ABSTRACT
A polifarmácia define-se como o consumo de cinco ou mais fármacos simultâneos durante um período de tempo determinado e é cada vez mais frequente em pessoas maiores de 65 anos. A osteoporose é a alteração metabólica óssea mais frequente nos países ocidentais e o segundo problema sanitário no mundo, depois das doenças cardiovasculares. Sua maior complicação é a fratura por fragilidade, afetando mais mulheres que homens. A prevenção de fraturas por osteoporose é feita com diversos tipos de remédios e os mais usados são os bifosfonatos. Estes são fármacos com amplo uso em Atenção Primária, principalmente para osteoporose pós-menopáusica. Apesar de serem bem tolerados, não estão isentos de efeitos secundários, sendo um dos mais graves a osteonecrose mandibular, como ocorre no caso exposto neste trabalho. Por este e outros motivos, sempre é importante ponderar risco-benefício de forma individualizada antes de começar qualquer tratamento e, principalmente, quando se trata a de pacientes polimedicados.
Polypharmacy is defined as consumption of five or more concomitant drugs over a period of time, and its incidence is more common in people aged over 65 years. Osteoporosis is the most frequent metabolic bone disease in Western countries and the second most frequent health problem worldwide after cardiovascular diseases. Its main complication is fracture caused by bone fragility, and it affects more women than men. Various treatments are available to prevent them, and one of the most commonly used treatments is bisphosphonate therapy. These drugs are widely used as first-line therapy, especially in postmenopausal osteoporosis. Although biphosphonates are generally well tolerated, they are not free of side effects, and one of the most serious ones is osteonecrosis of the jaw, as shown in the following clinical case. For these and other reasons, it is always important to perform risk-benefit analysis individually before starting any treatment, especially in patients with polypharmacy.
Polimedicación es el consumo de cinco o más fármacos de forma concomitante durante un período de tiempo determinado y aparece más frecuentemente en personas mayores de 65 años. La osteoporosis es la enfermedad metabólica ósea más frecuente en los países occidentales y el segundo problema sanitario en el mundo después de las enfermedades cardiovasculares. Su mayor complicación es la fractura por fragilidad, afectando más a mujeres que hombres. Para prevenirlas se emplean diversos tipos de medicinas, y las más utilizadas son los bifosfonatos. Estos son medicamentos ampliamente empleados en la Atención Primaria, principalmente en osteoporosis posmenopáusica. A pesar de ser generalmente bien tolerados, no están libres de efectos adversos, siendo uno de los más graves la osteonecrosis mandibular, como ocurre en el caso clínico expuesto. Por estos y otros motivos, siempre es importante valorar los riesgos-beneficios de forma individualizada antes de empezar cualquier tratamiento, y más cuando se trata de pacientes polimedicados.
Subject(s)
Humans , Female , Aged, 80 and over , Osteoporosis, Postmenopausal , Diphosphonates , Bisphosphonate-Associated Osteonecrosis of the Jaw , Mandible , PolypharmacyABSTRACT
There have been no reports of antifungal activity and composition of extracts from Thymus vulgaris, Rosmarinus officinalis or Origanum majorana from northeastern Mexico. Antifungal activity of these oils against Trichophyton rubrum, Trichophyton tonsurans, Trichophyton mentagrophytes, Microsporum gypseum, Microsporum canis and Epidermophyton floccosum was measured by diffusion assay. Additionally, antibacterial and antioxidant activities were evaluated. Antibacterial activity against Staphylococcus aureus and Streptococcus pyogenes was examined by microdilution. Antioxidant activity was assessed by 2, 2-difenil-1-picrilhidracil reduction test. The plant oils were characterized by both GC/MS and GC/FID. Oils of T. vulgaris and O. majorana showed growth inhibition activity against dermatophytes, especially T. vulgaris oil, which completely inhibited growth of all tested dermatophytes. The oils also showed bioactivity against bacteria, with minimum inhibitory concentration [MIC] values between 62.5 and 500 micro g/mL. The antioxidant activity of the oils was low, with effective concentration [EC50] values >250 micro g/mL. The major components in the oils were as follows: T. vulgaris, o-cymene, gamma-terpinene, thymol and carvacrol; R. officinalis, terpinen-4-ol and 1,8-cineole; O. majorana, terpinen-4-ol and thymol
ABSTRACT
The dengue virus is transmitted by Aedes aegypti. Several plants are used to control this mosquito. In the present study the chemical composition of the essential oils of Ruta chalepensis, Zanthoxylum fagara and Thymus vulgaris were analyzed, and their activities against larvae of two A. aegypti populations were evaluated. The major compounds found in T vulgaris were thymol and o-cymene at 39.8% and 30.5%, respectively, with the major components being oxygenated monoterpenes and monoterpene hydrocarbons at 55.5% and 40.4%, respectively. For Z. fagara, the major compounds were sylvestrene and E-caryophyllene at 25.3% and 23.6%, respectively, with the major components being sesquiterpene and monoterpene hydrocarbons at 51.1% and 37.5%, respectively. Ketones were the predominant group of compounds found in R. chalepensis, with the major components being 2-undecanone and 2- nonanona at 43.7% and 35.4%, respectively. Essential oils from T vulgaris, Z. fagara and R. chalepensis showed activity against larvae of the A. aegypti New Orleans strain, producing median lethal concentrations [LC[50]] of 2.14, 27.57 and 2.69.Mug/mL, respectively, at 24 h. LC[50] values produced against larvae of a local A. aegypti population in Nuevo Leon, Mexico, were 25.37, 60.42 and 20.13Mug/mL, respectively, at 24 h
ABSTRACT
Distintas variables de síntesis se evaluaron en la modificación por pilarización de dos arcillas esmectíticas con soluciones mixtas de Al-Fe-Ce. El efecto del ultrasonido durante la intercalación de las especies pilarizantes, el tipo de arcilla y la remoción de los óxidos de hierro del mineral natural fueron determinantes en la obtención de materiales activos en la oxidación de fenol en medio acuoso diluido con una buena selectividad a CO2 en condiciones experimentales moderadas (20 °C y presión atmosférica). Los sólidos fueron caracterizados por difracción de rayos X (DRX), fluorescencia de rayos X (FRX), reducción a temperatura programada de hidrógeno (RTP-H2) y microscopía electrónica de barrido (SEM), evidenciando una modificación estructural exitosa en todos los materiales. Con el empleo del ultrasonido se logró la modificación de los sólidos en un tiempo considerablemente menor (20 min.) al proceso tradicional (24 h), conservando las propiedades físico-químicas y catalíticas de los materiales. Igualmente, se evidenció un efecto de la naturaleza de la arcilla de partida sobre las propiedades químicas y catalíticas del material, así como una mejora al remover los óxidos de hierro del material natural, logrando sólidos con mejor actividad catalítica.
Different variables in synthesis were evaluated in the modification of two pillared smectite clays with mixed solutions of Al-Fe-Ce. The effect of ultrasound during the intercalation of pillaring species, the clay type, and the iron oxides removal of natural mineral were analyzed to obtain active materials in the phenol oxidation in aqueous diluted with a good selectivity to CO2 through moderate experimental conditions (temperature 298K and atmospheric pressure). The solids were characterized by X-ray diffraction (XRD), X-ray fluorescence (XRF), hydrogen temperature programmed reduction (TPR-H2), and scanning electron microscopy (SEM), showing a successful structural change in all materials. The use of ultrasound allows modifying solids considerably in less time (20 min) than the traditional process (24 hours) maintaining the physicochemical and catalytic properties of the materials. Likewise, evidence of effect of the nature of the starting clay on the chemical and catalytic properties of the material, as well as an improvement by removing iron oxides of natural materials, achieving solids with best catalytic activity.
Diferentes variáveis de síntese foram avaliadas na modificação por pilarização de duas argilas esmectíticas com soluções mistas de Al-Fe-Ce. O efeito do ultrassom durante a intercalação das espécies pilarizantes, o tipo de argila e a remoção dos óxidos de ferro do mineral natural foram determinantes na obtenção de materiais ativos na oxidação de fenol em meio aquoso diluído com uma boa seletividade a CO2 em condições experimentais moderadas (Temperatura 298K e pressão atmosférica). Os sólidos foram caracterizados por Difração de Raios-X (DRX), Fluorescência de Raios-X (FRX), Redução á Temperatura Programada de Hidrogênio (TPR-H2) e microscopia electrônica de barrido (SEM) evidenciando uma modificação estrutural exitosa em todos os materiais. Com o uso de ultrassom, conseguiu-se a modificação dos sólidos num tempo consideravelmente menor (20 min.) ao processo tradicional (24 horas) conservando as propriedades físico-químicas e catalíticas dos materiais. Igualmente, foi evidenciado um efeito da natureza da argila de partida sobre as propriedades químicas e catalíticas do material, assim como uma melhoria ao remover os óxidos de ferro do material natural, conseguindo-se assim sólidos com melhor atividade catalítica.
ABSTRACT
A 75-year-old woman with known diagnosis of Klippel-Trenaunay syndrome presented with acute onset of chest pain, dyspnea and elevated cardiac enzymes. She had triple vessel coronary artery disease on subsequent coronary angiography. Given the unavailability of venous conduits secondary to lower extremity varicosities, coronary artery bypass grafting with radial and internal mammary arterial grafts was carried out. The radial artery graft went into spasm two days later and required intracoronary vasodilators to relieve the spasm. The patient remained hypotensive and finally expired