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1.
Artigo em Inglês | MEDLINE | ID: mdl-31665873

RESUMO

BACKGROUND: Caffeine is a popular nutritional supplement among athletes. It is frequently used as an ergogenic aid to improve physical performance, delay fatigue, and increase muscle power. However, these effects have not been tested in CrossFit athletes. The aim of this study was to evaluate the effects of acute caffeine supplementation on workout performance, power, markers of muscle damage, and soreness in trained CrossFit men. METHODS: Nine men (28 ± 2 years) with experience in CrossFit (2 ± 0.3 years) were investigated in a randomized, double-blind, placebo-controlled crossover trial, with a 7-day washout between treatment periods. The athletes received anhydrous caffeine (CAF: 6 mg / kg body mass) or placebo (PLA) 60 minutes before a CrossFit workout with tasks that involved muscle strength, power, gymnastic movements, and metabolic conditioning. Blood samples were collected for creatine kinase (CK), C-reactive protein, and glucose determination. Workout performance, rating of perceived exertion (RPE), delayed-onset muscle soreness (DOMS), muscle strength (handgrip strength) and power (bench throw, jump squat and countermovement jump) were also evaluated. RESULTS: CAF resulted in higher glucose concentration after workout compared to PLA (+3.2 mmol/L, 95%CI: 2.1 to 4.3 vs +1.5, 95%CI: -0.1 to 3.0 mmol/L, p = 0.01). No differences were found between treatments in workout performance, CK, DOMS, RPE, muscle power and strength. CONCLUSIONS: Acute CAF supplementation did not alter performance, markers of muscle damage, power, and RPE in trained CrossFit men.

2.
Biotechnol J ; : e1900060, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31490634

RESUMO

Biosorption is known as an effective way to clean-up water from organic and inorganic contaminants and has also emerged as a promising technology to recover critical substances. Tannins are renewable materials, coming from multiple vegetable sources. A variety of biosorbents have been developed from tannins, including tannin resins, rigid foams, composites with mesoporous silica, cellulose, collagen, and magnetic adsorbents. These materials have shown an excellent ability to uptake heavy-metal cations (Cd(II), Cu(II), Pb(II), Ni(II), Cr(III)), owning to the chelating ability provided by the plentiful adjacent hydroxyl groups. In addition, tannin-adsorbents have shown exceptional ability to remove Cr(VI), and to uptake Au(III) and Pd(II) from strong acidic solutions, which has evident application in the recovery of precious metals from e-wastes leaching. The fact that tannin-adsorbents can reduce the oxidation state of these adsorbates to Cr(III) and to elemental species of Au and Pd is interesting. Adsorption of dyes, surfactants, pharmaceuticals and antimony is also feasible, but the removal of certain metalloid species, such as arsenic and phosphate, seems to be limited even after applying chemical modifications. This article presents a systematic review on the preparation of tannin-adsorbents and their application in water decontamination and in the recovery of critical metals.

3.
Mol Syst Biol ; 15(4): e8864, 2019 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-30952682
4.
PLoS One ; 14(3): e0213184, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30840689

RESUMO

Cervical cancer, caused by high oncogenic risk Human Papillomavirus (HPV) infection, continues to be a public health problem, mainly in developing countries. Using peptide phage display as a tool to identify potential molecular targets in HPV associated tumors, we identified α-mannosidase, among other enriched sequences. This enzyme is expressed in both tumor and inflammatory compartment of the tumor microenvironment. Several studies in experimental models have shown that its inhibition by swainsonine (SW) led to inhibition of tumor growth and metastasis directly and indirectly, through activation of macrophages and NK cells, promoting anti-tumor activity. Therefore, the aim of this work was to test if swainsonine treatment could modulate anti-tumor immune responses and therefore interfere in HPV associated tumor growth. Validation of our biopanning results showed that cervical tumors, both tumor cells and leukocytes, expressed α-mannosidase. Ex vivo experiments with tumor associated macrophages showed that SW could partially modulate macrophage phenotype, decreasing CCL2 secretion and impairing IL-10 and IL-6 upregulation, which prompted us to proceed to in vivo tests. However, in vivo, SW treatment increased tumor growth. Investigation of the mechanisms leading to this result showed that SW treatment significantly induced the accumulation of myeloid derived suppressor cells in the spleen of tumor bearing mice, which inhibited T cell activation. Our results suggested that SW contributes to cervical cancer progression by favoring proliferation and accumulation of myeloid cells in the spleen, thus exacerbating these tumors systemic effects on the immune system, therefore facilitating tumor growth.

5.
Acta Cir Bras ; 34(2): e201900203, 2019 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-30843936

RESUMO

PURPOSE: To analyze, histomorphologically, the influence of the geometry of nanostructured hydroxyapatite and alginate (HAn/Alg) composites in the initial phase of the bone repair. METHODS: Fifteen rats were distributed to three groups: MiHA - bone defect filled with HAn/Alg microspheres; GrHA - bone defect filled with HAn/Alg granules; and DV - empty bone defect; evaluated after 15 days postoperatively. The experimental surgical model was the critical bone defect, ≅8.5 mm, in rat calvaria. After euthanasia the specimens were embedded in paraffin and stained with hematoxylin and eosin, picrosirius and Masson-Goldner's trichrome. RESULTS: The histomorphologic analysis showed, in the MiHA, deposition of osteoid matrix within some microspheres and circumjacent to the others, near the bone edges. In GrHA, the deposition of this matrix was scarce inside and adjacent to the granules. In these two groups, chronic granulomatous inflammation was noted, more evident in GrHA. In the DV, it was observed bone neoformation restricted to the bone edges and formation of connective tissue with reduced thickness in relation to the bone edges, throughout the defect. CONCLUSION: The geometry of the biomaterials was determinant in the tissue response, since the microspheres showed more favorable to the bone regeneration in relation to the granules.


Assuntos
Alginatos/química , Materiais Biocompatíveis/química , Regeneração Óssea/efeitos dos fármacos , Durapatita/química , Nanoestruturas/química , Alginatos/administração & dosagem , Animais , Materiais Biocompatíveis/administração & dosagem , Regeneração Óssea/fisiologia , Durapatita/administração & dosagem , Masculino , Nanoestruturas/administração & dosagem , Ratos , Ratos Wistar , Espectrofotometria Infravermelho
6.
Braz J Microbiol ; 50(2): 435-443, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30796713

RESUMO

Considering the great lethality and sequels caused by meningitis, rapid diagnosis and prompt treatment initiation have a great impact on patient outcome. Here, we developed a multiplex-PCR for simultaneous detection of the four most prevalent bacterial pathogens directly in CSF samples. The multiplex-PCR was designed to detect the following genes: fbsA (Streptococcus agalactiae), lytA (Streptococcus pneumoniae), crtA (Neisseria meningitidis), p6 (Haemophilus influenzae), and 16S rRNA (any bacterial agent). The multiplex-PCR showed a DNA detection limit of 1 pg/µL. Among 447 CSF samples tested, 40 were multiplex-PCR positive, in which 27 and 13 had positive and negative bacterial culture, respectively. Our multiplex-PCR is fast, reliable, and easily implementable into a laboratory routine for bacterial meningitis confirmation, especially for patients who previously started antimicrobial therapy. Our molecular approach can substantially improve clinical diagnosis and epidemiological measures of meningitis disease burden.


Assuntos
Líquido Cefalorraquidiano/microbiologia , Haemophilus influenzae/genética , Meningites Bacterianas/diagnóstico , Neisseria meningitidis/genética , Streptococcus agalactiae/genética , Streptococcus pneumoniae/genética , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Haemophilus influenzae/isolamento & purificação , Humanos , Lactente , Recém-Nascido , Masculino , Meningites Bacterianas/microbiologia , Reação em Cadeia da Polimerase Multiplex/métodos , Neisseria meningitidis/isolamento & purificação , Streptococcus agalactiae/isolamento & purificação , Streptococcus pneumoniae/isolamento & purificação
7.
Sci Rep ; 9(1): 351, 2019 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-30674977

RESUMO

Alterations in specific DNA damage repair mechanisms in the presence of human papillomavirus (HPV) infection have been described in different experimental models. However, the global effect of HPV on the expression of genes involved in these pathways has not been analyzed in detail. In the present study, we compared the expression profile of 135 genes involved in DNA damage repair among primary human keratinocytes (PHK), HPV-positive (SiHa and HeLa) and HPV-negative (C33A) cervical cancer derived cell lines. We identified 9 genes which expression pattern distinguishes HPV-positive tumor cell lines from C33A. Moreover, we observed that Three Prime Repair Exonuclease 1 (TREX1) expression is upregulated exclusively in HPV-transformed cell lines and PHK expressing HPV16 E6 and E7 oncogenes. We demonstrated that TREX1 silencing greatly affects tumor cells clonogenic and anchorage independent growth potential. We showed that this effect is associated with p53 upregulation, accumulation of subG1 cells, and requires the expression of E7 from high-risk HPV types. Finally, we observed an increase in TREX1 levels in precancerous lesions, squamous carcinomas and adenocarcinomas clinical samples. Altogether, our results indicate that TREX1 upregulation is important for cervical tumor cells growth and may contribute with tumor establishment and progression.

8.
Buenos Aires; Médica Panamericana; 2019. 190 p. tab, ilus.
Monografia em Espanhol | LILACS | ID: biblio-1006102

RESUMO

La infancia es una etapa vital clave, ya que en ella se forman los cimientos que luego determinarán el desarrollo físico y mental de las personas. Por eso, brindar las herramientas necesarias para satisfacer las necesidades y los derechos del niño es fundamental para garantizar la inclusión y la igualdad de oportunidades de todos. El desarrollo del niño conlleva cambios biológicos, psicológicos y emocionales que ocurren desde el nacimiento hasta la adolescencia, a medida que el individuo pasa de la dependencia al aumento de la autonomía. La frecuencia de los trastornos del neurodesarrollo es importante y creciente y el pediatra desempeña un papel crucial en su detección oportuna, asesoría a las familias y estrategias de manejo o derivación para asegurar las mejores posibilidades de prevención y asistencia. Asimismo, la elevada morbilidad pediátrica asociada al concepto de enfermedad crónica requiere una actitud diagnóstica anticipatoria de la disfunción neurocognitiva y madurativa a la que están expuestos estos niños. En este nuevo volumen de las Series de Pediatría Garrahan destacados profesionales estudian la temática del desarrollo desde un abordaje interdisciplinario centrado en el rol del pediatra. Entre sus características se destacan: Presentación mediante casos y ejemplos de la práctica clínica de los trastornos más frecuentes del desarrollo infantil estructurados según las diferentes etapas de lactante, preescolar y escolar, así como el abordaje de la discapacidad intelectual, el impacto de la enfermedad crónica en el aprendizaje y los marcos normativos en educación. El cierre de cada capítulo con un recordatorio de puntos clave y lecturas recomendadas, además del material complementario disponible en el sitio web. Una obra sólida y práctica, que transmite la experiencia de los profesionales del Hospital de Pediatría Prof. Dr. Juan P Garrahan, dedicada a los pediatras, dondequiera que trabajen al servicio de la salud de los niños.


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Ensino de Recuperação , Desenvolvimento Infantil , Educação Especial , Insuficiência de Crescimento , Transtornos do Neurodesenvolvimento , Transtorno do Espectro Autista , Testes Auditivos , Transtornos da Linguagem , Transtornos de Aprendizagem , Deficiência Intelectual , Doença Crônica
9.
Buenos Aires; Médica Panamericana; 2019. 160 p. ilus, tab.
Monografia em Espanhol | LILACS | ID: biblio-1026447

RESUMO

Las consultas pediátricas por temas infectológicos son frecuentes y relevantes durante toda la infancia, desde la etapa neonatal hasta la adolescencia. En este nuevo volumen de las Series Garrahan: El ñino y las infecciones, se han seleccionado temas específicos, sobre la base de la actualización del conocimiento, los cambios epidemiológicos y de las conductas clínicas ocurridos en los últimos años y la necesidad del manejo adecuado de estas afecciones, ya sea ambulatorio o durante la internación. Entre sus aspectos sobresalientes se incluyen: El estudio de temas destacados como el abordaje del niño febril; las infecciones de piel y partes blandas, incluidas las asociadas con mordeduras; las infecciones en el recién nacido; las infecciones respiratorias bajas, incluida la tuberculosis; y las infecciones osteoarticulares, del sistema nervioso central e intraabdominales. La inclusión de un capítulo especial sobre la prevención de infecciones para ayudar a reducir su incidencia. El enfoque práctico, con discusión de casos clínicos y definición de conductas, y ubicando al pediatra en un papel central como coordinador de la atención interdisciplinaria. Aspectos clave y lecturas recomendadas en el cierre de cada capítulo. Una obra actualizada que aporta información científica y la experiencia de los profesionales del Hospital Garrahan, dedicada a todos los miembros del equipo de salud que atienden y cuidan niños dondequiera que trabajen al servicio de la salud infantil


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Osteomielite , Peritonite , Pneumonia , Febre Recorrente , Dermatopatias Infecciosas , Tuberculose , Mordeduras e Picadas , Artrite Infecciosa , Coqueluche , Vacinação , Meningites Bacterianas , Antibioticoprofilaxia , Febre , Febre de Causa Desconhecida , Encefalite Infecciosa , Sepse Neonatal
10.
Buenos Aires; Médica Panamericana; 2019. 184 p. tab, ilus.
Monografia em Espanhol | LILACS | ID: biblio-1006088

RESUMO

Las consultas pediátricas por enfermedad renal o de las vías urinarias son frecuentes e incluyen una amplia variedad diagnóstica que desafía al pediatra en su abordaje, la detección de riesgos en el corto y largo plazo, la derivación oportuna al especialista y el seguimiento de las condiciones que generaron cronicidad. En este nuevo volumen de las Series de Pediatría Garrahan se han reunido prestigiosos pediatras y nefrólogos infantiles para actualizar y trasnmitir el manejo integral de algunas de las patologías de mayor prevalencia e impacto, muchas de las cuales causan morbilidad alejada y requieren equipos multidisciplinarios que aseguren una transición en el cuidado del niño, el adolescente y el adulto. Entre sus caracterísitcas se destacan: El estudio detallado de patologías clínicas como las infecciones urinarias, la lesión renal aguda, el síndrome nefrótico, la enfermedad renal progresiva, las terapias de reemplazo renal y la hypertensión arterial. El desarrollo de casos clínicos con las secuencias habituales en el transcurso habitual de las enfermedades que permite destacar las presentaciones clínicas, las alternativas diagnósticas y terapéuticas, así como las posibilidades evolutivas. El cierre de cada capítulo con un recordatorio de puntos clave y lecturas recomendadas y, además, el material complementario disponible en el sitio web. El objetivo es compartir la modalidad de trabajo del hospital, con base en el rol central del pediatra como coordinador de la atención interdisciplinaria en cada una de sus etapas. Una obra actualizada y práctica que aporta información científica y experiencia de los profesionales de una institución de prestigio, de granutilidad para todos aquellos miembros del equipo de salud que atienden y cuidan niños, dondequiera que trabajen al servivio de la salud infantil.


Assuntos
Humanos , Pré-Escolar , Criança , Adolescente , Infecções Urinárias , Diálise Renal , Diálise Peritoneal , Insuficiência Renal Crônica , Lesão Renal Aguda , Síndrome Nefrótica
11.
Rev. Enferm. Atual In Derme ; 87(Suplemento)2019.
Artigo em Português | BDENF - Enfermagem | ID: biblio-1025356

RESUMO

Objetivo: identificar as condições de saúde e as necessidades de cuidados aos idosos assistidos pelo sistema de saúde suplementar no âmbito domiciliar de Florianópolis, Santa Catarina. Método: Estudo quantitativo, realizado no domicílio de 92 idosos atendidos pelo programa de atendimento domiciliar de uma instituição de saúde suplementar. Para a coleta de dados utilizou-se instrumento estruturado para caracterizar os idosos e suas necessidades de cuidado, sendo também aplicada a escala de Medida de Independência Funcional e o Mini Exame do Estado Mental. Resultados: A média de idade dos sujeitos foi de 83,2 anos, sendo que 67,5% pertenciam ao grupo dos idosos longevos. Metade da população encontrava-se acamada, sendo corroborado pela avaliação da capacidade funcional na qual 32% dos idosos apresentavam dependência total e avaliação cognitiva onde 54% de idosos estavam com perda de cognição severa. Conclusão: Os programas de assistência domiciliar visam à permanência dos idosos no domicílio, entretanto, as características de saúde encontradas na população exigem uma rede de suporte e apoio fortalecida


Objective: to identify the health conditions and care needs of the elderly population assisted by the supplementary health system in the home context of Florianópolis, Santa Catarina. Method: This is a quantitative study carried out in the home of 92 elderly people assisted by the home care program of a supplementary health institution. For the collection of data, a structured instrument was used to characterize the elderly people and their care needs, and the Functional Independence Measure and the Mini-Mental State Examination scale was also applied. Results: The mean age of the participants was 83.2 years old, and 67.5% belonged to the group of elderly people. Half of the population was bedridden, corroborated by the functional capacity assessment in which 32% of the elderly participants had total dependence and cognitive evaluation, and 54% of them had a loss of severe cognition. Conclusion: The home care programs aim at the stay of the elderly person in the home, however, the health characteristics found in the population demand a network of support and support strengthened


Assuntos
Humanos , Envelhecimento , Saúde do Idoso , Assistência Domiciliar
12.
Acta cir. bras ; 34(2): e201900203, 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-989053

RESUMO

Abstract Purpose: To analyze, histomorphologically, the influence of the geometry of nanostructured hydroxyapatite and alginate (HAn/Alg) composites in the initial phase of the bone repair. Methods: Fifteen rats were distributed to three groups: MiHA - bone defect filled with HAn/Alg microspheres; GrHA - bone defect filled with HAn/Alg granules; and DV - empty bone defect; evaluated after 15 days postoperatively. The experimental surgical model was the critical bone defect, ≅8.5 mm, in rat calvaria. After euthanasia the specimens were embedded in paraffin and stained with hematoxylin and eosin, picrosirius and Masson-Goldner's trichrome. Results: The histomorphologic analysis showed, in the MiHA, deposition of osteoid matrix within some microspheres and circumjacent to the others, near the bone edges. In GrHA, the deposition of this matrix was scarce inside and adjacent to the granules. In these two groups, chronic granulomatous inflammation was noted, more evident in GrHA. In the DV, it was observed bone neoformation restricted to the bone edges and formation of connective tissue with reduced thickness in relation to the bone edges, throughout the defect. Conclusion: The geometry of the biomaterials was determinant in the tissue response, since the microspheres showed more favorable to the bone regeneration in relation to the granules.

13.
Rev. chil. nutr ; 45(4): 381-392, dic. 2018. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-978101

RESUMO

RESUMEN Los minerales son elementos esenciales para la vida y su equilibrio es imprescindible para múltiples procesos fisiológicos, bioquímicos y metabólicos. La forma en que son ingeridos determina su funcionalidad. Se sugiere que los minerales quelados tienen mejor biodisponibilidad. El objetivo del trabajo fue realizar una revisión sistemática para verificar si los minerales quelados (MQ) son más biodisponibles que los no quelados (MNQ). Se revisaron publicaciones en el período entre 2007 y 2017 en las bases de datos Pubmed, Lilacs y Cochrane Library en los idiomas portugués e inglés, y con las palabras clave: "mineral chelates", "micronutrient chelate", "bioavailability micronutrient chelate", organic mineral, "iron chelate", "zinc chelate", "magnesium chelate", "copper chelate" y "chelate" y sus respectivas traducciones en portugués (idioma original de este artículo). Se seleccionaron 446 artículos, quedando 24 trabajos pendientes de aplicación de criterios de inclusión/exclusión, siendo 15 de ellos en animales (manganeso, zinc, cobre, hierro, cromo, cobalto y selenio) y 9 en humanos, sólo con hierro y calcio. Los estudios demostraron mayor absorción, transporte y biodisponibilidad para los MQ en comparación con los MNQ. Sin embargo, serían necesarios más estudios en humanos, abordando la biodisponibilidad de otros minerales, así como la estandarización de las dosificaciones de estos micronutrientes.


ABSTRACT Minerals are essential elements for life and their balance is important for multiple physiological, biochemical and metabolic processes. The way they are ingested determines their functionality. It has been suggested that chelated minerals have better bioavailability. The objective of this work was to perform a systematic review of published articles to verify if chelated minerals are more bioavailable than non-chelated minerals. Publications were reviewed in the period between 2007 and 2017 in Pubmed, Lilacs and Cochrane Library databases in Portuguese and English with the keywords: "mineral chelates", "micronutrient chelate", "bioavailability micronutrient chelate", organic mineral, "iron chelate", "zinc chelate", "magnesium chelate", "copper chelate" and "chelate" and their respective translations in Portuguese (the original language of this article). 446 articles were selected and 24 papers were left after the application of inclusion / exclusion criteria. Of these, 15 were in animals (manganese, zinc, copper, iron, chromium, cobalt and selenium) and 9 in humans, and focused on iron and calcium. The studies showed greater absorption, transport and bioavailability for chelated compared to non-chelated minerals. More human studies, however, are necessary to address the bioavailability of other minerals, as well as the standardization of the dosajes of these micronutrients.


Assuntos
Disponibilidade Biológica , Quelantes , Micronutrientes , Minerais , Zinco , Minerais na Dieta , Cobre , Ferro
14.
Hist Cienc Saude Manguinhos ; 25(3): 817-839, 2018 Jul-Sep.
Artigo em Português | MEDLINE | ID: mdl-30365738

RESUMO

This study of a historical nature analyzes the work of health visitors of the Public Health Service Foundation in Alagoas between 1960 and 1990 and the symbolic capital attributed to them. Documental and oral sources were used, the latter produced in interviews conducted using thematic oral history, given by the visitors, the physician and nurse. The information was analyzed based on the concepts of habitus, field, symbolic capital and distinction of Pierre Bourdieu, and revealed that health visitors were relevant in the healthcare of the communities where they worked with distinctive approaches to inculcate health practices through home visits and authority to reconfigure the hygienic habitus of families. This activity gave them symbolic power and capital legitimized by the community.

15.
Rev. Soc. Esp. Dolor ; 25(5): 278-290, sept.-oct. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-176502

RESUMO

En los últimos 15 años, el interés en las vías de recuperación y rehabilitación postoperatorias (ERAS) ha aumentado, ya que los tiempos de recuperación quirúrgica y las estadísticas intrahospitalarias han sido analizados tanto por médicos como por gestores. Aunque el enfoque para reducir la duración de la estancia hospitalaria es multifactorial e incluye objetivos de manejo para varios parámetros como la hemodinámica, administración de fluidos, ventilación, alimentación, motilidad intestinal y movilidad precoz, el manejo del dolor postoperatorio debe ser un área de enfoque fundamental. Los opioides son ampliamente conocidos por tener un perfil de efectos secundarios que ralentiza la recuperación hospitalaria, retrasando tanto el alta hospitalaria como el retorno a la normalidad funcional. Estos efectos secundarios incluyen la disminución de la motilidad intestinal, íleo, náuseas y vómitos postoperatorios, sedación y delirio. Además, se ha sugerido una asociación entre la administración de opioides y la recurrencia del cáncer en la población de oncología quirúrgica, específicamente cáncer de mama y próstata. Los anestesiólogos están bien posicionados para influir en el éxito de los protocolos ERAS para el control adecuado del dolor, teniendo muchas herramientas a su disposición para proporcionar preservación de opioides o incluso libres de ellos durante el periodo perioperatorio. Esta revisión resume la evidencia disponible sobre las terapias farmacológicas para conseguir un ahorro de opioides perioperatorios, exceptuando los antinflamatorios que tienen un efecto demostrado en este campo, y respalda el uso de dexmedetomidina, clonidina, ketamina, pregabalina, lidocaína, magnesio y esmolol como adyuvantes no-opioides dentro de programas multimodales para el tratamiento del dolor postoperatorio. A pesar de ello, se necesitan ensayos adicionales para dilucidar las combinaciones óptimas de estos adyuvantes


In the last 15 years, the interest in the postoperative recovery and rehabilitation pathways (ERAS) has increased since both doctors and managers have analyzed the times of surgical recovery and intrahospital statistics. Although the approach to reduce the length of hospital stay is multifactorial and includes management objectives for various parameters such as hemodynamics, fluid administration, ventilation, feeding, intestinal motility and early mobility, the management of postoperative pain should be an area of basic importance. Opioids are widely known to have a side effect profile that slows down hospital recovery, delaying both hospital discharge and return to functional normalcy. These side effects include decreased bowel motility, ileus, postoperative nausea and vomiting, sedation and delirium. In addition, an association has been suggested between the administration of opioids and the recurrence of cancer in the surgical oncology population, specifically breast and prostate cancer. Anesthesiologists are well positioned to influence the success of ERAS protocols for adequate pain control, having many tools at their disposal to provide opioid preservation or even free of them during the perioperative period. This review summarizes the available evidence on pharmacological therapies to achieve a saving of perioperative opioids, except anti-inflammatories that have a proven effect in this field, and supports the use of dexmedetomidine, clonidine, ketamine, pregabalin, lidocaine, magnesium and esmolol as non opioid adjuvants as agents within multimodal programs for the treatment of postoperative pain Despite this, additional tests are needed to elucidate the optimal combinations of these adjuvants


Assuntos
Humanos , Adjuvantes Farmacêuticos/administração & dosagem , Dor Pós-Operatória/tratamento farmacológico , Analgésicos não Entorpecentes/administração & dosagem , Redução de Custos , Cuidados Pré-Operatórios/métodos , Analgésicos Opioides/uso terapêutico
16.
Ann Med Surg (Lond) ; 33: 50-52, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30186597

RESUMO

Introduction: Malignant ovarian germ cell tumors (MOGCTs) are rare malignancies with an incidence of about 0.5/100,000. They account for less than 5% of all ovarian tumors, of which 32.8% are dysgerminomas, the female analogue of seminomas. These tumors occur in all age groups, with peak incidence below the age of 20 years in women. Aim: To describe the case of a bilateral ovarian dysgerminoma treatment with 11-year follow-up. Methods: Case report with details regarding clinical history, surgical treatment, chemotherapy and follow up. We include a brief literature review. Results: The patient underwent radical surgery for an advanced dysgerminoma, 20 cm in length, that compromised the contralateral ovary and sigmoid. Neoplastic cells were found in ascitic fluid. Subsequently, she underwent adjuvant chemotherapy according to a standard protocol. She has survived disease-free for more than 11 years. Conclusions: Dysgerminoma is a malignant neoplasm that, similar to other cancers, is easier to treat when diagnosed early. However, cures may be obtained even in advanced cases.

17.
Hist. ciênc. saúde-Manguinhos ; 25(3): 817-839, jul.-set. 2018. graf
Artigo em Português | LILACS-Express | ID: biblio-975427

RESUMO

Resumo De caráter histórico, o estudo analisa o trabalho das visitadoras sanitárias da Fundação Serviço de Saúde Pública, em Alagoas, entre 1960 e 1990 e o capital simbólico a elas conferido. Foram utilizadas fontes documentais e orais, estas produzidas em entrevistas realizadas com recurso da história oral temática, concedidas por visitadoras, médico e enfermeira. As informações foram analisadas com base nos conceitos de habitus, campo, capital simbólico e distinção, de Pierre Bourdieu, e revelaram que as visitadoras sanitárias foram relevantes na assistência à saúde das comunidades onde atuaram, detendo marcas distintivas para inculcar práticas sanitárias por meio de visitas domiciliares e discurso autorizado para reconfigurar o habitus higiênico das famílias. Essa atuação lhes conferiu poder e capital simbólicos legitimados pela comunidade.


Abstract This study of a historical nature analyzes the work of health visitors of the Public Health Service Foundation in Alagoas between 1960 and 1990 and the symbolic capital attributed to them. Documental and oral sources were used, the latter produced in interviews conducted using thematic oral history, given by the visitors, the physician and nurse. The information was analyzed based on the concepts of habitus, field, symbolic capital and distinction of Pierre Bourdieu, and revealed that health visitors were relevant in the healthcare of the communities where they worked with distinctive approaches to inculcate health practices through home visits and authority to reconfigure the hygienic habitus of families. This activity gave them symbolic power and capital legitimized by the community.

18.
HLA ; 92(4): 245-246, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30117289

RESUMO

HLA-A*80:04 shows one amino acid replacement, A76 > E, when compared with the A*80:01 allele.

19.
Arch. argent. pediatr ; 116(4): 298-300, ago. 2018. tab
Artigo em Espanhol | LILACS-Express | ID: biblio-1038435

RESUMO

La Emergentología Pediátrica se ha desarrollado en el mundo como una subespecialidad de la pediatría durante las últimas décadas. Los registros muestran una creciente necesidad de sus servicios. Esta orientación tuvo su empuje inicial en Estados Unidos de América y nuestro país ha continuado por el mismo camino, así como muchos otros países latinoamericanos. Aun así, habrá que intensificar su promoción y trabajar en el desarrollo de la investigación y la docencia relacionadas con el área para promover el bienestar de los niños, sus familias y de la sociedad en general.


Pediatric Emergency Medicine has developed around the world as a subspecialty of pediatrics. There is plenty of data reflecting a growing need for its services. The subspecialty was initiated in the United States and Argentina, together with other Latin American countries, followed the same path. Nevertheless, there is yet much to be done. It is necessary to strengthen its promotion and to stimulate research and teaching activities in order to continue improving the quality of care delivered to the pediatric population, their families and society as a whole.

20.
Sci Total Environ ; 642: 1075-1089, 2018 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-30045489

RESUMO

There is a growing demand for low-cost, effective adsorbents for arsenic removal from water intended for human consumption in affected rural areas. This work presents a novel adsorbent based on the coating of cork granulates with iron (oxy)hydroxides for the removal of As(III) and As(V) from aqueous matrices. A 26-3 fractional factorial design was used to determine the optimal conditions for the iron coating procedure. The optimal adsorbent was produced by coating low-density cork granulates with iron (oxy)hydroxides precipitated from a 0.05 mol L-1 FeCl3 solution at pH 7, 20 °C temperature and 20 g L-1 S/L ratio, in a single coating cycle. Arsenic adsorption was found to be dependent on pH, with inverse trends for As(III) and As(V). The iron leaching from the adsorbent was also taken into account to select the optimum pH, which was pH 9 for As(III) and pH 3 for As(V). Adsorption kinetics were better described by the pseudo-second-order model for As(III) and the Elovich model for As(V). Equilibrium was reached in 16 h for As(III) at pH 9 and 48 h for As(V) at pH 3. The isotherm models indicated different adsorption behaviours for As(III) and As(V), with better fits by Langmuir and Freundlich models, respectively. The Langmuir maximum adsorption capacity of iron-coated cork adsorbent for As(III) at pH 9 was 4.9 ±â€¯0.3 mg g-1. However, at low equilibrium concentrations, As(V) adsorption was higher than As(III) (e.g. 2.1 ±â€¯0.2 mg g-1 in equilibrium with 0.16 ±â€¯0.03 mg L-1). Speciation studies and XPS analyses indicated that no substantial oxidation of As(III) to As(V) occurred during the adsorption process. The study shows that iron coating can enhance both arsenate and arsenite adsorption capacity of cork materials, leading to an innovative natural adsorbent with high resilience and stability, with possible application in arsenic remediation.

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