RESUMO
This study presents a systematic review of the scientific and technological production related to the use of systems based on UV, H2O2, and Cl2 for the elimination of antibiotic-resistant bacteria (ARB) and genes associated with antibiotic resistance (ARGs). Using the Pro Know-C (Knowledge Development Process-Constructivist) methodology, a portfolio was created and analyzed that includes 19 articles and 18 patents published between 2011 and 2022. The results show a greater scientific-technological production in UV irradiation systems (8 articles and 5 patents) and the binary combination UV/H2O2 (9 articles and 4 patents). It was emphasized that UV irradiation alone focuses mainly on the removal of ARB, while the addition of H2O2 or Cl2, either individually or in binary combinations with UV, enhances the removal of ARB and ARG. The need for further research on the UV/H2O2/Cl2 system is emphasized, as gaps in the scientific-technological production of this system (0 articles and 2 patents), especially in its electrochemically assisted implementation, have been identified. Despite the gaps identified, there are promising prospects for the use of combined electrochemically assisted UV/H2O2/Cl2 disinfection systems. This is demonstrated by the effective removal of a wide range of contaminants, including ARB, fungi, and viruses, as well as microorganisms resistant to conventional disinfectants, while reducing the formation of toxic by-products.
Assuntos
Peróxido de Hidrogênio , Purificação da Água , Antagonistas de Receptores de Angiotensina , Purificação da Água/métodos , Cloro , Inibidores da Enzima Conversora de Angiotensina , Resistência Microbiana a Medicamentos/genética , Bactérias/genética , Desinfecção/métodos , Raios UltravioletaRESUMO
The presence of Emerging Pollutants (EPs) on the beaches of Acapulco, Mexico, is evaluated for the first time. Samples were taken from the discharge of the wastewater treatment plant at Olvidada beach, and at three beaches that receive contributions from different streams that cross through the city in Santa Lucia Bay (SLB). Using solid phase extraction and gas chromatography/mass spectrometry, 77 EPs were identified. A semiquantitative evaluation of their concentrations were made using the relative areas of the chromatographic peaks, showing that the contamination of the beaches of SLB is mainly due to the pollutants going into the streams of the micro-basins. A statistical factor analysis of all the EPs allowed differentiation of the sampling points, reducing the number of variables, which benefits future analytical determinations in the study area. Due to the toxicological characteristics of the compounds found, their presence on public-use beaches represents a risk to human health.
Assuntos
Poluentes Ambientais , Poluentes Químicos da Água , Humanos , México , Poluentes Ambientais/análise , Monitoramento Ambiental/métodos , Praias , Cidades , Poluentes Químicos da Água/análiseRESUMO
In this work, the use of natural organic wastes (orange and lemon peels) as sources of citric acid was evaluated along with the application of the photoelectro-Fenton (PEF) system under non-modified pH as a novel alternative to degrade a complex mixture of pharmaceuticals: sulfamethoxazole (SMX-7.90 × 10-5 mol/L) and trimethoprim (TMP-6.89 × 10-5 mol/L). The system was equipped with a carbon felt air diffusion cathode (GDE) and a Ti/IrO2 anode doped with SnO2 (DSA). A 3.6 × 10-5 mol/L solution of commercial citric acid was used as a reference. The pharmaceuticals' evolution in the mixture was followed by high-performance liquid chromatography (HPLC). The addition of natural products showed an efficient simultaneous degradation of the antibiotics (100% of SMX and TMP at 45 min and 90 min, respectively) similar to the performance produced by adding the commercial citric acid to the PEF system. Moreover, the addition of natural products allowed for an increment of biodegradability (100% removal of TOC by a modified Zahn Wellens test) and a decrease in ecotoxicity (0% in the bioassay with D. Magna) of the treated solutions. The antibacterial activity was eliminated after only 45 min of treatment, suggesting that the degradation by-products do not represent a significant risk to human health or the environment in general. Results suggest that, because of the efficient formation of Fe-citrate complexes, the PEF could be enhanced by the addition of natural organic wastes as a sustainable alternative ecological system for water contaminated pharmaceuticals. Additionally, the potential of reusing natural organic wastes has been exposed, contributing to an improved low-cost PEF by decreasing the environmental contamination produced by this type of waste.
Assuntos
Produtos Biológicos , Poluentes Químicos da Água , Antibacterianos , Ácido Cítrico , Eletrodos , Humanos , Peróxido de Hidrogênio/química , Concentração de Íons de Hidrogênio , Ferro/química , Oxirredução , Preparações Farmacêuticas , Sulfametoxazol , Trimetoprima , Poluentes Químicos da Água/químicaRESUMO
Introducción: El compromiso axilar es uno de los factores pronósticos más impor- tantes. Existen algunos factores predictivos del mismo, aunque la asociación con tipos moleculares es controvertida. El objetivo prima- rio es evaluar la asociación entre compromiso axilar de tumores TN y variables clínico - patológicas y secundariamente, comparar las ca- racterísticas de tumores TN con otros subtipos. Material y método: En una cohorte de 272 pacientes con cáncer de mama operadas en el Hospital Houssay entre 2008 y 2018, se registraron variables clínicas y anatomo-patológicas. Las mismas se dividen en 2 grupos de acuer- do a la IHQ: No TN (con expresión variable de receptores hormonales y/o Her2) y TN (sin expresión). Resultados: En TN no se encontró correlación positiva entre tamaño e invasión axilar (p=0.63), ni asociación entre mayor tamaño y mayor enferme- dad axilar (p=0.005), ni asociación entre mayor grado histológico y probabilidad de compromiso axilar. En ambos grupos existe una asociación estadísticamente significativa entre la invasión linfovascular y compromiso axilar independientemente del tamaño tumoral. Conclusiones: Los factores de riesgo asociados a compromiso axilar no se aplican en su totalidad a los TN. Es así que tumores TN <2cm tienen dos ve- ces más riesgo de presentar enfermedad axilar y casi cuatro veces más riesgo de tener 23 ganglios comprometidos.
Introduction: Axillary engagement is one of the most important prognostic factors in breast cancer. Some predictive factors have been described, but association with molecular types is controversial. The objective is to evaluate the association between axillary involvement of TN tumors and clinical - pathological variables. Secondarily, the characteristics of TN tumors are compared with other subtypes. Material and method: A retrospective cohort of 272 patients with breast cancer operated at Houssay Hospital between 2008 and 2018 was analyzed. Clinical and pathological variables were recorded. They were classified into 2 groups according to the IHC: No TN (variable expression of hormonal receptors and/or Her2) and TN (negative expression). Results: TN tumors size had no positive correlation with axillary invasion (p = 0.63), or association between larger size and greater axillary disease (p = 0.005). Nor was an association between higher histological grade and the probability of axillary involvement. In both groups there was a statistically significant association between lymphovascular inva- sion and specific axillary involvement beside tumor size. Conclusions: Risk factors associated with axillary involvement are not fully requi- red in TN. Thus, TN tumors <2cm are twice as risk of presenting axi- llary disease and almost four times more risk of ≥3 compromised nodes.
Assuntos
Neoplasias da Mama , Probabilidade , Fatores de Risco , LinfonodosRESUMO
This work deals with the theoretical approach of biodegradability, lipophilicity, and physiological activity of VAL and four degradation products (DPs) detected after 20 min of the photo-electro-Fenton (PEF) process. The biodegradability calculation, taking into account the change in the theoretical oxygen demand, showed that the four DPs had a more negative value than VAL, indicating that they are more susceptible to oxidation. However, these results do not imply more accessible biotransformation pathways than VAL, as observed using the EAWAG-BBD program, through which neutral biotransformation pathway prediction for VAL and DPs was made. Subsequently, by calculating the theoretical lipophilicity of the molecules (log P), the theoretical toxicity of the DPs was proposed, where the DPs had log P values between 1 and 3, lower values than those of VAL (log P = 4), indicating that DPs could be less toxic than the original compound (VAL). Both results suggest that VAL degradation (by photo-electro-Fenton process proposed) yields a positive effect on the environment. Finally, when molecular dynamic simulations were carried out, it was observed that DP1, DP2, and DP3 maintained similar interactions to those of VAL with the binding site of the AT1R. DP4 did not show any interaction. These results indicated that, despite the presence of DPs, generated after 20 min of the treatment, they could not exert a physiological activity in any organism the same way that does VAL.
Assuntos
Peróxido de Hidrogênio , Poluentes Químicos da Água , Computadores , Ferro , Oxirredução , Receptor Tipo 1 de Angiotensina , Valsartana , Poluentes Químicos da Água/análiseRESUMO
In this work photo-electro-Fenton (PEF) processes using a dimensionally stable anode-gas diffusion electrode (DSA-GDE) system under light emission diodes (LED)-type radiation were used in the degradation of the angiotensin-II-receptor antagonists (ARA II), valsartan (VAL), and losartan (LOS), which are used in the treatment of hypertension diseases, and are considered among the emerging contaminants (ECs). Organic acids as citric, tartaric, and oxalic acids were used as complexing agents of iron ions in order to maintain the performance of the Fenton reaction at near-neutral pH value. The results show that at 3.42 mA/cm2 after 90 min of electro-Fenton (EF) treatment, degradation of 70% of VAL and 100% of LOS were observed. Total degradation of VAL and LOS was reached with a PEF process at the same time with mineralization of 30%. When citric and tartaric acids were used instead of oxalic acid, similar results were obtained, i.e., total degradation of both compounds, LOS and VAL, after 90 min of treatment. The degradation performance can be attributed to the increase of the initial dissolved iron in the system, facilitating the Fe3+/Fe2+ turnover in the catalytic photo-Fenton reaction and consequently, hydroxyl radical (â¢OH) production. In addition, the increased photo-activity of the complexes can be associated with their high capability to complex Fe3+ and to promote ligand-to-metal charge transfer, which is of key importance to feed Fe2+ to the Fenton process. The results show that the system evaluated was more efficient to eliminate sartan family compounds using LED lighting in comparison with traditional UV-A lamps used in this kind of work. Moreover, three transformation products of VAL degradation and two transformation products of LOS degradation were identified by high-resolution mass spectrometry (HRMS) using hybrid quadrupole-time-of-flight (QTOF) MS and, at the end of the PEF system, the several organic compounds accumulated and no mineralized were effectively treated in a subsequent aerobic biological system.
Assuntos
Eletrodos , Losartan/química , Valsartana/química , Poluentes Químicos da Água/química , Anti-Hipertensivos/química , Anti-Hipertensivos/metabolismo , Biodegradação Ambiental , Ácido Cítrico/química , Difusão , Peróxido de Hidrogênio/química , Concentração de Íons de Hidrogênio , Radical Hidroxila/química , Ferro/química , Iluminação/instrumentação , Iluminação/métodos , Losartan/metabolismo , Oxirredução , Tartaratos/química , Valsartana/metabolismo , Poluentes Químicos da Água/metabolismoRESUMO
El modelo de relación de persona a persona, de Joyce Travelbee, sustenta el estudio cuyo objetivo es determinar apreciación usuaria respecto a la competencia de comunicación del profesional de enfermería, considerando las dimensiones: proactividad, actitud profesional, comunicación verbal, comunicación no verbal y apoyo emocional. Estudio cuantitativo, descriptivo, transversal. Universo: 305 personas hospitalizadas, 3 servicios públicos, V Región, Chile, octubre y diciembre 2013. Unidades Mediana Complejidad. Muestra151, > 18 años; estadía > 5 días; Glasgow = 15. Aceptación comité ética, consentimiento informado. Cuestionario satisfacción usuaria autoaplicado 17 ítemes escala Lickert 1-4. Alfa de Cronbach 0.943. Resultados: Alto grado de satisfacción global respecto de competencia de comunicación, las mujeres perciben una mayor insatisfacción que los hombres. Aumenta grado de satisfacción con mayor estadía; los jóvenes y quienes tienen mayor nivel de instrucción, mayor insatisfacción. La comunicación no verbal refleja menor nivel de satisfacción, en comparación con el resto de variables. La actitud profesional y proactividad se perciben en menor nivel que las otras dimensiones, siendo el apoyo emocional mejor valorado. Conclusiones: La comunicación y la visualización del otro como un ser único, autónomo, que tiene derecho a ser informado, tomar decisiones respecto a su salud, son dimensiones que deben ser respetadas. El centro del quehacer de la enfermera(o) como generador de cuidados a través de la comunicación, resaltando la relación persona a persona.
Joyce Travelbee's interpersonal relationship model sheds light on the study to measure customer rating regarding the quality of communication by the nursing professional, especially considering initiative, professional attitude, verbal communication, non-verbal communication and emotional support. Quantitative, descriptive, transversal study. Universe: 305 hospitalized persons at 3 public institutions, moderate complexity units. Sample size 151, > 18 years old; stay > 5 days; Glasgow=15. Ethics Committee acceptance, informed consent, signed. Customer satisfaction self-questionnaire 17 items, Lickert scale 1-4. Cronbach alpha 0.943. Results: High degree of overall satisfaction regarding the quality of communication. However, female patients are relatively less satisfied than male patients. The degree of satisfaction increases with the hospitalization length. Young and well educated patients show the lowest relative satisfaction level. Non-verbal communication is less well developed than verbal communication. Professional attitude and initiative are the least developed aspects and emotional support the highest developed parameter. Conclusions: Communication and patient perception as a unique, autonomous being with the right to be well informed and make his/her own health decisions are all dimensions to be respected. These should be the focus of the nursing professional and also a source of patient care thus enhancing the interpersonal relationship.
Assuntos
Humanos , Enfermagem , Satisfação do Paciente , Comunicação em Saúde , Epidemiologia Descritiva , Estudos Transversais , Inquéritos e QuestionáriosRESUMO
Se revisa el diagnóstico de Trastorno por Déficit de Atención en niños, en relación a su prevalencia (8 por ciento al 12 por ciento de los niños en edad escolar), siendo uno de los principales motivos de consulta en nuestro país. El objetivo del artículo es integrar los aportes de la mirada médica y la psicología en el diagnóstico, para que permitan otorgar las directrices de un tratamiento que considere el contexto y la particularidad de cada sujeto. Se describen los criterios diagnósticos utilizados y las implicancias de éste en el área de la salud mental, educación, familia y sociedad. Se plantea la comprensión desde la psicología, poniendo énfasis en considerar la inatención como síntoma de diversos cuadros emocionales en la infancia, al observar que desde el modelo médico generalmente este síntoma se reduce a un cuadro neurobiológico y a un posterior tratamiento principalmente farmacológico. La no consideración desde el paradigma de la complejidad y la multicausalidad en el diagnóstico, excluye áreas del desarrollo socio afectivo del niño que pueden ser fundamentales en la generación y el mantenimiento del cuadro. Se releva la necesidad de abordar este cuadro con una mirada más amplia en el diagnóstico e intervención, considerando los aspectos subjetivos e interaccionales, buscando así dar cuenta de un diagnóstico clínico completo y de un abordaje comprensivo integral.
This study reviews the diagnosis of attention deficit disorder in children, in relation to its prevalence (8 percent to 12 percent of school-age children), which makes it one of the main reasons for consultation in Chile. The article seeks to integrate the contributions of the medical and psychological points of view in the diagnosis, allowing the outline of treatment guidelines that take into account the context and the particularity of each subject. We describe the diagnostic criteria and the implications of this diagnosis in the area of mental health, education, family and society. We then approach the discussion from the psychology, underlining the lack of attention as a symptom of various emotional childhood disorders, observing that from the medical model this symptom is generally reduced to a neurobiological disorder and leads to an exclusively pharmacological treatment. We estimate that no consideration from the paradigm of the complexity and causality in the diagnosis, excludes the development of socio-affective areas of the child which can be critical in the generation and maintenance of the disorder. We finally propose deliverance of a wider look in the diagnosis of ADD, considering subjective aspects through the articulation of the medical assessment with a psychological evaluation. This would allow a full clinical diagnosis and an integrated comprehensive approach.