RESUMEN
In recent years the concern with emerging pollutants in water has become more prominent, especially pharmaceutical residues, such as antibiotics due to the influence to increase antibacterial resistance. Further, conventional wastewater treatment methods have not demonstrated efficiency for the complete degradation of these compounds, or they have limitations to treat a large volume of waste. In this sense, this study aims to investigate the degradation of amoxicillin, one of the most prescribed antibiotics, in wastewater via supercritical water gasification (SCWG) using a continuous flow reactor. For this purpose, the process operating conditions of temperature, feed flow rate, and concentration of H2O2 was evaluated using Experimental Design and Response Surface Methodology techniques and optimized by Differential Evolution methodology. Total organic carbon (TOC) removal, chemical oxygen demand (COD) degradability, reaction time, amoxicillin degradation rate, toxicity of degradation by-products, and gaseous products were evaluated. The use of SCWG for treatment achieved 78.4% of the TOC removal for the industrial wastewater. In the gaseous products, hydrogen was the majority component. Furthermore, high-performance liquid chromatography analyses demonstrated that the antibiotic amoxicillin was degraded. For a mass flow rate of 15 mg/min of amoxicillin fed into the reaction system, 14.4 mg/min was degraded. Toxicity tests with microcrustacean Artemia salina showed slight toxicity to treated wastewater. Despite that, the outcomes reveal the SCWG has great potential to degrade amoxicillin and may be applied to treat several pharmaceutical pollutants. Aside from this, carbon-rich effluents may lead to a significant energy gaseous product, especially, hydrogen and syngas.
Asunto(s)
Aguas Residuales , Contaminantes Químicos del Agua , Amoxicilina , Antibacterianos , Agua/química , Eliminación de Residuos Líquidos/métodos , Peróxido de Hidrógeno , Gases , Hidrógeno/química , Contaminantes Químicos del Agua/química , Carbono , Preparaciones FarmacéuticasRESUMEN
AIMS: Despite the fact that self-medication associated with temporomandibular disorders is clinically quite common and is considerably harmful, there is no instrument in the literature to assess this practice. The aim of this study was to construct and validate a questionnaire to study this important issue specifically. METHODS: After completing the literature review, semi-structured interviews, focus group and pretest, the first version of the instrument resulted in 62 questions. After face validity testing, pretest and the necessary corrections and changes, the instrument had 41 questions and was administered for validation to a sample of 110 patients diagnosed with TMD according to the RDC/TMD (1992) criteria. RESULTS: According to factor analysis, seven questions with loadings below 0.30 were removed, with the final version consisting of 34 questions. The analysis of internal consistency and temporal stability showed values of 0.844 for Cronbach's alpha coefficient and a Kappa coefficient of 0.810, respectively, indicating that the instrument presents sufficient reliability and reproducibility for its proposed objective. After validation, with the ultimate goal of classifying patients according to the degree/intensity of self-medication, a classification was proposed that allowed the discrimination of results into three distinct groups regarding self-medication exposure: mild, moderate or severe, based on the self-medication raw point score. CONCLUSION: The results of the instrument validation process showed that it has suitable properties for evaluating the practice of self-medication in patients with TMD.
Asunto(s)
Manejo del Dolor/estadística & datos numéricos , Automedicación/estadística & datos numéricos , Trastornos de la Articulación Temporomandibular/tratamiento farmacológico , Grupos Focales , Humanos , Dimensión del Dolor , Calidad de Vida , Reproducibilidad de los Resultados , Literatura de Revisión como Asunto , Automedicación/psicología , Encuestas y Cuestionarios , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/fisiopatología , Trastornos de la Articulación Temporomandibular/psicologíaRESUMEN
Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic inflammation and synovial hyperplasia, which usually affects multiple joints. The temporomandibular joint (TMJ) becomes susceptible to the development of changes resulting from RA. The aim of this study was to evaluate the presence of TMD and degenerative bone changes in TMJ in patients diagnosed with RA (rheumatoid arthritis). The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD) questionnaire was used for clinical evaluation of the TMJ and for TMD classification of 49 patients of both sexes and all ages. Individuals who had already undergone prior treatment for TMD and/or with a history of craniofacial trauma were excluded. The participants underwent cone beam computed tomography (CBCT) exams to assess possible degenerative changes in the mandibular condyle and the articular eminence. The frequencies of the changes found are presented and the possible associations between clinical and CT findings analyzed using the chisquare test. It was found that 75% of the patients had complaints of pain in the orofacial region, including arthralgia, myalgia or both. As for the diagnoses, 100% of the sample was diagnosed as RDC/TMD Group III (arthralgia, osteoarthritis or osteoarthrosis). The presence of degenerative bone changes was found in 90% of the subjects, the most prevalent being flattening (78.7%) and osteophytes (39.3%). The association test suggested a greater tendency to develop degenerative changes in asymptomatic individuals (p = 0.01). The asymptomatic nature of the involvement of the TMJ in RA can hide structural damage seen in imaging. Thus, the importance of early diagnosis and treatment to reduce structural and functional damage is emphasized.
A artrite reumatoide (AR) é uma doença sistêmica, autoimune, caracterizada por inflamação crônica e hiperplasia sinovial, que usualmente afeta múltiplas articulações. Dentre estas, a articulação temporomandibular (ATM), tornase susceptível ao desenvolvimento de alterações. O estudo objetiva avaliar a presença de desordem temporomandibular (DTM) e altera ções ósseas degenerativas da ATM (articulação temporo man di bu lar) de pacientes diagnosticados com AR (artrite reumatóide). Como metodologia, aplicouse o questionário Research Diagnostic Criteria for Temporomandibular Disorder (RDC/ TDM) em para avaliação clínica da ATM e classificação da desordem temporomandibular em 49 pacientes de ambos os sexos e idade variável. Foram excluídos os indivíduos que já haviam realizado tratamento prévio para DTM e/ou com histórico de traumatismo crâniofacial. Posteriormente os participantes foram submetidos a exames de tomografia computadorizada de feixe cônico (TCFC) para avaliação de possíveis alterações degenerativas no côndilo mandibular e na eminência articular. Foram apresentadas as frequências das alterações encontradas e verificouse a associação entre os achados clínicotomográficos por meio do teste do Quiquadrado. Após a avaliação clínica verificouse que 75% dos pacientes possuíam queixas de dor na região orofacial, variando entre a presença de artralgia, mialgia ou ambas. Quanto aos diagnósticos, 100% da amostra apresentou diagnóstico do Grupo III do RDC/TMD (artralgia, osteoartrite ou osteoartrose). A presença de alterações ósseas degenera tivas foi encontrada em 90% dos indivíduos avaliados, sendo que as mais prevalentes foram aplainamento (78,7%) e osteófito (39,3%). O teste de associação sugeriu uma maior tendência de desenvolvimento de alterações degenerativas nos indivíduos assintomáticos (p = 0.01). O caráter assintomático do envolvimento da ATM na AR pode ocultar danos estruturais vistos em imagem. Assim, ressaltase a importância do diagnóstico e tratamento precoces para redução de danos estruturais e funcionais.
Asunto(s)
Artritis Reumatoide/complicaciones , Trastornos de la Articulación Temporomandibular/complicaciones , Articulación Temporomandibular/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Masculino , Cóndilo Mandibular , Persona de Mediana Edad , Osteoartritis , Adulto JovenRESUMEN
Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic inflammation and synovial hyperplasia, which usually affects multiple joints. The temporomandibular joint (TMJ) becomes susceptible to the development of changes resulting from RA. The aim of this study was to evaluate the presence of TMD and degenerative bone changes in TMJ in patients diagnosed with RA (rheumatoid arthritis). The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD) questionnaire was used for clinical evaluation of the TMJ and for TMD classification of 49 patients of both sexes and all ages. Individuals who had already undergone prior treatment for TMD and/or with a history of craniofacial trauma were excluded. The participants underwent cone beam computed tomography (CBCT) exams to assess possible degenerative changes in the mandibular condyle and the articular eminence. The frequencies of the changes found are presented and the possible associations between clinical and CT findings analyzed using the chisquare test. It was found that 75% of the patients had complaints of pain in the orofacial region, including arthralgia, myalgia or both. As for the diagnoses, 100% of the sample was diagnosed as RDC/TMD Group III (arthralgia, osteoarthritis or osteoarthrosis). The presence of degenerative bone changes was found in 90% of the subjects, the most prevalent being flattening (78.7%) and osteophytes (39.3%).
A artrite reumatoide (AR) é uma doença sistêmica, autoimune, caracterizada por inflamação crônica e hiperplasia sinovial, que usualmente afeta múltiplas articulações. Dentre estas, a articulação temporomandibular (ATM), tornase susceptível ao desenvolvimento de alterações. O estudo objetiva avaliar a presença de desordem temporomandibular (DTM) e altera ções ósseas degenerativas da ATM (articulação temporo man di bu lar) de pacientes diagnosticados com AR (artrite reumatóide). Como metodologia, aplicouse o questionário Research Diagnostic Criteria for Temporomandibular Disorder (RDC/ TDM) em para avaliação clínica da ATM e classificação da desordem temporomandibular em 49 pacientes de ambos os sexos e idade variável. Foram excluídos os indivíduos que já haviam realizado tratamento prévio para DTM e/ou com histórico de traumatismo crâniofacial. Posteriormente os participantes foram submetidos a exames de tomografia computadorizada de feixe cônico (TCFC) para avaliação de possíveis alterações degenerativas no côndilo mandibular e na eminência articular. Foram apresentadas as frequências das alterações encontradas e verificouse a associação entre os achados clínicotomográficos por meio do teste do Quiquadrado. Após a avaliação clínica verificouse que 75% dos pacientes possuíam queixas de dor na região orofacial, variando entre a presença de artralgia, mialgia ou ambas. Quanto aos diagnósticos, 100% da amostra apresentou diagnóstico do Grupo III do RDC/TMD (artralgia, osteoartrite ou osteoartrose). A presença de alterações ósseas degenera tivas foi encontrada em 90% dos indivíduos avaliados, sendo que as mais prevalentes foram aplainamento (78,7%) e osteófito (39,3%).