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1.
Pflugers Arch ; 475(11): 1241-1250, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37552296

RESUMO

Chronic kidney disease (CKD) is one of the most common chronic diseases worldwide, with increasing rates of morbidity and mortality. Thus, early detection is essential to prevent severe adverse events and the progression of kidney disease to an end stage. Glomerular filtration rate (GFR) is the most appropriate index to evaluate renal function in both clinical practice and basic medical research. Several animal models have been developed to understand renal disease induction and progression. Specifically, murine models are useful to study the pathogenesis of renal damage, so a reliable determination of GFR is essential to evaluate the progression of CKD. However, as in clinical practise, the estimation of GFR in murine by levels of serum/urine creatinine or cystatin-C could not be accurate and needed other more reliable methods. As an alternative, the measurement of GFR by the clearance of exogenous markers like inulin, sinistrin, 51Cr-EDTA, 99mTc-DTPA, 125I-iothalamate, or iohexol could be performed. Nevertheless, both approaches-estimation or measurement of GFR-have their limitations and a standard method for the GFR determination has not been defined. Altogether, in this review, we aim to give an overview of the current methods for GFR assessment in murine models, describing each methodology and focusing on their advantages and limitations.

2.
J Clin Nurs ; 32(23-24): 8007-8016, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37715363

RESUMO

AIMS AND OBJECTIVES: To learn about the attitudes of nurses working in the Andalusian Public Health System regarding euthanasia and its legalisation. BACKGROUND: Euthanasia often finds itself in the crosshairs of ethical and political debate on an international scale. Currently, the Spanish Organic Law 3/2021 of 24 March, 2021, recognises euthanasia as a fundamental right in Spain. It is of particular interest to know about the views, attitudes and stances that Andalusian nurses have of euthanasia as they are key players within the framework of euthanasia and administration of life-ending drugs. They play a central role in guiding patients through the euthanasia application process. DESIGN: Observational descriptive study. METHODS: A study of Andalusian Public Health System nurses was carried out using non-probability convenience sampling. 518 nurses with an average age of 44.75 years answered in a questionnaire that was distributed on an online platform. Socio-demographic and occupational variables were assessed, together with the Death Anxiety Scale and the Euthanasia Attitude Scale. A bivariate analysis and a multivariate linear regression model were performed. The STROBE checklist was used. RESULTS: The mean score obtained on the Euthanasia Attitude Scale was 75.95 (SD = 16.53). The mean score obtained on the Death Anxiety Scale was 7.56 (SD = 3.05). The variables age and work experience were negatively correlated with the total scores of the Euthanasia Attitude Scale and the categories 'Ethical considerations', 'Practical considerations' and 'Treasuring life'. On the other hand, there was a significant positive correlation between age and work experience and 'Spiritual beliefs' category. CONCLUSIONS: The current situation shows a worrying paradox. There is a stark difference between positive professional attitudes towards euthanasia and the desire to participate in its application. RELEVANCE TO CLINICAL PRACTICE: It is vital that educational and healthcare institutions make the necessary efforts to ensure that nurses develop sound moral judgement, displaying the moral conscience and ethical commitment required of this established profession. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.


Assuntos
Eutanásia , Enfermeiras e Enfermeiros , Humanos , Adulto , Atitude do Pessoal de Saúde , Inquéritos e Questionários , Princípios Morais , Espanha
3.
Support Care Cancer ; 30(3): 2803-2810, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34845502

RESUMO

PURPOSE: Abiraterone acetate, prescribed for metastatic prostate cancer, has enhanced absorption with food. This effect was exploited in a randomized trial which showed noninferiority of PSA decline for 250 mg abiraterone with a low-fat meal (LOW) compared to 1,000 mg abiraterone fasting (STD). Drug was obtained via patient insurance. Patient out-of-pocket costs and adherence were surveyed. METHODS: Trial participants were randomized to STD or LOW, and surveys of adherence and out-of-pocket costs were administered at baseline and just before coming off study (follow-up). RESULTS: Out-of-pocket costs were available from 20 of 36 STD and 21 of 36 LOW patients. Median out-of-pocket costs for a month of drug were $0 (LOW) and $5 (STD); mean costs were $43.61 (LOW) and $393.83 (STD). The two groups did not differ significantly (p = 0.421). Maximum out-of-pocket cost was $1,000 (LOW) and $4,000 (STD). Monthly out-of-pocket costs > $500 were found in 1 LOW and 5 STD patients. For adherence, only 11 STD and 19 LOW patients had questionnaires completed at both baseline and follow-up. STD adherence was 98.18% at baseline and 91.69% at follow-up, differing significantly (p = 0.0078). LOW adherence was 96.52% at baseline and 97.86% at follow-up, not differing significantly (p = 0.3511). Adherence did not correlate with demographics. At follow-up, increasing adherence correlated significantly with decreasing dose (p = 0.013; rho = - 0.458). CONCLUSIONS: Out-of-pocket costs did not differ significantly in this limited analysis. Adherence was significantly different in STD as the trial progressed, which was not found in LOW. TRIAL REGISTRATION: ClinicalTrials.gov NCT01543776; registered March 5, 2012.


Assuntos
Gastos em Saúde , Neoplasias de Próstata Resistentes à Castração , Androstenos , Humanos , Masculino , Estudos Prospectivos
4.
J Pediatr Nurs ; 56: e1-e6, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32651034

RESUMO

PURPOSE: This study sought to determine the prevalence of menstrual migraine among female university students at the Nursing Faculty of Ciudad Real and to determine possible risk factors. DESIGN AND METHODS: A cross-sectional observational study was performed using a self-report questionnaire. Two hundred and ninety-nine female university students participated in the study; all were enrolled in the 2017/2018 academic year at the Faculty of Nursing. Participants were over the age of 18 years and without any diagnosed gynecological pathology. The main measurement tools were menstrual migraine between days -2 and +3 of the menstrual cycle, over the previous six cycles. RESULTS: The prevalence of menstrual migraine was 45.15%, identifying the following possible risk factors: dysmenorrhea (OR 9.19; 1.62-6.28% CI), use of hormonal contraceptive methods (OR 2.60; 95% CI 1.30-5.20), menstrual irritability (OR 2.34; 95% CI 1.25-4.40), menstrual dizziness (OR 2.05; 95% CI % 1.12-3.75) and daily consumption of cola beverages (OR 1.85; 95% CI % 1.04-3.32). CONCLUSIONS: The prevalence of this problem is high among our population and the approach is complex. PRACTICE IMPLICATIONS: It is necessary to continue to research the pharmacological measures and methods of pharmacological pain relief as well as interventions directed at lifestyle modifications considering the potential risk factors involved in menstrual migraine.


Assuntos
Transtornos de Enxaqueca , Universidades , Adulto , Estudos Transversais , Dismenorreia/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Transtornos de Enxaqueca/epidemiologia , Prevalência , Estudantes , Inquéritos e Questionários
5.
Entropy (Basel) ; 23(2)2021 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-33503933

RESUMO

Anaerobic digestion is a well-known technology with wide application in the treatment of high-strength organic wastes. The economic feasibility of this type of installation is usually attained thanks to the availability of fiscal incentives. In this review, an analysis of the different factors associated with this biological treatment and a description of alternatives available in literature for increasing performance of the process were provided. The possible integration of this process into a biorefinery as a way for producing energy and chemical products from the conversion of wastes and biomass also analyzed. The future outlook of anaerobic digestion will be closely linked to circular economy principles. Therefore, this technology should be properly integrated into any production system where energy can be recovered from organics. Digestion can play a major role in any transformation process where by-products need further stabilization or it can be the central core of any waste treatment process, modifying the current scheme by a concatenation of several activities with the aim of increasing the efficiency of the conversion. Thus, current plants dedicated to the treatment of wastewaters, animal manures, or food wastes can become specialized centers for producing bio-energy and green chemicals. However, high installation costs, feedstock dispersion and market distortions were recognized as the main parameters negatively affecting these alternatives.

6.
BMC Med Educ ; 20(1): 370, 2020 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-33081751

RESUMO

BACKGROUND: For many nursing students, clinical training represents a stressful experience. The levels of stress and anxiety may vary during students' educational training, depending on their ability to adopt behavioral strategies for coping with stress, and other factors. This study aimed to investigate the relationship between anxiety, perceived stress, and the coping strategies used by nursing students during their clinical training. METHODS: A cross-sectional correlational descriptive study. The sample consisted of 190 nursing students enrolled in the Nursing Faculty of Ciudad Real University in Spain. Participants provided data on background characteristics and completed the following instruments: the Perceived Stress Scale; the State-Trait Anxiety Inventory and the Coping Behavior Inventory. Relationships between scores were examined using Spearman's rho. RESULTS: The mean age of participants was 20.71 ± 3.89 years (range 18-46 years). Approximately half of the students (47.92%) indicated a moderate level of stress with a mean Perceived Stress Scale score of 22.78 (±8.54). Senior nursing students perceived higher levels of stress than novice students. The results showed a significant correlation for perceived stress and state anxiety (r = 0.463, p < .000) and also for trait anxiety (r = 0.718, p < .000). There was also a significant relationship between the total amount of perceived stress and the following domains of the coping behavior inventory: problem solving (r = -.452, p < .01), self-criticism (r = .408 p < .01), wishful thinking (r = .459, p < .01), social support(r = -.220, p < .01), cognitive restructuring (r = -.375, p < .01), and social withdrawal (r = .388, p < .01). In the current study, the coping strategy most frequently used by students was problem-solving, followed by social support and cognitive restructuring. CONCLUSIONS: Nursing students in our study presented a moderate level of stress, in addition there was a significant correlation with anxiety. Nursing teachers and clinical preceptors/mentors should be encouraged to develop programs to help prepare nursing students to cope with the challenges they are about to face during their clinical placements.


Assuntos
Estudantes de Enfermagem , Adaptação Psicológica , Adolescente , Adulto , Ansiedade/epidemiologia , Estudos Transversais , Humanos , Pessoa de Meia-Idade , Espanha , Estresse Psicológico/epidemiologia , Adulto Jovem
7.
Nurs Ethics ; 27(5): 1201-1212, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31448684

RESUMO

BACKGROUND: Considering the extensive debate that is currently taking place in Spain regarding euthanasia, it is important to examine the attitude of professionals who perform most of their duties at the bedside of these patients and their families. OBJECTIVES: The aim of the present study was to present an adaptation and validation of the Euthanasia Attitude Scale and to evaluate its psychometric properties among a sample of nursing students in Spain. RESEARCH DESIGN: A cross-sectional study design was conducted. PARTICIPANTS AND RESEARCH CONTEXT: Non-probabilistic sampling was used to recruit 396 Spanish nursing students. METHODS: A self-report questionnaire, including socio-demographic data and the Euthanasia Attitude Scale, were used for data collection. The psychometric properties of the Euthanasia Attitude Scale were assessed, including reliability and validity. Fit indices of the overall model were computed. ETHICAL CONSIDERATIONS: This study was approved by the Hospital Ethical Committee. Students were informed of the aims and procedures and provided written informed consent prior to data collection. RESULTS: The factorial solution comprised four domains and the scale demonstrated adequate internal consistency (Cronbach's alpha = .878). For the exploratory factor analysis, the Kaiser-Meyer-Olkin index of sampling adequacy was .905 and the Bartlett's Test of Sphericity was 2972.79 (p < .001). The initial factorial solution revealed four factors with eigenvalues of 6.78 for the first factor, 1.90 for the second one, 1.29 for the third, and 1.10 for the fourth factor. Moreover, there was a significant relationship between religiosity and the domains of the Euthanasia Attitude Scale. DISCUSSION: This study obtained a Cronbach's alpha coefficient of .88 which is in consonance with the findings reported by other studies whereby none of the items were removed and the initial structure based on four domains was conserved, with a factorial solution that explains 52.79% of the total variance. The displacement of some items of the domain may be explained by certain religious and/or cultural components as, in accordance with other studies, people with firm religious beliefs are more inclined to refuse euthanasia. CONCLUSION: According to the findings of this study, the Euthanasia Attitude Scale is a reliable and valid instrument to measure the attitudes toward euthanasia in a sample of Spanish nursing students. This Spanish adaptation will be valuable in future studies examining the attitude and implication of nurses, understanding that nurses are key figures in the euthanasia debate.


Assuntos
Atitude Frente a Morte , Eutanásia/psicologia , Psicometria/normas , Autorrelato , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Reprodutibilidade dos Testes , Espanha , Inquéritos e Questionários , Tradução
8.
Environ Monit Assess ; 192(8): 551, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32737594

RESUMO

Changes in consumer demand due to preferences for a healthier lifestyle have led to a new market offering fruit and salad products ready to eat. This affects the agro-industrial sector and the characteristic of waste streams generated having the organic fraction higher quality and representing a new opportunity of valorisation. This study experimentally evaluated the digestion of wastes derived from the fourth range product sector. It was also proposed the use of this digestate as a fermentation medium for producing plant growth-promoting cultures. Three digestion scenarios were studied: Scenario 1 considered biogas valorisation using a combined heat and power (CHP) unit. Scenario 2 featured biogas upgrading to be used as vehicle fuel. Finally, scenario 3 evaluated the transport of waste materials to the digestion plant by a network of pipes and pumps directly from the production chain. All three scenarios included the land application of a biostimulator based on the production of a plant growth-promoting culture derived from digestate. Life cycle analysis and life cycle costing were used to determine potential environmental impacts and costs over a lifetime of 25 years. The study showed that scenario 1 was the most favourable option for valorising this type of waste, although the economic assessment resulted in negative values for all three alternatives.


Assuntos
Frutas , Produtos Vegetais , Anaerobiose , Biocombustíveis , Monitoramento Ambiental
9.
Prostate ; 79(15): 1752-1761, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31497882

RESUMO

BACKGROUND: Docetaxel prednisone is a standard of care for men with metastatic castration-resistant prostate cancer (mCRPC), and plasma vascular endothelial growth factor (VEGF) levels are a poor prognostic factor in this population; therefore, we evaluated the combination of docetaxel prednisone with pazopanib, an oral VEGF receptor inhibitor, for safety and preliminary efficacy. METHODS: This is a two-site phase 1b Department of Defense Prostate Cancer Clinical Trials Consortium trial of docetaxel, prednisone, and pazopanib once daily and ongoing androgen deprivation therapy and prophylactic pegfilgrastim in men with mCRPC. The primary endpoint was safety and the determination of a maximum tolerated dose (MTD) through a dose-escalation and expansion design; secondary endpoints included progression-free and overall survival (OS), prostate specific antigen (PSA) declines, radiographic responses, and pharmacokinetic and plasma angiokine biomarker analyses. RESULTS: Twenty-five men were treated over six dose levels. Pegfilgrastim was added to the regimen after myelosuppression limited dose escalation. With pegfilgrastim, our target MTD of docetaxel 75 mg/m2 q3 weeks; prednisone 10 mg daily; and pazopanib 800 mg daily was reached. Eleven additional patients were accrued at this dose level for a total of 36 patients. Dose-limiting toxicities included neutropenia, syncope, and hypertension. Three deaths attributed to study treatment occurred. The objective response rate was 31%; median PFS was 14.1 months (95% confidence interval [CI]: 7.1 and 22.2); and OS was 18.6 months (95% CI: 11.8 and 22.2). CONCLUSIONS: The combination of docetaxel, prednisone, and pazopanib (with pegfilgrastim) was tolerable at full doses and demonstrated promising efficacy in a relatively poor risk patients with mCRPC. Further development of predictive biomarkers may enrich for patients who receive clinical benefit from this regimen.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Docetaxel/uso terapêutico , Prednisona/uso terapêutico , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , Pirimidinas/uso terapêutico , Sulfonamidas/uso terapêutico , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Docetaxel/administração & dosagem , Docetaxel/efeitos adversos , Humanos , Indazóis , Masculino , Dose Máxima Tolerável , Pessoa de Meia-Idade , Prednisona/administração & dosagem , Prednisona/efeitos adversos , Intervalo Livre de Progressão , Neoplasias de Próstata Resistentes à Castração/mortalidade , Neoplasias de Próstata Resistentes à Castração/patologia , Pirimidinas/administração & dosagem , Pirimidinas/efeitos adversos , Sulfonamidas/administração & dosagem , Sulfonamidas/efeitos adversos , Taxa de Sobrevida , Resultado do Tratamento
10.
Holist Nurs Pract ; 33(2): 111-120, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30747780

RESUMO

Despite the plethora of treatments available for patients with fibromyalgia, there is insufficient evidence to date as to what the ideal treatment approach is. This study sought to determine the effectiveness of a home program of audio-recorded guided imagery relaxation on people with fibromyalgia. This experimental 8-week longitudinal trial design was undertaken with 60 people diagnosed with fibromyalgia who were randomly assigned to either a guided imagery intervention group or a control group. Pain at tender points, anxiety, self-efficacy, quality of sleep, quality of life, and the impact of the fibromyalgia were determined at baseline, at 4 weeks, and at 8 weeks. After the guided imagery intervention, we found significant differences regarding trait anxiety, sleep quality, and tenderness at some of the tender points. There is a need, therefore, to develop and evaluate interventions that may enhance the quality of life of those affected by this disorder.


Assuntos
Fibromialgia/terapia , Imagens, Psicoterapia/métodos , Terapia de Relaxamento/métodos , Ansiedade/psicologia , Ansiedade/terapia , Feminino , Fibromialgia/psicologia , Humanos , Imagens, Psicoterapia/tendências , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Terapia de Relaxamento/tendências , Autoeficácia , Transtornos do Sono-Vigília/psicologia , Transtornos do Sono-Vigília/terapia , Inquéritos e Questionários , Gravação em Fita/métodos , Gravação em Fita/normas , Resultado do Tratamento
11.
BMC Psychiatry ; 18(1): 364, 2018 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-30424750

RESUMO

INTRODUCTION: Orthorexia nervosa (ON) is characterized by an obsession with healthy eating, which may lead to severe physical, psychological and social disorders. It is particularly important to research this problem in populations that do not receive clinical care in order to improve early detection and treatment. OBJECTIVE: The aim of this study was to research the prevalence of ON in a population of Spanish university students and to analyze the possible associations between ON and psychological traits and behaviors that are common to ED. METHOD: A cross-sectional study with 454 students from the University of Castilla La Mancha, Spain. In total, 295 women and 159 men participated, aged between 18 and 41 years. The ORTO-11-ES questionnaire and the Eating Disorder Inventory (EDI-2) were used for this study. The chi squared test was used to compare the homogeneity among the different groups. RESULTS: The scores on the ORTO-11-ES suggested that 17% of students were at risk of ON. The scores on the EDI-2 for the group at risk of ON were significant, compared to the remaining individuals, regarding their drive for thinness (17.1% vs 2.1%), bulimia (2.6% vs 0%), body dissatisfaction (26.3% vs. 12.4%), perfectionism (14.5% vs 4.8%), interoceptive awareness (13.2% vs 1.3%), asceticism (15.8% vs 3.7%) and impulsiveness (9.2% vs 1.9%). DISCUSSION AND CONCLUSION: These findings suggest that many of the psychological and behavioral aspects of ED are shared by people who are at risk of ON. Future research should use longitudinal data, examining the temporal relationship among these variables or other underlying variables that may contribute to the concurrence of ED and ON.


Assuntos
Dieta Saudável/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Estudantes/psicologia , Universidades , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Autorrelato , Espanha/epidemiologia , Inquéritos e Questionários , Adulto Jovem
12.
Holist Nurs Pract ; 32(1): 43-50, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29210877

RESUMO

The purpose of this study was to investigate the effect of an 8-week nursing intervention consisting of 2 weekly sessions of music and reminiscence therapy together with the application of reality orientation techniques. Our expectation at the onset of the study was that listening to music that was familiar and connected with the memory of past events would, due to the music's emotional impact, stimulate memory associations, leading, in turn, to a positive effect on depression and anxiety in people living with dementia. We carried out a pre-/posttest intervention design with a sample of 19 patients divided into 2 groups-a 10-patient control group and a 9-patient intervention group-in a nursing home in Spain. Goldberg tests for depression and anxiety have been assessed at baseline and postintervention in both groups. Our results confirm the valuable effect of music therapy and reminiscence therapy together with reality orientation techniques on depression in patients with mild Alzheimer disease. Our study may constitute an important starting point for further research on nursing interventions based on the provision of music and/or reminiscence therapy together with reality orientation techniques that is implemented on a daily basis in nursing homes.


Assuntos
Doença de Alzheimer/complicações , Doença de Alzheimer/terapia , Musicoterapia/métodos , Musicoterapia/normas , Orientação , Idoso , Idoso de 80 Anos ou mais , Depressão/complicações , Depressão/etiologia , Depressão/cirurgia , Feminino , Humanos , Masculino , Casas de Saúde/organização & administração , Casas de Saúde/tendências , Projetos Piloto , Espanha
13.
Eat Weight Disord ; 23(6): 745-752, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30196527

RESUMO

PURPOSE: The ORTO-11-ES questionnaire is a tool to assess the pathological obsession displayed by some individuals regarding healthy eating. The aims of this study were (1) to confirm the factor structure of the Spanish version of ORTO-11-ES using confirmatory factor analysis (CFA) and (2) to examine the possible association between the ORTO-11-ES score, gender and body mass index (BMI). METHODS: The sample comprised 492 students from the University of Castilla la Mancha, Spain. Of these, 280 were women (56.9%). Participants were surveyed using the ORTO-11-ES questionnaire. RESULTS: The confirmatory factor analysis (CFA) supported the 11 elements and 3 domains of this tool as the better fitting model; for the Comparative Fit Index (CFI) and the Tucker-Lewis Index (TLI), the values were 0.94 and 0.91, respectively, and the Root Mean-Square Error of Approximation (RMSEA) was 0.058. The tendency towards orthorexic behavior is more associated with the female gender. The BMI had no influence on the tendency for ON. CONCLUSIONS: This study is the first attempt to confirm the three-factor structure of a Spanish version of the ORTO-15 questionnaire. These findings suggest that the ORTO-11-ES may be a valuable tool for identifying subjects with specific eating behavior patterns. This information may be useful for health professionals involved in the research, development and implementation of interventions catered to individuals suffering from this eating disorder. LEVEL OF EVIDENCE: Level V, descriptive cross-sectional study.


Assuntos
Comportamento Alimentar/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Comportamento Obsessivo/diagnóstico , Adolescente , Índice de Massa Corporal , Estudos Transversais , Análise Fatorial , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Comportamento Obsessivo/psicologia , Espanha , Estudantes , Inquéritos e Questionários , Traduções , Adulto Jovem
14.
Prostate ; 77(4): 385-395, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27862097

RESUMO

BACKGROUND: Tasquinimod is an immunomodulating and anti-antiangiogenic oral agent with anti-prostate cancer activity in preclinical studies and in clinical trials of men with metastatic castration resistant prostate cancer (mCRPC), including single agent activity and in combination with taxanes. We sought to identify the maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D) of tasquinimod in combination with cabazitaxel and prednisone in men with chemorefractory mCRPC. METHODS: Men with mCRPC who had failed prior docetaxel chemotherapy received cabazitaxel 25 mg/m2 every 3 weeks with oral tasquinimod at 1 of 3 escalating dose levels (0.25, 0.5, and 1.0 mg once daily) with prednisone and PEG-filgastrim support, using a 3 + 3 dose escalation design. Treatment continued until progressive disease or unacceptable toxicity. RESULTS: We enrolled 25 men with chemorefractory mCRPC. The RP2D was 0.5 mg tasquinimod based on excess DLTs (two of three men) observed at dose level 3 (1.0 mg) including grade 3 sensory neuropathy and grade 3 atrial fibrillation. Dose level 2 was expanded to 14 men, where 3 DLTs were observed: grade 3 fatigue, grade 4 febrile neutropenia, and grade 3 liver function abnormalities. The proportion of men with a ≥30% PSA decline was 63% and the median composite progression-free survival (PFS) was 8.5 months (95% CI 4.2-16.4 months) based on 12 PFS events. The median number of cycles of cabazitaxel was 6 (range 1-13), with six men receiving >10 cycles. Best overall RECIST responses (CR + PR) were observed in three men (12%), with stable disease in 12 (48%). No pharmacokinetic interactions were observed. CONCLUSIONS: We determined the RP2D of tasquinimod combined with cabazitaxel to be 0.5 mg daily following a 3 week lead-in of tasquinimod 0.25 mg with growth factor support. No unexpected toxicities occurred. Prostate 77: 385-395, 2017. © 2016 Wiley Periodicals, Inc.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Progressão da Doença , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , Quinolonas/administração & dosagem , Taxoides/administração & dosagem , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Neoplasias de Próstata Resistentes à Castração/diagnóstico por imagem , Neoplasias de Próstata Resistentes à Castração/mortalidade , Taxa de Sobrevida/tendências , Resultado do Tratamento
15.
Int J Mol Sci ; 16(5): 9385-405, 2015 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-25918941

RESUMO

Concerns about greenhouse gas emissions have increased research efforts into alternatives in bio-based processes. With regard to transport fuel, bioethanol and biodiesel are still the main biofuels used. It is expected that future production of these biofuels will be based on processes using either non-food competing biomasses, or characterised by low CO2 emissions. Many microorganisms, such as microalgae, yeast, bacteria and fungi, have the ability to accumulate oils under special culture conditions. Microbial oils might become one of the potential feed-stocks for biodiesel production in the near future. The use of these oils is currently under extensive research in order to reduce production costs associated with the fermentation process, which is a crucial factor to increase economic feasibility. An important way to reduce processing costs is the use of wastes as carbon sources. The aim of the present review is to describe the main aspects related to the use of different oleaginous microorganisms for lipid production and their performance when using bio-wastes. The possibilities for combining hydrogen (H2) and lipid production are also explored in an attempt for improving the economic feasibility of the process.


Assuntos
Biocombustíveis/microbiologia , Microbiologia Industrial , Gerenciamento de Resíduos/métodos , Biomassa , Carbono/química , Dióxido de Carbono/química , Química Orgânica , Escherichia coli/metabolismo , Etanol/química , Fermentação , Hidrogênio/química , Lignina/química , Lipídeos/química , Microalgas/metabolismo , Saccharomyces cerevisiae/metabolismo , Triglicerídeos/química
16.
Artigo em Inglês | MEDLINE | ID: mdl-24171421

RESUMO

The production of H2 was studied using a packed bed reactor with polyurethane foam acting as support material. Experiments were performed using mixed microflora under non sterile conditions. The system was initially operated with synthetic wastewater as the sole substrate. Subsequently, cheese whey permeate was added to the system at varying organic loading rates (OLR). The performance of the reactor was evaluated by applying a continuous decrease in OLR. As a result, a significant decrease in H2 yields (HY) was observed with the decrease in OLR from 18.8 to 6.3 g chemical oxygen demand (COD)/L d. Microbial analysis demonstrated that the prevalence of non-hydrogen producers, Sporolactobacillus sp. and Prevotella, was the main reason for low HYs obtained. This behavior indicates that the fermentation under non-sterile conditions was favored by high concentrations of substrate by creating an adverse environment for nonhydrogen producer organisms.


Assuntos
Reatores Biológicos/microbiologia , Queijo , Hidrogênio/química , Eliminação de Resíduos Líquidos/instrumentação , Eliminação de Resíduos Líquidos/métodos , Fermentação , Prevotella/metabolismo
17.
Clin Transl Oncol ; 26(9): 2109-2115, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38514601

RESUMO

INTRODUCTION: Tuberculosis is one of the infectious diseases with greater morbidity and mortality worldwide. Cancer causes an important immunosuppression with increased risk of infections. There is an enlarged bidirectional incidence between tuberculosis and cancer, mainly due to latent tuberculosis. GUIDELINES REVIEW: There is great discrepancy between recommendations for screening and prophylaxis of latent tuberculosis in patients with solid tumors and systemic cancer therapy among different medical societies and guidelines. Most infectious diseases guidelines recommend it, while most oncology guidelines do not. DISCUSSION: Patients with solid tumours generally have a limited life expectancy and a state of intermittent immunosuppression, resulting in a lower risk of tuberculosis reactivation than other risky populations. There is a lack of prospective and retrospective studies analysing the benefit of screening and prophylaxis in this population. The first step is to study the incidence of active tuberculosis in this population to estimate the real magnitude of the problem.


Assuntos
Tuberculose Latente , Neoplasias , Guias de Prática Clínica como Assunto , Humanos , Neoplasias/complicações , Tuberculose Latente/diagnóstico , Antituberculosos/uso terapêutico , Incidência , Programas de Rastreamento/métodos , Hospedeiro Imunocomprometido , Antineoplásicos/uso terapêutico , Antineoplásicos/efeitos adversos
18.
ATS Sch ; 5(2): 322-331, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-39055331

RESUMO

Background: The management of massive hemoptysis is a high-risk, low-volume procedure that is associated with high mortality rates, and pulmonary and critical care medicine (PCCM) fellows often lack training. Simulation-based mastery learning (SBML) is an educational strategy that improves skill but has not been applied to massive hemoptysis management. Objective: This pilot study aimed to develop a high-fidelity simulator, implement an SBML curriculum, and evaluate the impact on PCCM fellows managing massive hemoptysis. Methods: We modified a simulator to bleed from segmental airways. Next, we developed an SBML curriculum and a validated 26-item checklist and set a minimum passing standard (MPS) to assess massive hemoptysis management. A cohort of traditionally trained providers was assessed using the checklist. First-year PCCM fellows reviewed a lecture before a pretest on the simulator using the skills checklist and underwent rapid-cycle deliberate practice with feedback. Subsequently, fellows were posttested on the simulator, with additional training as necessary until the MPS was met. We compared pretest and posttest performance and also compared SBML-trained fellows versus traditionally trained providers. Results: The MPS on the checklist was set at 88%. All first-year PCCM fellows (N = 5) completed SBML training. Mean checklist scores for SBML participants improved from 67.7 ± 8.4% (standard deviation) at pretest to 84.6 ± 6.7% at the initial posttest and 92.3 ± 5.4% at the final (mastery) posttest. Traditionally trained participants had a mean test score of 60.6 ± 13.1%. Conclusion: The creation and implementation of a massive hemoptysis simulator and SBML curriculum was feasible and may address gaps in massive hemoptysis management training.

19.
Nurse Educ Today ; 142: 106333, 2024 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-39116660

RESUMO

INTRODUCTION: Quality and inclusive education must include Information and Communication Technologies (ICT), which is a growing trend in educational environments since the COVID-19 pandemic. These technologies have transformed learning towards more collaborative and interactive models, but they also pose a barrier due to the lack of skills or knowledge about their use. This circumstance has been identified among some first-year nursing students. OBJECTIVE: The present study focuses on exploring the perception of students who participated in the experience of peer mentoring to improve adaptation to the use of Information and Communication Technologies. DESIGN AND METHODS: The study employed a descriptive qualitative approach, relying on in-depth interviews and a focus group conducted with 29 students who participated in the project between 2020 and 2023. Additionally, sociodemographic data and information about Information and Communication Technologies were collected through a self-administered questionnaire. RESULTS: The findings indicate that mentors exhibited higher competencies than those being mentored, yet the experience was positive and satisfying for both, emerging as an effective strategy to facilitate learning. Another noteworthy result is the performance of younger students in the role of mentors, a fact that contradicts similar experiences. CONCLUSION: In conclusion, peer mentoring emerges as a valid strategy for acquiring digital competencies and Information and Communication Technologies among first-year nursing students, fostering more inclusive learning environments.

20.
Clin Transl Oncol ; 26(1): 171-177, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37301805

RESUMO

PURPOSE: The CoVID-TE model was developed with the aim of predicting venous thrombotic events (VTE) in cancer patients with Sars-Cov-2 infection. Moreover, it was capable of predicting hemorrhage and mortality 30 days following infection diagnosis. The model is pending validation. METHODS/PATIENTS: Multicenter retrospective study (10 centers). Adult patients with active oncologic disease/ antineoplastic therapy with Sars-Cov-2 infection hospitalized between March 1, 2020 and March 1. 2022 were recruited. The primary endpoint was to study the association between the risk categories of the CoVID-TE model and the occurrence of thrombosis using the Chi-Square test. Secondary endpoints were to demonstrate the association between these categories and the occurrence of post-diagnostic Sars-Cov-2 bleeding/ death events. The Kaplan-Meier method was also used to compare mortality by stratification. RESULTS: 263 patients were enrolled. 59.3% were men with a median age of 67 years. 73.8% had stage IV disease and lung cancer was the most prevalent tumor (24%). A total of 86.7% had an ECOG 0-2 and 77.9% were receiving active antineoplastic therapy. After a median follow-up of 6.83 months, the incidence of VTE, bleeding, and death 90 days after Sars-Cov-2 diagnosis in the low-risk group was 3.9% (95% CI 1.9-7.9), 4.5% (95% CI 2.3-8.6), and 52.5% (95% CI 45.2-59.7), respectively. For the high-risk group it was 6% (95% CI 2.6-13.2), 9.6% (95% CI 5.0-17.9), and 58.0% (95% CI 45.3-66.1). The Chi-square test for trends detected no statistically significant association between these variables (p > 0.05). Median survival in the low-risk group was 10.15 months (95% CI 3.84-16.46), while in the high-risk group it was 3.68 months (95% CI 0.0-7.79). The differences detected were not statistically significant (p = 0.375). CONCLUSIONS: The data from our series does not validate of the CoVID-TE as a model to predict thrombosis, hemorrhage, or mortality in cancer patients with Sars-Cov-2 infection.


Assuntos
Antineoplásicos , COVID-19 , Neoplasias , Trombose , Tromboembolia Venosa , Adulto , Masculino , Humanos , Idoso , Feminino , COVID-19/complicações , SARS-CoV-2 , Estudos Retrospectivos , Teste para COVID-19 , Hemorragia , Trombose/etiologia , Neoplasias/complicações
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