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1.
J Infect ; 80(3): 271-278, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31917968

RESUMO

OBJECTIVES: To analyze the clinical and economic burden of community-acquired (CA) or community-onset healthcare-associated (COHCA) multidrug-resistant (MDR) infections requiring hospitalization. METHODS: Case-control study. Adults admitted with CA or COHCA MDR infections were considered cases, while those admitted in the same period with non-MDR infections were controls. The matching criteria were source of infection and/or microorganism. Primary outcome was 30-day clinical failure. Secondary outcomes were 90-day and 1-year mortality, hospitalization costs and resource consumption. RESULTS: 194 patients (97 cases and 97 controls) were included. Multivariate analysis identified age (odds ratio [OR], 1.07, 95% confidence interval [CI], 1.01-1.14) and SOFA score (OR, 1.45, CI95%, 1.15-1.84) as independent predictors of 30-day clinical failure. Age (hazard ratio [HR] 1.09, 95%CI, 1.03-1.16) was the only factor associated with 90-day mortality, whereas age (HR 1.06, 95%CI, 1.03-1.09) and Charlson Index (HR 1.2, 95%CI, 1.07-1.34) were associated with 1-year mortality. MDR group showed longer hospitalization (p<0.001) and MDR hospitalization costs almost doubled those in the non-MDR group. MDR infections were associated with higher antimicrobial costs. CONCLUSIONS: Worse economic outcomes were identified with community-onset MDR infections. MDR was associated with worse clinical outcomes but mainly due to higher comorbidity of patients in MDR group, rather than multidrug resistance.

2.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 63(5): 327-335, sept.-oct. 2019. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-188923

RESUMO

Objetivo: El objetivo de este estudio es evaluar el tamaño de la glena en una población española normal, compararla con resultados previos en otras poblaciones y relacionarlo con los tamaños de implante que se comercializan para la artroplastia invertida de hombro. Material y métodos: Estudio antropométrico de la glena humana utilizando tomografías computarizadas de 154 pacientes con edades superiores a 30 años, realizados entre enero de 2015 y diciembre de 2017. Se valoran tomografías computarizadas de hombro con cortes de 2mm de grosor y 0mm de intervalo entre cortes, en algoritmo óseo y de partes blandas, realizándose reconstrucción 3D sobre la cual se obtienen mediciones de longitud y anchura de la glena. El punto superior de la glena se determinó en la zona superior del ovoide de la glena, en el tubérculo supraglenoideo, justo por debajo del reborde circunferencial que rodea la glena. El punto inferior se determinó como el punto más alejado del punto superior en el contorno de la glena, a nivel superior del reborde circunferencial que rodea la glena. Los puntos anterior y posterior fueron determinados como los extremos del eje transversal mayor en un plano perpendicular al eje superoinferior, por dentro del reborde circunferencial que rodea la glena. Las diferencias entre sexos, edad, altura, peso y relaciones de tamaños fueron evaluados. Resultados: La glena tiene un eje longitudinal medio de 28,78mm y una anchura de 20,27mm. Los valores del tamaño de la glena son significativamente diferentes en hombres y mujeres, siendo mayor en hombres. El tamaño de la glena está bien correlacionado con la estatura del paciente, existiendo una asociación positiva entre la estatura y la longitud y anchura de la superficie glenoidea. Las metaglenas circulares disponibles hoy en el mercado presentan tamaños no inferiores a 24-25mm de diámetro. Conclusión: La población del sur de España presenta un tamaño de la superficie glenoidea inferior a la población americana y semejante a la cohorte asiática. Los datos antropométricos expresados pueden ser útiles para la elección de la metaglena más apropiada en la población del sur de España


Objective: To evaluate the size of the glenoid in a southern Spanish population, to compare it with previous results from other populations and determine the size of the implants that are marketed for shoulder arthroplasty. Material and methods: Between January 2015 and December 2017, an anthropometrical study of the human glenoid was performed using computed axial tomography scans (CT) of 154 patients over 30 years old. The glenoid dimensions were analysed 3-dimensionally using 2mm interval thicknesses, determining the average height and width of the glenoid. The upper point of the glenoid geometry was determined as the supraglenoid tubercle of the ovoid glenoid surface, where the long head of the biceps tendon is thought to originate. The lower point was then positioned at the furthest point from the upper point on the glenoid contour. Anterior and posterior points were determined such that the 3-dimensional anterior-posterior distance was maximized on the plane perpendicular to the upper-lower axis. Sex differences and correlations between sides and among the respective parameters in the glenohumeral dimensions were also evaluated. Results: The glenoid had an average height of 28.78mm and width of 20.27mm. The values were significantly different between the men and the women, being greater in the men. The glenoid size is well correlated with the patient's size. Direct correlations exist between the glenoid height and width and the glenoid size and the patient's height. The available metaglenoids currently on the market are no bigger than 25-24mm. Conclusion: In comparison, the southern Spanish population have a glenoid size similar to the Caucasian population, but smaller than that of the American population. The data shown could be useful to improve the design of shoulder prostheses for the southern Spanish population


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Artroplastia do Ombro/instrumentação , Cavidade Glenoide/anatomia & histologia , Desenho de Prótese , Prótese de Ombro , Cavidade Glenoide/diagnóstico por imagem , Valores de Referência , Espanha , Tomografia Computadorizada por Raios X
3.
Rev Esp Quimioter ; 32 Suppl 1: 37-44, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31131591

RESUMO

Urinary tract infections are one of the most common health problems and entail a high consumption of health system resources. Due to the increase in global antibiotic resistances in recent years, it is increasingly common to find uropathogens with multiple resistance mechanisms, including quinolone-resistant bacteria, broad-spectrum ß-lactamase producers and carbapenemase producers. In this scenario, the role of fosfomycin has gained considerable importance, given its spectrum of activity against multidrug resistant microorganisms (Gram-positive and Gram-negative), becoming an attractive alternative therapy. Regarding the use of fosfomycin in complicated urinary tract infections, there is increasing clinical experience with patients with infections caused by multidrug resistant bacteria, those with recurrent urinary tract infection and special populations such as those with kidney transplants. Randomized comparative studies and series are underway, which will provide greater evidence. Nevertheless, more studies are needed to confirm the enormous potential of fosfomycin in complicated urinary tract infection in the era of multiresistance.


Assuntos
Antibacterianos/uso terapêutico , Fosfomicina/uso terapêutico , Infecções Urinárias/tratamento farmacológico , Administração Intravenosa , Administração Oral , Animais , Antibacterianos/administração & dosagem , Antibacterianos/farmacocinética , Farmacorresistência Bacteriana Múltipla , Fosfomicina/administração & dosagem , Fosfomicina/farmacocinética , Humanos , Sistema Urinário/metabolismo , Infecções Urinárias/complicações , Infecções Urinárias/microbiologia
4.
Rev Esp Cir Ortop Traumatol ; 63(5): 327-335, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31078443

RESUMO

OBJECTIVE: To evaluate the size of the glenoid in a southern Spanish population, to compare it with previous results from other populations and determine the size of the implants that are marketed for shoulder arthroplasty. MATERIAL AND METHODS: Between January 2015 and December 2017, an anthropometrical study of the human glenoid was performed using computed axial tomography scans (CT) of 154 patients over 30 years old. The glenoid dimensions were analysed 3-dimensionally using 2mm interval thicknesses, determining the average height and width of the glenoid. The upper point of the glenoid geometry was determined as the supraglenoid tubercle of the ovoid glenoid surface, where the long head of the biceps tendon is thought to originate. The lower point was then positioned at the furthest point from the upper point on the glenoid contour. Anterior and posterior points were determined such that the 3-dimensional anterior-posterior distance was maximized on the plane perpendicular to the upper-lower axis. Sex differences and correlations between sides and among the respective parameters in the glenohumeral dimensions were also evaluated. RESULTS: The glenoid had an average height of 28.78mm and width of 20.27mm. The values were significantly different between the men and the women, being greater in the men. The glenoid size is well correlated with the patient's size. Direct correlations exist between the glenoid height and width and the glenoid size and the patient's height. The available metaglenoids currently on the market are no bigger than 25-24mm. CONCLUSION: In comparison, the southern Spanish population have a glenoid size similar to the Caucasian population, but smaller than that of the American population. The data shown could be useful to improve the design of shoulder prostheses for the southern Spanish population.


Assuntos
Artroplastia do Ombro/instrumentação , Cavidade Glenoide/anatomia & histologia , Desenho de Prótese , Prótese de Ombro , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Cavidade Glenoide/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Espanha , Tomografia Computadorizada por Raios X
5.
Int J Infect Dis ; 78: 103-106, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30391324

RESUMO

There is little published data on benznidazole dosing, or levels in cerebrospinal fluid. In this report, we describe the clinical course of an immunosuppressed patient with Chagas central nervous system involvement. He was treated successfully with larger benznidazole doses than are recommended, in order to reach therapeutically effective concentrations in the brain.


Assuntos
Encéfalo/metabolismo , Doença de Chagas/imunologia , Imunossupressores/administração & dosagem , Transplante de Rim , Nitroimidazóis/administração & dosagem , Humanos , Hospedeiro Imunocomprometido , Masculino , Pessoa de Meia-Idade , Nitroimidazóis/farmacocinética
6.
J Clin Microbiol ; 55(8): 2391-2399, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28515220

RESUMO

Azole-resistant Aspergillus fumigatus is an increasing worldwide problem with major clinical implications. Surveillance is warranted to guide clinicians to provide optimal treatment to patients. To investigate azole resistance in clinical Aspergillus isolates in our institution, a Belgian university hospital, we conducted a laboratory-based surveillance between June 2015 and October 2016. Two different approaches were used: a prospective culture-based surveillance using VIPcheck on unselected A. fumigatus (n = 109 patients, including 19 patients with proven or probable invasive aspergillosis [IA]), followed by molecular detection of mutations conferring azole resistance, and a retrospective detection of azole-resistant A. fumigatus in bronchoalveolar lavage fluid using the commercially available AsperGenius PCR (n = 100 patients, including 29 patients with proven or probable IA). By VIPcheck, 25 azole-resistant A. fumigatus specimens were isolated from 14 patients (12.8%). Of these 14 patients, only 2 had proven or probable IA (10.5%). Mutations at the cyp51A gene were observed in 23 of the 25 A. fumigatus isolates; TR34/L98H was the most prevalent mutation (46.7%), followed by TR46/Y121F/T289A (26.7%). Twenty-seven (27%) patients were positive for the presence of Aspergillus species by AsperGenius PCR. A. fumigatus was detected by AsperGenius in 20 patients, and 3 of these patients carried cyp51A mutations. Two patients had proven or probable IA and cyp51A mutation (11.7%). Our study has shown that the detection of azole-resistant A. fumigatus in clinical isolates was a frequent finding in our institution. Hence, a rapid method for resistance detection may be useful to improve patient management. Centers that care for immunocompromised patients should perform routine surveillance to determine their local epidemiology.


Assuntos
Antifúngicos/farmacologia , Aspergilose/diagnóstico , Aspergillus fumigatus/isolamento & purificação , Azóis/farmacologia , Farmacorresistência Fúngica , Técnicas Microbiológicas/métodos , Técnicas de Diagnóstico Molecular/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Aspergilose/microbiologia , Aspergillus fumigatus/efeitos dos fármacos , Bélgica , Feminino , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
7.
Chem Commun (Camb) ; 53(26): 3757-3760, 2017 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-28304028

RESUMO

Herein, we report the synthesis and the study of a novel mixed biradical with BDPA and TEMPO radical units that are covalently bound by an ester group (BDPAesterTEMPO) as a polarizing agent for fast dissolution DNP. The biradical exhibits an extremely high DNP NMR enhancement of >50 000 times, which constitutes one of the largest signal enhancements observed so far, to the best of our knowledge.

8.
Eur J Clin Microbiol Infect Dis ; 36(3): 501-507, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27832392

RESUMO

Our objective was to compare mortality, epidemiology, and morbidity in hospitalized patients with candidemia which was both related and unrelated to the central venous catheter (CVC). This was a monocentric, retrospective cohort study of candidemia. The sample consisted of 103 patients with laboratory-confirmed nosocomial candidemia hospitalized between 2006 and 2013 in a tertiary care public hospital. We included 65 (63.1 %) patients (24 in the CVC-positive group, 41 in the CVC-negative group). Demographic data and risk factors were recorded using a structured case report form. In the group of candidemia associated to the CVC, survival at day 50 was 58.6 ± 11.9 %, compared to 26.5 ± 8.9 % for the CVC-negative group (p-value = 0.012); the hazard ratio of death was 0.38 (95 % confidence interval 0.17-0.85, p-value = 0.019). Compared with the CVC-positive patients, CVC-negative patients were often colonized with yeast (41.5 % vs. 16.7 %, p-value = 0.041), had a shorter previous in-hospital stay (20 days vs. 34 days, p-value = 0.023), and were more severely ill (severe sepsis 85.4 % vs. 58.3 %, p-value = 0.016). In this study, when the origin of candidemia was not the CVC, patients were more seriously ill, had a higher mortality rate, and the removal of the catheter seemed to lead to disappointing results. It would be useful to explore the impact of retention of the CVC on survival in the CVC-negative patients, where the CVCs are essential to treating these patients.


Assuntos
Candidemia/epidemiologia , Candidemia/mortalidade , Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/mortalidade , Cateteres Venosos Centrais/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Candidemia/patologia , Infecções Relacionadas a Cateter/patologia , Demografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida , Adulto Jovem
9.
Histochem Cell Biol ; 147(3): 377-388, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27600719

RESUMO

Current tissue engineering technology focuses on developing simple tissues, whereas multilayered structures comprising several tissue types have rarely been described. We developed a highly biomimetic multilayered palate substitute with bone and oral mucosa tissues using rabbit cells and biomaterials subjected to nanotechnological techniques based on plastic compression. This novel palate substitute was autologously grafted in vivo, and histological and histochemical analyses were used to evaluate biointegration, cell function, and cell differentiation in the multilayered palate substitute. The three-dimensional structure of the multilayered palate substitute was histologically similar to control tissues, but the ex vivo level of cell and tissue differentiation were low as determined by the absence of epithelial differentiation although cytokeratins 4 and 13 were expressed. In vivo grafting was associated with greater cell differentiation, epithelial stratification, and maturation, but the expression of cytokeratins 4, 13, 5, and 19 at did not reach control tissue levels. Histochemical analysis of the oral mucosa stroma and bone detected weak signals for proteoglycans, elastic and collagen fibers, mineralization deposits and osteocalcin in the multilayered palate substitute cultured ex vivo. However, in vivo grafting was able to induce cell and tissue differentiation, although the expression levels of these components were always significantly lower than those found in controls, except for collagen in the bone layer. These results suggest that generation of a full-thickness multilayered palate substitute is achievable and that tissues become partially differentiated upon in vivo grafting.


Assuntos
Órgãos Bioartificiais , Materiais Biocompatíveis , Palato/citologia , Engenharia Tecidual/métodos , Animais , Osso e Ossos/citologia , Diferenciação Celular , Células Cultivadas , Técnicas In Vitro , Mucosa Bucal/citologia , Mucosa Bucal/transplante , Palato/anatomia & histologia , Coelhos , Transplante Autólogo
10.
Eur J Clin Microbiol Infect Dis ; 36(3): 487-494, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27787664

RESUMO

In April 2015, the Spanish National Health System (SNHS) developed a national strategic plan for the diagnosis, treatment, and management of hepatitis C virus (HCV). Our aim was to analyze the impact of this on human immunodeficiency virus (HIV)-infected patients included in the HERACLES cohort during the first 6 months of its implementation. The HERACLES cohort (NCT02511496) was set up in March 2015 to evaluate the status and follow-up of chronic HCV infection in patients co-infected with HIV in the south of Spain. In September 2015, the data were analyzed to identify clinical events (death, liver decompensation, and liver fibrosis progression) and rate of treatment implementation in this population. The study population comprised a total of 3474 HIV/HCV co-infected patients. The distribution according to liver fibrosis stage was: 1152 F0-F1 (33.2 %); 513 F2 (14.4 %); 641 F3 (18.2 %); 761 F4 (21.9 %); and 407 whose liver fibrosis was not measured (12.3 %). During follow-up, 248 patients progressed by at least one fibrosis stage [7.1 %; 95 % confidence interval (CI): 6.3-8 %]. Among cirrhotic patients, 52 (6.8 %; 95 % CI: 5.2-8.9 %) developed hepatic decompensation. In the overall population, 50 patients died (1.4 %; 95 % CI: 1.1-1.9 %). Eight hundred and nineteen patients (23.56 %) initiated interferon (IFN)-free treatment during follow-up, of which 47.8 % were cirrhotic. In our study, during 6 months of follow-up, 23.56 % of HIV/HCV co-infected patients included in our cohort received HCV treatment. However, we observed a high incidence of negative short-term outcomes in our population.


Assuntos
Antivirais/uso terapêutico , Infecções por HIV/complicações , Acesso aos Serviços de Saúde , Hepatite C Crônica/complicações , Hepatite C Crônica/tratamento farmacológico , Cirrose Hepática/epidemiologia , Falência Hepática/epidemiologia , Adulto , Idoso , Feminino , Política de Saúde , Hepatite C Crônica/diagnóstico , Hepatite C Crônica/mortalidade , Humanos , Cirrose Hepática/patologia , Falência Hepática/patologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Espanha , Análise de Sobrevida , Resultado do Tratamento
11.
Phys Chem Chem Phys ; 18(4): 3151-8, 2016 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-26742686

RESUMO

Spherical nanoparticles and fibres observable by cryo-electron microscopy are spontaneously formed by the Finland trityl radical at concentrations above 15 mM. These species represent a new class of paramagnetic, metal-free, nanoscale supramolecular materials. Self-association was observed under a variety of experimental conditions, including aqueous solution at room temperature, low temperature frozen glasses and the gas phase. Oligomers formed by at least 5 Finland radicals were detected by ion-mobility mass spectrometry. Magnetic susceptibility data as well as low temperature EPR spectra show coupling between electronic spins in the self-assembled species. Quantum chemical calculations show stacking along the C3 symmetry axis. Nanoparticle formation requires additional lateral packing that can be provided by hydrogen bonding involving the triangular array of carboxylic acid groups leading to the assembly of geodesic spheres.

12.
J Clin Virol ; 72: 42-5, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26395519

RESUMO

BACKGROUND: The diagnosis of CMV infection is challenging and the quality of serological laboratory testing is critical, especially in pregnancy and in the determination of transplant recipients and donors serostatus. OBJECTIVES: Evaluate the performances of the new LIAISON(®) CMV II line: LIAISON(®) CMV IgG II, LIAISON(®) CMV IgM II and LIAISON(®) CMV IgG Avidity II in comparison with the routine methods used in our laboratory. STUDY DESIGN: The evaluation of LIAISON(®) CMV IgG II and LIAISON(®) CMV IgM II was performed on both prospective routine samples and retrospective selected samples for a total of 383 sera. CMV IgG avidity was assessed with 88 samples. RESULTS: The overall agreement was 98.8% for the IgG and 95% for the IgM on the routine population. On selected retrospective samples, excellent agreement was found in the seronegative and past infection groups. In the recent infection group, discordances were observed in 7.1% of IgG and 13.1% of IgM. No recent infection was missed with LIAISON(®). Avidity agreement with VIDAS(®) was 81%. On 51 sera with a known time of infection, no high avidity was found in the group infected for less than 3 months and 82% of the samples showed a high avidity in the group infected for more than 3 months. CONCLUSION: The performances of the fully automated LIAISON(®) CMV II line assays are comparable to those of the reference methods used in our lab for both prospective and selected populations. This new CMV line is a useful tool for the diagnosis of CMV infections and CMV immune status in clinical settings.


Assuntos
Afinidade de Anticorpos , Infecções por Citomegalovirus/diagnóstico , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Testes Sorológicos/métodos , Automação Laboratorial/métodos , Humanos , Estudos Prospectivos , Estudos Retrospectivos
13.
J Mycol Med ; 25(2): 151-4, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25840851

RESUMO

A patient with refractory diffuse lymphoma treated for pulmonary invasive aspergillosis developed a concomitant primary cutaneous mucormycosis. The mucormycete was identified by sequencing as Mucor circinelloides. This case confirms the importance of a rapid pathogen diagnosis in immunocompromised patients and the usefulness of molecular methods for identification of rare fungal species.


Assuntos
Mucor/isolamento & purificação , Mucormicose/microbiologia , Zigomicose/microbiologia , Aspergilose/complicações , Aspergilose/microbiologia , Coinfecção , Dermatomicoses/microbiologia , Feminino , Humanos , Hospedeiro Imunocomprometido , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/imunologia , Linfoma Difuso de Grandes Células B/microbiologia , Pessoa de Meia-Idade , Mucormicose/complicações
14.
Phys Chem Chem Phys ; 17(8): 5785-94, 2015 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-25626422

RESUMO

A new class of guest-induced, bi-radical self-assembled organic capsules is reported. They are formed by the inclusion of a tetramethylammonium (TMA) cation between two monomers of the stable trityl radical OX63. OX63 is extensively used in dissolution dynamic nuclear polarization (DNP) where it leads to NMR sensitivity enhancements of several orders of magnitude. The supramolecular properties of OX63 have a strong impact on its DNP properties. An especially relevant case is the polarization of choline-containing metabolites, where complex formation between choline and OX63 results in faster relaxation.


Assuntos
Cápsulas/química , Indenos/química , Compostos de Tritil/química , Dimerização , Espectroscopia de Ressonância de Spin Eletrônica , Espectroscopia de Ressonância Magnética , Compostos de Amônio Quaternário/química , Temperatura
15.
Rev. esp. investig. quir ; 18(3): 107-111, 2015. graf, ilus, tab
Artigo em Inglês | IBECS | ID: ibc-142366

RESUMO

Background: Some of the variability in functional results after reconstructive proctocolectomy (RP) may be explained by the excessive intrinsic motility of the ileum and ileoanal pouches. The effect of performing a single or double myotomy on several functional variables after RP was the aim of this prospective, randomized and single blinded experimental study in beagle dogs . Materials and Methods: 33 beagle dogs were randomized in three groups: Group I (12 dogs), a standard RP with a 10 cm ileal J-pouch-anal anastomosis was performed; Group II (10 dogs), a longitudinal myotomy of 8 cm on the wall of the pouch was added to the RP; Group III (11 dogs), same as group II with a further 10 cm longitudinal myotomy in the afferent prepouch ileum loop. Variables studied were daytime and night-time number and characteristics of the stools, as well as their changes over the study period, the intestinal transit time, measured in minutes, and the compliance and capacity of the pouches. Results: No difference in morbidity between groups was found. Mean nocturnal stools were statistically significant lower in groups II and III. Although we observed a trend for lower daytime stool frequency, more percentage of soft-hard stools over the study period, longer intestinal transit time and larger reservoirs in group II, none of these variables reached statistical significant differences. Conclusions. Although the myotomies do not increase the morbidity of the RP, there is no clear clinical evidence of their effectiveness in providing better functional outcomes. Performing two myotomies is not better than only one. Our study do not support a hypothetic use of myotomies for patients with functional failure after a RP


No disponible


Assuntos
Animais , Cães , Colectomia/métodos , Bolsas Cólicas , Bolsas Cólicas/veterinária , Anastomose Cirúrgica/métodos , Anastomose Cirúrgica/veterinária , Doenças do Íleo/cirurgia , Doenças do Íleo/veterinária , Íleo/cirurgia , Estudos Prospectivos , Análise de Variância , Hemorragia Gastrointestinal/cirurgia , Hemorragia Gastrointestinal/veterinária
16.
Magn Reson Chem ; 51(11): 729-33, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25941036

RESUMO

Long-lived states (LLS) are relaxation-favored spin population distributions of J-coupled magnetic nuclei. LLS were measured, along with classical (1)H and (15)N relaxation rate constants, in amino acids of the N-terminal Unique domain of the c-Src kinase, which is disordered in vitro under physiological conditions. The relaxation rates of LLS can probe motions and interactions in biomolecules. LLS of the aliphatic protons of glycines, with lifetimes approximately four times longer than their spin-lattice relaxation times, are reported for the first time in an intrinsically disordered protein domain. LLS relaxation experiments were integrated with 2D spectroscopy methods, further adapting them for studies on proteins.


Assuntos
Glicina/química , Proteínas Intrinsicamente Desordenadas/química , Prótons , Quinases da Família src/química , Proteína Tirosina Quinase CSK , Humanos , Isótopos de Nitrogênio , Ressonância Magnética Nuclear Biomolecular , Estrutura Terciária de Proteína , Fatores de Tempo
17.
J Chromatogr A ; 1248: 1-8, 2012 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-22717036

RESUMO

Halonitromethanes (HNMs) are a class of nitrogenous disinfection by-products (N-DBPs) that have so far received little attention and focused largely on trichloronitromethane. By contrast, trihalomethanes (THMs) are the most commonly regulated DBPs and have been the subject of much study. This paper reports the first miniaturized system for the simultaneous determination of the nine known HNMs and four THMs in tap and swimming pool water. Micro liquid-liquid extraction (MLLE) is an adaptation of EPA Method 551.1 using ethyl acetate instead of methyl tert-butyl ether as extractant and large injected sample volumes (30 µL) in combination with programmed temperature vaporizer-gas chromatography-mass spectrometry for improved sensitivity and selectivity. Because extraction is done with a few microlitres of organic solvent (200 µL) and practically all extract is injected into the instrument, MLLE can be regarded as a virtually solvent-free sample preparation technique. The proposed method provided an extraction efficiency of ∼85%, average limits of detection (tribromonitromethane excluded) of 30 ng/L and relative standard deviations of ∼6.0%. The influence of various dechlorinating agents on the stability of the thirteen target analytes in treated water was evaluated; the only salt allowing both types of compounds to be efficiently preserved was (NH(4))(2)SO(4), but only for 1 day at 4 °C. Therefore, acidifying the sample at pH ∼3.4-the optimum value for MLLE-at the time of collection is recommended in order to ensure that both HNMs and THMs retain their integrity for 2 days during storage at 4 °C.


Assuntos
Desinfetantes/isolamento & purificação , Microextração em Fase Líquida/métodos , Metano/análogos & derivados , Nitroparafinas/isolamento & purificação , Trialometanos/isolamento & purificação , Poluentes Químicos da Água/isolamento & purificação , Água/análise , Desinfetantes/análise , Desinfecção , Cromatografia Gasosa-Espectrometria de Massas/métodos , Halogenação , Limite de Detecção , Metano/análise , Metano/isolamento & purificação , Éteres Metílicos , Nitroparafinas/análise , Piscinas , Trialometanos/análise , Poluentes Químicos da Água/análise
18.
Anal Bioanal Chem ; 402(7): 2315-23, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22065346

RESUMO

Halonitromethanes (HNMs) are one of the most cytotoxic and genotoxic classes found among the unregulated disinfection by-products formed by the reaction of chemical disinfectants with natural organic matter in water. Typical methods used to determine these compounds in water (mainly trichloronitromethane) are based on the Environmental Protection Agency (EPA) method 551.1 using liquid-liquid extraction. A fast and straightforward method for the determination of the nine HNMs in water has been developed using a static headspace (HS) coupled with gas chromatography-mass spectrometry (GC-MS). Important parameters controlling headspace extraction were optimised to obtain the highest sensitivity: 250 µL of methyl tert-butyl ether (as a chemical modifier) and 6 g of anhydrous sodium sulphate were added to the water sample; an oven temperature of 80 °C and an equilibration time of 20 min were also selected. The addition of a chemical modifier favoured the volatilisation of all HNMs, increasing their signals up to approximately four times. Under optimum conditions, the method developed provides limits of detection between 0.03 and 0.60 µg/L and a relative standard deviation of ~6.0%. The developed method was validated and then compared with the reference method EPA 551.1 for the analysis of tap and swimming pool water. A good agreement in the results was observed, which corroborated the good performance of the proposed HS-GC-MS method.


Assuntos
Água Doce/química , Cromatografia Gasosa-Espectrometria de Massas/métodos , Metano/análogos & derivados , Metano/análise
19.
An. sist. sanit. Navar ; 34(2): 203-217, mayo-ago. 2011. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-90207

RESUMO

Fundamento. La insuficiencia cardiaca es un proceso de altaprevalencia que origina repetidos ingresos hospitalarios consobrecarga asistencial e incremento del gasto sanitario. Losobjetivos de este trabajo son describir y caracterizar los casoscon estancias prolongadas por este síndrome, detectandoposibles factores asociados a la misma.Método. Estudio de cohorte histórica de todos los episodiosde personas mayores de 45 años, ingresados por insuficienciacardiaca en el Sistema Sanitario Público Español en el período1997-2007. Fuente: 808.229 episodios clasificados como GruposRelacionados de Diagnóstico 127 y 544, según el Conjunto MínimoBásico de Datos del Instituto de Información Sanitaria. Seevaluaron variables sociodemográficas (edad, género, comunidadautónoma), clínicas (comorbilidades, complicaciones, tipode ingreso y alta) y de gestión (estancia, tipo de hospital, reingresos).Se definió estancia anormalmente prolongada aquellaque superó el percentil 90 (14 y 16 días, respectivamente),construyéndose un modelo de regresión logística para valorarsus posibles factores asociados.Resultados. Presentaron estancias anormalmente prolongadasel 11,4%, mostrando inferior edad media y mayor número dediagnósticos y procedimientos, reingresos y mortalidad que elgrupo sin estancias prolongadas. Padecer anemia, insuficienciarenal, TEP o ictus así como el reingreso y el ingreso programadose asociaron a mayor probabilidad de estancia anormalmenteprolongada.Conclusión. Es posible definir un perfil de comorbilidady sociodemográfico que valore la probabilidad de tener uningreso prolongado, si bien dadas las características de lasbases de datos administrativas la capacidad discriminativadel modelo es discreta(AU)


Background. Heart failure is a process of high prevalencethat causes repeated hospital admissions with increasedhealth care costs. The aim of this article is to describe andcharacterize the cases with long stays due to this syndrome,identifying associated factors wherever possible.Method. An historical cohort of all the episodes of peopleover 45 years with a diagnosis of heart failure admitted inthe Spanish Public Health System in the period 1997-2007.Source: 808,229 episodes classified as Diagnosis RelatedGroups 127 and 544 according to the Minimum Basic Dataprovided by the Institute for Health Information. We assessedsociodemographic variables (age, gender, region),clinical variables (comorbidities, complications, type of admissionand discharge) and management variables (lengthof stay, type of hospital readmissions). An abnormally prolongedstay (APS) was defined as one exceeding the 90thpercentile (14 and 16 days, respectively); we built a logisticregression model to assess their possible associated factors.Results. Eleven point four percent (11.4%) presented abnormallyprolonged stays, showing lower mean age and increasednumber of diagnoses and procedures, readmissions andmortality than the non-abnormally prolonged stay group.Anemia, kidney failure, pulmonary embolism or stroke aswell as readmission and scheduled admission were associatedwith increased likelihood of APS.Conclusion. It is possible to define a comorbidities andsociodemographic profile to assess the likelihood of a prolongedhospital stay, but given the nature of administrativedatabase the model’s discriminative ability is quite discreet(AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/patologia , Espanha/etnologia , Insuficiência Cardíaca/economia , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/prevenção & controle , Insuficiência Cardíaca/terapia , Comorbidade/tendências , Espanha/epidemiologia
20.
Nutr. hosp., Supl ; 4(3): 3-14, mayo 2011. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-170969

RESUMO

Una vida larga es un signo de buena salud. El envejecimiento de la población es un triunfo de la sociedad moderna que refleja un éxito de las políticas de salud pública y el desarrollo socioeconómico. Podemos entenderlo como un proceso fisiológico e irreversible asociado con una alteración progresiva de las respuestas homeostáticas adaptativas del organismo, que provocan cambios en la estructura y función de los diferentes sistemas y además aumenta la vulnerabilidad del individuo al estrés ambiental y a la enfermedad. Los cambios fisiológicos, psicológicos y sociales que acompañan al envejecimiento condicionan el estado nutricional de las personas mayores. En ocasiones las modificaciones en los patrones dietéticos aberrantes que desarrollan les colocan en riesgo de desnutrición. Los individuos mayores presentan una pérdida de interés por la comida probablemente en relación con las pérdidas sensoriales, la sensación de hambre se reduce y se sacian más rápidamente. Se estima que la prevalencia de desnutrición en el anciano ha sido establecida en un 5-10% entre pacientes independientes y en un 30-65% en institucionalizados y hospitalizados. Prevenir la desnutrición es una obligación socio-sanitaria que debe iniciarse con el cuidado de la alimentación por su impacto en el ámbito biológico, psicológico y social (AU)


Having a long life is a sign of good health. Further ageing of our population can be considered a victory of modern society, which reflects successful public health policies and socio-economic development. Ageing may be regarded as an irreversible physiologic process associated to a progressive dysfunction in the adaptative homeostatic answers of our body, thus leading to changes in the structure and function of different systems and also increasing individual vulnerability against environmental stress and disease. Physiological, psychological and social changes linked to ageing determine the nutritional status in the elderly. Aberrant modifications in the diet models developed by the aged can eventually put them at a risk of malnutrition. Elderly individuals show a lack of interest about food, which is probably due to sensory losses; the sensation of hunger is reduced and they get satisfied more quickly. Malnutrition prevalence in the elderly has been established in 5% to 10% among independent patients and in 30% to 65% among institutionalized and hospitalized patients. Given its impact on the biological as well as on the psychological and social scope, malnutrition prevention is a socio-sanitary must that has to begin by paying attention to nutrition (AU)


Assuntos
Humanos , Idoso , Envelhecimento/fisiologia , Desnutrição/epidemiologia , Avaliação Nutricional , Transtornos Nutricionais/prevenção & controle , Fatores de Risco , Anorexia/epidemiologia , Sarcopenia/epidemiologia , Nutrição do Idoso , Assistência Integral à Saúde/organização & administração , Expectativa de Vida/tendências
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