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1.
Bioresour Technol ; 388: 129708, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37625653

RESUMO

The rise of contaminants of emerging concern in water-resources due to human activities has driven research toward wastewater treatment, specifically adsorption. The utilization of woody biomass for biochar production in adsorption has shown promise due to its high availability. This study shows the preparation of magnetic biochars (MB) from waste black wattle sawdust, utilizing ZnCl2 and NiCl2 (proportions: 1:0.5:0.5 = MB-0.5 and 1:1:1 = MB-1) as activating and magnetic agents. Synthesized via microwave-assisted-pyrolysis, MB boasts a high surface area (up to 765 m2.g-1) and functional groups, enhancing metoprolol medicine adsorption. Nonlinear kinetic and isothermal models were tested; the Avrami fractional-order kinetic model and Liu's isothermal model provided the best fits for experimental data. Thermodynamics and spectroscopic studies revealed spontaneous and exothermic adsorption processes, with physisorption magnitude and dominance of hydrogen-bond and π-π-interactions. MB can be easily extracted from an aqueous medium using magnetic fields, while adsorption capacity could be regenerated through green solvent elution.

3.
Behav Sci (Basel) ; 13(5)2023 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-37232659

RESUMO

In Portugal, like in other European countries, the COVID-19 pandemic aggravated the risk of poverty and social exclusion faced by migrants. This study aimed to assess mental health and well-being, and their social determinants, among Brazilian and Cape Verdean immigrant populations two years after the COVID-19 pandemic while exploring the role of positive psychological factors such as resilience and perceived social support. We conducted a cross-sectional survey combining online and face-to-face questionnaires for data collection between February and November 2022 on dimensions of mental health considered potentially relevant to the post-pandemic context: psychological distress, anxiety, and depression. Overall, 604 immigrants were included (322 Brazilian and 282 Cape Verdean); 58.5% of those surveyed were women and 41.5% were men. The results revealed that gender (being a woman) was associated with both psychological distress and depression, higher education was associated with anxiety, and that, for the three mental health dimensions under analysis, the perception of discrimination and resilience were negative and positive predictors, respectively. Findings can inform the design and implementation of relevant public mental health promotion programs with a focus on equity targeted to the general population. Such programs would help to address the psychological and social impacts of this long-term, insidious global pandemic that has challenged governments, health care systems, health care professionals, individuals, families, and communities worldwide.

4.
Environ Sci Pollut Res Int ; 30(20): 58684-58696, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36997777

RESUMO

Sapelli wood sawdust-derived magnetic activated carbon (SWSMAC) was produced by single-step pyrolysis using KOH and NiCl2 as activating and magnetization agents. SWSMAC was characterized by several techniques (SEM/EDS, N2 adsorption/desorption isotherms, FTIR, XRD, VSM, and pHPZC) and applied in the brilliant blue FCF dye adsorption from an aqueous medium. The obtained SWSMAC was a mesoporous material and showed good textural properties. Metallic nanostructured Ni particles were observed. Also, SWSMAC exhibited ferromagnetic properties. In the adsorption experiments, adequate conditions were an adsorbent dosage of 0.75 g L-1 and a solution pH of 4. The adsorption was fast, and the pseudo-second-order demonstrated greater suitability to the kinetic data. The Sips model fitted the equilibrium data well, and the maximum adsorption capacity predicted by this model was 105.88 mg g-1 (at 55 °C). The thermodynamic study revealed that the adsorption was spontaneous, favorable, and endothermic. Besides, the mechanistic elucidation suggested that electrostatic interactions, hydrogen bonding, π-π interactions, and n-π interactions were involved in the brilliant blue FCF dye adsorption onto SWSMAC. In summary, an advanced adsorbent material was developed from waste by single-step pyrolysis, and this material effectively adsorbs brilliant blue FCF dye.


Assuntos
Carvão Vegetal , Poluentes Químicos da Água , Adsorção , Carvão Vegetal/química , Madeira , Poluentes Químicos da Água/química , Termodinâmica , Cinética , Fenômenos Magnéticos , Concentração de Íons de Hidrogênio , Azul de Metileno/química
5.
J. health sci. (Londrina) ; 25(1): 43-49, 20230330.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1510135

RESUMO

The calyx of the Hibiscus plant are used in the form of an infusion in popular medicine with the purpose of contributing to the weight loss of its users. Therefore, the objective of this work was to verify in the literature the therapeutic potential of Hibiscus sabdariffa tea for weight loss. This is an integrative review done in the following databases: Scopus, PubMed, Science Direct, Web of Science. The final sample consisted of 6 articles. Half of the selected articles had the clear objective of evaluating weight loss, the others evaluated anti-metabolic and anti-stress properties, obesity-related adipogenesis and control of lipid indicators. In the selected studies, the most used part of the plant was the calyx, being fresh and dry. Factors such as the concentration and form of supply of the Hibiscus sabdariffa extract seem to be points to be taken into account in experiments that have food intake as an influence on the other variables. The studies brought evidence that Hibiscus sabdariffa extracts contribute to weight loss and to the suppression of weight gain in human and animal groups with metabolic disorders, without change for the healthy human/animal group. However, studies on the long-term maintenance of weight loss, once achieved, the efficacy and safety of its use, are still insufficient according to the collected evidence.(AU)


Os cálices da planta Hibiscus são utilizados na forma de infusão na medicina popular com o propósito de contribuir na perda ponderal de seus usuários. Diante disto, o trabalho teve como objetivo verificar na literatura o potencial terapêutico do chá de Hibiscus sabdariffa para a perda ponderal. Trata-se de uma revisão integrativa realizada nas bases: Scopus, PubMed, Science Direct, Web of Science. A amostra final foi formada por 6 artigos. Metade dos artigos selecionados tinham como objetivo claro avaliar a perda de peso, os demais avaliavam as propriedades antimetabólicas e antiestresse, adipogênese relacionada à obesidade e controle dos indicadores lipídicos. Nos estudos selecionados, a parte da planta mais utilizada foi o cálice, sendo eles frescos e secos. Fatores como a concentração e a forma de fornecimento do extrato do Hibiscus sabdariffa parecem ser pontos a serem levados em consideração em experimentos que tenham a ingestão alimentar como influência sobre as demais variáveis. Os estudos trouxeram evidencias de que os extratos de Hibiscus sabdariffa contribuem para a perda de peso e para a supressão do ganho de peso em grupos humanos e animais com disfunções metabólicas, sem alteração para o grupo de humanos/animais saudáveis. No entanto, estudos sobre a manutenção a longo prazo da perda de peso, uma vez alcançada, a eficácia e segurança de seu uso, ainda são insuficientes de acordo com as evidências coletadas.(AU)

6.
Molecules ; 28(4)2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36838808

RESUMO

Water pollution by dyes has been a major environmental problem to be tackled, and magnetic adsorbents appear as promising alternatives to solve it. Herein, magnetic activated carbons were prepared by the single-step method from Sapelli wood sawdust, properly characterized, and applied as adsorbents for brilliant blue dye removal. In particular, two magnetic activated carbons, MAC1105 and MAC111, were prepared using the proportion of biomass KOH of 1:1 and varying the proportion of NiCl2 of 0.5 and 1. The characterization results demonstrated that the different proportions of NiCl2 mainly influenced the textural characteristics of the adsorbents. An increase in the surface area from 260.0 to 331.5 m2 g-1 and in the total pore volume from 0.075 to 0.095 cm3 g-1 was observed with the weight ratio of NiCl2. Both adsorbents exhibit ferromagnetic properties and the presence of nanostructured Ni particles. The different properties of the materials influenced the adsorption kinetics and equilibrium of brilliant blue dye. MAC111 showed faster kinetics, reaching the equilibrium in around 10 min, while for MAC1105, it took 60 min for the equilibrium to be reached. In addition, based on the Sips isotherm, the maximum adsorption capacity was 98.12 mg g-1 for MAC111, while for MAC1105, it was 60.73 mg g-1. Furthermore, MAC111 presented the potential to be reused in more adsorption cycles than MAC1105, and the use of the adsorbents in the treatment of a simulated effluent exhibited high effectiveness, with removal efficiencies of up to 90%.


Assuntos
Carvão Vegetal , Poluentes Químicos da Água , Adsorção , Corantes , Fenômenos Magnéticos , Cinética , Azul de Metileno , Concentração de Íons de Hidrogênio
7.
Rev. méd. Urug ; 38(3): e38307, sept. 2022.
Artigo em Espanhol | LILACS, BNUY | ID: biblio-1409863

RESUMO

Resumen: Introducción: el tratamiento "gold standard" de la colecistitis aguda es la colecistectomía laparoscópica temprana. En pacientes añosos de alto riesgo anestésico-quirúrgico, con cuadros de evolución subaguda y/o con repercusión sistémica, es alternativa el tratamiento médico exclusivo o asociado al drenaje vesicular percutáneo. Objetivo: analizar y comparar las recomendaciones internacionales con las conductas terapéuticas en dos centros asistenciales de tercer nivel para pacientes con colecistitis aguda. Método: trabajo descriptivo, prospectivo de 161 pacientes con colecistitis aguda litiásica asistidos en los departamentos de emergencia del Hospital de Clínicas y el Hospital Español entre mayo de 2018 y mayo de 2019. Resultados: la colecistectomía laparoscópica temprana fue indicada en el 88% de los pacientes, con 3% de conversión y 9% de morbilidad. 12% recibieron manejo no operatorio, asociándose en el 65% colecistostomía percutánea. La edad avanzada, comorbilidades, discrasias y la severidad del cuadro presentaron asociación significativa con la modalidad terapéutica (p <0,05). El 40% de los pacientes en los que se realizó manejo no operatorio presentó recurrencias sintomáticas. A todos se les realizó la colecistectomía en diferido. Conclusiones: la colecistectomía laparoscópica temprana es la conducta terapéutica más frecuente. Las principales indicaciones de manejo no operatorio en nuestro medio son las características sistémicas desfavorables. El mismo presenta altas tasas de éxito y escasa morbilidad con una recurrencia sintomática del 40%.


Abstract: Introduction: early laparoscopic cholecystectomy is the gold standard treatment for acute cholecystitis. However, exclusive medical treatment (EMC) or medical treatment associated with percutaneous gallbladder drainage is the treatment of choice in elderly patients given their high surgical and anesthetic risk and upon the subacute course of the condition and/or its systemic repercussions. Objective: to analyze and compare international guidelines to the therapeutic behavior for patients with acute cholecystectomy in two third-level hospitals. Methodology: descriptive, prospective study of 161 patients with litiasic acute cholecystitis treated in the ER of Hospital de Clínicas and Hospital Español between May 2018 and May 2019. Results: early laparoscopic cholecystectomy was indicated in 88% of patients, conversion being 3% and morbidity 9%. Twelve percent of patients received non-surgical treatment, 65% of which evidenced percutaneous cholecystostomy. Old age, comorbidities, dyscrasias, and severity of the condition were closely related to the therapeutic modality (p < 0.05). Forty percent of patients who received non-surgical treatment presented symptomatic repercussions. They all underwent delayed cholecystectomy. Conclusions: early laparoscopic cholecystectomy is the most frequent treatment of choice. Unfavorable systemic characteristics are the main indications for non-surgical management in our country. This surgical treatment evidences high success rates and scarce morbidity with 40% of systemic repercussions.


Resumo: Introdução: o tratamento padrão ouro da colecistite aguda é a colecistectomia laparoscópica precoce. Em pacientes idosos com alto risco anestésico-cirúrgico, com evolução subaguda e/ou repercussão sistêmica, o tratamento clínico isolado ou associado à drenagem percutânea da vesícula biliar é uma alternativa. Objetivo: analisar e comparar recomendações internacionais com condutas terapêuticas em dois centros terciários para pacientes com colecistite aguda. Método: estudo descritivo e prospectivo de 161 pacientes com colecistite aguda de cálculos atendidos nos serviços de emergência do Hospital de Clínicas e Hospital Español no período maio de 2018 - maio de 2019. Resultados: a colecistectomia laparoscópica precoce foi indicada em 88% dos pacientes, com 3% de conversão e 9% de morbidade. 12% receberam tratamento não operatório, associado a 65% colecistostomia percutânea. Idade avançada, comorbidades, discrasias e gravidade do quadro apresentaram associação significativa com a modalidade terapêutica (p < 0,05). 40% dos pacientes nos quais o manejo não operatório foi realizado apresentaram recidivas sintomáticas. Todos foram submetidos à colecistectomia diferida. Conclusões: a colecistectomia laparoscópica precoce é a abordagem terapêutica mais frequente. As principais indicações para o manejo não operatório em nosso meio são as características sistêmicas desfavoráveis. Apresentando altas taxas de sucesso e baixa morbidade com recorrência sintomática de 40%.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Colecistectomia Laparoscópica/estatística & dados numéricos , Colecistite Aguda/terapia , Recidiva , Estudos Prospectivos , Guias de Prática Clínica como Assunto , Colecistite Aguda/cirurgia
8.
Chem Biodivers ; 19(6): e202200107, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35474603

RESUMO

The dichloromethane extract of the cashew nuts from Anacardium occidentale was fractionated by rotation locular countercurrent chromatography aimed at discovering metabolites that could be useful as new models for photosynthesis inhibitors. The chemical fractionation afforded a complex mixture of anacardic acids, which upon catalytic hydrogenation yielded anacardic acid (1). Methylation of 1 via reaction with diazomethane afforded an ester 2. Both compounds were evaluated using polarographic approaches and fluorescence studies of chlorophyll a (ChL a). The in vitro assays informed the decision for the classification of 1 and 2 as Hill reaction inhibitors. Besides that, 1 inhibited the donor side of the PSII, while 2 acted as an energy transfer inhibitor. Therefore, this study is important for the development of herbicides.


Assuntos
Ácidos Anacárdicos , Anacardium , Ácidos Anacárdicos/química , Ácidos Anacárdicos/farmacologia , Anacardium/química , Clorofila A , Nozes/química , Fotossíntese
9.
Adv Mater ; 34(27): e2201826, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35475584

RESUMO

Stretching a coiled carbon nanotube (CNT) yarn can provide large, reversible electrochemical capacitance changes, which convert mechanical energy to electricity. Here, it is shown that the performance of these "twistron" harvesters can be increased by optimizing the alignment of precursor CNT forests, plastically stretching the precursor twisted yarn, applying much higher tensile loads during precoiling twist than for coiling, using electrothermal pulse annealing under tension, and incorporating reduced graphene oxide nanoplates. The peak output power for a 1 and a 30 Hz sinusoidal deformation are 0.73 and 3.19 kW kg-1 , respectively, which are 24- and 13-fold that of previous twistron harvesters at these respective frequencies. This performance at 30 Hz is over 12-fold that of other prior-art mechanical energy harvesters for frequencies between 0.1 and 600 Hz. The maximum energy conversion efficiency is 7.2-fold that for previous twistrons. Twistron anode and cathode yarn arrays are stretched 180° out-of-phase by locating them in the negative and positive compressibility directions of hinged wine-rack frames, thereby doubling the output voltage and reducing the input mechanical energy.

10.
Sensors (Basel) ; 22(3)2022 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-35161788

RESUMO

Satellite tropospheric propagation studies strongly rely on beacon receiver measurements. We were interested in performing a measurement campaign to characterize rain attenuation statistics. In this article, we outline some of the characteristics and drawbacks one faces when trying to perform a radio wave satellite beacon propagation experiment at the Ka-band with low-cost measurement equipment. We used an affordable beacon receiver consisting of a commercial low-noise block down-converter, an outdoor dual-reflector antenna, and a software-defined radio unit. To measure rain attenuation events, we needed to work out where the reference signal level was at all times. However, as we did not have a radiometer to remove the impact of gases and clouds, since it is a very expensive device, we used a procedure that involved the subtraction of a stable and reliable reference level (template) from the raw received beacon level. This template was extracted from observations during non-rainy periods. The procedure implemented for extracting the template was based on the same data processing methodology used by other authors in this field. Here, we describe through specific examples the main characteristics of the templates extracted on non-rainy days, as well as the impact of some meteorological parameters and unavoidable, but small antenna pointing errors.

11.
Am J Case Rep ; 23: e934600, 2022 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-35058422

RESUMO

BACKGROUND BRASH syndrome is a newly recognized clinical entity characterized by bradycardia, renal failure, atrioventricular blockade, shock, and hyperkalemia. Patients with BRASH syndrome often have severe bradycardia that is refractory to antidotes and chronotropic medications. In these situations, transvenous pacemaker and renal replacement therapy may be necessary. Therefore, rapid diagnosis and correct management of this entity are crucial to reduce mortality. We report a case and the management of BRASH syndrome in the Emergency Department. CASE REPORT A 76-year-old man with chronic kidney disease stage 3, essential hypertension and psoriasis, and receiving atenolol presented to the Emergency Department with lethargy and weakness that started 3 days ago, with rapid deterioration into shock. His initial laboratory tests revealed hyperkalemia, metabolic acidosis, and acute kidney injury. His initial electrocardiogram was remarkable for sinus bradycardia with junctional escape rhythm with ventricular rate of 26 bpm. A chest X-ray was normal. Transthoracic echocardiogram showed normal systolic and diastolic function. Atenolol was immediately held. He was treated with potassium-lowering agents and vasoactive drugs. Due to the persistence of bradycardia, even after reversal of hyperkalemia, a temporary transvenous pacemaker was placed. Renal replacement therapy was not required. Renal function improved and heart rate stabilized at 80 bpm. The patient was discharged and advised to avoid atrioventricular-blocking agents, with Cardiology follow-up. CONCLUSIONS BRASH syndrome is a serious complication due to a combination of hyperkalemia, hypotension, and bradycardia in the setting of kidney dysfunction and medications that block the atrioventricular node. Hemodynamic support and temporary pacemaker use may be needed to manage this entity.


Assuntos
Bradicardia , Hiperpotassemia , Idoso , Arritmias Cardíacas , Bradicardia/etiologia , Bradicardia/terapia , Eletrocardiografia , Humanos , Hiperpotassemia/terapia , Masculino , Síndrome do Nó Sinusal
12.
World J Emerg Surg ; 16(1): 46, 2021 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-34507603

RESUMO

On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.


Assuntos
COVID-19/epidemiologia , Saúde Global , Pandemias , Pesquisa Biomédica , COVID-19/diagnóstico , COVID-19/terapia , Vacinas contra COVID-19 , Atenção à Saúde/organização & administração , Política de Saúde , Acesso aos Serviços de Saúde , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Humanos , Cooperação Internacional , Vacinação em Massa/organização & administração , Pandemias/prevenção & controle , Política , Atenção Primária à Saúde/organização & administração , Telemedicina/organização & administração
13.
Front Public Health ; 9: 656454, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34055720

RESUMO

The increasing number of international migrants (ranging from 153 million in 1990 to ~272 million in 2019) brought to attention the wide variation of national contexts concerning the policy measures to protect migrants' rights and ensuring their equal access to basic and essential services, namely in health. Sexual and Reproductive Health (SRH) is a key component to the overall health and quality of life and is impacted by power inequities inherent to society's institutions, environment, economics, and culture. In Portugal, guidelines for intervention in SRH are insufficient, a gap that is more pronounced with migrant populations due to the absence of culturally sensitive indicators to assess and monitor SRH. The aim of this work was 2-fold: to identify good practices in the SRH field, with a particular focus, whenever possible, on migrant populations, and to identify relevant and inclusive indicators to monitor SRH in Portugal. A Delphi panel (via online survey) with 66 experts (researchers, teachers, and health professionals) and 16 stakeholders (non-governmental organizations, civil society, and governmental organizations) was implemented in two rounds. Panelists were asked to state their level of agreement (5-point Likert-type scale) regarding four different SRH areas: Sexual Health, Reproductive Health, Social-Structural Factors, and Good Practices. Items were based on literature review and a World Café with 15 experts and stakeholders. Participation rate was 68% and response rate was 97% on the first round. From the initial list of 142 items, a total of 118 (83%) items were approved by consensus. Findings may provide extended opportunities for the healthcare system to engage in better informed decisions and more inclusive and integrative strategies regarding SRH, contributing to build political measures toward sexual and reproductive justice.


Assuntos
Saúde Reprodutiva , Migrantes , Consenso , Comparação Transcultural , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Portugal , Qualidade de Vida
14.
Rev. bioét. (Impr.) ; 29(1): 44-54, enero-mar. 2021.
Artigo em Português | LILACS | ID: biblio-1251076

RESUMO

Resumo A relação médico-paciente difere significativamente das demais interações sociais. Não por acaso, cresce expressivamente o número de estudos voltados exclusivamente à referida área. O fortalecimento da concepção de autonomia passou também a abranger a figura do paciente, com notória ampliação de sua esfera de participação e de influência na tomada de decisão em tratamentos e em procedimentos clínicos, mitigando aquela concepção exacerbadamente paternalista que recaía sobre a figura do profissional médico. Porém, daí insurge grave problemática: quais são os limites dessa autonomia? Acredita-se que a solução se encontra na ideia do paternalismo libertário, tese de Richard Thaler e Cass Sunstein, em que o médico atua como arquiteto da escolha do paciente. A partir do método hipotético-dedutivo, o objetivo do presente ensaio é verificar a possibilidade de adequar o método do paternalismo libertário à prática médica, mormente em relação aos hard cases , estabelecendo o alcance e os limites da autonomia do paciente.


Abstract The doctor-patient relationship differs significantly from other social interactions, and in the last years studies on this subject have grown significantly. The concept of autonomy now also encompasses patients, with notable expansion of their sphere of participation and influence in decision-making in treatments and clinical procedures, mitigating that overly paternalistic role of the physician. But this change poses a serious question: what are the limits of this autonomy? This article believes in the solution of libertarian paternalism, an idea proposed by Richard Thaler and Cass Sunstein, in which the doctor acts as a choice architect for the patient. Based on the hypothetico-deductive method, this study verifies the possibility of adapting libertarian paternalism to current medical practices, mainly in hard cases, establishing the scope and limits of patient autonomy.


Resumen La relación médico-paciente difiere significativamente de otras interacciones sociales. No es coincidencia que haya un aumento expresivo de estudios centrados exclusivamente en esta área. El fortalecimiento del concepto de autonomía ha abarcado también la figura del paciente, con una notable ampliación de su esfera de participación y influencia en las decisiones sobre tratamientos y procedimientos clínicos, mitigando la concepción extremadamente paternalista que recae en la figura del profesional médico. Sin embargo, esto plantea un problema grave: ¿dónde están los límites de esta autonomía? El artículo argumenta que la solución radica en la idea de paternalismo libertario propuesta por Richard Thaler y Cass Sunstein, según la cual el médico actuaría como el arquitecto de elección del paciente. Con base en el método hipotético-deductivo, el objetivo de este estudio fue verificar la posibilidad de adaptar la metodología del paternalismo libertario a la práctica médica, especialmente con relación a los casos difíciles ( hard cases ), para establecer el alcance y los límites de la autonomía del paciente.


Assuntos
Relações Médico-Paciente , Recusa do Paciente ao Tratamento , Paternalismo , Autonomia Pessoal
15.
Rev. méd. Urug ; 37(2): e37210, 2021. graf
Artigo em Espanhol | LILACS, UY-BNMED, BNUY | ID: biblio-1289849

RESUMO

Resumen: La perforación esofágica espontánea o síndrome de Boerhaave es una entidad poco frecuente. Se define como la rotura del esófago no relacionada con traumatismos, exploraciones invasivas, patología esofágica previa o cuerpos extraños. Las roturas esofágicas se consideran como la perforación más grave del tracto digestivo, con una alta tasa de morbimortalidad relacionada principalmente con el desarrollo de mediastinitis posterior. Presentamos un paciente de sexo masculino de 63 años, que postingesta copiosa presenta esfuerzo de vómito inefectivo y posteriormente intenso dolor epigástrico, acompañado de enfisema subcutáneo. Se realiza tomografía de tórax que evidencia colección de contraste paraesofágica. Con planteo de síndrome de Boerhaave se decide cirugía de urgencia. Destacamos que el principal elemento pronóstico es el tiempo de resolución quirúrgica, por lo que debemos considerar esta patología como diagnóstico diferencial en pacientes con dolor torácico de inicio agudo.


Summary: Spontaneous esophageal perforation or Boerhaave syndrome is rather an unusual condition. It may be defined as the rupture of the esophagus that is not associated to trauma, invasive explorations, previous esophagus pathology or foreign bodies. Esophageal ruptures are considered as the most severe perforations of the digestive tract, with high morbimortality rates which are mainly associated to the development of subsequent mediastinitis. The study presents a 63-year-old patient who, after copious food intake, evidences unsuccessful effort to vomit effort and subsequent intense epigastric pain, accompanied by subcutaneous emphysema. Abdominal contrast scan reveals paraesophageal collection and a decision is made to perform an emergency surgery upon the suspicion of Boerhaave syndrome. It is worth pointing out that time for surgical resolution is the main prognostic element, and thus, this condition is to be considered as differential diagnosis in patients with acute thoracic pain.


Resumo: A perfuração esofágica espontânea ou síndrome de Boerhaave é uma entidade rara. É definida como ruptura do esôfago não relacionada a trauma, exames invasivos, patologia esofágica prévia ou corpos estranhos. As rupturas esofágicas são consideradas as perfurações mais graves do trato digestivo, com alto índice de morbimortalidade principalmente relacionado ao desenvolvimento de mediastinite posterior. Apresentamos um paciente do sexo masculino, 63 anos, que após ingestão abundante apresentou esforço ineficaz de vômito e, posteriormente, dor epigástrica intensa, acompanhada de enfisema subcutâneo. Foi realizada tomografia de tórax que evidenciou coleção de contraste paraesofágico. Com diagnóstico de síndrome de Boerhaave, a cirurgia de emergência foi decidida. Ressaltamos que o principal elemento prognóstico é o tempo de resolução cirúrgica, portanto, devemos considerar essa patologia como um diagnóstico diferencial em pacientes com dor torácica de início agudo.


Assuntos
Masculino , Pessoa de Meia-Idade , Perfuração Esofágica , Perfuração Espontânea
16.
Environ Sci Pollut Res Int ; 27(33): 41394-41404, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32681342

RESUMO

This study presents the extraction of antibiotic amoxicillin (AMX) from aqueous solution employing activated carbons (AC) from olive biomass (OB). Two AC were prepared using ZnCl2 (activator agent), and a conventional muffle furnace (ACF) or microwave oven (ACMW). The structure, morphology, and textural properties from both AC were analyzed by scanning electron microscope (SEM), pH of point-zero-charge (pHPZC), infrared spectroscopy (FTIR), and N2 adsorption/desorption isotherms. AC with mesoporous structures rich in oxygenated groups and high specific area (as high as 1742 m2 g-1) were helpful for the efficient and fast adsorption of AMX. The Avrami kinetic nonlinear equation showed the best fitting for the empirical data when related to the pseudo-1st and pseudo-2nd order. The isothermal experimental data followed the Liu nonlinear model, displaying at 25 °C the maximum sorption capacity of 237.02 and 166.96 mg g-1 for the ACF and ACMW, respectively. An adsorption test with synthetic hospital effluent was carried out to evaluate the possibility of applying both adsorbents in wastewater purification. The purification efficiency was up to 94.4% and 91.96% for ACF and ACMW, respectively. Therefore, the AC obtained from OB (containing a mixture of seed, pulp, and olive peel) has a high potential for application in removing emerging contaminants from the wastewater.


Assuntos
Olea , Poluentes Químicos da Água , Adsorção , Amoxicilina , Biomassa , Carvão Vegetal , Concentração de Íons de Hidrogênio , Cinética
17.
J Hazard Mater ; 398: 122903, 2020 11 05.
Artigo em Inglês | MEDLINE | ID: mdl-32512448

RESUMO

The present research describes the synthesis of new nanomagnetic activated carbon material with high magnetization, and high surface area prepared in a single pyrolysis step that is used for the carbonization, activation, and magnetization of the produced material. The pyrolysis step of tucumã seed was carried out in a conventional tubular oven at 600 °C under N2-flow. It was prepared three magnetic carbons MT-1.5, MT-2.0, MT-2.5, that corresponds to the proportion of biomass: ZnCl2 always 1:1 and varying the proportion of NiCl2 of 1.5, 2.0, and 2.5, respectively. These magnetic nanocomposites were characterized by Vibrating Sample Magnetometer (VSM), X-ray diffraction, scanning electron microscopy, thermogravimetric analysis, hydrophobic/hydrophilic balance, CHN/O elemental analysis, modified Boehm titration, N2 adsorption-desorption isotherms; and pHpzc. All the materials obtained presented Ni particles with an average crystallite size of less than 33 nm. The MT-2.0 was employed for the removal of nicotinamide and propranolol from aqueous solutions. Based on Liu isotherm, the Qmax was 199.3 and 335.4 mg g-1 for nicotinamide and propranolol, respectively. MT-2.0 was used to treat simulated pharmaceutical industry effluents attaining removal of all organic compounds attaining up to 99.1 % of removal.


Assuntos
Carvão Vegetal , Poluentes Químicos da Água , Adsorção , Cloretos , Fenômenos Magnéticos , Niacinamida , Níquel , Propranolol , Pirólise , Poluentes Químicos da Água/análise , Zinco
18.
Clin Neurol Neurosurg ; 194: 105832, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32311617

RESUMO

OBJECTIVE: Differential diagnosis between Parkinson's disease (PD) dementia and dementia with Lewy bodies (DLB) is difficult due to common features, whereas management decisions and research endpoints depend upon knowledge of dementia severity. We aimed to assess risk factors for age at dementia onset, as well as which neuropsychiatric features are associated with pharmacotherapy and signs and symptoms of Lewy body dementia. PATIENTS AND METHODS: Patients with PD dementia or DLB were evaluated for age at disease onset, education, sanitation, anthropometric measures, alcohol use, smoking, history of infections or head trauma with unconsciousness, family history of neurodegenerative diseases, functional independence, cognition, behavior, motor features, caregiver burden and pharmacotherapy. RESULTS: Fifty-one patients were recruited (37 with DLB, 14 with PD dementia). Cumulative alcohol use and married status were associated with earlier dementia onset, whereas history of treated systemic infections and cumulative family history of primary neurodegenerative diseases led to later dementia onset. The length of dementia was shorter only for severely impaired patients who used anti-depressants, but not for users of cholinesterase inhibitors, while no behavioral symptom was associated with dopaminergic therapy. Night-time behavior disturbances were inversely associated with sleep satisfaction, while caregiver burden was more affected by depression and motor features. Non-motor symptoms were more burdensome for patients with DLB, while in PD dementia anxiety and dysphoria occurred when motor features were less burdensome. CONCLUSIONS: PD dementia and DLB are two phenotypes of the same pathological entity, differing mostly by the occurrence of parkinsonian signs. Predictors of dementia onset differ from other neurodegenerative diseases.


Assuntos
Doença por Corpos de Lewy/psicologia , Transtornos Mentais/psicologia , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas , Antidepressivos/uso terapêutico , Cuidadores , Efeitos Psicossociais da Doença , Estudos Transversais , Diagnóstico Diferencial , Escolaridade , Feminino , Humanos , Doença por Corpos de Lewy/diagnóstico , Doença por Corpos de Lewy/tratamento farmacológico , Masculino , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/etiologia , Pessoa de Meia-Idade , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/genética , Doença de Parkinson/diagnóstico , Doença de Parkinson/psicologia , Fatores de Risco , Fatores Socioeconômicos
19.
World J Emerg Surg ; 14: 54, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31827593

RESUMO

Renal and urogenital injuries occur in approximately 10-20% of abdominal trauma in adults and children. Optimal management should take into consideration the anatomic injury, the hemodynamic status, and the associated injuries. The management of urogenital trauma aims to restore homeostasis and normal physiology especially in pediatric patients where non-operative management is considered the gold standard. As with all traumatic conditions, the management of urogenital trauma should be multidisciplinary including urologists, interventional radiologists, and trauma surgeons, as well as emergency and ICU physicians. The aim of this paper is to present the World Society of Emergency Surgery (WSES) and the American Association for the Surgery of Trauma (AAST) kidney and urogenital trauma management guidelines.


Assuntos
Injúria Renal Aguda/terapia , Guias como Assunto , Sistema Urinário/lesões , Cirurgia Geral/organização & administração , Cirurgia Geral/tendências , Hemodinâmica/fisiologia , Humanos , Escala de Gravidade do Ferimento , Rim/lesões , Rim/cirurgia , Triagem/métodos
20.
World J Emerg Surg ; 14: 56, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31867050

RESUMO

Duodeno-pancreatic and extrahepatic biliary tree injuries are rare in both adult and pediatric trauma patients, and due to their anatomical location, associated injuries are very common. Mortality is primarily related to associated injuries, but morbidity remains high even in isolated injuries. Optimal management of duodeno-bilio-pancreatic injuries is dictated primarily by hemodynamic stability, clinical presentation, and grade of injury. Endoscopic and percutaneous interventions have increased the ability to non-operatively manage these injuries. Late diagnosis and treatment are both associated to increased morbidity and mortality. Sequelae of late presentations of pancreatic injury and complications of severe pancreatic trauma are also increasingly addressed endoscopically and with interventional radiology procedures. However, for moderate and severe extrahepatic biliary and severe duodeno-pancreatic injuries, immediate operative intervention is preferred as associated injuries are frequent and commonly present with hemodynamic instability or peritonitis. The aim of this paper is to present the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) duodenal, pancreatic, and extrahepatic biliary tree trauma management guidelines.


Assuntos
Ductos Biliares Extra-Hepáticos/lesões , Duodeno/lesões , Pâncreas/lesões , Traumatismos Abdominais/cirurgia , Ductos Biliares Extra-Hepáticos/cirurgia , Duodeno/cirurgia , Avaliação Sonográfica Focada no Trauma/métodos , Cirurgia Geral/organização & administração , Cirurgia Geral/tendências , Guias como Assunto , Humanos , Pâncreas/cirurgia , Tomografia Computadorizada por Raios X/métodos , Centros de Traumatologia/organização & administração , Triagem/métodos , Ultrassonografia/métodos
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