RESUMO
One challenge of the citrus industry is the treatment and disposal of its effluents due to their high toxicity, substantial organic load, and consequent resistance to conventional biotechnological processes. This study introduces a novel approach, using electrochemical oxidation with a boron-doped diamond anode to efficiently remove organic compounds from biodegraded pulp wash (treated using the fungus Pleurotus sajor-caju.) The findings reveal that employing a current density of 20 mA cm-2 achieves notable results, including a 44.1% reduction in color, a 70.0% decrease in chemical oxygen demand, an 88.0% reduction in turbidity, and an impressive 99.7% removal of total organic carbon (TOC) after 6 h of electrolysis. The energy consumption was estimated at 2.93 kWh g-1 of removed TOC. This sequential biological-electrochemical procedure not only significantly reduced the mortality rate (85%) of Danio rerio embryos but also reduced the incidence of morphologically altered parameters. Regarding acute toxicity (LC50) of the residue, the process demonstrated a mortality reduction of 6.97% for D. rerio and a 40.88% lethality decrease for Lactuca sativa seeds. The substantial reduction in toxicity and organic load observed in this study highlights the potential applicability of combined biological and electrochemical treatments for real agroindustrial residues or their effluents.
Assuntos
Diamante , Poluentes Químicos da Água , Diamante/química , Poluentes Químicos da Água/análise , Eletrólise/métodos , Compostos Orgânicos , Eletrodos , OxirreduçãoRESUMO
HER2-positive breast cancer is an aggressive subtype identified in the 1980s. The development of therapies targeting the HER2 has improved outcomes. The current standard of care, established in 2012 is dual blockade with trastuzumab + pertuzumab as first-line followed by TDM-1 as second-line. Several suboptimal choices are available in third-line or more. In 2019 the presentation of several trials evaluating new drugs and regimens in third-line has re-opened questions about sequencing, treatment of triple positive disease and treatment choice after exposure to TDM-1. These include tucatinib, neratinib and trastuzumab-deruxtecan. Other agents - including other antibody drug conjugates and bispecific antibodies as well as combinations - will lead to further changes in coming years. Additionally, should the numerous putative biomarkers thus identified ever come into use at the clinic, choice of treatment and response evaluation may be substantially changed.
Assuntos
Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/enzimologia , Receptor ErbB-2/metabolismo , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Humanos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Next-generation ALK TKIs have become the new standard of care in first-line setting in advanced ALK-positive NSCLC patients. However, sequential strategies at progression are relevant, as may have an impact on patients' outcome. In this commentary we discuss whether genomic-tailored strategies at progression would be more suitable for improving outcome of ALK-positive NSCLC patients.
Assuntos
Quinase do Linfoma Anaplásico/antagonistas & inibidores , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Mutação , Inibidores de Proteínas Quinases/uso terapêutico , Quinase do Linfoma Anaplásico/genética , Carcinoma Pulmonar de Células não Pequenas/enzimologia , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/patologia , Resistencia a Medicamentos Antineoplásicos , Humanos , Neoplasias Pulmonares/enzimologia , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Medicina de Precisão/métodosRESUMO
Our aim was to investigate the impact of comorbid body dysmorphic disorder (BDD) on the response to sequential pharmacological trials in adult obsessive-compulsive disorder (OCD) patients. The sequential trial initially involved fluoxetine monotherapy followed by one of three randomized, add-on strategies: placebo, clomipramine or quetiapine. We included 138 patients in the initial phase of fluoxetine, up to 80 mg or the maximum tolerated dosage, for 12 weeks. We invited 70 non-responders to participate in the add-on trial; as 54 accepted, we allocated 18 to each treatment group and followed them for an additional 12 weeks. To evaluate the combined effects of sex, age, age at onset, initial severity, type of augmentation and BDD on the response to sequential treatments, we constructed a model using generalized estimating equations (GEE). Of the 39 patients who completed the study (OCD-BDD, n = 13; OCD-non-BDD, n = 26), the OCD-BDD patients were less likely to be classified as responders than the OCD-non-BDD patients (Pearson Chi-Square = 4.4; p = 0.036). In the GEE model, BDD was not significantly associated with a worse response to sequential treatments (z-robust = 1.77; p = 0.07). The predictive potential of BDD regarding sequential treatment strategies for OCD did not survive when the analyses were controlled for other clinical characteristics.
Assuntos
Antidepressivos de Segunda Geração/uso terapêutico , Antidepressivos Tricíclicos/uso terapêutico , Antipsicóticos/uso terapêutico , Transtornos Dismórficos Corporais/psicologia , Clomipramina/uso terapêutico , Fluoxetina/uso terapêutico , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Fumarato de Quetiapina/uso terapêutico , Adulto , Antidepressivos de Segunda Geração/efeitos adversos , Antidepressivos Tricíclicos/efeitos adversos , Antipsicóticos/efeitos adversos , Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/epidemiologia , Brasil , Clomipramina/efeitos adversos , Comorbidade , Quimioterapia Combinada , Feminino , Fluoxetina/efeitos adversos , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Estudos Prospectivos , Fumarato de Quetiapina/efeitos adversos , Fatores de Risco , Resultado do TratamentoRESUMO
Introducción: La infección por Helicobacter pylori, está asociada a múltiples complicaciones: gastritis crónica, úlcera gástrica y duodenal, cáncer gástrico y linfoma tipo MALT. Los niveles de erradicación y adherencia con la terapia estándar han declinado progresivamente en los últimos años. La terapia secuencial modificada podría ser una alternativa para mejorar su eficacia y la adherencia al tratamiento en vista de la alta resistencia actual a la claritromicina. Objetivos: Comparar la eficacia de la terapia triple secuencial estándar y la terapia triple secuencial modificada con levofloxacina para la erradicación de Helicobacter pylori. Materiales y Métodos: Se estudiaron 140 pacientes con infección por Helicobacter pylori comprobada por biopsia gástrica que fueron asignados en forma aleatorizada en dos grupos de tratamiento: Grupo de terapia secuencial estándar con omeprazol y amoxicilina por 5 días, seguido de omeprazol, claritromicina y metronidazol por 5 días adicionales. Grupo de terapia secuencial modificada con omeprazol y amoxicilina por 5 días, seguido de omeprazol, levofloxacina y metronidazol por 5 días adicionales. La erradicación se confirmó por biopsia gástrica posterior al tratamiento. Se realizó un cuestionario dirigido para evaluar la adherencia y los efectos secundarios en cada grupo. Resultados: Se evaluaron 70 pacientes en cada grupo. La tasa de erradicación y de abandono de tratamiento fue de 80% y 5,71% respectivamente en el grupo de terapia secuencial modificada comparando con 65,71% y 11,42% en el grupo de terapia secuencial estándar, siendo estadísticamente significativas las diferencias en ambos casos (p<0,05). Conclusiones: La terapia secuencial modificada con levofloxacina logra mayores tasas de erradicación y de adherencia al tratamiento del Helicobacter pylori cuando se compara con la terapia secuencial estándar.
Introduction: The infection by Helicobacter pylori, is associate with multiple complications: chronic gastritis, gastric and duodenal ulcer, gastric cancer and lymphoma type MALT. The levels of eradication and adherence with the standard therapy have declined progressively in the last years. The sequential modified therapy could be an alternative to improve his efficiency and the adherence to the treatment in view of the high current resistance to the clarithromycin. Aims: To compare the efficiency of the triple sequential standard therapy and the triple sequential therapy modified with levofloxacin for the eradication of Helicobacter pylori. Materials and Methods: 140 patients were studied by infection by Helicobacter pylori verified by gastric biopsy that they were assigned in randomized form in two groups of treatment: Group of sequential standard therapy with omeprazole and amoxicillin for 5 days, followed by omeprazole, clarithromycin and metronidazole for 5 additional days. Group of sequential therapy modified with omeprazole and amoxicillin for 5 days, followed by omeprazole, levofloxacin and metronidazole for 5 additional days. The eradication was confirmed by gastric biopsy later to the treatment. Was realized a questionnaire to evaluate the adherence and the side effects in every group. Results: 70 patients were evaluated in every group. The rate of eradication and suspension of treatment was 80% and 5,71 % respectively in the group of sequential modified therapy comparing with 65,71% and 11,42% in the group of sequential standard therapy, being statistically significant the differences in both cases (p <0,05). Conclusions: The sequential therapy modified with levofloxacin achieves major rates of eradication and of adherence to the treatment of the Helicobacter pylori when it is compared with the sequential standard therapy.