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1.
Polymers (Basel) ; 15(9)2023 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-37177145

RESUMO

This work evaluates for the first time the potential of an environmentally friendly plasticizer derived from epoxidized Brazil nut oil (EBNO) for biopolymers, such as poly(lactic acid) (PLA). EBNO was used due to its high epoxy content, reaching an oxirane oxygen content of 4.22% after 8 h of epoxidation for a peroxide/oil ratio of 2:1. Melt extrusion was used to plasticize PLA formulations with different EBNO contents in the range of 0-10 phr. The effects of different amounts of EBNO in the PLA matrix were studied by performing mechanical, thermal, thermomechanical, and morphological characterizations. The tensile test demonstrated the feasibility of EBNO as a plasticizer for PLA by increasing the elongation at break by 70.9% for the plasticized PLA with 7.5 phr of EBNO content in comparison to the unplasticized PLA. The field-emission scanning electron microscopy (FESEM) of the fractured surfaces from the impact tests showed an increase in porosity and roughness in the areas with EBNO addition, which was characteristic of ductile failure. In addition, a disintegration test was performed, and no influence on the PLA biodegradation process was observed. The overall results demonstrate the ability of EBNO to compete with other commercial plasticizers in improving the ductile properties of PLA.

2.
Polymers (Basel) ; 14(22)2022 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-36433143

RESUMO

In this work, different silk fillers combined with maleinized corn oil (MCO), as environmentally friendly plasticizers, were used to modify the mechanical and thermal properties of polylactic acid (PLA) composites. Melt extrusion and injection were used to obtain samples with a content of 10 wt.% of MCO and 0.5 phr of different silk fillers: crushed silk (CS), silk fibroin microparticles (SFM), and silk fibroin nanoparticles (SFN). PLA formulation with 10 wt.% of MCO and 0.5 g of CS per hundred grams of composite (phr) showed the highest increase in mechanical ductile properties with an increase in elongation at break of approximately 1400%, compared with PLA. Differential scanning calorimetry (DSC) showed a decrease of 2 °C in their glass transition temperature with the addition of different silk fillers. In addition, SFM and SFN increase the degree of crystallinity of PLA. This increment was also confirmed by infrared spectroscopy analysis. Field emission scanning electron microscopy (FESEM) images revealed a good dispersion of the different silk fillers. Among them, PLA formulation with 10 wt.% MCO and 0.5 phr of SFN, showed an optimal balance between maximum resistance and elongation at break, with 52.0 MPa and 10.8%, respectively, improving elongation at break by 635%. Furthermore, all samples were satisfactorily disintegrated under composting conditions.

3.
Polymers (Basel) ; 14(19)2022 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-36236152

RESUMO

The present work analyzes the influence of modified, epoxidized and maleinized corn oil as a plasticizing and/or compatibilizing agent in the PLA-PHB blend (75% PLA and 25% PHB wt.%). The chemical modification processes of corn oil were successfully carried out and different quantities were used, between 0 and 10% wt.%. The different blends obtained were characterized by thermal, mechanical, morphological, and disintegration tests under composting conditions. It was observed that to achieve the same plasticizing effect, less maleinized corn oil (MCO) is needed than epoxidized corn oil (ECO). Both oils improve the ductile properties of the PLA-PHB blend, such as elongation at break and impact absorb energy, however, the strength properties decrease. The ones that show the highest ductility values are those that contain 10% ECO and 5% MCO, improving the elongation of the break of the PLA-PHB blend by more than 400% and by more than 800% for the sample PLA.

4.
Polymers (Basel) ; 13(12)2021 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-34201407

RESUMO

Gum rosin (GR) was used as a natural additive to improve the compatibility between polylactic acid, PLA, and poly(butylene adipate-co-terephthalate, PBAT, blended with 20 wt.% of PBAT (PLA/PBAT). The PBAT was used as a soft component to increase the ductility of PLA and its fracture toughness. The coalescence of the PBAT domains was possible due to the plasticization effect of the GR component. These domains contributed to increasing the toughness of the final material due to the variation and control of the PBAT domains' size and consequently, reducing the stress concentration points. The GR was used in contents of 5, 10, 15, and 20 phr. Consequently, the flexural properties were improved and the impact resistance increased up to 80% in PLA/PBAT_15GR with respect to the PLA/PBAT formulation. Field emission scanning electron microscope (FESEM) images allowed observing that the size of PBAT domains of 2-3 µm was optimal to reduce the impact stress. Differential scanning calorimetry (DSC) analysis showed a reduction of up to 8 °C on the PLA melting temperature and up to 5.3 °C of the PLA glass transition temperature in the PLA/PBAT_20GR formulation, which indicates an improvement in the processability of PLA. Finally, transparent films with improved oxygen barrier performance and increased hydrophobicity were obtained suggesting the potential interest of these blends for the food packaging industry.

5.
Polymers (Basel) ; 13(14)2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34301132

RESUMO

In this study, for the first time, Brazil nut seed oil was chemically modified with maleic anhydride to obtain maleinized Brazil nut seed oil (MBNO). The same process was developed to obtain maleinized hemp seed oil (MHO). The use of MBNO and MHO was studied as bio-based plasticizers by incorporating them with different contents ranging from 0 to 10 phr in a polylactic acid (PLA) matrix. By means of mechanical, thermal and thermomechanical characterization techniques, the properties of the different formulations were studied to evaluate the plasticizing effect of the MBNO and MHO. With the addition of both plasticizers, a significant increase in ductile properties was observed, reaching an increase in elongation at break of 643% with 7.5 phr MBNO and 771% with 10 phr MHO compared to neat PLA. In addition, it has been observed that the mechanical resistant properties do not decrease, since the oils enhance the crystallization of PLA by increasing the free volume between its chains and counteracting the effect. Finally, a disintegration test was carried out under thermophilic conditions at 58 °C for 27 days, demonstrating that the incorporation of MHO and MBNO does not significantly affect the biodegradability of neat PLA.

6.
Polymers (Basel) ; 13(9)2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-34067087

RESUMO

Mater-Bi® NF866 (MB) was blended with gum rosin and two pentaerythritol esters of gum rosin (labeled as LF and UT), as additives, to produce biobased and compostable films for food packaging or agricultural mulch films. The films were prepared by blending MB with 5, 10, and 15 wt.% of each additive. The obtained films were characterized by optical, colorimetric, wettability, and oxygen barrier properties. Moreover, the additives and the MB-based films were disintegrated under composting conditions and the effect of each additive on the biodegradation rate was studied. All films were homogeneous and optically transparent. The color of the films tended to yellow tones due to the addition of pine resin derivatives. All the formulated films presented a complete UV-transmittance blocking effect in the UVA and UVB region, and those with 5 wt.% of pine resin derivatives increased the MB hydrophobicity. Low amounts of resins tend to maintain the oxygen transmission rate (OTR) values of the neat MB, due to its good solubilizing and compatibilizing effects. The disintegration under composting conditions test revealed that gum rosin completely disintegrates in about 90 days, while UT degrades 80% and LF degrades 5%, over 180 days of incubation. As expected, the same tendency was obtained for the disintegration of the studied films, although Mater-Bi® reach 28% of disintegrability over the 180 days of the composting test.

7.
Polymers (Basel) ; 13(8)2021 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-33920060

RESUMO

The use of a new bio-based plasticizer derived from epoxidized chia seed oil (ECO) was applied in a poly(lactic acid) (PLA) matrix. ECO was used due to its high epoxy content (6.7%), which led to an improved chemical interaction with PLA. Melt extrusion was used to plasticize PLA with different ECO content in the 0-10 wt.% range. Mechanical, morphological, and thermal characterization was carried out to evaluate the effect of ECO percentage. Besides, disintegration and migration tests were studied to assess the future application in packaging industry. Ductile properties improve by 700% in elongation at break with 10 wt.% ECO content. Field emission scanning electron microscopy (FESEM) showed a phase separation with ECO content equal or higher than 7.5 wt.%. Thermal stabilization was improved 14 °C as ECO content increased. All plasticized PLA was disintegrated under composting conditions, not observing a delay up to 5 wt.% ECO. Migration tests pointed out a very low migration, less than 0.11 wt.%, which is to interest to the packaging industry.

8.
Polymers (Basel) ; 13(4)2021 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-33546216

RESUMO

This contribution focuses on the development of flax and flax/basalt hybrid reinforced composites based on epoxidized linseed oil (ELO) resin, exploiting the feasibility of different ratios of glutaric anhydride (GA) to maleinized linseed oil (MLO) in the hardener system (50:0, 40:10 and 30:20 wt.%) to provide crosslinked thermosets with balanced properties. The hybrid laminates have been manufactured by resin transfer molding (RTM) and subjected to dynamic-mechanical (DMA) and thermal gravimetry (TGA) analysis. The presence of glutaric anhydride (GA) resulted in hard and relatively brittle flax and flax/basalt laminates, whose loss moduli decreased as the number of basalt plies diminished. Furthermore, the increase in MLO content in the GA:MLO hardener system shifted the glass transition temperatures (Tg) from 70 °C to 59 and 56 °C, which is representative of a decrease in brittleness of the crosslinked resin. All samples exhibited two stages of their decomposition process irrespective of the MLO content. The latter influenced the residual mass content that increased with the increase of the MLO wt.% from 10 to 30 wt.%, with shifts of the final degradation temperatures from 410 °C to 425 °C and 445 °C, respectively.

9.
Artigo em Inglês | MEDLINE | ID: mdl-33050616

RESUMO

The current COVID-19 pandemic has paralysed whole countries, which have had to confine their entire population and this changed people's lives worldwide. The aim of this study is to identify the reasons for and the level of commitment to physical activity among the Spanish population during confinement and the return to the "new normal". A sample of 1025 amateurs, 534 males and 491 females with an average age of 35 years old were interviewed using an online survey that collected their motives for practising sport and their commitment to physical activity. A cluster analysis combining hierarchical and non-hierarchical methods was performed, identifying three groups of amateurs: High Commitment (n = 650), Moderate Commitment (n = 324), and Low Commitment (n = 81). The main motives shown by the different groups were psychological motives related to an improved or managed general or emotional well-being. Regarding commitment, all the groups showed higher scores in enthusiasm for physical activity than affliction from sport. The variables referring to gender, educational level and sports habits showed differences that enabled the identification of the different groups. These findings highlight the importance of conducting segmentation studies that provide specific population profiles to improve the action strategies of governments and specialists.


Assuntos
Infecções por Coronavirus/prevenção & controle , Motivação , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena , Esportes/psicologia , Adulto , COVID-19 , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Pneumonia Viral/epidemiologia , Espanha/epidemiologia
10.
An. psicol ; 36(3): 553-560, oct. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-195672

RESUMO

El objetivo de este estudio fue conocer cómo se ha llevado a cabo el trabajo psicológico en el proceso de formación deportiva de los luchadores olímpicos españoles. Partiendo de un enfoque cualitativo, el instrumento utilizado fue una entrevista semi-estructurada, la cual se aplicó a 21 luchadores olímpicos. Los resultados muestran que los deportistas conceden gran importancia a los factores psicológicos en su disciplina, y que son fundamentales en la etapa de alta competición para alcanzar la excelencia. Consideran la motivación y la autoconfianza como las variables psicológicas más significativas en el rendimiento deportivo y predictoras del éxito en lucha. También se valoran aspectos necesarios como la capacidad de sacrificio, constancia, disciplina y perseverancia. Estiman que no han trabajado adecuadamente los aspectos psicológicos, y solo en épocas recientes se ha incorporado la figura del psicólogo deportivo a su entrenamiento


The aim of this study was to know how psychological work has been carried out in sports training process of Spanish Olympic wrestlers. From a qualitative perspective, the instrument used was a semi-structured interview, which was applied to 21 Olympic wrestlers. The results show that athletes attach great importance to psychological factors in their discipline, and that they are essential at the high competition stage to achieve excellence.They consider motivation and self-confidence as the most significant psychological variables in sports performance, and predictors of wrestling success. Also necessary aspects such as a capacity for self-sacrifice, constancy, discipline and perseverance are valued. They estimate that psychological aspects have not been properly trained, and only in recent times has the figure of the sports psychologist been incorporated into their training


Assuntos
Humanos , Masculino , Feminino , Psicologia do Esporte/métodos , Atletas/psicologia , Luta Romana/psicologia , Desempenho Atlético/psicologia , Adaptação Psicológica , Inquéritos e Questionários , Motivação , Comportamento Competitivo
11.
Polymers (Basel) ; 12(6)2020 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-32545882

RESUMO

In this study, different compatibilizing agents were used to analyze their influence on immiscible blends of polylactide (PLA) and biobased high-density polyethylene (bioPE) 80/20 (wt/wt). The compatibilizing agents used were polyethylene vinyl acetate (EVA) with a content of 33% of vinyl acetate, polyvinyl alcohol (PVA), and dicumyl peroxide (DPC). The influence of each compatibilizing agent on the mechanical, thermal, and microstructural properties of the PLA-bioPE blend was studied using different microscopic techniques (i.e., field emission electron microscopy (FESEM), transmission electron microscopy (TEM), and atomic force microscopy with PeakForce quantitative nanomechanical mapping (AFM-QNM)). Compatibilized PLA-bioPE blends showed an improvement in the ductile properties, with EVA being the compatibilizer that provided the highest elongation at break and the highest impact-absorbed energy (Charpy test). In addition, it was observed by means of the different microscopic techniques that the typical droplet-like structure is maintained, but the use of compatibilizers decreases the dimensions of the dispersed droplets, leading to improved interfacial adhesion, being more pronounced in the case of the EVA compatibilizer. Furthermore, the incorporation of the compatibilizers caused a very marked decrease in the crystallinity of the immiscible PLA-bioPE blend.

12.
Materials (Basel) ; 11(10)2018 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-30279367

RESUMO

Recycling polymers is common due to the need to reduce the environmental impact of these materials. Polypropylene (PP) is one of the polymers called 'commodities polymers' and it is commonly used in a wide variety of short-term applications such as food packaging and agricultural products. That is why a large amount of PP residues that can be recycled are generated every year. However, the current increasing introduction of biodegradable polymers in the food packaging industry can negatively affect the properties of recycled PP if those kinds of plastics are disposed with traditional plastics. For this reason, the influence that generates small amounts of biodegradable polymers such as polylactic acid (PLA), polyhydroxybutyrate (PHB) and thermoplastic starch (TPS) in the recycled PP were analyzed in this work. Thus, recycled PP was blended with biodegradables polymers by melt extrusion followed by injection moulding process to simulate the industrial conditions. Then, the obtained materials were evaluated by studding the changes on the thermal and mechanical performance. The results revealed that the vicat softening temperature is negatively affected by the presence of biodegradable polymers in recycled PP. Meanwhile, the melt flow index was negatively affected for PLA and PHB added blends. The mechanical properties were affected when more than 5 wt.% of biodegradable polymers were present. Moreover, structural changes were detected when biodegradable polymers were added to the recycled PP by means of FTIR, because of the characteristic bands of the carbonyl group (between the band 1700⁻1800 cm-1) appeared due to the presence of PLA, PHB or TPS. Thus, low amounts (lower than 5 wt.%) of biodegradable polymers can be introduced in the recycled PP process without affecting the overall performance of the final material intended for several applications, such as food packaging, agricultural films for farming and crop protection.

13.
Expert Rev Gastroenterol Hepatol ; 12(5): 471-478, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29629846

RESUMO

INTRODUCTION: Pancreatic neuroendocrine tumors (pNETs) represent a small part of pancreatic neoplasms, and the knowledge about their indolent clinical course remains a subject of investigation. They occur sporadically or as part of familial cancer syndromes and are classified by WHO in 3 categories. There is ongoing research to understand their molecular profiling and leading mutations. Areas covered: The aim of this review is to clarify the overall aspects of tumorigenesis, to expose the latest developments in understanding the course of the disease and the possible therapeutic implications of these. The review also discusses functional and non-functional pNETs and associated inherited syndromes as well as pNET molecular profiling and its possible guidance in the use of targeted therapy. Expert commentary: In the next decade, a more extensive application of new technologies will help improve quality of life and survival, individualizing treatment protocols and identifying which therapeutic strategy is more suitable for each kind of NET.


Assuntos
Biomarcadores Tumorais/genética , Perfilação da Expressão Gênica/métodos , Tumores Neuroendócrinos/genética , Neoplasias Pancreáticas/genética , Antineoplásicos/uso terapêutico , Biomarcadores Tumorais/metabolismo , Tomada de Decisão Clínica , Regulação Neoplásica da Expressão Gênica , Humanos , Terapia de Alvo Molecular , Tumores Neuroendócrinos/tratamento farmacológico , Tumores Neuroendócrinos/metabolismo , Tumores Neuroendócrinos/patologia , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/metabolismo , Neoplasias Pancreáticas/patologia , Medicina de Precisão , Valor Preditivo dos Testes , Transdução de Sinais
14.
Clin Lung Cancer ; 19(1): 35-41, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28757336

RESUMO

Several oncogenic drivers have been identified in non-small cell lung cancer. Targeted therapies for these aberrations have already been successfully developed and implemented in clinical practice. Owing to improved sensitivity in genetic testing, more and more tumors with multiple driver mutations are identified, resulting in dilemmas for treating physicians whether and which targeted therapy to use. In this case series, we provide an overview of patients with intrinsic double mutations in oncogenic drivers and their reported response to targeted therapies, with a focus on epidermal growth factor receptor, anaplastic lymphoma kinase, cMET, and Kirsten rat sarcoma viral oncogene. We also include an unpublished case report on a patient with an epidermal growth factor receptor L858R and cMET exon 14 skipping.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/genética , Neoplasias Pulmonares/genética , Mutação/genética , Proteínas Proto-Oncogênicas c-met/genética , Quinase do Linfoma Anaplásico/genética , Resistencia a Medicamentos Antineoplásicos/genética , Receptores ErbB/genética , Feminino , Testes Genéticos , Humanos , Pessoa de Meia-Idade , Terapia de Alvo Molecular , Metástase Neoplásica , Proteínas Proto-Oncogênicas p21(ras)/genética
16.
Crit Rev Oncol Hematol ; 113: 256-267, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28427515

RESUMO

INTRODUCTION: The Fibroblast Growth Factor Receptor (FGFR) family consists of Tyrosine Kinase Receptors (TKR) involved in several biological functions. Recently, alterations of FGFR have been reported to be important for progression and development of several cancers. In this setting, different studies are trying to evaluate the efficacy of different therapies targeting FGFR. AREAS COVERED: This review summarizes the current status of treatments targeting FGFR, focusing on the trials that are evaluating the FGFR profile as inclusion criteria: Multi-Target, Pan-FGFR Inhibitors and anti-FGF (Fibroblast Growth Factor)/FGFR Monoclonal Antibodies. EXPERT OPINION: Most of the TKR share intracellular signaling pathways; therefore, cancer cells tend to overcome the inhibition of one tyrosine kinase receptor by activating another. The future of TKI (Tyrosine Kinase Inhibitor) therapy will potentially come from multi-targeted TKIs that target different TKR simultaneously. It is crucial to understand the interaction of the FGF-FGFR axis with other known driver TKRs. Based on this, it is possible to develop therapeutic strategies targeting multiple connected TKRs at once. One correct step in this direction is the reassessment of multi target inhibitors considering the FGFR status of the tumor. Another opportunity arises from assessing the use of FGFR TKI on patients harboring FGFR alterations.


Assuntos
Neoplasias/tratamento farmacológico , Inibidores de Proteínas Quinases/uso terapêutico , Receptores de Fatores de Crescimento de Fibroblastos/antagonistas & inibidores , Resistencia a Medicamentos Antineoplásicos , Fatores de Crescimento de Fibroblastos/antagonistas & inibidores , Fatores de Crescimento de Fibroblastos/fisiologia , Fusão Gênica , Humanos , Terapia de Alvo Molecular , Mutação , Neoplasias/genética , Receptores de Fatores de Crescimento de Fibroblastos/genética , Receptores de Fatores de Crescimento de Fibroblastos/fisiologia , Transdução de Sinais/fisiologia
17.
Minerva Chir ; 72(3): 206-218, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28198177

RESUMO

Treatment of advanced hepatocellular carcinoma remains a challenge, with discouraging results in terms of survival. Following the approval of the multikinase inhibitor sorafenib, a large number of molecular targeted agents have been tested, but many have failed to demonstrate significant efficacy in clinical trials. However, the deeper knowledge in HCC pathogenesis achieved through the years has enabled us to explore new targetable pathways as well as biomarkers that could lead to treatment personalization. In this review, we provide a comprehensive update of the most recent data regarding new drugs under investigation ‒ some like regorafenib, very close to its approval ‒ and new possible targets for future treatments.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Antineoplásicos/uso terapêutico , Carcinoma Hepatocelular/tratamento farmacológico , Neoplasias Hepáticas/tratamento farmacológico , Terapia de Alvo Molecular , Seleção de Pacientes , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/terapia , Humanos , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/terapia , Metáfora , Terapia de Alvo Molecular/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
18.
Med Clin (Barc) ; 124(2): 41-3, 2005 Jan 22.
Artigo em Espanhol | MEDLINE | ID: mdl-15691430

RESUMO

BACKGROUND AND OBJECTIVE: Among nosocomial infections, pneumonia is one of the most important ones due to the mortality, morbidity and the increase of costs that it causes. The implementation of a cost-effective surveillance system for these infections is a challenge for hospitals. The objective of this work was to evaluate three selective methods of surveillance for nosocomial pneumonias in non-critical adult patients. PATIENTS AND METHOD: A prospective surveillance of nosocomial pneumonias was carried out during 4 months in an university hospital of the Valencian Community, by means of three methods based on reports of chest x-ray, consumption of several antibiotics and health-care workers' liaison. Subsequently, possible cases were confirmed through revision of patient's charts, comparing each method with the reference one. RESULTS: Of 541 possible cases of pneumonia, 27 were confirmed. The cumulative incidence was 3.67 cases/1,000 admissions and the incidence density was 5.9 cases/10,000 patient-days. The method with the highest sensitivity was that dealing with the consumption of antibiotics (85.2%), followed by x-rays (70.4%). The method based on the personnel's liaison had 99.4% specificity, while that of x-rays was 75.5%. Negative predictive values were above 95% for the three methods. CONCLUSIONS: A surveillance system for nosocomial pneumonia based on reports of chest x-rays may be very efficient, providing the necessary information to program and to evaluate the prevention and control activities for these infections in the hospital.


Assuntos
Infecção Hospitalar/prevenção & controle , Vigilância da População/métodos , Idoso , Feminino , Humanos , Masculino , Estudos Prospectivos
19.
Med. clín (Ed. impr.) ; 124(2): 41-43, ene. 2005. tab
Artigo em Es | IBECS | ID: ibc-036412

RESUMO

FUNDAMENTO Y OBJETIVO: Entre las infecciones nosocomiales, la neumonía es una de las más importantes por la mortalidad, la morbilidad y el aumento de costes que ocasiona. La implementación de un sistema coste-efectivo para la vigilancia de estas infecciones supone un reto para los hospitales. El objetivo de este trabajo es evaluar 3 métodos selectivos de vigilancia de neumonías nosocomiales en pacientes adultos no críticos. PACIENTES Y MÉTODO: Se ha realizado una vigilancia prospectiva de neumonías nosocomiales durante 4 meses en un hospital universitario de la Comunidad Valenciana, mediante 3 métodos basados en los informes de radiografía de tórax, consumo de varios antibióticos y la declaración del personal sanitario. Posteriormente, se confirmaron los posibles casos mediante revisión de la historia clínica y se comparó cada método con el de referencia consistente en la combinación de los 3. RESULTADOS: De 541 posibles casos de neumonía nosocomial detectados, se confirmaron 27. La incidencia acumulada fue 3,67 casos/1.000 ingresos y la densidad de incidencia de 5,9 casos/10.000 pacientes-día. El método con mayor sensibilidad fue el de consumo de antibióticos(85,2%), seguido por el de radiografías (70,4%). El método basado en la declaración del personal presentó un 99,4% de especificidad, y el de radiografías, un 75,5%. Los valores predictivos negativos fueron superiores al 95% en los 3 métodos. CONCLUSIONES: Un sistema de vigilancia de neumonías nosocomiales basado en los informes de radiografías de tórax puede ser muy eficiente, y proporciona la información necesaria para programar y evaluar las actividades de prevención y control de estas infecciones en el hospital


BACKGROUND AND OBJECTIVE: Among nosocomial infections, pneumonia is one of the most important ones due to the mortality, morbidity and the increase of costs that it causes. The implementation of a cost-effective surveillance system for these infections is a challenge for hospitals. The objective of this work was to evaluate three selective methods of surveillance for nosocomial pneumonias in non-critical adult patients. PATIENTS AND METHOD: A prospective surveillance of nosocomial pneumonias was carried outduring 4 months in an university hospital of the Valencian Community, by means of three methods based on reports of chest x-ray, consumption of several antibiotics and health-care workers’ liaison. Subsequently, possible cases were confirmed through revision of patient’scharts, comparing each method with the reference one. RESULTS: Of 541 possible cases of pneumonia, 27 were confirmed. The cumulative incidence was 3.67 cases / 1,000 admissions and the incidence density was 5.9 cases / 10,000 patient days. The method with the highest sensitivity was that dealing with the consumption of antibiotics (85.2%), followed by x-rays (70.4%). The method based on the personnel’s liaison had 99.4% specificity, while that of x-rays was 75.5%. Negative predictive values were above 95% for the three methods. CONCLUSIONS: A surveillance system for nosocomial pneumonia based on reports of chest x-rays may be very efficient, providing the necessary information to program and to evaluate the prevention and control activities for these infections in the hospital


Assuntos
Humanos , Pneumonia/epidemiologia , Infecção Hospitalar/epidemiologia , Monitoramento Epidemiológico , Radiografia Torácica/métodos , Antibacterianos/uso terapêutico , Valor Preditivo dos Testes
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