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The importance of bioactive compounds in agro-industrial by-products of plant origin lies in their direct impacts on human health. These compounds have been shown to possess antioxidant, anti-inflammatory, and antimicrobial properties, contributing to disease prevention and strengthening the immune system. In particular, the antimicrobial action of these compounds emerges as an important tool in food preservation, providing natural alternatives to synthetic preservatives and contributing to combating antimicrobial resistance. Using agro-industrial by-products of plant origin not only addresses the need to reduce waste and promote sustainability but also inaugurates a new era in the formulation of functional foods. From fruit peels to pulps and seeds, these by-products are emerging as essential ingredients in the creation of products that can promote health. Continued research in this area will unveil new applications and properties of these by-products and open doors to a food paradigm in which health and sustainability converge, paving the way to a healthier and more equitable future. The present review presents an overview of our knowledge of agro-industrial by-products and some of their more relevant health-promoting bioactivities.
Assuntos
Anti-Infecciosos , Antioxidantes , Antioxidantes/farmacologia , Antioxidantes/química , Anti-Infecciosos/farmacologia , Anti-Infecciosos/química , Humanos , Agricultura , Plantas/químicaRESUMO
Avocado paste (AP) is an industrial byproduct and a potential source of bioactive compounds, so there is great interest in its valorization. The objective of the present study was to evaluate the effects of adding AP to corn chips regarding their nutritional profile and sensory acceptability. Three AP-supplemented corn chip samples were prepared (C-2%, C-6%, and C-10%), along with a control chip (C), whose total phenolics, flavonoids, antioxidant capacity, proximate composition, minerals, fatty acids, and sensory acceptability were evaluated. Regarding the content of phenolic compounds and flavonoids, significant increases were found between all samples (p < 0.05), particularly between C and C-10% (from 0.93 to 3.56 mg GAE/g dw and 1.17 to 6.61 mg QE/g dw, respectively). Their antioxidant capacity also increased significantly (p < 0.05) with all methods used (FRAP, DPPH, ORAC, and TEAC). Regarding the sensory analysis, no significant differences were found (p > 0.05) between C and C-2% in the parameters of smell, color, flavor, and overall acceptability; however, the texture of C-2% was better evaluated. The C-2% sample also had the highest acceptability; 82% of the participants mentioned that they would buy the C-2%, higher than the rest of the samples. These results suggest the feasibility of adding 2% AP as a strategy to improve the nutritional properties of corn chips without compromising their sensory acceptability; therefore, AP may be used as a food ingredient.
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La pandemia por COVID-19 resultó un problema para la salud pública mundial, que impactó particularmente al sector de trabajadores que debían trabajar y estar expuestos durante el periodo de cuarentena. Objetivo, analizar la incidencia de COVID-19 y sus características en trabajadores(as) activos(as) durante 34 semanas. Investigación descriptiva y transversal. Población constituida por todos los trabajadores(as) activos de sectores priorizados, con diagnóstico confirmado de COVID-19. De los 1.186 casos confirmados, 658 casos (55%) correspondió a trabajadores activos, una incidencia de 1,7 casos x 1000 (mayor a la esperada), con predominio en trabajadores(as) del sector salud (267casos), choferes del transporte y trabajadores de funerarias (253 casos). El 68,7% menor de 40 años y predominio del sexo masculino (61,2%). En el personal de salud, el 30% correspondió a personal de enfermería y 22% en médicos. La tasa de mortalidad en la población de trabajadores activos fue de 0,07 x cada 1000, con un índice de mortalidad de 0,05 y un índice de recuperación del 95,5%, comportamiento similar al de la población general. Sin embargo, la tasa de letalidad (trabajadores activos positivos fallecidos) fue del 4,4% (29 casos), donde el 75% (22/29) fueron enfermeras y médicos, lo que confirmó al sector salud y trabajadores(as) de servicios, como población trabajadora altamente expuesta y vulnerable, lo que justificó priorizar las medidas de prevención en estos trabajadores, al iniciar el sistema de vigilancia epidemiológica, la vacunación y la dotación con uso adecuado de la protección personal(AU)
The COVID-19 Pandemic was a problem for global public health, which particularly impacted the sector of workers who had to work and were exposed during the quarantine period. The objective was to analyze the incidence of COVID- 19 and its characteristics in active workers during 34 weeks. Descriptive and cross-sectional research. Population made up of all active workers in prioritized sectors, with a confirmed diagnosis of COVID-19. Of the 1,186 confirmed cases, 658 cases (55%) corresponded to active workers, an incidence of 1.7 cases per 1,000 (higher than expected), with a predominance of workers in the health sector (267 cases), transport drivers and funeral home workers (253 cases). 68.7% under 40 years of age and predominance of the male sex (61.2%). In health personnel, 30% corresponded to nursing personnel and 22% to doctors. The mortality rate in the population of active workers was 0.07 x every 1000, with a mortality rate of 0.05 and a recovery rate of 95.5%, behavior similar to that of the general population. However, the fatality rate (deceased positive active workers) was 4.4% (29 cases), where 75% (22/29) were nurses and doctors, which confirmed the health sector and service workers, as a highly exposed and vulnerable working population, which justified prioritizing prevention measures in these workers, by initiating the epidemiological surveillance system, vaccination and provision with adequate use of personal protection(AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , COVID-19/mortalidade , COVID-19/epidemiologia , Venezuela/epidemiologia , Mulheres Trabalhadoras/estatística & dados numéricos , Estudos Transversais , Estudos de Coortes , Categorias de TrabalhadoresRESUMO
Food waste is a serious problem with negative environmental and economic consequences. Unused food (either as waste or by-products and referred to as food residues in the present work) is a source of carbohydrates, lipids, proteins, vitamins, minerals and bioactive compounds that could be used in an alternate or secondary life cycle to avoid discarding it. The present work reviews the potential use of food residues for the bioengineering of single-cell protein (SCP), addressing aspects of production, nutrition and safety, as well as the main challenges and perspectives. SCP is obtained from various microorganisms, including fungi, bacteria, yeasts and algae, in pure or mixed form. SCP generally contains a higher percentage of protein (30-80%) compared to soy (38.6%), fish (17.8%), meat (21.2%) and whole milk (3.28%). SCP is a source of essential amino acids, including methionine, threonine and lysine. The use of food residues as substrates for the production of SCP would reduce production costs (35-75%); however, optimization and industrial scaling are some of the main challenges to its sustainable production. The use food waste and agro by-products from the food industry could be a promising alternative to obtain protein according to a circular production scheme.
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ABSTRACT: Background: Recurrent aphthous stomatitis (RAS) is the most common oral ulceration. Its prevalence in the general population varies between 5% and 60%, and during the acute period, it causes pain and interferes with basic activities, such as eating, swallowing and talking. Dentoxol® is a medical mouthrinse that cleans, moisturizes and lubricates the mouth, mechanically stimulating local epithelial regeneration. The aim of this study was to evaluate the efficacy of Dentoxol® in improving the general state of patient with minor RAS using two different treatment schemes. Material and methods: Thirty-nine patients with RAS were recruited in a prospective observational pilot study. Two dosing regimens, 5 ml of Dentoxol® twice daily and 5 ml of Dentoxol® three times daily were evaluated. Results: Efficacy to improve the general state was significant superior in "Three time daily" group compared with "twice daily" at 72 h (66% vs 33% respectively). No pain was reported in approximately 90% of cases at 96 h of use in both group without significant differences between the groups in any evaluation time-point. Conclusion: Despite the limitations of these preliminary data, Dentoxol® shows promising beneficial properties for the management of minor RAS.
Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Estomatite Aftosa/tratamento farmacológico , Antissépticos Bucais/uso terapêutico , Recidiva , Projetos Piloto , Estudos Prospectivos , Úlceras Orais/tratamento farmacológicoRESUMO
One of the biggest problems faced by food industries is the generation of large amounts of agro-industrial byproducts, such as those derived from fruit processing, as well as the negative effects of their inadequate management. Approximately 1/3 of the food produced worldwide is unused or is otherwise wasted along the chain, which represents a burden on the environment and an inefficiency of the system. Thus, there is growing interest in reintroducing agro-industrial byproducts (both from fruits and other sources) into the processing chain, either by adding them as such or utilizing them as sources of health-promoting bioactive compounds. The present work discusses recent scientific studies on the nutritional and bioactive composition of some agro-industrial byproducts derived from fruit processing, their applications as ingredients to supplement baked foods, and their main biological activities on the consumer's health. Research shows that agro-industrial fruit byproducts can be incorporated into various baked foods, increasing their fiber content, bioactive profile, and antioxidant capacity, in addition to other positive effects such as reducing their glycemic impact and inducing satiety, all while maintaining good sensory acceptance. Using agro-industrial fruit byproducts as food ingredients avoids discarding them; it can promote some bioactivities and maintain or even improve sensory acceptance. This contributes to incorporating edible material back into the processing chain as part of a circular bioeconomy, which can significantly benefit primary producers, processing industries (particularly smaller ones), and the final consumer.
RESUMO
The blood-brain barrier (BBB) is a physical structure whose main function is to strictly regulate access to circulating compounds into the central nervous system (CNS). Vegetable-derived phenolic compounds have been widely studied, with numerous epidemiologic and interventional studies confirming their health-related bioactivities across multiple cells, organs and models. Phenolics are non-essential xenobiotics, and should theoretically be unable to cross the BBB. The present work summarizes current experimental evidence that reveals that not only are phenolic compounds able to cross the BBB and bioaccumulate in the brain, but there is some stereoselectivity, which suggests the presence of specific transporters that allow them to reach the brain. Some molecules cross the BBB intact, while others do so only after being biotransformed or metabolized elsewhere. Once inside the CNS, they prevent or counter oxidative stress, which maintains the molecular, cellular, structural and functional integrity of the brain, and subsequently, overall human health.
Assuntos
Antioxidantes/farmacologia , Barreira Hematoencefálica/metabolismo , Sistema Nervoso Central/efeitos dos fármacos , Fenóis/farmacologia , Xenobióticos/farmacologia , Animais , Antioxidantes/metabolismo , Transporte Biológico , Sistema Nervoso Central/metabolismo , Humanos , Fenóis/química , Fenóis/metabolismo , Ratos , Xenobióticos/metabolismoRESUMO
Resumen Introducción: El cáncer de esófago (CE) constituye la sexta causa de muerte por cáncer en el mundo. La disección endoscópica submucosa (DES) es una técnica que permite la resección en bloque de lesiones del tubo digestivo. Tiene rol curativo en pacientes seleccionados y potenciales ventajas sobre la esofagectomía. Objetivo: Describir los resultados perioperatorios y oncológicos de la DES como tratamiento del CE en nuestro centro. Materiales y Método: Estudio retrospectivo de pacientes sometidos a DES por CE entre los años 2010-2020. Resultados: Diez pacientes fueron tratados con DES por CE entre los años 2010 y 2020. El 80% eran hombres y la edad promedio fue de 72 años (63-84). La resección en bloque fue lograda en todos los casos y no se presentó morbimortalidad perioperatoria. Todas las disecciones fueron R0 y el 90% cumplió con estándares de curación. El seguimiento promedio fue de 38 meses (3,5-123). La sobrevida global fue de 90%. La sobrevida específica por cáncer y libre de recurrencia fue de 100%. Discusión: La morbimortalidad asociada a la esofagectomía es alta. La DES sería una alternativa más segura, que permite lograr un R0 y eventualmente la curación en pacientes seleccionados con CE limitado a la mucosa o submucosa. Conclusión: La presente constituye la primera serie reportada de pacientes con cáncer esofágico sometidos a DES en nuestro país. Muestra excelentes resultados oncológicos y seguridad del procedimiento, comparables a las grandes series descritas en la literatura internacional.
Introduction: Esophageal cancer is the sixth leading cause of death by cancer worldwide. Endoscopic submucosal dissection (ESD) is a technique that allows en bloc resection of early lesions of the digestive tract. It has curative potential in selected patients and potential benefits over esophagectomy for the treatment of esophageal cancer (EC). Aim: To report the results of ESD for EC in a high-volume center in Chile. Materials and Method: Retrospective descriptive study of patients who underwent ESD for EC at our center. Results: A total of 10 patients were treated with ESD for EC between 2010 and 2020. Eighty percent were male patients, the average age was 72 years (63-84). En bloc resection was achieved in all cases and there were no complications or mortality. All of the dissections were classified as R0 and 90% met curative standards. The mean follow-up was 38 months (3.5-123). Overall survival was 90%. Cancer-specific survival was 100% and recurrence-free survival was 100%. Discussion: The rate of morbidity and mortality of esophagectomy is high. ESD would be a safer technique, which allows R0 resections and eventually curation in selected patients with EC limited to the mucosa or submucosa. Conclusion: This is the first report of ESD for the treatment of EC in our country, it shows excellent oncologic results and safety of the procedure, comparable to those reported in the larger series published to date.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias Esofágicas/cirurgia , Ressecção Endoscópica de Mucosa/métodos , Neoplasias Esofágicas/patologia , Estudos Prospectivos , Resultado do Tratamento , Trato Gastrointestinal/cirurgiaRESUMO
The physiology and biochemistry of young Opuntia spp. cladodes relate with their Crassulacean acid metabolism, which extends over the day-night cycle in four phases, is species-dependent and is affected by water availability. This study aimed to assess the interaction among species, time-of-day, and the soil water potential (ΨW) on biochemical and physiological characteristics of cladodes of Opuntia species. Three-week-old cladodes were harvested at 7:00 a.m. and 3:00 p.m. from plants with or without irrigation for 30 d (-0.17 and -5.72 MPa soil ΨW), from O. albicarpa, O. ficus-indica, O. hyptiacantha, O. megacantha, and O. streptacantha. The experimental design was a factorial 5 x 2 x 2 (species, sampling time and soil ΨW). The experimental unit was one cladode per plant, and six repetitions were evaluated. Total acids, glucose, fructose, sucrose, starch, total phenolics, free amino acids, and soluble proteins concentrations were evaluated, as well as acid invertase and neutral invertase activities. The interaction among species x soil ΨW and species x time of the day was significant (P ≤ 0.05) in all variables evaluated. An exception was the species x soil ΨW on starch concentration (P = 0.1827). The biochemical and physiological characteristics of Opuntia cladodes were modified by the time of the day and soil ΨW interaction, but most of the characteristics were positively or inversely affected depending on the species, frequently displaying a descending trend following O. streptacantha, O. hyptiacantha, O. megacantha, O. albicarpa and O. ficus-indica. The total acids, glucose, fructose, starch, soluble proteins, and free amino acids concentrations revealed that domestication significantly modifies C and N metabolism in Opuntia.
Assuntos
Opuntia , Fenóis , Extratos Vegetais , Solo , ÁguaRESUMO
BACKGROUND: Oral microorganisms produce damage through the transfer to bloodstream, colonizing other tissues or direct damage in the oral cavity. Aim to study the quantitative interactions between C. albicans and the mutans streptococci and ms serotypes in the saliva of the oral cavity of patients with Down syndrome (DS). MATERIAL AND METHODS: Included 120 patients of both genders, 60 patients with Down syndrome (DS) and 60 pa- tients as a control group (CG). Samples of saliva were taken, and bacteria and fungi were grown on TYCSB and Saboureaud agar. Microbiological, serological and quantitative analyses were performed to determine the kind of isolated of microorganisms corresponding to the ms c, e, f and k for species S. mutans and d and g for S. sobrinus and C. albicans. Electronic scanning microscopy was employed to visualize and confirm the colonies under study. Statistics analysis included t-test proofs for matched data test, Scheffé and ANOVA. RESULTS: Forming units (CFU) per mL of saliva of C. albicans a significant difference was observed among DSAssuntos
Candida albicans
, Síndrome de Down
, Feminino
, Humanos
, Masculino
, Boca
, Saliva
, Streptococcus mutans
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Feather mites are the most numerous group of symbionts permanently associated to birds. They are highly specialized to particular microhabitats on their hosts and most of them may be considered as commensals, but several species are parasites. This manuscript documents for the first time a combined infestation by quill mites Dermoglyphus passerinusGaud, 1974 (Analgoidea: Dermoglyphidae) and feather mites Strelkoviacarus sp.(Analgidae: Anomalginae), in domestic canaries (Serinus canaria domestica) (Linnaeus, 1758) (Passeriformes: Fringillidae) in Mexico City, Mexico. Description of the case, the feather and skin lesions, and findings associated with the infection are presented. This manuscript aims to contribute to the knowledge of mite species that can affect the plumage of Serinus canaria domestica; as well as to the diagnosis and control of these infestations.
Assuntos
Doenças das Aves/parasitologia , Canários , Infestações por Ácaros/veterinária , Animais , Feminino , Masculino , México , Infestações por Ácaros/parasitologia , ÁcarosRESUMO
Resumen: Introducción: La lumbalgia aguda (LA) es un problema en diferentes ámbitos de atención. La Central de Emergencias de Adultos (CEA) intenta brindar atención inmediata, especializada y eficaz. Nuestro objetivo fue estimar la prevalencia y describir el proceso de atención habitual. Material y métodos: Para la estimación de prevalencia, se incluyó una muestra aleatoria de 5,333 consultas admitidas en CEA de un solo hospital entre Enero y Diciembre de 2016. Se definió como numerador a los casos de LA según diagnóstico de triaje al ingreso. Una cohorte retrospectiva con todos los casos de LA se utilizó para describir estudios complementarios y conductas terapéuticas instaurados en CEA, con seguimiento ambulatorio posterior. Resultados: La lumbalgia aguda representó 4.37% (IC 95%: 3.83-4.95%) de las consultas. Se incluyeron 1,096 casos de LA: edad media de 53.26 ± 19.85 años, 55.93% (613) sexo femenino y escasas comorbilidades. La mediana de tiempo de atención fue de 3.28 horas y se internó 6.20%, 70% (778) recibió tratamiento en CEA, las vías de administración más utilizadas fueron: endovenosa (61.86%) e intramuscular (20.62%). Los analgésicos utilizados fueron: 55.38% corticoides, 55.02% AINE, 34.85% opiáceos. Los estudios complementarios solicitados en CEA o hasta los 30 días postegreso fueron: 52.19% laboratorio, 47.17% radiografía/s, 28.38% resonancia/s, 10.77% tomografía/s, 9.12% intervencionismo/s. Conclusiones: Este estudio aporta datos epidemiológicos sobre LA y evidencia la necesidad de fomentar el uso racional de los recursos.
Abstract: Introduction: Acute back pain (LA) is a considerable problem in any care setting. The Emergency Department (ED) intended to provide immediate, timely and effective care. Our objective was to estimate the prevalence and describe the usual care process. Material and methods: To estimate prevalence, a random sample was included of 5,333 consultations admitted in ED at hospital XX between January and December 2016. LA cases were defined according to the diagnosis at arrival. A retrospective cohort with all LA cases was used to describe complementary studies and therapeutic behaviors established in ED or within the subsequent 30 days outpatient follow-up. Results: LA represented 4.37% (95% CI: 3.83-4.95%) of consultations. A total of 1,096 cases of LA were included: mean age of 53.26 ± 19.85 years, 55.93% (613) female sex and few comorbidities. The median attention time was 3.28 hours and 6.20% was admitted. 70% (778) received treatment in CEA, being the most used administration routes: intravenous (61.86%), and intramuscular (20.62%). The analgesics used were: 55.38% corticosteroids, 55.02% NSAIDs, 34.85% opioids. The complementary studies requested during ED or until 30 days after discharge, were: 52.19% laboratory, 47.17% radiography, 28.38% RM, 10.77% tomography, 9.12% interventionism. Conclusions: This study provides epidemiological data of LA in Argentina and demonstrates the need to promote the rational use of resources.
Assuntos
Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Dor Lombar , Serviço Hospitalar de Emergência , Alta do Paciente , Estudos Retrospectivos , Hospitais PrivadosRESUMO
Resumen Introducción: La esofagectomía presenta una alta morbilidad postoperatoria. Sin embargo, las definiciones de las complicaciones son variables. Un grupo multinacional (esophagectomy complications consensus group; ECCG) propuso definiciones estandarizadas. Objetivo: Evaluar las complicaciones postoperatorias en esofagectomía según las definiciones propuestas por el ECCG. Materiales y Método: Realizamos un estudio de cohorte retrospectivo, a partir de una base de datos prospectiva. Se incluyeron pacientes sometidos a una esofagectomía por cáncer entre 1996 y 2018 en un centro. Se aplicaron las definiciones de las complicaciones postoperatorias según el ECCG. Resultados: Se incluyeron 215 pacientes (Hombres 64%; edad 67 [31-82] años). Un 64% presentaban alguna comorbilidad. Existió un predominio de carcinoma escamoso con un 68%. La ubicación tumoral más frecuente fue el tercio inferior del esófago (48%). Se utilizó un abordaje abierto en 74% y mínimamente invasivo en 26%. La morbilidad postoperatoria total fue de 67%. Las complicaciones más frecuentes fueron las respiratorias alcanzando un 27%. En total, un 25% de los pacientes presentó una filtración de la anastomosis esofagogástrica, de las cuales un 24% fueron tipo II (no requirieron una reintervención quirúrgica). Se produjo una paresia de cuerda vocal en 7%, todas tipo I (no requirieron terapia específica). Se presentó una fístula quilosa en 2%, en 1% se trataron con nutrición parenteral (tipo II) y en 1% se realizó una reintervención (tipo III). Conclusión: La esofagectomía se asocia a una alta morbilidad. Las principales complicaciones son las respiratorias y las gastrointestinales. La utilización de las definiciones de consenso permite una estandarización y graduación de las complicaciones.
Introduction: Esophagectomy presents a high postoperative morbidity. However, the definitions used are variable. A multinational group (esophagectomy complications consensus group; ECCG) proposed standardized definitions. Aim: To evaluate postoperative complications in esophagectomy according to the definitions proposed by the ECCG. Materials and Method: We conducted a retrospective cohort study, based on a prospective database. Patients undergoing esophagectomy for cancer between 1996 and 2018 at one center were included. The definitions of postoperative complications according to the ECCG were applied. Results: We included 215 patients (64% men, age 67 [31-82] years). Sixty-four percent had some comorbidity. There was a predominance of squamous carcinoma with 68%. The most frequent tumor location was the lower third of the esophagus (48%). An open approach was used in 74% and minimally invasive in 26%. Total postoperative morbidity was 67%. The most frequent complications were respiratory complications, which reached 27%. The leakage of the esophagogastric anastomosis reached 25%, 24% were type II (did not require surgical reoperation). There was a vocal cord paresis in 7%, all were classified as type I (did not require specific therapy). A chylous fistula was presented in 2%, in 1% they were treated with parenteral nutrition (type II) and in 1% a reoperation was performed (type III). Conclusion: Esophagectomy is associated with a high morbidity. The main complications are respiratory and gastrointestinal. The use of consensus definitions allows standardization and grading of complications.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Complicações Pós-Operatórias , Neoplasias Esofágicas/epidemiologia , Esofagectomia/efeitos adversos , Estudos Retrospectivos , Estudos de Coortes , MorbidadeRESUMO
BACKGROUND: Vancomycin is used for treating coagulase-negative staphylococcus infections in neonates. However, concerns about the appropriate empirical dosing required for optimal efficacy, still remain. AIM: To assess the relationship between the initial doses of vancomycin used in a Neonatal Intensive Care Unit (NICU) with the possibility of achieving therapeutic target of AUC024h/MIC > 400 µg/h/mL. METHODS: Retrospective and descriptive study carried out between February 2016 and March 2018. All neonates treated with vancomycin for suspected/proven Gram-positive infection and with at least one trough serum concentration level were included. Probability of target attainment (PTA) was evaluated through resampling of AUC and MIC values. RESULTS: Final dataset included 38 patients and 49 trough vancomycin levels; 94.7% of these cases (n = 36) were confirmed Gram-positive infections. The median AUC/MIC values for the trough values vancomycin < 10 µg/mL group and for the ≥ 10 µg/mL group were 327 (IQR 174-395) and 494 (IQR 318-631) respectively (p = 0.035). Current empirical dosing strategy has a 47.7% PTA (AUC/MIC > 400) when taking institutional MICs into account. CONCLUSIONS: It is not possible to assure achieving a AUC/MIC > 400 µg/h/mL when considering institutional sensibilities. Current empiric dosing strategies should be reconsidered and further investigation needs to be done to help determine the appropriate empirical dosing required for optimal efficacy in neonates.
Assuntos
Vancomicina/administração & dosagem , Antibacterianos , Área Sob a Curva , Humanos , Recém-Nascido , Testes de Sensibilidade Microbiana , Estudos Retrospectivos , Infecções EstafilocócicasRESUMO
Resumen Introducción: Vancomicina es un antimicrobiano ampliamente utilizado para infecciones por Staphylococcus coagulasa negativa en neonatos; sin embargo, no existe claridad sobre la dosis empírica que asegure su eficacia terapéutica. Objetivo: Evaluar la relación entre las dosis iniciales de vancomicina utilizadas en una Unidad de Cuidado Intensivo Neonatal (UCIN) con la eventualidad de alcanzar el objetivo terapéutico de área bajo la curva sobre concentración inhibitoria mínima (ABC/CIM) mayor a 400 µg/h/mL. Materiales y Método: Estudio descriptivo y retrospectivo, realizado entre febrero 2016 y marzo 2018. Se incluyeron neonatos en tratamiento con vancomicina por sospecha/confirmación de infección por cocáceas grampositivas y medición de concentraciones plasmáticas de vancomicina al inicio del tratamiento. La probabilidad de alcanzar el objetivo terapéutico se evaluó mediante re-muestreo de valores de ABC y CIM. Resultados: Se incluyeron 38 pacientes con 49 concentraciones plasmáticas de vancomicina. Los aislados microbiológicos se confirmaron en 94,7% de los pacientes (n = 36). Los valores de ABC/CIM en dos grupos (según niveles valle de vancomicina < 10 µg/mL y ≥ 10 µg/mL), fueron de una mediana de 327 (IQ 25-75 = 174-395) y 494 (IQ 25-75 = 318-631), respectivamente (p = 0,035). Las dosis empíricas utilizadas logran logran un objetivo terapéutico (ABC/CIM > 400) de sólo 47,7% considerando CIMs en nuestra institución. Conclusiones: Teniendo en cuenta las sensibilidades institucionales, no es posible asegurar alcanzar ABC/CIM > 400 µg/h/mL. Se debe seguir investigando para replantear las actuales estrategias de dosificación y así determinar la más apropiada para neonatos.
Abstract Background: Vancomycin is used for treating coagulase-negative staphylococcus infections in neonates. However, concerns about the appropriate empirical dosing required for optimal efficacy, still remain. Aim: To assess the relationship between the initial doses of vancomycin used in a Neonatal Intensive Care Unit (NICU) with the possibility of achieving therapeutic target of AUC024h/MIC > 400 µg/h/mL. Methods: Retrospective and descriptive study carried out between February 2016 and March 2018. All neonates treated with vancomycin for suspected/proven Gram-positive infection and with at least one trough serum concentration level were included. Probability of target attainment (PTA) was evaluated through resampling of AUC and MIC values. Results: Final dataset included 38 patients and 49 trough vancomycin levels; 94.7% of these cases (n = 36) were confirmed Gram-positive infections. The median AUC/MIC values for the trough values vancomycin < 10 µg/mL group and for the ≥ 10 µg/mL group were 327 (IQR 174-395) and 494 (IQR 318-631) respectively (p = 0.035). Current empirical dosing strategy has a 47.7% PTA (AUC/MIC > 400) when taking institutional MICs into account. Conclusions: It is not possible to assure achieving a AUC/MIC > 400 µg/h/mL when considering institutional sensibilities. Current empiric dosing strategies should be reconsidered and further investigation needs to be done to help determine the appropriate empirical dosing required for optimal efficacy in neonates.
Assuntos
Humanos , Recém-Nascido , Vancomicina/administração & dosagem , Infecções Estafilocócicas , Testes de Sensibilidade Microbiana , Estudos Retrospectivos , Área Sob a Curva , AntibacterianosRESUMO
OBJECTIVES: To investigate the effect of systemic administration of the immunosuppressant dexamethasone (DM) while inducing hamster buccal pouch DMBA carcinogenesis. Materials and Methods. Two different experiments were performed. In the first experiment, hamsters' right buccal pouches in group A (n = 10) were painted three times per week with 7,12-dimethylbenzanthracene (DMBA) 0.5%, while pouches of animals in group B (n = 10) were painted three times per week with 7,12-dimethylbenzanthracene (DMBA) 0.5%, while pouches of animals in group B (. RESULTS: The time of macroscopic neoplasm development was reduced when DM-DMBA coexposition was employed, finding tumors after 10-12 weeks of exposition. In addition, the frequency of histopathological lesions was higher. CONCLUSION: Immunomodulatory action of dexamethasone may reduce the time of oral squamous cell carcinoma (OSCC) induction and may increase the incidence of neoplasms developed.
Assuntos
9,10-Dimetil-1,2-benzantraceno/toxicidade , Carcinógenos/toxicidade , Carcinoma de Células Escamosas/induzido quimicamente , Dexametasona/toxicidade , Neoplasias Bucais/induzido quimicamente , Animais , Carcinoma de Células Escamosas/patologia , Cricetinae , Masculino , Mesocricetus , Mucosa Bucal/efeitos dos fármacos , Mucosa Bucal/patologia , Neoplasias Bucais/patologiaRESUMO
INTRODUCTION: Acute back pain (LA) is a considerable problem in any care setting. The Emergency Department (ED) intended to provide immediate, timely and effective care. Our objective was to estimate the prevalence and describe the usual care process. MATERIAL AND METHODS: To estimate prevalence, a random sample was included of 5,333 consultations admitted in ED at hospital XX between January and December 2016. LA cases were defined according to the diagnosis at arrival. A retrospective cohort with all LA cases was used to describe complementary studies and therapeutic behaviors established in ED or within the subsequent 30 days outpatient follow-up. RESULTS: LA represented 4.37% (95% CI: 3.83-4.95%) of consultations. A total of 1,096 cases of LA were included: mean age of 53.26 ± 19.85 years, 55.93% (613) female sex and few comorbidities. The median attention time was 3.28 hours and 6.20% was admitted. 70% (778) received treatment in CEA, being the most used administration routes: intravenous (61.86%), and intramuscular (20.62%). The analgesics used were: 55.38% corticosteroids, 55.02% NSAIDs, 34.85% opioids. The complementary studies requested during ED or until 30 days after discharge, were: 52.19% laboratory, 47.17% radiography, 28.38% RM, 10.77% tomography, 9.12% interventionism. CONCLUSIONS: This study provides epidemiological data of LA in Argentina and demonstrates the need to promote the rational use of resources.
INTRODUCCIÓN: La lumbalgia aguda (LA) es un problema en diferentes ámbitos de atención. La Central de Emergencias de Adultos (CEA) intenta brindar atención inmediata, especializada y eficaz. Nuestro objetivo fue estimar la prevalencia y describir el proceso de atención habitual. MATERIAL Y MÉTODOS: Para la estimación de prevalencia, se incluyó una muestra aleatoria de 5,333 consultas admitidas en CEA de un solo hospital entre Enero y Diciembre de 2016. Se definió como numerador a los casos de LA según diagnóstico de triaje al ingreso. Una cohorte retrospectiva con todos los casos de LA se utilizó para describir estudios complementarios y conductas terapéuticas instaurados en CEA, con seguimiento ambulatorio posterior. RESULTADOS: La lumbalgia aguda representó 4.37% (IC 95%: 3.83-4.95%) de las consultas. Se incluyeron 1,096 casos de LA: edad media de 53.26 ± 19.85 años, 55.93% (613) sexo femenino y escasas comorbilidades. La mediana de tiempo de atención fue de 3.28 horas y se internó 6.20%, 70% (778) recibió tratamiento en CEA, las vías de administración más utilizadas fueron: endovenosa (61.86%) e intramuscular (20.62%). Los analgésicos utilizados fueron: 55.38% corticoides, 55.02% AINE, 34.85% opiáceos. Los estudios complementarios solicitados en CEA o hasta los 30 días postegreso fueron: 52.19% laboratorio, 47.17% radiografía/s, 28.38% resonancia/s, 10.77% tomografía/s, 9.12% intervencionismo/s. CONCLUSIONES: Este estudio aporta datos epidemiológicos sobre LA y evidencia la necesidad de fomentar el uso racional de los recursos.