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1.
Rev. med. Risaralda ; 27(1): 64-69, ene.-jun. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1280494

ABSTRACT

Resumen Introducción: El shock hemorrágico es una de las causas más comunes de muerte en pacientes con trauma debido a que pone en marcha un círculo vicioso de mecanismos que incluyen hipotermia, acidosis y coagulopatía. Para mitigar estos efectos, se han propuesto estrategias de control de daños, incluido el aporte controlado de líquidos con hipotensión permisiva contemplando metas en la presión arterial sistólica para mantener una adecuada perfusión de los tejidos. Objetivo: Conocer información actualizada acerca del manejo de la hipotensión permisiva en pacientes con trauma. Metodología: Se buscó información en las bases de datos Web-of-Science y Scopus de los últimos cinco años. El resultado arrojó un total de 118 artículos de los cuales se tomaron 30, según los criterios de inclusión y exclusión. Resultados: Todos los artículos consideran el uso de la hipotensión permisiva como una buena opción para el manejo de los pacientes con trauma e hipotensión, sin embargo, difieren en qué momento es adecuado utilizarlo y en qué condiciones se debe realizar. Conclusiones: Si bien la hipotensión permisiva se ha convertido en uno de los pilares fundamentales en el manejo prehospitalario del paciente con trauma, se requieren estudios investigativos en humanos para soportar cuándo y cómo debe utilizarse.


Abstract Introduction: Hemorrhagic shock is one of the most common causes of death in trauma patients, because it sets in motion a vicious cycle of mechanisms, including hypothermia, acidosis, and coagulopathy. To mitigate these effects, damage control strategies have been proposed, including the controlled intake of fluids with permissive hypotension, contemplating goals in systolic blood pressure, and thus, maintaining adequate tissue perfusion. Objective: The present research aimed to review the literature in search of updated information about the management of permissive hypotension in patients with trauma. Methodology: Information was searched in the Web-of-Science and Scopus databases in the last five years. The result yielded a total of 118 articles, of which 30 were taken according to the inclusion and exclusion criteria. Results: All the articles consider the use of permissive hypotension as a good option for the management of patients with trauma and hypotension, however, they differ when it is appropriate to use it and under what conditions it should be performed. Conclusions: Although permissive hypotension has become one of the fundamental pillars in the prehospital management of the patient with trauma, research studies in humans are required to support when and how it should be used.


Subject(s)
Humans , Shock, Hemorrhagic , Wounds and Injuries , Hypotension , Hypothermia , Tissues , Acidosis , Blood Pressure , Cause of Death , Health Strategies , Alkalies , Arterial Pressure
2.
Espaç. saúde (Online) ; 22(1): [774], 2021. ilust, tab
Article in Portuguese | LILACS | ID: biblio-1284493

ABSTRACT

A reflexão da prática de processos de aprendizagem, por meio da participação em programas de desenvolvimento docente, contribui para a emancipação profissional e para a consolidação de uma profissão autônoma. Objetivou analisar as evidências científicas sobre a utilização de programas de desenvolvimento docente, para ativar a prática reflexiva de processos de aprendizagem. Trata-se de uma revisão integrativa realizada nas bases de dados SciELO, DOAJ e ERIC, no período de 2016 a 2020, resultando em 17 estudos relacionados com a temática. Foram elegíveis 9 (53%) publicações resgatadas na base DOAJ, 6 (35%) na ERIC e 2 (12%) na SciELO. Os estudos apontaram que os programas de formação continuada são opções para auxiliar os docentes no processo de reflexão sobre a prática.


Subject(s)
Growth and Development , Education, Continuing , Alkalies , Faculty , Learning , Publications
3.
Espaç. saúde (Online) ; 22(1): [774], 2021. ilust
Article in Portuguese | LILACS | ID: biblio-1284486

ABSTRACT

O estudo teve como objetivo evidenciar as produções científicas acerca do processo de Desenvolvimento Docente no ensino superior na área da saúde, no período de 2009 a 2019. Trata-se de uma revisão integrativa, realizada nas bases de dados: Medical Literature Analysis and Retrievel System Online (MEDLINE); Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS); e Scientific Electronic Library Online (SciElo), com descritores, desenvolvimento docente, educação e escola médica. A partir dos critérios de inclusão, foram selecionados doze artigos (inglês e português) para discussão e resultados. Surgiram três categorias: percepção docente, papel da Instituição de Ensino Superior e formação, educação continuada e Desenvolvimento Docente. Concluiu-se que, apesar de um aumento expressivo de programas de Desenvolvimento Docente, muito ainda precisa ser realizado, especialmente no que se refere à gestão, planejamento e envolvimento do corpo docente.


Subject(s)
Schools , Education, Higher , Growth and Development , Education , Education, Continuing , Planning , Faculty , Catchment Area, Health , Alkalies , Literature
4.
Rev. latinoam. enferm. (Online) ; 29: e3397, 2021. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1150012

ABSTRACT

Objective: to describe scientific evidence regarding the use of prone positioning in the care provided to patients with acute respiratory failure caused by COVID-19. Method: this is a scoping review. PRISMA Extension for Scoping Reviews was used to support the writing of this study. The search was conducted in seven databases and resulted in 2,441 studies, 12 of which compose the sample. Descriptive statistics, such as relative and absolute frequencies, was used to analyze data. Results: prone positioning was mainly adopted in Intensive Care Units, lasted from a minimum of 12 up to 16 hours, and its prescription was based on specific criteria, such as PaO2/FiO2 ratio, oxygen saturation, and respiratory rate. The most prevalent complications were: accidental extubation, pressure ulcer, and facial edema. Decreased hypoxemia and mortality rates were the main outcomes reported. Conclusion: positive outcomes outweighed complications. Various cycles of prone positioning are needed, which may cause potential work overload for the health staff. Therefore, an appropriate number of trained workers is necessary, in addition to specific institutional protocols to ensure patient safety in this context.


Objetivo: descrever as evidências científicas acerca da utilização da posição prona na assistência ao paciente com insuficiência respiratória aguda provocada por COVID-19. Método: trata-se de uma scoping review. O instrumento PRISMA Extension for Scoping Reviews foi utilizado para a redação do estudo. As buscas foram realizadas em sete bases de dados, resultando em 2.441 estudos dos quais 12 compõem a amostra. Uma análise descritiva dos dados foi realizada empregando frequências relativas e absolutas. Resultados: a utilização da posição prona ocorreu principalmente em Unidades de Terapia Intensiva, com duração mínima de 12 a 16 horas, e teve como fundamentos de indicação critérios específicos, tais como a relação PaO2/FiO2, a saturação de oxigênio e a frequência respiratória. As complicações mais prevalentes da sua utilização foram: extubação acidental, lesão por pressão e edema facial. Identificou-se a redução da hipoxemia e da mortalidade como principais desfechos evidenciados na amostra. Conclusão: os desfechos positivos sobressaíram-se face às complicações. São necessários vários ciclos de pronação do paciente, fator causador de possível sobrecarga de trabalho da equipe de saúde. Portanto, são importantes um adequado dimensionamento dos profissionais, uma equipe treinada e protocolos institucionais específicos a fim de se garantir a segurança do paciente nesse contexto.


Objetivo: describir las evidencias científicas acerca de la utilización de la posición prona en la atención al paciente con insuficiencia respiratoria aguda provocada por COVID-19. Método: se trata de una revisión de escopo. El instrumento PRISMA Extension for Scoping Reviews fue utilizado para la redacción del estudio. Las búsquedas fueron realizadas en siete bases de datos, resultando en 2.441 estudios de los cuales 12 integran la muestra. Un análisis descriptivo de los datos fue desarrollado empleando frecuencias relativas y absolutas. Resultados: la utilización de la posición prona ocurrió principalmente en Unidades de Terapia Intensiva, con duración mínima de 12 a 16 horas, y tuvo como fundamentos de indicación criterios específicos, tales como la relación PaO2/FiO2, la saturación de oxígeno y la frecuencia respiratoria. Las complicaciones más frecuentes de su uso fueron: desintubación accidental, lesión por presión y edema facial. Se identificó la reducción de la hipoxemia y de la mortalidad como principales resultados evidenciados en la muestra. Conclusión: los resultados positivos se destacaran ante las complicaciones. Son necesarios varios ciclos de pronación del paciente, factor causante de una posible sobrecarga de trabajo del equipo de salud. Por lo tanto, son importantes un adecuado dimensionamiento de los profesionales, un equipo capacitado y protocolos institucionales específicos a fin de garantizar la seguridad del paciente en ese contexto.


Subject(s)
Patient Care Team , Respiratory Distress Syndrome , Respiratory Insufficiency , Respiratory Tract Infections , Prone Position , Coronavirus Infections , Pressure Ulcer , Edema , Alkalies , Equipment and Supplies , Airway Extubation , Critical Care Nursing , Intensive Care Units , Hypoxia
5.
Infectio ; 24(4): 224-228, oct.-dic. 2020. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1114873

ABSTRACT

Resumen Objetivo: Comparar los resultados obtenidos de diferentes sistemas de identificación de C. auris. Métodos: Análisis descriptivo con datos recopilados durante 2016-19 mediante la vigilancia nacional. Se evaluaron los resultados generados por los sistemas MicroScan, Phoenix BD, VITEK 2 y MALDI-TOF MS de instituciones hospitalarias de 843 aislamientos clínicos sospechosos de C. auris remitidos al INS y se compararon con los resultados generados de confirmación a través de MALDI- TOF MS (Bruker Daltonics) o PCR. Resultados: De los 843 aislamientos clínicos remitidos al INS, el 81,7% fueron confirmados como C. auris mediante MALDI- TOF MS o PCR en el INS y el resto, 18,3%, fueron identificados como otras especies de Candida spp. Las identificaciones correctas enviadas por los laboratorios representaron el 42,4%. MicroScan identificó C. auris principalmente como C. haemulonii, C. guilliermondii, C. albicans y C. famata; Phoenix BD, VITEK 2 y MALDI-TOF MS identificó C. auris como C. haemulonii. Discusión: Estudios señalan que C. auris exhibe una estrecha relación filogenética con C. haemulonii. Las identificaciones discrepantes pueden darse debido a que las bases de datos de los sistemas de diagnóstico son limitadas para este patógeno. Las deficiencias de los sistemas comerciales para la identificación de C. auris deben ser complementados con otros sistemas como MALDI-TOF MS o pruebas moleculares.


Abstract Objective: To compare the identification results obtained by different identification systems of C. auris isolates. Methods: A descriptive study with data collected during the years 2016-19 through surveillance. The results generated by the MicroScan, Phoenix BD, VITEK 2 and MALDI-TOF MS systems of 843 clinical isolates of C. auris submitted to the INS were evaluated and compared with the results generated from confirmation through MALDI-TOF MS (Bruker Daltonics) or PCR. Results: Out of 843 clinical isolates submitted to the INS, 81.7% were confirmed as C. auris by MALDITOF MS or PCR in the INS and the rest, 18.3%, were identified as other species of Candida spp. The correct identifications sent by the laboratories was 42.4%. MicroScan identified C. auris as C. haemulonii, C. guilliermondii, C. albicans and C. famata; Phoenix BD, VITEK 2 and MALDI-TOF MS identified C. auris as C. haemulonii. Discussion: Studies indicate that C. auris exhibits a close phylogenetic relationship with C. haemulonii. In addition, discrepant identifications may occur because the databases of diagnostic systems are limited with reference to this pathogen. The deficiencies of commercial systems for the identification of C. auris must be complemented with other systems such as MALDI-TOF MS or molecular tests.


Subject(s)
Humans , Female , Candida , Surveillance , Diagnosis , Laboratories , Polymerase Chain Reaction , Epidemiology, Descriptive , Colombia , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization , Molecular Diagnostic Techniques , Alkalies
6.
SMAD, Rev. eletrônica saúde mental alcool drog ; 16(3): 88-104, jul.-set. 2020. ilus
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1150195

ABSTRACT

OBJETIVO: este estudo de revisão sistemática de literatura buscou analisar as relações entre mindfulness e regulação emocional. MÉTODO: foram consultadas diversas bases de dado nacionais e internacionais e selecionou-se para análise 60 artigos publicados no período de 2009 a 2019. RESULTADOS: Em termos conceituais, mindfulness é prevalentemente considerado como um traço, e menos como um estado ou habilidade. Os resultados dos estudos empíricos sugerem que mindfulness mostra-se associado ao uso de estratégias de regulação emocional adaptativas favorecendo o funcionamento psíquico saudável. Apontam-se também os limites e contribuições desta revisão. CONCLUSÃO: Há a necessidade de mais estudos que considerem o aspecto processual de mindfulness e que possibilitem capturar a vivência subjetiva da prática, tendo em visto a prevalência de estudos quantitativos que fizeram uso de escalas de autorrelato.


OBJECTIVE: This systematic literature review study sought to analyze the relationship between mindfulness and emotional regulation. METHOD: Several national and international databases were consulted and 60 articles published in the period from 2009 to 2019 were selected for analysis. RESULTS: In conceptual terms, mindfulness is predominantly considered as a trait, and less as a state or skill. The results of empirical studies suggest that mindfulness is associated with the use of adaptive emotional regulation strategies favoring healthy psychic functioning. The limits and contributions of this review are also pointed out. CONCLUSION: It is concluded that there is a need for further studies that consider the procedural aspect of mindfulness and that make it possible to capture the subjective experience of the practice, considering the prevalence of quantitative studies that used self-report scales.


OBJETIVO: este estudio de revisión sistemática de la literatura buscó analizar la relación entre la atención plena y la regulación emocional. MÉTODO: se consultaron varias bases de datos nacionales e internacionales y se seleccionaron para su análisis 60 artículos publicados en el período de 2009 a 2019. RESULTADOS: en términos conceptuales, la atención plena se considera predominantemente como un rasgo, y menos como un estado o habilidad. Los resultados de los estudios empíricos sugieren que la atención plena se asocia con el uso de estrategias adaptativas de regulación emocional que favorecen el funcionamiento psíquico saludable. También se señalan los límites y las contribuciones de esta revisión. CONCLUSIÓN: se concluye que es necesario realizar más estudios que consideren el aspecto procesal de la atención plena y que permitan capturar la experiencia subjetiva de la práctica, considerando la prevalencia de estudios cuantitativos que utilizaron escalas de autoinforme.


Subject(s)
Aptitude , Mental Health , Alkalies , Emotions , Self Report , Mindfulness , Emotional Regulation
7.
Arq. bras. med. vet. zootec. (Online) ; 72(5): 1947-1958, Sept.-Oct. 2020. tab, graf, ilus
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1131542

ABSTRACT

Objetivou-se avaliar a destoxificação da torta de mamona bruta (TMB), por meio de dois produtos alcalinos em diferentes concentrações, e seus efeitos sobre a composição química, a degradabilidade in situ da MS e o fracionamento de proteínas. Utilizou-se o hidróxido de cálcio [Ca(OH)2] e o hidróxido de sódio (NaOH) em duas concentrações (60 e 90 gramas), diluídos em quatro quantidades de água (1.000; 1.500; 2.000 e 2.500mL de água por quilo de TMB). Observou-se que, das diferentes concentrações utilizadas, somente a utilização de 90 e 60 gramas de Ca(OH)2 e NaOH, respectivamente, conseguiu destoxificar 100% da TMB, ambas diluídas em 2.000mL de água. Por outro lado, ao avaliar o tempo mínimo de contato dos reagentes com a TMB para uma máxima destoxificação, observou-se que três horas de contato é o tempo necessário para os reagentes diminuírem em 100% as proteínas citotóxicas, além de não deixar atividade hemaglutinante nesse material. A destoxificação com o NaOH proporcionou maior degradação das proteínas solúveis e da matéria seca, favorecendo a disponibilização do nitrogênio não proteico, estando sua aplicação em escala industrial na dependência de estudos sobre viabilidade operacional e econômica.(AU)


This study aimed to evaluate the detoxification of crude castor (DCC) through two alkaline products in different concentrations and their effects on the chemical composition, in situ degradability of DM and the fractionation of proteins. We used the calcium hydroxide [Ca(OH)2] and sodium hydroxide (NaOH) in two concentrations (60 and 90 grams) diluted in 4 quantities of water (1,000; 1,500; 2,000 and 2,500ml of water per kilo of DCC). It was observed that in the different concentrations used, only the use of 90 and 60 grams of Ca(OH)2 and NaOH, respectively managed to detoxify 100% of the DCC, both diluted in 2,000ml of water. On the other hand, when assessing the minimum time of contact of the reagents with the DCC for maximum detoxification, it was observed that with three hours of contact is the time required for the reagents decrease in 100% of the cytotoxic proteins, in addition to not leave haemagglutinating activity in this material. The detoxification with NaOH provided greater degradation of soluble proteins and degradation of dry matter, favoring the provision of non-protein nitrogen, while its application on an industrial scale is in the dependence of studies on operational feasibility and cost.(AU)


Subject(s)
Ricinus/toxicity , Ricinus/chemistry , Sodium Hydroxide/administration & dosage , Calcium Hydroxide/administration & dosage , Inactivation, Metabolic , Plants, Toxic/toxicity , Alkalies/administration & dosage
8.
Rev. med. Risaralda ; 26(1): 92-96, ene.-jun. 2020. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1127007

ABSTRACT

Resumen Objetivo: Reportar un caso sobre el uso de la terapia de presión negativa como tratamiento alternativo en el manejo de una úlcera vascular arterial de miembros inferiores. Métodos: Por medio de la historia clínica, se revisó los registros previos de una paciente en un centro de atención médica de tercer nivel en Popayán, Colombia. Posteriormente, se realizó una revisión sistemática bibliográfica a través de las bases de datos de Pubmed, ScienceDirect y Scielo. Resultados: La terapia de presión negativa favoreció el proceso de cicatrización, permitiendo el cierre de la herida. Conclusiones: Actualmente, este sistema se considera un apoyo fundamental en el tratamiento de las heridas complejas, las cuales suponen un reto terapéutico importante.


Abstract Objective: To report a case about the use of the Negative-pressure wound therapy as an alternative treatment for arterial vascular ulcers presented in the lower limbs. Methods: The patient's records were reviewed based on her medical history in a tertiary referral care center in Popayan, Colombia. Subsequently, a systematic literature review was conducted through the Pubmed database, ScienceDirect, and Scielo. Results: The use of Negative-pressure wound therapy favored the lesion healing process. Conclusions: Nowadays, this system is considered as an essential treatment for complex wounds, which represent a major therapeutic challenge.


Subject(s)
Humans , Female , Middle Aged , Ulcer , Lower Extremity , Negative-Pressure Wound Therapy , Pressure , Therapeutics , Wounds and Injuries , Tertiary Healthcare , Alkalies
9.
Arq. bras. med. vet. zootec. (Online) ; 72(3): 647-654, May-June, 2020. ilus, tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1128504

ABSTRACT

The elastic cartilage is composed by chondroblasts and chondrocytes, extracellular matrix and surrounded by perichondrium. It has a low regeneration capacity and is a challenge in surgical repair. One of obstacles in engineering a structurally sound and long-lasting tissue is selecting the most appropriate scaffold material. One of the techniques for obtaining biomaterials from animal tissues is the decellularization that decreases antigenicity. In this work, alkaline solution was used in bovine ear elastic cartilages to evaluate the decellularization and the architecture of the extracellular matrix. The cartilages were treated in alkaline solution (pH13) for 72 hours and lyophilized to be compared with untreated cartilages by histological analysis (hematoxylin-eosin, Masson's trichrome and Verhoeff slides). Areas of interest for cell counting and elastic fiber quantification were delineated, and the distribution of collagen and elastic fibers and the presence of non-fibrous proteins were observed. The results demonstrated that the alkaline solution caused 90% decellularization in the middle and 13% in the peripheral region, and maintenance of the histological characteristics of the collagen and elastic fibers and non-fibrous protein removal. It was concluded that the alkaline solution was efficient in the decellularization and removal of non-fibrous proteins from the elastic cartilages of the bovine ear.(AU)


A cartilagem elástica é composta por condroblastos e condrócitos, matriz extracelular e envolta por pericôndrio. Possui uma baixa capacidade de regeneração e é um desafio em reparos cirúrgicos. Um dos obstáculos na engenharia de tecido estruturalmente sólido e de longa duração é a seleção do material de arcabouço mais adequado. Uma das técnicas para obtenção de biomateriais oriundos de tecidos animais é a descelularização, que diminui a antigenicidade. Neste trabalho, foi utilizada solução alcalina em cartilagem elástica auricular bovina para avaliar a descelularização e a arquitetura da matriz extracelular. As cartilagens foram tratadas em solução alcalina (pH13) durante 72 horas e liofilizadas, e comparadas com cartilagens não tratadas por análise histológica (hematoxilina-eosina, tricrômio de Masson e Verhoeff). Foram determinadas as áreas de interesse para contagem celular e quantificação de fibras elásticas, observada a distribuição de colágeno e fibras elásticas e a presença de proteínas não fibrosas. Os resultados demonstraram que a solução alcalina causou 90% de descelularização na região central e 13% na região periférica, manutenção das características histológicas do colágeno e fibras elásticas e remoção das proteínas não fibrosas. Concluiu-se que a solução alcalina foi eficiente na descelularização e retirada de proteínas não fibrosas de cartilagens elásticas da orelha de bovinos.(AU)


Subject(s)
Biocompatible Materials , Chondrocytes , Tissue Engineering/veterinary , Elastic Cartilage , Extracellular Matrix , Cattle , Cartilage , Eosine Yellowish-(YS) , Alkalies
10.
Rev. colomb. anestesiol ; 48(1): 30-37, Jan.-Mar. 2020. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1092917

ABSTRACT

Abstract Introduction: Enhanced recovery after surgery (ERAS) programs in adults have positively impacted morbidity, mortality, and healthcare costs. Its effects on the pediatric population is recognized. Objective: To prepare a narrative review on the current evidence of the various strategies within the framework of enhancing recovery after pediatric surgery, in the context of major abdominal surgery. Methods: A search was conducted on the scientific evidence available in databases (Pubmed/Medline, Science Direct, OVID, SciELO), in order to prepare a narrative literature review. Conclusion: Notwithstanding the limited evidence on the practicality of the ERAS protocols in the pediatric population undergoing major abdominal surgery, better results could be accomplished if these strategies are adopted.


Resumen Introducción: Los programas de recuperación intensificada después de cirugía (ERAS, por sus siglas del inglés enhanced recovery after surgery) en adultos han impactado positivamente en morbilidad, mortalidad y costos en salud. Es conocido su efecto respecto a su efectividad en población pediátrica. Objetivo: Elaborar una revisión narrativa respecto a la evidencia actual de las diferentes estrategias en el marco de programas de recuperación intensificada en cirugía pediátrica (ERPS, por sus siglas del inglés enhancing recovery in pediatric surgery), en el contexto de cirugía abdominal mayor. Métodos: Se realizó una búsqueda sobre la evidencia científica disponible en bases de datos (Pubmed/Medline, Science Direct, OVID, SciELO) para elaborar una revisión narrativa de la literatura. Conclusiones: Aunque existe evidencia limitada sobre la utilidad de los protocolos ERAS en la población pediátrica sometida a cirugía abdominal mayor, podrían lograrse mejores resultados si se adoptan estas estrategias en pacientes pediátricos.


Subject(s)
Humans , Child , Health Strategies , Health Care Costs , Enhanced Recovery After Surgery , Effectiveness , Unified Health System , Morbidity , Mortality , Alkalies
11.
Rev. latinoam. enferm. (Online) ; 28: e3377, 2020. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1126969

ABSTRACT

Objective: to synthesize the knowledge and to critically evaluate the evidences arising from randomized controlled trials on the efficacy of the complementary therapies in the management of cancer pain in adult patients with cancer in palliative care. Method: a systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The search for articles in the MEDLINE, ISI Web of Knowledge, CENTRAL Cochrane, and PsycINFO databases, as well as the manual search, selection of studies, data extraction, and methodological assessment using the Cochrane Bias Risk tool were performed independently by two reviewers. Results: eight hundred and fifteen (815) studies were identified, six of them being selected and analyzed, of which three used massage therapy, one study used a combination of progressive muscle relaxation and guided imaging, and another two studies used acupuncture. Most of the studies had an uncertain risk of bias (n=4; 67%). Conclusion: while the evidence from the studies evaluating the use of massage therapy or the use of progressive muscle relaxation and guided imaging for the management of cancer pain in these patients demonstrated significant benefits, the other two studies that evaluated the use of acupuncture as a complementary therapy showed contradictory results, therefore, needing more research studies to elucidate such findings.


Objetivo: sintetizar o conhecimento e avaliar criticamente as evidências provenientes de ensaios clínicos controlados randomizados sobre a eficácia das terapias complementares no manejo da dor oncológica em pacientes adultos com câncer em cuidados paliativos. Método: revisão sistemática guiada pelo Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A busca dos artigos nas bases de dados MEDLINE, ISI Web of Knowledge, CENTRAL Cochrane e PsycINFO, bem como a busca manual, seleção dos estudos, extração dos dados e avaliação metodológica pela ferramenta do Risco de Viés da Cochrane foram realizadas por dois revisores de forma independente. Resultados: foram identificados 815 estudos, sendo seis selecionados e analisados, dos quais três utilizaram a massagem terapêutica, um estudo usou uma combinação de relaxamento muscular progressivo e imagem guiada, e outros dois estudos a acupuntura. A maioria dos estudos apresentou risco de viés incerto (n=4; 67%). Conclusão: enquanto as evidências dos estudos que avaliaram o uso da massagem terapêutica ou o uso de relaxamento muscular progressivo e imagem guiada para manejo da dor oncológica nesses pacientes mostraram benefícios significativos, os outros dois estudos que avaliaram o uso da acupuntura como terapia complementar exibiram resultados divergentes, necessitando, portanto, de mais pesquisas para elucidar tais achados.


Objetivo: sintetizar conocimiento y realizar el análisis crítico de las evidencias procedentes de ensayos clínicos controlados aleatorios sobre la eficacia de las terapias complementarias en el manejo del dolor oncológico en pacientes adultos con cáncer en cuidados paliativos. Método: revisión sistemática guiada por el Preferred Reporting Items for Systematic Reviews and Meta-Analyses. La búsqueda de artículos en las bases de datos MEDLINE, ISI Web of Knowledge, CENTRAL Cochrane y PsycINFO, así como la búsqueda manual, selección de estudios, extracción de datos y evaluación metodológica con la utilización de la herramienta Riesgo de Sesgo de Cochrane se realizaron por dos revisores de forma independiente. Resultados: se identificaron 815 estudios, de los cuales, seis fueron seleccionados y analizados, siendo que tres utilizaron masaje terapéutico, un estudio utilizó una combinación de relajación muscular progresiva e imagen guiada, y otros dos estudios la acupuntura. La mayor parte de los estudios presentaron riesgo de sesgo incierto (n=4; 67%) Conclusión: mientras las evidencias de los estudios que evalúan el uso de la del masaje terapéutico o el uso de la relajación muscular progresiva y las imágenes guiadas para el manejo del dolor oncológico en estos pacientes demostraron beneficios significativos, los otros dos estudios que evaluaron el uso de la acupuntura como terapia complementaria mostraron resultados divergentes, razón por la cual se requiere de más investigación para dilucidar tales hallazgos.


Subject(s)
Humans , Male , Female , Adult , Oncology Nursing , Palliative Care , Therapeutics , Complementary Therapies , Efficacy , Imagery, Psychotherapy , Quality Indicators, Health Care , Acupuncture , Alkalies , Evidence-Based Nursing , Cancer Pain , Massage , Muscle Relaxation , Neoplasms
12.
Paidéia (Ribeirão Preto, Online) ; 30: e3022, 2020. tab, graf
Article in English | LILACS, INDEXPSI | ID: biblio-1135444

ABSTRACT

Abstract Interventions to reduce stigma related to people who use drugs can improve their quality of life and adherence to treatment. This review aimed to identify and analyze studies on interventions to reduce the stigma related to people who use drugs. Searches were performed in the following databases, without period delimitation: PubmMed, APA PsycNET, ScienceDirect, Web of Science, and VHL. Considering secondary referencing, we identified a total of 5,488 records. This review covered 28 articles and was based on PRISMA. Although target audiences comprising students and health professionals were predominant, as well as the use of quantitative methods, sample size and interventions varied among studies. The selected studies present considerable methodological limitations. We concluded that no evidence confirms the effectiveness of the proposed interventions and which of them should continue to be applied for this specific aim. It is essential to invest in approaches other than those traditionally adopted.


Resumo Intervenções para a redução do estigma relacionado às pessoas que usam drogas podem melhorar sua qualidade de vida e adesão ao tratamento. Esta revisão teve por objetivo identificar e analisar estudos de intervenções para reduzir o estigma relacionado às pessoas que usam drogas. Foram realizadas buscas nas bases PubMed, APA PsycNET, ScienceDirect, Web of Science e BVS, sem delimitação de ano. Foram identificados 5.488 registros somados à busca secundária de referências. Esta revisão abrange 28 artigos e foi baseada no PRISMA. Houve variação no tamanho da amostra e intervenções, embora o público-alvo de estudantes e profissionais da saúde e o uso de métodos quantitativos tenham sido predominantes. Limitações metodológicas consideráveis foram identificadas nos estudos. Portanto, conclui-se que não há evidências que permitam inferir que as intervenções propostas são efetivas e quais delas deveriam continuar a ser empregadas para essa finalidade. É imprescindível investir em abordagens distintas das adotadas tradicionalmente.


Resumen Las intervenciones para la reducción del estigma relacionado a las personas que usan drogas pueden mejorar su calidad de vida y la adherencia al tratamiento. Esta revisión tuvo como objetivo identificar y analizar los estudios sobre las intervenciones para la reducción del estigma relacionado a las personas que usan drogas. Se realizaron búsquedas en las bases de datos PubMed, APA PsycNET, ScienceDirect, Web of Science y BVS, sin delimitación del año. Se identificaron 5.488 registros sumados a la búsqueda secundaria de referencias. Esta revisión abarca 28 artículos y se basó en PRISMA. Hubo una variación en el tamaño de la muestra y las intervenciones, aunque fueron predominantes el público objetivo de estudiantes y profesionales de la salud y el uso de métodos cuantitativos. Se identificaron limitaciones metodológicas considerables en los estudios. Se concluye que no hay evidencias de que las intervenciones propuestas son efectivas y cuáles deberán seguir siendo utilizadas para este propósito. Es esencial invertir en enfoques distintos de los adoptados tradicionalmente.


Subject(s)
Psychology , Quality of Life , Christianity , Health Personnel , Substance-Related Disorders , Alkalies , Social Stigma
13.
Chinese Journal of Biotechnology ; (12): 1356-1364, 2020.
Article in Chinese | WPRIM | ID: wpr-826841

ABSTRACT

Salinity is the most important factor for the growth of crops. It is an effective method to alleviate the toxic effect caused by salt stress using saline-alkali-tolerant and growth-promoting bacteria in agriculture. Seven salt-tolerant bacteria were screened from saline-alkali soil, and the abilities of EPS production, alkalinity reduction and IAA production of the selected strains were investigated. A dominant strain DB01 was evaluated. The abilities of EPS production, alkalinity reduction and IAA production of strain DB01 were 0.21 g/g, 8.7% and 8.97 mg/L, respectively. The isolate was identified as Halomonas aquamarina by partial sequencing analysis of its 16S rRNA genes, and had the ability to inhibit the growth of Fusarium oxysporum f. sp., Alternaria solani, Phytophthora sojae and Rhizoctonia cerealis. It also could promote root length and germination rate of wheat seedlings under salt stress. Halomonas aquamarina can provide theoretical basis for the development of soil microbial resources and the application in saline-alkali soil improvement.


Subject(s)
Alkalies , Metabolism , Bacteria , Genetics , Halomonas , Genetics , Plant Roots , Microbiology , RNA, Ribosomal, 16S , Genetics , Salt Tolerance , Genetics , Seedlings , Microbiology , Soil , Chemistry , Soil Microbiology , Triticum , Microbiology
14.
Electron. j. biotechnol ; 39: 91-97, may. 2019. ilus, graf, tab
Article in English | LILACS | ID: biblio-1052260

ABSTRACT

BACKGROUND: Lipases are extensively exploited in lots of industrial fields; cold-adapted lipases with alkali-resistance are especially desired in detergent industry. Penicillium cyclopium lipase I (PCL) might be suitable for applications of detergent industry due to its high catalytic efficiency at low temperature and relatively good alkali stability. In this study, to better meet the requirements, the alkali stability of PCL was further improved via directed evolution with error-prone PCR. RESULTS: The mutant PCL (N157F) with an improved alkali stability was selected based on a high-throughput activity assay. After incubating at pH 11.0 for 120 min, N157F retained 70% of its initial activity, which was 23% higher than that of wild type PCL. Combined with the three-dimensional structure analysis, N157F exhibited an improved alkali stability under the high pH condition due to the interactions of hydrophilicity and ß-strand propensity. Conclusions: This work provided the theoretical foundation and preliminary data for improving alkali stability of PCL to meet the industrial requirements, which is also beneficial to improving alkali-tolerance ability of other industrial enzymes via molecular modification.


Subject(s)
Penicillium/enzymology , Enzyme Stability , Detergent Industry , Lipase/metabolism , Penicillium/isolation & purification , Penicillium/genetics , Polymerase Chain Reaction/methods , Cold Temperature , Alkalies , Biocatalysis , Hydrophobic and Hydrophilic Interactions , Hydrogen-Ion Concentration , Lipase/isolation & purification , Lipase/genetics , Mutation
15.
Rev. colomb. anestesiol ; 47(1): 49-56, Jan.-Mar. 2019. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-985434

ABSTRACT

Abstract Introduction: Heart failure is a chronic, progressive, prevalent disease, with a high impact on health systems and on the quality of life of patients and families. Dyspnea is a common symptom and management with opioids has been proposed. Objective: To conduct a systematic review of the literature pertaining to the use of opioids for the management of dyspnea in patients with stable chronic heart failure, functional class New York Heart Association (NYHA) II, III, or IV. Materials and methods: A systematic review was conducted in the MEDLINE, Embase, Cochrane, OVID, LILACS, and PROSPERO databases of articles published in 5 languages between January 1, 1995 and July 31, 2018. Studies describing the administration of any type of opioid for the management of dyspnea in patients with stable chronic heart failure NYHA II, III, or IV were included. Results: Four clinical trials were obtained for the final analysis with a total number of 70 patients, describing opioid administration for the management of dyspnea in patients with stable chronic heart failure, NYHA II, III, or IV. Conclusion: In adult patients with compensated chronic heart failure under optimum treatment, there is low-quality evidence that shows benefit with the use of opioids for the management of dyspnea. For a stronger recommendation, controlled, randomized studies with a larger number of subjects are required.


Resumen Introducción: La insuficiencia cardiaca es una enfermedad crónica, progresiva, prevalente, con un alto impacto en los sistemas de salud y en la calidad de vida de los pacientes y sus familias, la disnea es un síntoma común y se ha planteado el uso de opioides para su control. Objetivo: Revisión sistemática de la literatura sobre el uso de opioides en el manejo de la disnea en pacientes con insuficiencia cardiaca crónica estable con clase funcional NYHA II, III o IV. Materiales y métodos: Se realizó una revisión sistemática de los artículos encontrados en las bases de datos MEDLINE, Embase, Cochrane, OVID, LILACS, PROSPERO a partir del 1 de enero del 1995 hasta el 31 de julio del 2018, publicados en cinco idiomas. Se incluyeron aquellos estudios en los cuales se describe la administración de cualquier tipo de opioide para el manejo de la disnea en pacientes con insuficiencia cardiaca crónica estable, NYHA II, III o IV. Resultados: Se incluyeron cuatro ensayos clínicos para el análisis final, con un numero total de 70 pacientes, en los cuales se describe la administración de opioides para el manejo de la disnea en pacientes con insuficiencia cardiaca crónica estable, NYHA II, III, o IV. Conclusiones: En pacientes adultos con insuficiencia cardiaca crónica compensada en tratamiento óptimo, existe evidencia de baja calidad que muestra beneficio para el manejo de la disnea con opioides, deben realizarse estudios aleatorizados controlados con una cantidad de individuos mayor para poder generar una recomendación más fuerte.


Subject(s)
Humans , Quality of Life , Heart Failure , Analgesics, Opioid , Review Literature as Topic , MEDLINE , Alkalies , LILACS
16.
Article in English | WPRIM | ID: wpr-764041

ABSTRACT

Streptococcus mutans is one of the important bacteria that forms dental biofilm and cause dental caries. Virulence genes in S. mutans can be classified into the genes involved in bacterial adhesion, extracellular polysaccharide formation, biofilm formation, sugar uptake and metabolism, acid tolerance, and regulation. The genes involved in bacterial adhesion are gbps (gbpA, gbpB, and gbpC) and spaP. The gbp genes encode glucan-binding protein (GBP) A, GBP B, and GBP C. The spaP gene encodes cell surface antigen, SpaP. The genes involved in extracellular polysaccharide formation are gtfs (gtfB, gtfC, and gtfD) and ftf, which encode glycosyltransferase (GTF) B, GTF C, and GTF D and fructosyltransferase, respectively. The genes involved in biofilm formation are smu630, relA, and comDE. The smu630 gene is important for biofilm formation. The relA and comDE genes contribute to quorum-sensing and biofilm formation. The genes involved in sugar uptake and metabolism are eno, ldh, and relA. The eno gene encodes bacterial enolase, which catalyzes the formation of phosphoenolpyruvate. The ldh gene encodes lactic acid dehydrogenase. The relA gene contributes to the regulation of the glucose phosphotransferase system. The genes related to acid tolerance are atpD, aguD, brpA, and relA. The atpD gene encodes F1F0-ATPase, a proton pump that discharges H⁺ from within the bacterium to the outside. The aguD gene encodes agmatine deiminase system and produces alkali to overcome acid stress. The genes involved in regulation are vicR, brpA, and relA.


Subject(s)
Agmatine , Alkalies , Antigens, Surface , Bacteria , Bacterial Adhesion , Biofilms , Dental Caries , Glucose , Lactic Acid , Metabolism , Oxidoreductases , Phosphoenolpyruvate , Phosphopyruvate Hydratase , Proton Pumps , Streptococcus mutans , Streptococcus , Virulence
17.
Rev. med. Risaralda ; 24(2): 119-124, jul.-dic. 2018. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-985682

ABSTRACT

Resumen Introducción. Se revisaron los fundamentos biológicos de la medicina regenerativa, en particular de las células madre y de los factores de crecimiento plaquetarios. Se presentan la clasificación, fuentes de obtención y mecanismos de acción propuestos para las células madre, así como los grandes desafíos biotecnológicos para el desarrollo de la medicina regenerativa y la evidencia clínica de su relación seguridad/efectividad en la práctica médica. Objetivo. Revisar y sistematizar la información actualizada acerca de los fundamentos y potenciales usos de la medicina regenerativa. Metodología. Se realizó una búsqueda sistemática de la literatura en las bases de datos Pubmed, Medline, Science y Cochrane, entre los años 2010 y el 2016, mediante las siguientes palabras clave: stem cells, mesenchymal stem cells, medicine regenerative, homing, platelet-rich plasma, platelet growth factors.


Abstract Introduction. We reviewed the biological fundaments of regenerative medicine, in particular of stem cells and the platelet growth factors. We presented the classification, sources of supply and proposed mechanisms of action for stem cells, as well as the great challenges of biotechnology for the development of regenerative medicine and the clinical evidence of its safety/efficacy relationship in medical practice. Objective. Review and systematize the updated information about the fundaments and potential uses of the regenerative medicine. Methodology. A systematic literature search was conducted in the Pubmed, Medline, Science and Cochrane databases, between 2010 and 2016, using the following key words: stem cells, mesenchymal stem cells, medicine regenerative, homing, platelet-rich plasma, platelet growth factors.


Subject(s)
Humans , Stem Cells , Intercellular Signaling Peptides and Proteins , Regenerative Medicine , Platelet-Rich Plasma , Biological Products , Biotechnology , Alkalies
18.
Arch. argent. pediatr ; 116(6): 409-414, dic. 2018. ilus, tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-973685

ABSTRACT

Antecedentes. La ingesta de sustancias cáusticas en pediatría constituye una causa frecuente de atención médica en Urgencias. El uso indiscriminado de limpiadores químicos y la facilidad de adquisición son factores determinantes para estas lesiones. Población y métodos. Estudio descriptivo analítico. Se incluyeron niños < 16 años, entre enero de 1998 y diciembre de 2017. Se identificó el agente químico cáustico ingerido por el niño como ácido o alcalino. Se realizó una endoscopía digestiva para tipificar el grado de quemadura. Se comparó el grado de quemadura con el tipo de cáustico; por medio de la prueba de chi² o exacta de Fisher, se consideró significativo el valor de P < 0,05. Resultados. Ingresaron 133 niños en Urgencias por ingesta de cáusticos. El agente cáustico fue ácido en el 41 % y alcalino en el 59 %. El agente ácido más frecuente fue el ácido muriático (36,8 %), mientras que el alcalino fue la sosa (soda) cáustica (41,4 %). La quemadura del esófago fue más frecuente en la ingesta de sosa en comparación con otros cáusticos (p= 0,001), mientras que la quemadura del estómago (p= 0,001) y del duodeno (p= 0,002) fue estadísticamente significativa en la ingesta de ácido muriático. El grupo de edad que más frecuentemente ingirió algún cáustico (93,2 %) fueron los menores de 5 años. Conclusiones. El cáustico ingerido con mayor frecuencia fue un agente alcalino, que provocó quemadura esofágica, mientras que un agente ácido provocó quemaduras en el estómago y el duodeno evidenciadas por endoscopía.


Background. Caustic ingestion in pediatrics is a common cause of visits to the Emergency Department. An indiscriminate use of cleaning chemicals and an easy access to them are determining factors for these injuries. Population and methods. Descriptive, analytical study. Children aged < 16 years hospitalized between January 1998 and December 2017 were included. The ingested caustic substance was identified as acid or alkaline. A gastrointestinal endoscopy was done to establish the burn grade. The grade of the burn was compared to the type of caustic substance using the χ² test or the Fisher's exact test; a P value < 0.05 was considered significant. Results. A total of 133 children were admitted to the Emergency Department due to caustic ingestion. The caustic agent was acid in 41 % of cases and alkaline, in 59 %. The most common acid caustic substance was muriatic acid (36.8 %) and the most common alkaline caustic agent was caustic soda (41.4 %). An esophageal burn was the most common consequence of caustic soda ingestion compared to other caustic agents (p = 0.001), whereas muriatic acid ingestion was the most statistically significant cause of stomach burn (p = 0.001) and duodenal burn (p = 0.002). The age group that most commonly ingested some caustic agent (93.2 %) corresponded to children younger than 5 years. Conclusions. The most common type of ingested caustic agent was alkaline, which caused esophageal burn; whereas, the ingestion of an acid caustic substance caused stomach and duodenal burns, as evidenced by endoscopy.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Burns, Chemical/diagnosis , Caustics/poisoning , Endoscopy, Gastrointestinal/methods , Gastrointestinal Tract/injuries , Stomach/injuries , Acids/poisoning , Burns, Chemical/etiology , Burns, Chemical/epidemiology , Epidemiology, Descriptive , Age Factors , Duodenum/injuries , Alkalies/poisoning , Emergency Service, Hospital , Esophagus/injuries
19.
Electron. j. biotechnol ; 34: 37-42, july. 2018. tab, graf
Article in English | LILACS | ID: biblio-1045997

ABSTRACT

Background: Astaxanthin from natural sources is typically esterified with fatty acids; hence, it must be hydrolyzed to remove esters before identification and quantification by conventional HPLC. Alkaline-catalyzed saponification and enzyme-catalyzed enzymolysis are the most commonly used de-esterification methods. However, information on the efficiency and isomerization during de-esterification of natural astaxanthin esters by these two methods remains scarce. Therefore, we conducted two HPLC-based experiments to determine which method is better for hydrolyzing astaxanthin esters. Results: To assess the effect of enzymolysis (0.67 U/mL cholesterol esterase, at 37°C) and saponification (0.021 M NaOH, at 5°C) conditions on free astaxanthin recovery and destruction or structural transformation of astaxanthin, we varied the total treatment time across a range of 195 min. The results showed that enzymolysis and saponification were complete in 60 min and 90 min, respectively. After complete hydrolysis, the maximum free astaxanthin recovery obtained by enzymolysis was 42.6% more than that obtained by saponification. The identification of by-products, semi-astacene and astacene, during the process of saponification also indicated that a more severe degradation of astaxanthin occurred during saponification. Moreover, the composition of astaxanthin isomers during saponification was similar to that of the isomers during enzymolysis between 30 min and 75 min (all-trans:9-cis:13-cis = 21:3:1, approximately) but dramatically changed after 90 min, whereas the composition in the enzymolysis treatment remained relatively stable throughout. Conclusion: Compared with saponification, enzymolysis with cholesterol esterase was recommended as a more accurate method for de-esterification of natural astaxanthin esters for further qualitative and quantitative HPLC analysis.


Subject(s)
Xanthophylls/chemistry , Esters/chemistry , Carotenoids , Xanthophylls/metabolism , Alkalies , Enzymes/metabolism , Esters/metabolism , Hydrolysis , Isomerism
20.
Rev. colomb. psiquiatr ; 47(2): 119-128, abr.-jun. 2018. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-960178

ABSTRACT

ABSTRACT Background: Previous studies suggest that inflammatory molecules play an important role in the pathophysiology of Bipolar Disorder (BD). The evidence suggests that BD may present a progressive course. Therefore there are theories that postulate the relationship between progression and stages of the disease with distinct peripheral biomarkers. Objective: The aim of this study was to carry out a systematic review of the literature of studies about the association between peripheral inflammatory markers and clinical variables related with staging in BD patients. Methods: We conducted a systematic review using electronic databases: PubMed, SciELO, LiLACS and PsycINFO. Keywords were divided into inflammatory markers and, BD and staging. Studies involving euthymic BD patients, studies evaluating peripheral biomarkers and studies correlating these with clinical variables related to neuroprogression or stage of BD were included. Results: We present and discuss the methods and findings of ten articles. The inflammatory markers were measured with different techniques and show some contradictories results. The TNF superfamily and inflammatory cytokines may have a relationship with the neuroprogression of the disease. Conclusions: This study suggests that TNF and ILs could play a role in neuroprogression. However, longitudinal studies are needed to clarify the relationship between factors associated with neuroprogression.


RESUMEN Introducción: Estudios previos indican que las moléculas inflamatorias tienen un papel importante en la fisiopatología del trastorno bipolar (TB). La evidencia apunta a que el TB puede presentar un curso progresivo. Por lo tanto, existen teorías que han postulado una relación entre la progresión y los estadios de la enfermedad con diferentes biomarcadores Revisión sistemática periféricos. Objetivo: El objetivo de este estudio es realizar una revisión sistemática de la literatura de los estudios sobre la asociación entre los marcadores inflamatorios periféricos y las variables clínicas relacionadas con la estadificación en los pacientes con TB. Métodos: Se llevó a cabo una revisión sistemática usando las bases de datos electrónicas PubMed, SciELO, LiLACS y PsycINFO. Las palabras clave se dividieron en marcadores inflamatorios y TB y estadificación. Se incluyeron estudios que evaluaron a pacientes con TB en fase de eutimia, estudios que evaluaron biomarcadores periféricos y estudios que correlacionaron dichos marcadores con las variables clínicas relacionadas con la neuroprogresión o estadificación del TB. Resultados: Se presentan y se discuten los métodos y los hallazgos de 10 artículos. Los marcadores inflamatorios se determinaron con diferentes técnicas y mostraron resultados contradictorios. La super familia del factor de necrosis tumoral y las citocinas inflamatorias podrían tener una relación con la neuroprogresión de la enfermedad. Conclusiones: El presente estudio indica que el factor de necrosis tumoral y las intereucinas pueden tener un papel en la neuroprogresión del TB. Sin embargo, se requieren estudios longitudinales con el fin de clarificar la relación entre los factores asociados con la neuro-progresión.


Subject(s)
Humans , Male , Female , Bipolar Disorder , Biomarkers , Play and Playthings , Disease , Longitudinal Studies , Cytokines , Alkalies
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