and poly(butylene adipate-co-terephthalate) (PBAT) are prepared by electrospinning. For this purpose, a biodegradable/bio-based polyitaconate containing azoles groups (PTTI) is incorporated at 10 wt.% into the electrospinning formulations. The resulting fibers functionalized with azole moieties are uniform and free of beads. Then, the accessible azole groups are subjected to N-alkylation, treatment that provides cationic azolium groups with antibacterial activity at the surface of fibers. The positive charge density, roughness, and wettability of the cationic fibers are evaluated and compared with flat films. It is confirmed that these parameters exert an important effect on the antimicrobial properties, as well as the length of the alkylating agent and the hydrophobicity of the matrix. The quaternized PLA/PTTI fibers exhibit the highest efficiency against the tested bacteria, yielding a 4-Log reduction against S. aureus and 1.7-Log against MRSA. Then, biocompatibility and bioactivity of the fibers are evaluated in terms of adhesion, morphology and viability of fibroblasts. The results show no cytotoxic effect of the samples, however, a cytostatic effect is appreciated, which is ascribed to the strong electrostatic interactions between the positive charge at the fiber surface and the negative charge of the cell membranes.


Assuntos
Polímeros , Staphylococcus aureus , Polímeros/farmacologia , Poliésteres/farmacologia , Antibacterianos/farmacologia , Interações Hidrofóbicas e Hidrofílicas
6.
ACS Appl Polym Mater ; 4(9): 6543-6552, 2022 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-36590989

RESUMO

Here, we report the development of antibacterial and compostable electrospun polylactic acid (PLA) fibers by incorporation of a multifunctional biobased polymer in the process. The multifunctional polymer was synthesized from the bio-sourced itaconic acid building block by radical polymerization followed by click chemistry reaction with hydantoin groups. The resulting polymer possesses triazole and hydantoin groups available for further N-alkylation and chlorination reaction, which provide antibacterial activity. This polymer was added to the electrospinning PLA solution at 10 wt %, and fiber mats were successfully prepared. The obtained fibers were surface-modified through the accessible functional groups, leading to the corresponding cationic triazolium and N-halamine groups. The fibers with both antibacterial functionalities demonstrated high antibacterial activity against Gram-positive and Gram-negative bacteria. While the fibers with cationic surface groups are only effective against Gram-positive bacteria (Staphylococcus epidermidis and Staphylococcus aureus), upon chlorination, the activity against Gram-negative Escherichia coli and Pseudomonas aeruginosa is significantly improved. In addition, the compostability of the electrospun fibers was tested under industrial composting conditions, showing that the incorporation of the antibacterial polymer does not impede the disintegrability of the material. Overall, this study demonstrates the feasibility of this biobased multifunctional polymer as an antibacterial agent for biodegradable polymeric materials with potential application in medical uses.

7.
Sci Total Environ ; 806(Pt 4): 150917, 2022 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-34653463

RESUMO

Catalyst stability has become a challenging issue for advanced oxidation processes (AOPs). Herein, we report an alternative method based on 3D printing technology to obtain zero-valent iron polylactic acid prototypes (ZVI@PLA) in a single step and without post etching treatment. ZVI@PLA was used to activate persulfate (PS) for the removal of Tetracycline (TC) in recirculating mode under two different heating methodologies, thermal bath and contactless heating promoted by magnetic induction (MIH). The effect of both heating methodologies was systematically analysed by comparing the kinetic constant of the degradation processes. It was demonstrated that the non-contact heating of ZVI by MIH reactivates the surface of the catalyst, renewing the surface iron content exposed to the pollutant solution, which makes the ZVI@PLA catalyst reusable up to 10 cycles with no efficiency reduction. In contrast, by using a conventional thermal bath, the kinetic constant gradually decreases over the 10 cycles, because of the superficial iron consumption, being the kinetic constant 5 times lower in the 10th run compared to MIH experiment. X-ray diffraction and Mössbauer spectroscopy confirmed the presence of metallic iron embedded in the ZVI@PLA prototype, whose crystalline structure remained unchanged for 10th cycles of MIH. Moreover, it was proven that with no contact heating technology at low magnetic fields (12.2 mT), the solution temperature does not increase, but only the surface of the catalyst does. Under these superficial heated conditions, kinetic rate is increased up to 0.016 min-1 compared to the value of 0.0086 min-1 obtained for conventional heating at 20 °C. This increase is explained not only by PS activation by iron leaching but also by the contribution of ZVI in the heterogeneous activation of persulfate.


Assuntos
Ferro , Poluentes Químicos da Água , Oxirredução , Poliésteres , Impressão Tridimensional , Tetraciclina
9.
Polymers (Basel) ; 12(4)2020 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-32331281

RESUMO

A series of well-defined antimicrobial polymers composed of comonomers bearing thiazole ring (2-(((2-(4-methylthiazol-5-yl)ethoxy)carbonyl)oxy)ethyl methacrylate monomer (MTZ)) and non-hemotoxic poly(ethylene glycol) side chains (poly(ethylene glycol) methyl ether methacrylate (PEGMA)) were synthesized by reversible addition-fragmentation chain transfer (RAFT) polymerization. By post-polymerization functionalization strategy, polymers were quaternized with either butyl or octyl iodides to result in cationic amphiphilic copolymers incorporating thiazolium groups, thus with variable hydrophobic/hydrophilic balance associated to the length of the alkylating agent. Likewise, the molar percentage of PEGMA was modulated in the copolymers, also affecting the amphiphilicity. The antimicrobial activities of these cationic polymers were determined against Gram-positive and Gram-negative bacteria and fungi. Minimum inhibitory concentration (MIC) was found to be dependent on both length of the alkyl hydrophobic chain and the content of PEGMA in the copolymers. More hydrophobic octylated copolymers were found to be more effective against all tested microorganisms. The incorporation of non-ionic hydrophilic units, PEGMA, reduces the hydrophobicity of the system and the activity is markedly reduced. This effect is dramatic in the case of butylated copolymers, in which the hydrophobic/hydrophilic balance is highly affected. The hemolytic properties of polymers analyzed against human red blood cells were greatly affected by the hydrophobic/hydrophilic balance of the copolymers and the content of PEGMA, which drastically reduces the hemotoxicity. The copolymers containing longer hydrophobic chain, octyl, are much more hemotoxic than their corresponding butylated copolymers.

10.
Actas Urol Esp (Engl Ed) ; 44(3): 164-171, 2020 Apr.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32035807

RESUMO

INTRODUCTION: In patients with prostate cancer, high NLR seems to be associated with worse survival. Abiraterone acetate (AA) is a new generation hormonal treatment that has shown to increase PFS and OS in mCRPC. MATERIAL AND METHODS: Retrospective analysis of patients treated with AA in our center (December 2012-September 2018). We analyzed the association of the NLR (< or ≥ 3) before and after 6 months of treatment with PSA response, PFS, OS, and hormone sensitivity prior to AA (< or> 12 months). RESULTS: We have treated 56 patients with a median age of 82 (62-94), of which 22 (39%) had NLR ≥ 3 before treatment. There is a statistically significant association between the NLR prior to treatment<3 and PSA response, OR=9,444, P=.001, and there was no association with the NLR at 6 months of treatment. Statistically significant differences were found between the groups of NLR 3 prior to treatment with abiraterone in PFS with 15 months of median vs. 9 and P=.008, and in OS with 20 months vs. 9 with P=.014. With respect to the determination of NLR at 6 months, there are no differences in the survival curves between both groups. There are significant differences between the NLR prior to treatment according to the length of hormone sensitivity (P=.026). CONCLUSIONS: Our results suggest that NLR could provide relevant information and could act as an early and accessible prognostic marker in patients with mCRPC in first line treatment with Abiraterone.


Assuntos
Androstenos/uso terapêutico , Linfócitos , Neutrófilos , Neoplasias de Próstata Resistentes à Castração/sangue , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Neoplasias de Próstata Resistentes à Castração/patologia , Estudos Retrospectivos , Resultado do Tratamento
11.
J Appl Microbiol ; 127(4): 1048-1056, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31328837

RESUMO

AIM: The molecular typing and the susceptibility of Staphylococcus aureus strains of swine origin to antibiotics, oregano (Origanum vulgare L.) essential oil (EO) and Chilean blackberry maqui (Aristotelia chilensis (Molina) Stuntz) extract were determined. METHODS AND RESULTS: Twenty S. aureus strains of swine origin were subjected to molecular typing, of which six strains were selected for antimicrobial susceptibility testing. The epsilon test (Etest) was used to determine the antibiotic susceptibility. The susceptibility to natural antimicrobials (NAs): oregano EO, maqui extract, thymol (Thy) and carvacrol (Carv), was carried out using the disk diffusion method. The S. aureus strains were genetically diverse. All strains were resistant to at least one class of antibiotic, and two strains were multidrug-resistant. The minimum inhibitory concentration of oregano EO, Thy and Carv was 0·01-0·04%. Maqui extract did not show antistaphylococcal activity. CONCLUSIONS: Natural antimicrobials extracted from oregano have an inhibitory activity against S. aureus strains from swine origin, with no effect using maqui extract. SIGNIFICANCE AND IMPACT OF THE STUDY: This study provides information about the characteristics of S. aureus strains of swine origin, and about the potential use of NAs from oregano to enhance the control of antibiotic-resistant S. aureus strains in the pork supply chain.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana/efeitos dos fármacos , Magnoliopsida/química , Óleos Voláteis/farmacologia , Extratos Vegetais/farmacologia , Staphylococcus aureus/efeitos dos fármacos , Suínos/microbiologia , Animais , Cimenos , Testes de Sensibilidade Microbiana , Tipagem Molecular , Monoterpenos/química , Origanum/química , Staphylococcus aureus/classificação , Staphylococcus aureus/genética , Timol/química
12.
Rev. clín. esp. (Ed. impr.) ; 219(4): 177-183, mayo 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-186528

RESUMO

Antecedentes y objetivo: Los objetivos de este estudio fueron evaluar la prevalencia de diabetes mellitus tratada farmacológicamente, analizar los patrones de prescripción de los fármacos antidiabéticos y evaluar el grado de control de la enfermedad en la provincia de Cádiz. Pacientes y métodos: Estudio observacional retrospectivo utilizando las bases de datos del Sistema Público de Salud del Servicio Andaluz de Salud entre los años 2014 a 2016, ambos inclusive. Se consideró persona adulta con diabetes tratada (PADT) aquella persona mayor de 14 años que había consumido al menos un envase de medicación del grupo A10 a lo largo de cada uno de los años correspondientes de estudio. Resultados: La prevalencia de PADT varió entre el 8,65% y el 8,83% de 2014 a 2016, respectivamente. Un 71% de PADT estaban tratadas solo con fármacos no insulínicos, un 11% con insulinas y un 18% con una combinación de ambos. En aproximadamente un tercio de las PADT no se había realizado una determinación de HbA1c a lo largo de cada año. El 69% de las PADT evaluadas tenía en 2016 un adecuado grado de control de acuerdo a los criterios de la RedGDPS (según HbA1c y edad). Conclusión: La prevalencia de diabetes tratada farmacológicamente en la provincia de Cádiz es elevada y parece ir en aumento. Los pacientes presentan un limitado control glucémico, al que puede contribuir de forma predominante el seguimiento inadecuado en casi una tercera parte de los mismos


Background and objective: The aim of the study was to assess the prevalence of diabetes mellitus treated pharmacologically, analyse the prescription patterns of antidiabetic drugs and assess the degree of control over the disease in the province of Cadiz. Patients and methods: An observational retrospective study was conducted with the databases of the public health system of the Andalusian Health Service between 2014 and 2016, inclusive. Adults with treated diabetes (ATD) were considered those older than 14 years who had consumed at least 1 package of medication from the A10 group during the corresponding year covered by the study. Results: The prevalence of ATD varied between 8.65% and 8.83% from 2014 to 2016, respectively. Seventy-one percent of the ATD were treated with only noninsulin drugs, 11% were treated with insulin, and 18% were treated with a combination of both. For approximately one-third of the ATD, an HbA1c reading was not performed during each year. Sixty-nine percent of the assessed ATD in 2016 had an appropriate degree of control according to RedGDPS criteria (based on HbA1c and age). Conclusion: The prevalence of pharmacologically treated diabetes in the province of Cadiz is high and appears to be increasing. The patients presented limited glycaemic control, to which inadequate follow-up in almost a third of the patients could be the major contributor


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Diabetes Mellitus/epidemiologia , Hipoglicemiantes/uso terapêutico , Hiperglicemia/prevenção & controle , Diabetes Mellitus/tratamento farmacológico , Índice Glicêmico/efeitos dos fármacos , Prevalência , Estudos Retrospectivos , Glicemia/análise , Hemoglobinas Glicadas/análise
13.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 45(1): 52-62, ene.-feb. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-188048

RESUMO

OBJETIVOS: Desarrollar recomendaciones sobre el uso de la combinación paracetamol/tramadol (P/T) en pacientes con dolor moderado-intenso, basadas en la mejor evidencia y experiencia. MÉTODOS: Se siguió la metodología de grupos nominales y Delphi apoyados por una revisión sistemática de la literatura (RSL). Se seleccionó un panel multidisciplinar de 12 expertos en el manejo del dolor. En la primera reunión de grupo nominal se definió el objetivo, alcance, usuarios, apartados del documento de consenso, así como recomendaciones generales preliminares. Para la RSL se definieron los criterios de inclusión y exclusión, y las estrategias de búsqueda. Dos revisores seleccionaron y analizaron los artículos. Esta evidencia se discutió en una segunda reunión de grupo nominal y se generaron las recomendaciones definitivas. Para cada recomendación, el nivel de evidencia y el grado de recomendación se clasificaron según el modelo de Oxford, y el grado de acuerdo por técnica Delphi. Se definió acuerdo si al menos el 70% de los participantes contestaron ≥ 7 en cada recomendación (1 = total desacuerdo a 10 = total acuerdo). RESULTADOS: Se generaron 20 recomendaciones que cubren aspectos generales, como la evaluación del dolor, y específicos del manejo de P/T. Estos últimos abarcan la indicación de la combinación P/T (perfil de paciente, dosificación, pauta, formulaciones), gestión del riesgo (contraindicaciones, precauciones, interacciones, uso concomitante con otras medicaciones, seguimiento, situaciones especiales) y la educación del paciente. CONCLUSIONES: Estas recomendaciones pretenden resolver algunos interrogantes clínicos habituales y facilitar la toma de decisiones respecto al uso de la combinación P/T en pacientes con dolor moderado-intenso


OBJECTIVES: To present recommendations on the use of the paracetamol/tramadol (P/T) combination in patients with moderate-intense pain based on best evidence and experience. METHODS: The method of nominal groups and Delphi was followed, and supported by a systematic literature review (SLR). A multidisciplinary panel of 12 experts in pain management was selected. In the first nominal group meeting, the aim, scope, users, and sections of the consensus document, were defined, along with the preliminary general recommendations. For the SLR, the inclusion and exclusion criteria, as well as the search strategies, were defined. Two reviewers selected and analysed the articles. This evidence was discussed in a second nominal group meeting, and definitive recommendations were developed. For each recommendation, the evidence levels and grade of recommendation grades were classified according to the Oxford model, and the grade according to the Delphi technique. It was defined as an agreement if at least 70% of the participants scored ≥ 7 for each recommendation (1 = total disagreement to 10 = total agreement). RESULTS: A total of 20 recommendations were produced, which covered general aspects, such as the assessment of pain, and those specific to P/T management. These latter included the indications of the P/T combination (patient profile, dosing, prescription, formulations), risk management (contraindications, precautions, interactions, concomitant use with other medications, follow-up, special situations), and patient education. CONCLUSIONS: These recommendations attempt to resolve any of the routine clinical questions, and help in the making of decisions on the use of the P/T combination in patients with moderate-intense pain


Assuntos
Humanos , Acetaminofen/administração & dosagem , Tramadol/administração & dosagem , Dor/tratamento farmacológico , Analgésicos/administração & dosagem , Combinação de Medicamentos , Dor/fisiopatologia , Índice de Gravidade de Doença
14.
Semergen ; 45(1): 52-62, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-30686297

RESUMO

OBJECTIVES: To present recommendations on the use of the paracetamol/tramadol (P/T) combination in patients with moderate-intense pain based on best evidence and experience. METHODS: The method of nominal groups and Delphi was followed, and supported by a systematic literature review (SLR). A multidisciplinary panel of 12 experts in pain management was selected. In the first nominal group meeting, the aim, scope, users, and sections of the consensus document, were defined, along with the preliminary general recommendations. For the SLR, the inclusion and exclusion criteria, as well as the search strategies, were defined. Two reviewers selected and analysed the articles. This evidence was discussed in a second nominal group meeting, and definitive recommendations were developed. For each recommendation, the evidence levels and grade of recommendation grades were classified according to the Oxford model, and the grade according to the Delphi technique. It was defined as an agreement if at least 70% of the participants scored ≥7 for each recommendation (1=total disagreement to 10=total agreement). RESULTS: A total of 20 recommendations were produced, which covered general aspects, such as the assessment of pain, and those specific to P/T management. These latter included the indications of the P/T combination (patient profile, dosing, prescription, formulations), risk management (contraindications, precautions, interactions, concomitant use with other medications, follow-up, special situations), and patient education. CONCLUSIONS: These recommendations attempt to resolve any of the routine clinical questions, and help in the making of decisions on the use of the P/T combination in patients with moderate-intense pain.


Assuntos
Acetaminofen/administração & dosagem , Dor/tratamento farmacológico , Tramadol/administração & dosagem , Analgésicos/administração & dosagem , Técnica Delphi , Combinação de Medicamentos , Humanos , Dor/fisiopatologia , Índice de Gravidade de Doença
15.
Rev Clin Esp (Barc) ; 219(4): 177-183, 2019 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30595234

RESUMO

BACKGROUND AND OBJECTIVE: The aim of the study was to assess the prevalence of diabetes mellitus treated pharmacologically, analyse the prescription patterns of antidiabetic drugs and assess the degree of control over the disease in the province of Cadiz. PATIENTS AND METHODS: An observational retrospective study was conducted with the databases of the public health system of the Andalusian Health Service between 2014 and 2016, inclusive. Adults with treated diabetes (ATD) were considered those older than 14 years who had consumed at least 1 package of medication from the A10 group during the corresponding year covered by the study. RESULTS: The prevalence of ATD varied between 8.65% and 8.83% from 2014 to 2016, respectively. Seventy-one percent of the ATD were treated with only noninsulin drugs, 11% were treated with insulin, and 18% were treated with a combination of both. For approximately one-third of the ATD, an HbA1c reading was not performed during each year. Sixty-nine percent of the assessed ATD in 2016 had an appropriate degree of control according to RedGDPS criteria (based on HbA1c and age). CONCLUSION: The prevalence of pharmacologically treated diabetes in the province of Cadiz is high and appears to be increasing. The patients presented limited glycaemic control, to which inadequate follow-up in almost a third of the patients could be the major contributor.

19.
J Fish Biol ; 90(6): 2344-2362, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28419464

RESUMO

Chrysobrycon mojicai sp. nov. is described from forest streams that are part of the Amazon River basin in Colombia. It is distinguished from all congeners by having most of the maxillary teeth with distal tips lateroventrally curved (v. teeth straight along their lengths) and a greater number of dentary teeth (20-27 v. 11-19, except in Chrysobrycon yoliae). The posterior margin of the ventral process of the quadrate does not reach the vertical through the posterior margin of the symplectic and these features differentiate C. mojicai from Chrysobrycon myersi and C. yoliae (v. posterior margin of ventral process of quadrate reaching vertical through posterior margin of symplectic). In species of Chrysobrycon, the frontals are extensively contacting each other along the midline, resulting in an absent frontal fontanel and a reduced parietal fontanel. This extensive contact between the frontals modifying the fontanels is a condition rarely found within the Stevardiinae and hence is proposed as an additional diagnostic characteristic for the genus. An updated identification key for all Chrysobrycon species is provided.


Assuntos
Characidae/classificação , Animais , Characidae/anatomia & histologia , Characidae/fisiologia , Colômbia , Feminino , Gravidez , Rios , Caracteres Sexuais , Especificidade da Espécie
20.
Langmuir ; 33(11): 2872-2877, 2017 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-28247766

RESUMO

Herein, we propose a strategy to fabricate core-shell microstructures ordered in hexagonal arrays by combining the breath figures approach and phase separation of immiscible ternary blends. This simple strategy to fabricate these structures involves only the solvent casting of a ternary polymer blend under moist atmosphere, which provides a facile and low-cost fabrication method to obtain the porous structures with a core-shell morphology. For this purpose, blends consisting of polystyrene (PS) as a major component and PS40-b-P(PEGMA300)48 amphiphilic copolymer and polydimethylsiloxane (PDMS) as minor components were dissolved in tetrahydrofuran and cast onto glass wafers under humid conditions, 70% of relative humidity. The resulting porous morphologies were characterized by optical and confocal Raman microscopy. In particular, confocal Raman results demonstrated the formation of core-shell morphologies into the ordered pores, in which the PS forms the continuous matrix, whereas the other two phases are located into the cavities (PDMS is the core while the amphiphilic copolymer is the shell). Besides, by controlling the weight ratio of the polymer blends, the structural parameters of the porous structure such as pore diameter and the size of the core can be effectively tuned.

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