Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 469
Filtrar
Mais filtros

Tipo de documento
Intervalo de ano de publicação
1.
J Genet Couns ; 2023 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-37282361

RESUMO

Understanding how gender norms affect parents' communication of genetic and cancer risk information to their children can enable healthcare professionals to better facilitate cascade genetic testing. We conducted a qualitative study with semi-structured interviews to determine social factors associated with parents carrying the BRCA1/2 pathogenic variants who communicated cancer prevention practices to their children. Thirty adult carriers (23 women, 7 men) participated in the interviews. All had at least one child aged over 8 years old. Interview topics included their discovery of the variants, their relationship to their body and to the risk of cancer, as well as disclosure to and subsequent communication with their children after testing positive for BRCA1/2. The interviews were analyzed qualitatively, and the major themes identified were identified and compared. We described the roles played by the BRCA1/2 carriers and their partners in communicating cancer prevention practices to their children, from how they managed their own risk of cancer after testing positive, to how they disclosed the risks linked to these pathogenic variants to their children. We also described their involvement in the process of their children going for professional genetic consultation. Gender norms lead women to be more attentive than men to their own health and that of their loved ones. In the context of the transmission of genetic information to children, gender differences in behavior are reinforced by perceptions of the risks of BRCA1/2 variants and women's related health management practices. Cancer prevention is shaped by complex links between gender norms and health management practices.

2.
Br J Haematol ; 188(6): 888-897, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31782146

RESUMO

The International Prognostic Index (IPI) is the most widely used score for non-Hodgkin lymphoma but lacks the ability to identify a high-risk population in diffuse large B-cell lymphoma (DLBCL). Low absolute lymphocyte count and high monocytes have proved to be unfavourable factors. Red-cell distribution width (RDW) has been associated with inflammation and beta-2 microglobulin (B2M) with tumour load. The retrospective study included 992 patients with DLBCL treated with R-CHOP. In the multivariate analysis, age, Eastern Cooperative Oncology Group performance status (ECOG-PS), stage, bulky mass, B2M, RDW, and lymphocyte/monocyte ratio (LMR) were independently related to progression-free survival (PFS). A new prognosis score was generated with these variables including age categorized into three groups (0, 1, 2 points); ECOG ≥ 3-4 with two; stage III/IV, bulky mass, high B2M, LMR < 2·25 and RDW > 0·96 with one each; for a maximum of 9. This score could improve the discrimination of a very high-risk subgroup with five-year PFS and overall survival (OS) of 19% and 24% versus 45% and 59% of R (revised)-IPI respectively. This score also showed greater predictive ability than IPI. A new score is presented including complete blood cell count variables and B2M, which are readily available in real-life practice without additional tests. Compared to R-IPI, it shows a more precise high-risk assessment and risk discrimination for both PFS and OS.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Contagem de Células Sanguíneas/métodos , Linfócitos/metabolismo , Linfoma Difuso de Grandes Células B/sangue , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Monócitos/metabolismo , Microglobulina beta-2/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Ciclofosfamida/farmacologia , Ciclofosfamida/uso terapêutico , Doxorrubicina/farmacologia , Doxorrubicina/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prednisona/farmacologia , Prednisona/uso terapêutico , Prognóstico , Fatores de Risco , Rituximab/farmacologia , Rituximab/uso terapêutico , Vincristina/farmacologia , Vincristina/uso terapêutico , Adulto Jovem
4.
J Physiol ; 595(13): 4467-4473, 2017 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-28378458

RESUMO

KEY POINTS: Changes in nerve conduction velocity following an impulse (i.e. velocity recovery cycles) reflect after-potentials, and can provide an indication of altered nerve membrane properties. This study used microneurography to assess the effects of ischaemia on single human sympathetic fibres innervating the dorsum of the foot. It was found that velocity recovery cycles can distinguish whether a sympathetic nerve fibre is depolarized or not. The method may be used to detect membrane depolarization of sympathetic nerve fibres in human patients when autonomic neuropathy is suspected. ABSTRACT: The aim of this study was to determine whether velocity recovery cycles (VRCs) could detect the effects of ischaemia on sympathetic nerve fibres. VRCs of human sympathetic nerve fibres of the superficial peroneal nerve innervating the dorsum of the foot were recorded by microneurography in seven healthy volunteers. Sympathetic nerve fibres were identified by studying their response to manoeuvres increasing sympathetic outflow and by measuring activity-dependent slowing at 2 Hz stimulation. VRCs were assessed at rest, during 30 min of induced limb ischaemia and during 20 min of recovery after ischaemia. From each VRC was measured the relative refractory period (RRP), the supernormality and the time to peak supernormality (SN@). During ischaemia, RRP increased from the baseline value of 37.4 ± 8.7 ms (mean ± SEM) to 67.1 ± 12.1 ms (P < 0.01) and SN@ increased from 68.6 ± 9.8 ms to 133.8 ± 11.0 ms (P < 0.005). The difference between SN@ and RRP separated ischaemic from non-ischaemic sympathetic nerve fibres. It is concluded that these sympathetic nerve fibres are sensitive to ischaemia, and that VRCs provide a method to study changes of axonal membrane potential of human sympathetic nerve fibres in vivo.


Assuntos
Potenciais de Ação , Pé/inervação , Isquemia/fisiopatologia , Sistema Nervoso Simpático/fisiologia , Adulto , Feminino , Pé/irrigação sanguínea , Humanos , Precondicionamento Isquêmico/efeitos adversos , Masculino , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/inervação , Período Refratário Eletrofisiológico , Fluxo Sanguíneo Regional
5.
Am J Gastroenterol ; 112(4): 606-612, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28139656

RESUMO

OBJECTIVES: High-resolution manometry (HRM) is the preferred method for the evaluation of motility disorders. Recently, an update of the diagnostic criteria (Chicago 3.0) has been published. The aim of this study was to compare the performance criteria of Chicago version 2.0 (CC2.0) vs. 3.0 (CC3.0) in a cohort of healthy volunteers and symptomatic patients. METHODS: HRM studies of asymptomatic and symptomatic individuals from several centers of Spain and Latin America were analyzed using both CC2.0 and CC3.0. The final diagnosis was grouped into hierarchical categories: obstruction (achalasia and gastro-esophageal junction obstruction), major disorders (distal esophageal spasm, absent peristalsis, and jackhammer), minor disorders (failed frequent peristalsis, weak peristalsis with small or large defects, ineffective esophageal motility, fragmented peristalsis, rapid contractile with normal latency and hypertensive peristalsis) and normal. The results were compared using McNemar's and Kappa tests. RESULTS: HRM was analyzed in 107 healthy volunteers (53.3% female; 18-69 years) and 400 symptomatic patients (58.5% female; 18-90 years). In healthy volunteers, using CC2.0 and CC3.0, obstructive disorders were diagnosed in 7.5% and 5.6%, respectively, major disorders in 1% and 2.8%, respectively, minor disorders in 25.2% and 15%, respectively, and normal in 66.4% and 76.6%, respectively. In symptomatic individuals, using CC2.0 and CC3.0, obstructive disorders were diagnosed in 11% and 11.3%, respectively, major disorders in 14% and 14%, respectively, minor disorders in 33.3% and 24.5%, respectively, and normal in 41.8% and 50.3%, respectively. In both groups of individuals, only an increase in normal and a decrease in minor findings using CC3.0 were statistically significant using McNemar's test. DISCUSSIONS: CC3.0 increases the number of normal studies when compared with CC2.0, essentially at the expense of fewer minor disorders, with no significant differences in major or obstructive disorders. As the relevance of minor disorders is questionable, our data suggest that CC3.0 increases the relevance of abnormal results.


Assuntos
Acalasia Esofágica/diagnóstico , Espasmo Esofágico Difuso/diagnóstico , Manometria , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Acalasia Esofágica/classificação , Acalasia Esofágica/fisiopatologia , Doenças do Esôfago/classificação , Doenças do Esôfago/diagnóstico , Doenças do Esôfago/fisiopatologia , Transtornos da Motilidade Esofágica/classificação , Transtornos da Motilidade Esofágica/diagnóstico , Transtornos da Motilidade Esofágica/fisiopatologia , Espasmo Esofágico Difuso/classificação , Espasmo Esofágico Difuso/fisiopatologia , Junção Esofagogástrica/fisiopatologia , Feminino , Voluntários Saudáveis , Humanos , América Latina , Masculino , Pessoa de Meia-Idade , Peristaltismo/fisiologia , Espanha , Adulto Jovem
6.
Eur J Clin Microbiol Infect Dis ; 36(4): 641-648, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27888402

RESUMO

In this study we attempt to assess the utility of a simplified step-wise diagnostic algorithm to determinate the aetiology of encephalitis in daily clinical practice and to describe the main causes in our setting. This was a prospective cohort study of all consecutive cases of encephalitis in adult patients diagnosed between January 2010 and March 2015 at the University Hospital Vall d'Hebron in Barcelona, Spain. The aetiological study was carried out following the proposed step-wise algorithm. The proportion of aetiological diagnoses achieved in each step was analysed. Data from 97 patients with encephalitis were assessed. Following a simplified step-wise algorithm, a definite diagnosis was made in the first step in 53 patients (55 %) and in 12 additional cases (12 %) in the second step. Overall, a definite or probable aetiological diagnosis was achieved in 78 % of the cases. Herpes virus, L. monocytogenes and M. tuberculosis were the leading causative agents demonstrated, whereas less frequent aetiologies were observed, mainly in immunosuppressed patients. The overall related mortality was 13.4 %. According to our experience, the leading and treatable causes of encephalitis can be identified in a first diagnostic step with limited microbiological studies. L. monocytogenes treatment should be considered on arrival in some patients. Additional diagnostic effort should be made in immunosuppressed patients.


Assuntos
Algoritmos , Técnicas de Laboratório Clínico/métodos , Testes Diagnósticos de Rotina/métodos , Encefalite Infecciosa/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Espanha , Adulto Jovem
7.
Neurologia ; 32(1): 22-28, 2017.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-25660184

RESUMO

INTRODUCTION: During acute stroke, 30% of all patients present dysphagia and 50% of that subgroup will experience bronchoaspiration. Our aim was to compare mortality and bronchoaspiration rates associated with the water test compared to those associated with a 2 volume/3 texture test controlled with pulse oximetry (2v/3t-P test) in our stroke unit. PATIENTS AND METHODS: Over a 5-year period, we performed a prospective analysis of all consecutive acute ischaemic stroke patients hospitalised in the Stroke Unit. Dysphagia was evaluated using the water test between 2008 and 2010 (group 0 or G0), and the 2v/3t-P test (group 1 or G1) between 2011 and 2012. We analysed demographic data, vascular risk factors, neurological deficit on the NIHSS, aetiological subtype according to TOAST criteria, clinical subtype according to the Oxfordshire classification, prevalence of dysphagia, percentage of patients with bronchoaspiration, and mortality. RESULTS: We examined 418 patients with acute stroke (G0=275, G1=143). There were significant differences between the 2 groups regarding the percentage of patients with TACI (17% in G0 vs. 29% in G1, P=.005) and median NIHSS score (4 points in G0 vs. 7 points in G1, P=.003). Since adopting the new swallowing test, we detected a non-significant increase in the percentage of dysphagia (22% in G0 vs. 25% in G1, P=.4), lower mortality (1.7% in G0 vs. 0.7% in G1, P=.3) and a significant decrease in the bronchoaspiration rate (6.2% in G0 vs. 2.1% in G1, P=.05). CONCLUSIONS: Compared to the water test used for dysphagia screening, the new 2v/3t-P test lowered bronchoaspiration rates in acute stroke patients.


Assuntos
Transtornos de Deglutição/diagnóstico , Programas de Rastreamento , Acidente Vascular Cerebral/complicações , Idoso , Transtornos de Deglutição/etiologia , Feminino , Hospitalização , Humanos , Masculino , Prevalência , Estudos Prospectivos , Fatores de Risco
8.
Allergol Immunopathol (Madr) ; 42(5): 476-84, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24094444

RESUMO

OBJECTIVES: Assessment of demographic and clinical factors that have an impact on the quality of life (QoL) of patients with asthma in Spain. PATIENTS AND METHODS: Multicenter, prospective, observational, cohort study, conducted in 40 Spanish Pneumology Units during a 12-month period. Data on sociodemographic, clinical variables, asthma treatment and QoL were collected in a case report form. RESULTS: 536 patients (64.6% women, mean age: 54) were recruited. Reported QoL was better for patients from Northern and Central Spain as compared with those from the South and the East (p<0.001), students and employed patients as compared with housewives and unemployed (p<0.01), for those who had received asthma information (p<0.01), for those with milder daytime symptoms (p<0.01) and for patients with higher level of education (p<0.05). CONCLUSIONS: Among the factors that have a significant effect on patients' QoL only symptom control and patient education on asthma control are modifiable. Therefore, all the strategies should be tailored to improve such factors when managing asthma patients.


Assuntos
Asma/psicologia , Educação de Pacientes como Assunto , Qualidade de Vida , Adulto , Idoso , Asma/tratamento farmacológico , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Espanha , Adulto Jovem
9.
Neurologia ; 29(9): 567-72, 2014.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-24140159

RESUMO

INTRODUCTION: Epidemiological studies have demonstrated that patients with diabetes mellitus have an increased risk of developing Alzheimer disease, but the relationship between the 2 entities is not clear. DEVELOPMENT: Both diseases exhibit similar metabolic abnormalities: disordered glucose metabolism, abnormal insulin receptor signalling and insulin resistance, oxidative stress, and structural abnormalities in proteins and ß-amyloid deposits. Different hypotheses have emerged from experimental work in the last two decades. One of the most comprehensive relates the microvascular damage in diabetic polyneuritis with the central nervous system changes occurring in Alzheimer disease. Another hypothesis considers that cognitive impairment in both diabetes and Alzheimer disease is linked to a state of systemic oxidative stress. Recently, attenuation of cognitive impairment and normalisation of values in biochemical markers for oxidative stress were found in patients with Alzheimer disease and concomitant diabetes. Antidiabetic drugs may have a beneficial effect on glycolysis and its end products, and on other metabolic alterations. CONCLUSIONS: Diabetic patients are at increased risk for developing Alzheimer disease, but paradoxically, their biochemical alterations and cognitive impairment are less pronounced than in groups of dementia patients without diabetes. A deeper understanding of interactions between the pathogenic processes of both entities may lead to new therapeutic strategies that would slow or halt the progression of impairment.


Assuntos
Doença de Alzheimer/etiologia , Diabetes Mellitus Tipo 2/complicações , Transtornos Cognitivos/etiologia , Demência/etiologia , Diabetes Mellitus Tipo 2/metabolismo , Progressão da Doença , Humanos , Estresse Oxidativo
10.
Med Intensiva ; 38(3): 140-5, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23769945

RESUMO

OBJECTIVE: Although several studies have established the association between antibiotics and Clostridium difficile infection (CDI), there is a lack of epidemiological studies on the incidence of CDI in European Intensive Care Units outside the context of infection outbreaks. The present study describes the incidence, patient characteristics, complications, and recurrence rates of CDI in a Spanish ICU. DESIGN: A retrospective study was carried out. SETTING: A clinical-surgical ICU with 34 beds, a tertiary referral hospital with 1400 beds. PATIENTS: All patients over 18 years of age admitted to the ICU from January 2010 to December 2011 with diarrhea for more than 48 h. INTERVENTIONS: None. STUDY VARIABLES: Underlying diseases, risk factors, fever, leukocyte count, complications, recurrence of infection. RESULTS: A total of 1936 adult patients were admitted. Seven patients acquired CDI (0.36%), representing an infection rate of 3.1 per 10,000 bed-days and a cumulative incidence rate of 3.6 in two years. The mean age was 61 years. Six patients showed some degree of immunosuppression. The mean APACHE II score at ICU admission was 17 (IQR 13-24). Severe sepsis was reported in 5 cases of CDI, three of which presented shock and multiorgan dysfunction. Four patients presented recurrence of CDI during hospitalization. ICU admission was prolonged for a mean of 24 days (SD 17.8) after diagnosis. CONCLUSIONS: Less than 1% of the patients admitted to a clinical-surgical ICU in a large teaching institution in Spain developed CDI. However, a high risk of recurrence/complications was associated with prolonged ICU stay.


Assuntos
Clostridioides difficile/isolamento & purificação , Infecções por Clostridium/epidemiologia , Diarreia/epidemiologia , Hospitais Universitários/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , Centros de Atenção Terciária/estatística & dados numéricos , APACHE , Adulto , Idoso , Clostridioides difficile/genética , Infecções por Clostridium/complicações , Comorbidade , Diarreia/complicações , Suscetibilidade a Doenças , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Insuficiência de Múltiplos Órgãos/epidemiologia , Insuficiência de Múltiplos Órgãos/etiologia , Recidiva , Estudos Retrospectivos , Fatores de Risco , Choque/epidemiologia , Choque/etiologia , Espanha/epidemiologia , Adulto Jovem
11.
Chemosphere ; 355: 141830, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38552801

RESUMO

Monitoring networks show that the European Union Nitrates Directive (ND) has had mixed success in reducing nitrate concentrations in groundwater. By combining machine learning and monitored nitrate concentrations (1992-2019), we estimate the total area of nitrate hotspots in Europe to be 401,000 km2, with 47% occurring outside of Nitrate Vulnerable Zones (NVZs). We also found contrasting increasing or decreasing trends, varying per country and time periods. We estimate that only 5% of the 122,000 km2 of hotspots in 2019 will meet nitrate quality standards by 2040 and that these may be offset by the appearance of new hotspots. Our results reveal that the effectiveness of the ND is limited by both time-lags between the implementation of good practices and pollution reduction and an inadequate designation of NVZs. Substantial improvements in the designation and regulation of NVZs are necessary, as well as in the quality of monitoring stations in terms of spatial density and information available concerning sampling depth, if the objectives of EU legislation to protect groundwater are to be achieved.


Assuntos
Água Subterrânea , Poluentes Químicos da Água , Nitratos/análise , Monitoramento Ambiental/métodos , Poluentes Químicos da Água/análise , Europa (Continente)
12.
Rev Esp Cir Ortop Traumatol ; 68(3): T253-T261, 2024.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38232932

RESUMO

INTRODUCTION: The main complication of percutaneous iliosacral screw fixation is implant malposition, which can lead to vascular and nerve damage. The anatomical variability of the sacrum can make screw insertion difficult under fluoroscopic guidance. Among the methods described to improve the accuracy of this technique, stands out the use of computed tomography (CT). The aim of this study is to compare the results of iliosacral screw insertion with fluoroscopy or CT navigation. METHODOLOGY: Retrospective cohort study of 66 iliosacral screws in 56 patients during 11 years. The screws were inserted with fluoroscopy in the operating room or with CT in the radiodiagnosis area. We collected data on patient characteristics, lesions, treatment, and clinical and radiological results. RESULTS: Forty-seven screws were inserted with fluoroscopy and 19 with CT. A percentage of 18.2 of screws perforated the S1 osseous corridor. All of them were inserted with fluoroscopy guidance (0 vs. 34%; p<0.01). Those operated with CT accumulated more sacral dysmorphism criteria than those operated with fluoroscopy (2.2 vs. 1.6; p=0.02). The S1 corridor on the axial CT view was narrower in those in whom perforation had occurred (18.8 vs. 21.0mm; p=0.02). Two cases with perforation developed S1 radiculalgia. Two endopelvic screws had to be removed. CONCLUSION: We advise the use of CT guidance for iliosacral screw insertion in patients with sacral dysmorphism or narrow S1 corridors in facilities where other navigation methods are not available.

13.
Rev Esp Cir Ortop Traumatol ; 68(4): T363-T372, 2024.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38325573

RESUMO

INTRODUCTION: Rotational ankle fractures are common, have diverse personalities and affect both robust and fragile patients. Postoperative complications are frequent, creating a sizeable economic burden. The primary purpose of this study was to expand current knowledge on predictors of postoperative complications after low-energy ankle fracture fixation. MATERIALS AND METHODS: A retrospective single-center cohort study was completed of patients undergoing internal fixation OF low-energy ankle fractures. The primary outcome was first-year postoperative complications, classified as major (surgical) or minor (non-surgical). Data on patients, their injuries, and treatments were collected. To identify potential predictors of outcomes, logistic regression methods were used, with a backward-stepwise method used for model fitting. RESULTS: In total, 663 patients of median age 59 years were analysed. We found a high rate of complications (28.4%), with wound-healing issues and infections predominant. Overall, 14.8% had minor complications, while 13.6% required an unplanned reoperation. On multivariable analysis, the most consistent predictors of complications were older age (OR: 1.02 per year), longer operating time (3.32 per hour), and smoking (2.91). CONCLUSIONS: Older patients and smokers who sustain fractures requiring more complex surgery are at higher risk of postoperative complications.

14.
Clin Genet ; 83(2): 175-80, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22376243

RESUMO

The mutation spectrum of 175 ß-thalassemia (ß-thal) carriers, identified in pilot carrier screening on 22,713 individuals from Balearic Islands (Spain), is reported. The ß(0) CD39 (C>T) mutation is the most frequent (61.1%), followed by ß(+) IVS-I-110 (G>A) (12.0%), ß(+) IVS-I-6 (T>C) and ß(0) IVS-1-1 (G>A) (3.4% both) and eight other rare mutations (2.9-0.6%); with a distinct prevalence and distribution between islands. Minorca shows the highest prevalence in Iberian populations, with a single mutation, CD39 (C>T), present in most ß-thal carriers. Ibiza is the only Western Mediterranean population where the most frequent ß-thal mutation is IVS-I-110 (G>A). These results can be explained by a combination of historical-demographic characteristics together with evolutionary forces such as founder effect, genetic drift and probably selection by malaria. Knowledge of the mutational spectrum in the Balearic Islands will enable to optimize mutation detection strategy for genetic diagnosis of ß-thal in these islands.


Assuntos
Heterozigoto , Mutação , Globinas beta/genética , Talassemia beta/genética , Deriva Genética , Testes Genéticos , Genética Populacional , Genótipo , Humanos , Ilhas/epidemiologia , Mutação Puntual , Isolamento Reprodutivo , Espanha/epidemiologia , Talassemia beta/epidemiologia
15.
Int J Pharm ; 646: 123432, 2023 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-37739095

RESUMO

Extended release formulations play a crucial role in the pharmaceutical industry by maintaining steady plasma levels, reducing side effects, and improving therapeutic efficiency and compliance. One commonly used method to develop extended release formulations is direct compression, which offers several advantages, such as simplicity, time savings, and cost-effectiveness. However, successful direct compression-based extended release formulations require careful assessment and an understanding of the excipients' attributes. The scope of this work is the characterization of the compaction behavior of some matrix-forming agents and diluents for the development of extended release tablets. Fifteen excipients commonly used in extended release formulations were evaluated for physical, compaction and tablet properties. Powder properties (e.g., particle size, flow properties, bulk density) were evaluated and linked to the tablet's mechanical properties in a fully integrated approach, and data were analyzed by constructing a principal component analysis (PCA). Significant variability was observed among the various excipients. The present work successfully demonstrates the applicability of PCA as an effective tool for comparative analysis, pattern and clustering recognition and correlations between excipients and their properties, facilitating the development and manufacturing of direct compressible extended release formulations.

16.
RSC Adv ; 13(23): 15947-15959, 2023 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-37260570

RESUMO

Graphene oxide (GO) has attracted increasing interest for biomedical applications owing to its outstanding properties such as high specific surface area, ability to bind functional molecules for therapeutic purposes and solubility, together with mechanical resistance and good thermal conductivity. The combination of GO with other biomaterials, such as calcium phosphate (CaP) and biodegradable polymers, presents a promising strategy for bone tissue engineering. Presently, the development of these advanced biomaterials benefits from the use of additive manufacturing techniques, such as 3D printing. In this study, we develop a 3D printed PLA:CaP:GO scaffold for bone tissue engineering. First, GO was characterised alone by XPS to determine its main bond contributions and C : O ratio. Secondly, we determined the GO dose which ensures the absence of toxicity, directly exposed in vitro (human osteoblast-like cells MG-63) and in vivo (zebrafish model). In addition, GO was microinjected in the zebrafish to evaluate its effect on immune cells, quantifying the genetic expression of the main markers. Results indicated that the GO tested (C : O of 2.14, 49.50% oxidised, main bonds: C-OH, C-O-C) in a dose ≤0.25 mg mL-1 promoted MG63 cells viability percentages above 70%, and in a dose ≤0.10 mg mL-1 resulted in the absence of toxicity in zebrafish embryos. The immune response evaluation reinforced this result. Finally, the optimised GO dose (0.10 mg mL-1) was combined with polylactic acid (PLA) and CaP to obtain a 3D printed PLA:CaP:GO scaffold. Physicochemical characterisation (SEM/EDS, XRD, FT-Raman, nano-indentation) was performed and in vivo tests confirmed its biocompatibility, enabling a novel approach for bone tissue-related applications.

17.
J Phys Chem C Nanomater Interfaces ; 127(22): 10480-10487, 2023 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-37313120

RESUMO

The influence of the inclusion of the organic solvent propylene carbonate (PC) in microporous membranes based on poly(l-lactic acid) (PLLA) and poly(vinylidene fluoride-co-hexafluoropropylene) P(VDF-HFP) has been studied based on its relevance for the application of those separator membranes in lithium-ion batteries. The membranes have been produced through solvent casting and characterized with respect to the swelling ratio originated by the uptake of the organic solvent. The organic solvent uptake affects the porous microstructure and crystalline phase of both membrane types. The organic solvent uptake amount affects the crystal size of the membranes as a consequence of the interaction between the solvent and the polymer, since the presence of the solvent modifies the melting process of the polymer crystals due to a freezing temperature depression effect. It is also shown that the organic solvent partially penetrates into the amorphous phase of the polymer, leading to a mechanical plasticizing effect. Thus, the interaction between the organic solvent and the porous membrane is essential to properly tailor membrane properties, which in turn will affect lithium-ion battery performance.

18.
Mater Horiz ; 10(12): 5796-5804, 2023 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-37815428

RESUMO

The industrial adoption of low-carbon technologies and renewable electricity requires novel tools for electrifying unitary steps and efficient energy storage, such as the catalytic synthesis of valuable chemical carriers. The recently-discovered use of microwaves as an effective reducing agent of solid materials provides a novel framework to improve this chemical-conversion route, thanks to promoting oxygen-vacancy formation and O2-surface exchange at low temperatures. However, many efforts are still required to boost the redox properties and process efficiency. Here, we scrutinise the dynamics and the physicochemical dependencies governing microwave-induced redox transformations on solid-state ion-conducting materials. The reduction is triggered upon a material-dependent induction temperature, leading to a characteristically abrupt rise in electric conductivity. This work reveals that the released O2 yield strongly depends on the material's composition and can be tuned by controlling the gas-environment composition and the intensity of the microwave power. The reduction effect prevails at the grain surface level and, thus, amplifies for fine-grained materials, and this is ascribed to limitations in oxygen-vacancy diffusion across the grain compared to a microwave-enhanced surface evacuation. The precise cyclability and stability of the redox process will enable multiple applications like gas depuration, energy storage, or hydrogen generation in several industrial applications.

19.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38043738

RESUMO

INTRODUCTION: Rotational ankle fractures are common, have diverse personalities and affect both robust and fragile patients. Postoperative complications are frequent, creating a sizeable economic burden. The primary purpose of this study was to expand current knowledge on predictors of postoperative complications after low-energy ankle fracture fixation. MATERIALS AND METHODS: A retrospective single-center cohort study was completed of patients undergoing internal fixation OF low-energy ankle fractures. The primary outcome was first-year postoperative complications, classified as major (surgical) or minor (non-surgical). Data on patients, their injuries, and treatments were collected. To identify potential predictors of outcomes, logistic regression methods were used, with a backward-stepwise method used for model fitting. RESULTS: In total, 663 patients of median age 59 years were analyzed. We found a high rate of complications (28.4%), with wound-healing issues and infections predominant. Overall, 14.8% had minor complications, while 13.6% required an unplanned reoperation. On multivariable analysis, the most consistent predictors of complications were older age (OR=1.02 per year), longer operating time (3.32 per hour), and smoking (2.91). CONCLUSIONS: Older patients and smokers who sustain fractures requiring more complex surgery are at higher risk of postoperative complications.

20.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37918689

RESUMO

INTRODUCTION: The main complication of percutaneous iliosacral screw fixation is implant malposition, which can lead to vascular and nerve damage. The anatomical variability of the sacrum can make screw insertion difficult under fluoroscopic guidance. Among the methods described to improve the accuracy of this technique, stands out the use of computed tomography (CT). The aim of this study is to compare the results of iliosacral screw insertion with fluoroscopy or CT navigation. METHODOLOGY: Retrospective cohort study of 66 iliosacral screws in 56 patients during 11 years. The screws were inserted with fluoroscopy in the operating room or with CT in the radiodiagnosis area. We collected data on patient characteristics, lesions, treatment, and clinical and radiological results. RESULTS: Forty-seven screws were inserted with fluoroscopy and 19 with CT. A percentage of 18.2 of screws perforated the S1 osseous corridor. All of them were inserted with fluoroscopy guidance (0 vs. 34%; p<0.01). Those operated with CT accumulated more sacral dysmorphism criteria than those operated with fluoroscopy (2.2 vs. 1.6; p=0.02). The S1 corridor on the axial CT view was narrower in those in whom perforation had occurred (18.8 vs. 21.0mm; p=0.02). Two cases with perforation developed S1 radiculalgia. Two endopelvic screws had to be removed. CONCLUSION: We advise the use of CT guidance for iliosacral screw insertion in patients with sacral dysmorphism or narrow S1 corridors in facilities where other navigation methods are not available.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA