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1.
J Hosp Infect ; 143: 203-212, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37858805

RESUMO

BACKGROUND: Central-venous-line-associated bloodstream infection (CLABSI) is a significant cause of morbidity and mortality in preterm infants. As there is large variation in the reported effect of multi-modal preventive strategies, it could be relevant to propose new additional strategies. AIM: To assess the impact of a new perfusion system on CLABSI rate. METHODS: A before-and-after study was performed in infants born at <32 weeks of gestation or with birth weight <1500 g who required a multi-perfusion system connected to a central venous line. In the first 12-month period ('before'), the pre-existing perfusion system (multiple stopcocks) was used. An intervention period then occurred with implementation of a new perfusion closed system, without change in 'bundles' related to various aspects of central line care. During the second 12-month period ('after'), the CLABSI rate was assessed and compared with the pre-intervention period. FINDINGS: In total, 313 infants were included in this study (before: N=163; after: N=150), and 46% had birth weight <1000 g. The change in perfusion system resulted in a significant decrease in CLABSI rate from 11.3 to 2.2 per 1000 catheter-days (P<0.001). The period was independently associated with an 88% reduction in the risk of CLABSI after implementation of the new perfusion system [odds ratio (OR) 0.12, 95% confidence interval (CI) 0.03-0.39; P<0.001]. The duration of central line use was also associated with CLABSIs (for each additional day: OR 1.05, 95% CI 1.02-1.07; P<0.001). CONCLUSIONS: Implementation of the new perfusion system was feasible in a large neonatal unit, and reduced the CLABSI rate soon after implementation.


Assuntos
Infecções Relacionadas a Cateter , Cateterismo Venoso Central , Cateteres Venosos Centrais , Sepse , Humanos , Recém-Nascido , Cateterismo Venoso Central/efeitos adversos , Cateterismo Venoso Central/métodos , Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/prevenção & controle , Recém-Nascido Prematuro , Peso ao Nascer , Sepse/epidemiologia , Sepse/prevenção & controle , Perfusão , Recém-Nascido de muito Baixo Peso
2.
Neuropharmacology ; 236: 109573, 2023 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-37196855

RESUMO

Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor alterations, which is preceded by a prodromal stage where non-motor symptoms are observed. Over recent years, it has become evident that this disorder involves other organs that communicate with the brain like the gut. Importantly, the microbial community that lives in the gut plays a key role in this communication, the so-called microbiota-gut-brain axis. Alterations in this axis have been associated to several disorders including PD. Here we proposed that the gut microbiota is different in the presymptomatic stage of a Drosophila model for PD, the Pink1B9 mutant fly, as compared to that observed in control animals. Our results show this is the case: there is basal dysbiosis in mutant animals evidenced by substantial difference in the composition of midgut microbiota in 8-9 days old Pink1B9 mutant flies as compared with control animals. Further, we fed young adult control and mutant flies kanamycin and analyzed motor and non-motor behavioral parameters in these animals. Data show that kanamycin treatment induces the recovery of some of the non-motor parameters altered in the pre-motor stage of the PD fly model, while there is no substantial change in locomotor parameters recorded at this stage. On the other hand, our results show that feeding young animals the antibiotic, results in a long-lasting improvement of locomotion in control flies. Our data support that manipulations of gut microbiota in young animals could have beneficial effects on PD progression and age-dependent motor impairments. This article is part of the Special Issue on "Microbiome & the Brain: Mechanisms & Maladies".


Assuntos
Doença de Parkinson , Animais , Drosophila , Canamicina , Antibacterianos , Proteínas Quinases
3.
Environ Sci Process Impacts ; 23(8): 1182-1197, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34302159

RESUMO

Volatile organic silicon compounds (VOSiC) are harmful pollutants to the biota and ecological dynamics as well as biogas-based energy conversion systems. However, there is a lack of understanding regarding the source of VOSiCs in biogas, especially arising from the biochemical conversion of siloxane polymers such as polydimethylsiloxanes (PDMS). The biodegradation of PDMS was evaluated under anaerobic/microaerobic conditions (PO2 = 0, 1, 3, 5%), using wastewater treatment plant (WWTP) sludge as an inoculum and PDMS as a co-substrate (0, 50, 100, 500 ppm). On average, strictly anaerobic treatments produced significantly less methane than the 3 and 5% microaerated ones, which show the highest PMDS biodegradation at 50 ppm. Thauera sp. and Rhodococcus sp. related phylotypes were identified as the most abundant bacterial groups in microaerated treatments, and siloxane-related molecules were identified as remnants of PDMS catabolism. Our study demonstrates that microaeration promotes changes to the native bacterial community which favour the biological degradation of PDMS. This confirms that the presence of VOSiC (e.g., D4-D6) in biogas is not only due to its direct input in wastewaters, but also to the PDMS microbial catabolism. Microaerobic conditions enhance both PDMS and (subsequent) VOSiC degradation in the liquid phase, increasing the concentrations of D4 and D5 in biogas, and the production of less toxic siloxane-based derivatives in the liquid phase. This study suggests that microaeration of the anaerobic sludge can significantly decrease the concentration of PDMSs in the WWTP effluent. However, for WWTPs to become effective barriers for the emission of these ecotoxic contaminants to the environment, such a strategy needs to be coupled with an efficient biodegradation of VOSiCs from the biogas.


Assuntos
Esgotos , Siloxanas , Anaerobiose , Biodegradação Ambiental , Biocombustíveis/análise , Reatores Biológicos , Águas Residuárias
4.
Ultrasound Obstet Gynecol ; 57(5): 790-797, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-32149439

RESUMO

OBJECTIVES: Increased nuchal translucency (NT) thickness is an antenatal marker of aneuploidy or malformation that can lead to termination of pregnancy. This study assessed the long-term neurodevelopmental prognosis of infants who had isolated increased NT in utero. METHODS: This was a prospective cohort study of infants with a NT thickness > 95th percentile in the first trimester, but with a normal karyotype and no major anomalies, and controls with normal NT matched for birth weight, Apgar score, place of birth, parity and gestational age at birth. At 2 years of corrected age, all infants underwent the psychometric Brunet-Lézine test to evaluate their developmental quotient (DQ), overall (global) and specifically for the areas of posture, language, coordination and sociability. RESULTS: A total of 203 chromosomally normal infants were included in the increased-NT group and 208 in the control group. The mean global DQ was significantly lower in the increased-NT group than in the control group (108.6 ± 9.7 vs 112.8 ± 8.3; P < 0.0001), but it was within the normal range expected for that age in both groups. Similarly, the mean DQs for coordination, sociability and language, but not for posture, were significantly lower in infants with increased NT than in controls. Only one case with increased NT had a DQ < 70 (defined as severe neurodevelopmental impairment), compared with none in the control group. The difference between the two groups remained significant for a NT threshold ≥ 99th percentile and when the data were adjusted for NT thickness, the infant's sex and the mother's educational level. In the increased-NT group, NT thickness was < 3.5 mm in over half (56%) of the infants, between 3.5 mm and 5 mm in 33% and > 5 mm in 11%, with a mean global DQ of 108.4, 110.1 and 109.7, respectively. CONCLUSIONS: Infants who had isolated increased fetal NT in the first trimester had a significantly lower, but normal, DQ at a corrected age of 2 years, when compared with controls. The findings were independent of the infant's sex, fetal NT thickness and the mother's educational level. © 2020 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.


Assuntos
Feto/patologia , Transtornos do Neurodesenvolvimento/epidemiologia , Medição da Translucência Nucal/estatística & dados numéricos , Adulto , Estudos de Casos e Controles , Pré-Escolar , Feminino , Feto/diagnóstico por imagem , Humanos , Lactente , Recém-Nascido , Cariótipo , Masculino , Testes de Estado Mental e Demência , Transtornos do Neurodesenvolvimento/diagnóstico , Transtornos do Neurodesenvolvimento/etiologia , Gravidez , Primeiro Trimestre da Gravidez , Prevalência , Estudos Prospectivos
5.
Rev. psiquiatr. infanto-juv ; 37(1): 5-16, ene.-mar. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193560

RESUMO

INTRODUCCIÓN: La escala CBCL de Achenbach completada por padres evalúa un amplio rango de problemas conductuales y emocionales de inicio en la infancia. Sus subescalas "retraimiento-depresión" y principalmente "problemas de pensamiento" se han propuesto como medida de detección de riesgo de psicosis en adolescentes. Dentro de los posibles endofenotipos de la esquizofrenia se plantean la disfunción ejecutiva y la alteración en el lenguaje pragmático. OBJETIVOS: Identificar mediante ambas subescalas de la CBCL un subgrupo de niños y adolescentes con puntuaciones elevadas entre los pacientes que consultan en psiquiatría infantil por trastornos del neurodesarrollo y que tienen antecedentes familiares de esquizofrenia. MATERIAL Y MÉTODOS: Los padres completan la escala CBCL de Achenbach, CCC-Childrens Communication Checklist- (evaluación del lenguaje pragmático) y BRIEF-2 (evaluación conductual de la función ejecutiva). RESULTADOS: Se incluyeron 21 niños (16 niños: 5 niñas). Edad media 11,4 años. Los diagnósticos principales fueron TDAH (66,7%), trastorno de aprendizaje (9,5%) y TEA (9,5%). Las dos subescalas de la CBCL "retraimiento-depresión" y "problemas de pensamiento" discriminan dos grupos, uno con afectación (n=11) con puntuaciones por encima del Pc70 y otro sin afectación (n=10) con puntuaciones inferiores al Pc70. Los casos con afectación mostraron más dificultades en el lenguaje pragmático y función ejecutiva que los del grupo sin afectación. CONCLUSIONES: Realizar una evaluación dimensional más completa de la psicopatología, como la que ofrece la CBCL, en niños con trastornos del neurodesarrollo y antecedentes familiares de esquizofrenia puede ayudar a describir mejor las dificultades premórbidas e identificar casos susceptibles de seguimiento longitudinal e intervención precoz


INTRODUCTION: The CBCL is a standardized form that parents fill out to describe their children ́s behavioral and emotional problems. Previous studies have suggested that two subscales, "withdrawal-depressed" and mainly "thought problems" may have utility as a psychosis risk screening measure in youth. Executive function and higher-order language dysfunctions have been postulated as potential endophenotypes for schizophrenia. OBJECTIVES: To identify by means of the two CBCL subscales mentioned above, a group of children and adolescents with higher ratings amongst those patients attending an outpatient psychiatric clinic, who present a neurodevelopmental disorder and a family history of schizophrenia MATERIAL AND METHODS: Parents filled out CBCL, CCC-Childrens Communication Checklist- (evaluates pragmatic language) and BRIEF-2 (Behavior Rating Inventory of Executive Function). RESULTS: Twenty-one children were included (16 males; 5 females). Mean age 11,4 y/o. Main diagnoses were ADHD (66,7%), Learning Disorder (9,5%) and ASD (9,5%). CBCL subscales "withdrawn-depressed" and "thought problems" discriminated two groups. One with higher ratings (above Pc70) showing the presence of symptoms (n=11) and the other with lower ratings (below Pc70) indicating symptom absence (n=10). The first group showed more pragmatic language difficulties as well as poorer executive function. CONCLUSIONS: A more comprehensive dimensional evaluation of the psychopathology of children with neurodevelopmental disorders and family history of schizophrenia, by means of CBCL, may provide a better description of premorbid difficulties, helping to identify more vulnerable cases for long term follow up and early intervention


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Função Executiva , Transtornos do Neurodesenvolvimento/patologia , Transtornos do Neurodesenvolvimento/psicologia , Esquizofrenia/fisiopatologia , Anamnese , Psicopatologia/métodos , Estudos Transversais , Transtornos da Comunicação , Deficiências da Aprendizagem
6.
Mar Pollut Bull ; 150: 110701, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31796235

RESUMO

Mangroves in the Northwest Coast of South America are contaminated with heavy metals due to wastewater discharges from industries, affecting the biota from this environment. However, bacteria proliferate in these harsh environmental conditions becoming possible sentinel of these contaminations. In this study, bacterial community composition was analyzed by throughput sequencing of the 16S rRNA gene from polluted and pristine mangrove sediments affected by marked differences in heavy metal concentrations. Core bacteria were dominated by Proteobacteria, Firmicutes, and Bacteroidetes phyla, with strong differences between sites at class and genus levels, correlated with metal levels. Increment of abundance on specific OTUs were associated with either elevated or decreased concentrations of metals and with the sulfur cycle. The abundance of Sulfurovum lithotrophicum, Leptolinea tardivitalis, Desulfococcus multivorans and Aminobacterium colombiense increases when metals rise. On contrary, Bacillus stamsii, Nioella nitrareducens and Clostridiisalibacter paucivorans abundance increases when metal levels are reduced. We propose these OTUs as bacterial sentinels, whose abundance can help monitor the restoration programs of contaminated mangrove sediments in the future.


Assuntos
Monitoramento Ambiental , Sedimentos Geológicos/microbiologia , Metais Pesados , Poluentes Químicos da Água/análise , Áreas Alagadas , Bactérias , RNA Ribossômico 16S , América do Sul
11.
Pediatr. aten. prim ; 16(63): 213-218, jul.-sept. 2014. tab
Artigo em Espanhol | IBECS | ID: ibc-127988

RESUMO

Introducción: la apendicitis aguda en menores de cuatro años presenta una incidencia elevada de complicaciones con respecto a otras edades, propias de un diagnóstico tardío, como la peritonitis. Con este estudio se pretende encontrar datos que ayuden a un diagnóstico precoz que reduzca su incidencia. Material y métodos: estudio retrospectivo de los niños menores de cuatro años con diagnóstico de apendicitis aguda confirmada a partir de una muestra anatomopatológica. Se registraron y analizaron variables demográficas, clínicas y analíticas, pruebas de imagen y anatomopatológicas, y complicaciones quirúrgicas. Resultados: de 82 pacientes incluidos, se encontró una relación de 1,5:1 hombre:mujer, que varió según la franja de edad, hallando un 85,7% de mujeres en menores de dos años y un 43,2% entre dos y cuatro años. Los síntomas más frecuentes fueron dolor abdominal progresivo, vómitos, anorexia y decaimiento. Los signos más frecuentes fueron dolor a la palpación en la fosa iliaca derecha, defensa abdominal y fiebre. No hubo diferencias en cuanto a hallazgos analíticos, radiológicos o anatomopatológicos. La peritonitis fue más frecuente en los pacientes con fiebre >38,5 °C el primer día (odds ratio: 3,36; p=0,009). No se observó relación significativa entre edad y aumento de riesgo de peritonitis. Conclusiones: la apendicitis aguda en menores de cuatro años sigue siendo un reto diagnóstico. Los síntomas y signos son similares a los clásicos de la apendicitis, aunque asocian más frecuentemente decaimiento y fiebre alta y de corta evolución; esta última triplica el riesgo de perforación apendicular y peritonitis, sobre todo en mujeres menores de dos años (AU)


Introduction: acute appendicitis in children under 4 years old shows a high incidence of complications due to a late diagnosis such as peritonitis, in comparison to other ages. This study is aimed to find data in order to achieve an early diagnosis to reduce their incidence. Methodology: retrospective study for children under 4 years with confirmed diagnosis of acute appendicitis from pathological sample. Demographic, clinical, laboratory, imaging, anatomical pathology and surgical complications data were recorded and analyzed. Results: eighty-two patients were enrolled, and a 1.5:1 ratio of male/female was found, which varied by age group, where 85.7% of female in children under 2 years and 43.2% between 2 and 4 years were found. The most frequent symptoms were progressive abdominal pain, vomiting, anorexia and malaise. The most common signs were tenderness in right lower quadrant, rebound pain and fever. There were no differences in laboratory, radiological or anatomical pathology findings. Peritonitis was more frequent in patients with fever >38.5 °C on the first day (OR 3.36; p=0.009). No significant relationship was observed between age and increased risk of peritonitis. Conclusions: acute appendicitis in children under 4 years is still a diagnostic challenge. Symptoms and signs are similar to classic appendicitis, though most frequently associated malaise and high fever and short evolution. Fever is related to a three times higher risk of appendical perforation and peritonitis, especially in women younger than 2 years (AU)


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Apendicite/complicações , Apendicite/cirurgia , Apendicite , Diagnóstico Precoce , Perfuração Intestinal/complicações , Estudos Retrospectivos , Peritonite/complicações , Peritonite/cirurgia , Emergências/epidemiologia , 28599
12.
Strahlenther Onkol ; 189(5): 372-9, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23519360

RESUMO

BACKGROUND: Intracranial peripheral primitive neuroectodermal tumors (P-PNET) are extremely rare. They can be easily misdiagnosed as central nervous system primitive neuroectodermal tumors (CNS-PNET) or meningiomas. Little is known about the optimal treatment and prognosis of these tumors. PATIENTS AND METHODS: We evaluated the treatment and outcome of 17 patients with intracranial, nonmetastatic, genetically confirmed P-PNET. Three patients were treated at our institutions. Thirteen other cases providing sufficient treatment and follow-up information were extracted from the literature. RESULTS: The median age at diagnosis was 17 years. All patients underwent initial surgery. Complete resection was achieved in 9 of the 17 cases (53 %). Combined adjuvant treatment consisting of radiotherapy (focal, n = 10; craniospinal, n = 1) and chemotherapy was administered to 11 of the 17 patients (59 %). The median follow-up time was 1.4 years. In 8 of the 17 patients (47 %), the disease progressed; 4 of the 17 patients (24 %) died. The 2-year progression-free and overall survival rates were 64 % and 76 %, respectively. CONCLUSION: The differential diagnosis for intracranial, meningeal-based, small, round-cell tumors should include P-PNET. It is highly probable that complete resection has a positive impact on survival--as previously reported for extracranial P-PNET--but this cannot be shown by our data. Intensive adjuvant treatment consisting of radiotherapy and chemotherapy seems to be essential. A statistically grounded recommendation for the appropriate target volume and radiation dose is not yet possible. However, in most case reports of primary intracranial P-PNET published to date, patients were treated with focal irradiation. The optimal chemotherapy regimen has yet to be established, with both the Ewing tumor and CNS-PNET protocols being promising candidates for effective treatment.


Assuntos
Neoplasias Encefálicas/radioterapia , Tumores Neuroectodérmicos Primitivos Periféricos/radioterapia , Terminologia como Assunto , Adolescente , Adulto , Neoplasias Encefálicas/diagnóstico , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tumores Neuroectodérmicos Primitivos Periféricos/diagnóstico , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
14.
Farm. hosp ; 36(3): 135-140, mayo-jun. 2012. tab
Artigo em Espanhol | IBECS | ID: ibc-107827

RESUMO

Introducción El presente estudio comparó las condiciones reales de uso de trastuzumab en la práctica clínica con las descritas oficialmente en ficha técnica. Además, se midió el gasto asociado a su uso. Métodos Estudio observacional de prescripción-indicación de trastuzumab en un hospital de tercer nivel desde enero de 2006 hasta el 31 de diciembre de 2007. Se analizó si el uso de trastuzumab en la práctica clínica se adecuaba a ficha técnica en lo referente a: sobreexpresión del HER2, indicación (cáncer de mama), esquema de tratamiento, línea de tratamiento, dosis, frecuencia y número de ciclos. Para medir el gasto, se calculó el número total de miligramos utilizados y posteriormente se multiplicó por el precio por miligramo de venta del laboratorio más IVA. Resultados Todos los pacientes (n=77) usaron trastuzumab para cáncer de mama. El 62,6% de los pacientes presentó sobreexpresión del HER2+++. Se utilizaron 29 esquemas no autorizados en ficha técnica. El gasto total de trastuzumab durante el periodo de estudio fue de 1.537.622,73 euros. Conclusiones: Aunque el trastuzumab se utiliza siempre en cáncer de mama, se usa en condiciones distintas a las autorizadas en ficha técnica, tanto en lo referente a la sobreexpresión de HER2, como en los esquemas de tratamiento (AU)


Introduction This study compares trastuzumab's actual conditions of use in clinical practice with those officially described on its summary of product characteristics. We also measure the cost associated with its use. Methods Observational study of the prescription/indication of trastuzumab in a tertiary hospital from January 2006 to 31 December 2007. We analysed whether trastuzumab use in clinical practice complied with its summary of product characteristics, concerning the following: HER2 over expression, indication (breast cancer), treatment plan, line of treatment, dosage, frequency and number of cycles. To measure cost, we calculated the total number of milligrams used and then multiplied it by the laboratory's sale price per milligram plus VAT. Results All patients (n=77) used trastuzumab for breast cancer. Sixty-two point two percent of patients presented with HER2+++ over expression. Twenty-nine treatment plans were used, that were not authorised on the summary of product characteristics. The total trastuzumab cost during the study period was €1537 622.73. ConclusionsAlthough trastuzumab is always used for breast cancer, it is used in conditions other than those described on its summary of product characteristics, both for HER2 over expression and treatment plans (AU)


Assuntos
Humanos , Feminino , Prescrições de Medicamentos/normas , Anticorpos Monoclonais/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Rotulagem de Medicamentos/normas , Estudos Prospectivos , Progressão da Doença
15.
Environ Microbiol ; 14(5): 1224-39, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22335606

RESUMO

Most marine sponges establish a persistent association with a wide array of phylogenetically and physiologically diverse microbes. To date, the role of these symbiotic microbial communities in the metabolism and nutrient cycles of the sponge-microbe consortium remains largely unknown. We identified and quantified the microbial communities associated with three common Mediterranean sponge species, Dysidea avara, Agelas oroides and Chondrosia reniformis (Demospongiae) that cohabitate coralligenous community. For each sponge we quantified the uptake and release of dissolved organic carbon (DOC) and nitrogen (DON), inorganic nitrogen and phosphate. Low microbial abundance and no evidence for DOC uptake or nitrification were found for D. avara. In contrast A. oroides and C. reniformis showed high microbial abundance (30% and 70% of their tissue occupied by microbes respectively) and both species exhibited high nitrification and high DOC and NH(4) (+) uptake. Surprisingly, these unique metabolic pathways were mediated in each sponge species by a different, and host specific, microbial community. The functional convergence of microbial consortia found in these two sympatric sponge species, suggest that these metabolic processes may be of special relevance to the success of the holobiont.


Assuntos
Bactérias/classificação , Fenômenos Fisiológicos Bacterianos , Consórcios Microbianos/fisiologia , Filogenia , Poríferos/microbiologia , Animais , Bactérias/genética , Bactérias/metabolismo , Carbono/metabolismo , Mar Mediterrâneo , Dados de Sequência Molecular , Nitrogênio/metabolismo , RNA Ribossômico 16S/genética , Simbiose
16.
Farm Hosp ; 36(3): 135-40, 2012.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-22137162

RESUMO

INTRODUCTION: This study compares trastuzumab's actual conditions of use in clinical practice with those officially described on its summary of product characteristics. We also measure the cost associated with its use. METHODS: Observational study of the prescription/indication of trastuzumab in a tertiary hospital from January 2006 to 31 December 2007. We analysed whether trastuzumab use in clinical practice complied with its summary of product characteristics, concerning the following: HER2 over expression, indication (breast cancer), treatment plan, line of treatment, dosage, frequency and number of cycles. To measure cost, we calculated the total number of milligrams used and then multiplied it by the laboratory's sale price per milligram plus VAT. RESULTS: All patients (n=77) used trastuzumab for breast cancer. Sixty-two point two percent of patients presented with HER2+++ over expression. Twenty-nine treatment plans were used, that were not authorised on the summary of product characteristics. The total trastuzumab cost during the study period was €1537 622.73. CONCLUSIONS: Although trastuzumab is always used for breast cancer, it is used in conditions other than those described on its summary of product characteristics, both for HER2 over expression and treatment plans.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Carcinoma/tratamento farmacológico , Rotulagem de Medicamentos , Prescrições de Medicamentos/normas , Fidelidade a Diretrizes , Hospitais Universitários/estatística & dados numéricos , Anticorpos Monoclonais Humanizados/administração & dosagem , Anticorpos Monoclonais Humanizados/economia , Antineoplásicos Hormonais/administração & dosagem , Antineoplásicos Hormonais/economia , Antineoplásicos Hormonais/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/economia , Protocolos de Quimioterapia Combinada Antineoplásica/normas , Neoplasias da Mama/economia , Neoplasias da Mama/metabolismo , Carboplatina/administração & dosagem , Carcinoma/economia , Carcinoma/metabolismo , Carcinoma/secundário , Cisplatino/administração & dosagem , Desoxicitidina/administração & dosagem , Desoxicitidina/análogos & derivados , Docetaxel , Esquema de Medicação , Custos de Medicamentos/estatística & dados numéricos , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Fidelidade a Diretrizes/economia , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Proteínas de Neoplasias/antagonistas & inibidores , Proteínas de Neoplasias/biossíntese , Proteínas de Neoplasias/imunologia , Paclitaxel/administração & dosagem , Guias de Prática Clínica como Assunto , Honorários por Prescrição de Medicamentos/estatística & dados numéricos , Estudos Prospectivos , Receptor ErbB-2/antagonistas & inibidores , Receptor ErbB-2/biossíntese , Receptor ErbB-2/imunologia , Espanha , Taxoides/administração & dosagem , Trastuzumab , Vimblastina/administração & dosagem , Vimblastina/análogos & derivados , Vinorelbina , Gencitabina
17.
Bone Marrow Transplant ; 47(4): 522-7, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21602901

RESUMO

High-dose chemotherapy (HDC) followed by autologous stem cell rescue (ASCR) is the only curative treatment for metastatic retinoblastoma, but its feasibility in developing countries is unknown. We report 11 consecutive children (six unilateral) treated in three South-American middle-income countries with HDC-ASCR. One patient had metastatic retinoblastoma at diagnosis and the remaining ones had a metastatic relapse. Metastatic sites included BM=6, bone=4, orbit=5 and central nervous system (CNS)=4. All patients received induction with conventional chemotherapy achieving CR at a median of 5.7 months from the diagnosis of metastasis. Conditioning regimens included carboplatin and etoposide with thiotepa in six or with CY in four or melphalan in one patient. All patients engrafted after G-CSF-mobilized peripheral blood ASCR and no toxic deaths occurred. Two children received post-ASCR CNS radiotherapy. Seven children have disease-free survival (median follow-up 39 months). CNS relapse, isolated (n=3) or with systemic relapse (n=1), occurring at a median of 7 months after ASCT was the most common event. In the same period, five children with metastatic retinoblastoma did not qualify for HDC-ASCR and died. We conclude that HDC-ASCR is a feasible and effective treatment for children with metastatic retinoblastoma in middle-income countries.


Assuntos
Antineoplásicos/administração & dosagem , Carboplatina/administração & dosagem , Etoposídeo/administração & dosagem , Melfalan/administração & dosagem , Retinoblastoma/terapia , Transplante de Células-Tronco , Condicionamento Pré-Transplante/métodos , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Metástase Neoplásica , Retinoblastoma/mortalidade , Retinoblastoma/patologia , América do Sul , Transplante Autólogo
18.
Mol Biol Rep ; 39(1): 629-34, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21603859

RESUMO

In the last few years haemodiafiltration with on-line regeneration of ultrafiltrate (HFR) has been shown to have a positive impact on inflammation and oxidative stress biomarkers, but its effect on antioxidant levels and on oxidative damage to biomolecules in the long-term is still unknown. This is a randomised clinical study over 12 months involving 40 patients on haemodialysis, comparing the effect of HFR (n=25) dialysis with haemodialysis with polysulfone (HD-PS, n=15) on oxidative stress. Total antioxidant capacity, enzymatic antioxidant [superoxide dismutase (SOD), catalase and glutathione peroxidase], non-enzymatic (GSH) and biomarkers of oxidative stress (TBARs, carbonyl groups and 8-OH-dG) were evaluated. The antioxidant activity decreased in the lymphocytes of patients dialysed with HFR, with a significant decrease in the enzyme SOD. In the oxidative stress biomarkers, an increase was seen in the levels of 8-OH-dG in patients on HD-PS dialysis but not in those treated with HFR. Throughout the year the changes in antioxidant levels and biomarkers of oxidative damage in patients dialysed with HFR were generally more modest and fluctuated less than those dialysed with HD-PS. Our study indicates that, in general, long-term dialysis with HFR does not modified antioxidant parameters or increases the oxidative damage to biomolecules. The HFR showed to be a biocompatible technique for long-term dialysis.


Assuntos
Biomarcadores/sangue , Hemodiafiltração/métodos , Falência Renal Crônica/terapia , Estresse Oxidativo/fisiologia , Diálise Renal/métodos , Análise de Variância , Catalase/sangue , Glutationa Peroxidase/sangue , Humanos , Polímeros/uso terapêutico , Sulfonas/uso terapêutico , Superóxido Dismutase/sangue , Substâncias Reativas com Ácido Tiobarbitúrico/metabolismo
19.
Pharm. care Esp ; 13(2): 74-90, mar.-abr. 2011. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-108644

RESUMO

Introducción: La psoriasis es una enfermedad crónica que influye mucho en la autoestima y la calidad de vida. La mejor manera de evaluar su impacto es llevar a cabo estudios que recojan la opinión de los propios pacientes. La farmacia es un recurso muy adecuado para realizarlos, pues a ella acuden todo tipo de pacientes independientemente de la gravedad del trastorno y/o del estatus de tratamiento. Objetivos: Conocer las variables sociodemográficas, la localización y el tipo de psoriasis, el tiempo de evolución, las comorbilidades, la pertenencia a asociaciones, la relación con el médico y los conocimientos sobre psoriasis. Métodos: Estudio descriptivo utilizando tres cuestionarios: SF-36, Skindex-29 y Psoriafarm. Se presentan los datos preliminares. Resultados: Participaron 47 farmacéuticos de 36 farmacias, que recogieron 200 respuestas válidas (52% mujeres y 48% varones). El 60,5% de los encuestados llevaban más de 10 años diagnosticados, el 78% presentaban afección moderada o leve, y la presentación más frecuente era la vulgar o en placas (53%). El 37% padecía otra enfermedad crónica. El 84% refirió empeorar con el estrés y un 49,5% había sufrido un trastorno emocional en el último año. El 56,5% consideraba que no disponía de información suficiente sobre su enfermedad, y un 58% estaba satisfecho con la atención médica. Conclusiones: Los datos obtenidos en cuanto al tipo de psoriasis concuerdan con los procedentes de otros trabajos realizados en distintos ámbitos. Los resultados muestran la importancia de los factores emocionales en la sintomatología de la psoriasis. Aunque la relación con los médicos recibe una buena calificación, los pacientes demandan más información sobre la enfermedad y los tratamientos, que podría facilitarse desde la farmacia, aunque no existen prácticamente estudios sobre intervenciones en este ámbito (AU)


Introduction: Psoriasis is a chronic illness with a significant impact on self-confidence and quality of life. The best way to assess its impact is to carry out patient-centered surveys. Community pharmacies are is a very suitable place for these surveys because they serve all kinds of patients regardless of the disease severity or the treatment status. Objectives: To know socio demographic variables, location and type of psoriasis, evolution time, comorbidities, patient advocacy groups membership, patient physician relationship, knowledge about psoriasis. Methods: Retrospective cross-sectional study using 3 questionnaires: SF-36, Skindex-29 and Psoriafarm. The preliminary data are presented. Results: 47 pharmacists in 36 pharmacies took part in the survey, collecting 200 valid answers (52.0% women and 48.0% men). 60.5% had been diagnosed over 10 years ago, 78.0% presented moderate or mild affection, and the most common type was plaque psoriasis (53.0%). 37.0% presented other chronic disease. 84.0% stated that symptoms worsened with stress and 49.5% had suffered an emotional disorder in the previous year. 56.5% said that they did not have enough information regarding their illness and 58.0% were satisfied with medical care. Conclusions: Data about the type of psoriasis are consistent with other surveys in different settings. Emotional factors have a significant influence on psoriasis symptoms. Although the patients- physicians relationship obtains a high score, patients demand more information on the illness and treatments, which could be provided in the pharmacy, although there are virtually no studies regarding interventions in this setting (AU)


Assuntos
Humanos , Masculino , Feminino , Psoríase/tratamento farmacológico , Opinião Pública , Atitude Frente a Saúde , Farmacêuticos/ética , Farmacêuticos/psicologia , Farmacêuticos/normas , Assistência Farmacêutica/organização & administração , Comorbidade , Inquéritos e Questionários/organização & administração , Cuidados Médicos/métodos , Cuidados Médicos/organização & administração
20.
Anim Reprod Sci ; 123(3-4): 139-48, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21168290

RESUMO

Cryopreserved straws of semen (n=228) from Holstein bulls (n=47) were examined for bacterial presence and sperm DNA fragmentation (SDF) dynamics. Commercial semen doses (representing six ejaculates per individual) were randomly selected from a bull stud in Spain. The dynamics of SDF were assessed after thawing (T0) and at 4, 24, 48, 72 and 96h of incubation at 37°C, using the commercial variant of the sperm chromatin dispersion test for Bovine (Halomax®). One group of bulls showed a bacterial presence in semen samples between 0 and 96h of incubation (n=23, group A) while the other did not (n=24, group B). Immediate post-thaw differences in SDF were not observed when both groups were compared. However, the rate of increase in SDF (rSDF) over time, considered as an estimate of the kinetic behaviour of sperm DNA survival, was significantly higher (P<0.05) in semen samples from group A (0.7% per hour) versus group B (0.05% per hour). Polymerase Chain Reaction (PCR) assay was used for DNA amplification using primers designed for specific regions of the bacterial gene that codifies for 16S rRNA. Different species within the phyla Bacteroidetes, Firmicutes, Proteobacteria, Cyanobacteria, Fusobacteria and Actinobacteria were identified. The results show that (1) SDF at baseline (T0) may not be affected by the presence of bacteria but the rSDF can increase due to bacterial growth during incubation, (2) the increase in the rSDF is characteristic of some bulls but not for others, and (3) certain bacterial strains are repeatedly found in separate ejaculates from the same bull.


Assuntos
Fenômenos Fisiológicos Bacterianos , Fragmentação do DNA , Sêmen/metabolismo , Sêmen/microbiologia , Animais , Bactérias/citologia , Bactérias/genética , Bovinos , Cinética , Masculino , Modelos Teóricos , Reação em Cadeia da Polimerase/métodos , RNA Ribossômico 16S/análise , Fatores de Tempo
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