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1.
Top Companion Anim Med ; 60: 100875, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38631428

RESUMO

Pet obesity is still a major health issue, which is considered an epidemic by some researchers. Prevention is one of the cornerstones of veterinary care, emphasizing the importance of proactive measures. Human lifestyle was affected during the COVID-19 pandemic, resulting in an increased overweight prevalence in the population. The prevalence of overweight and obesity in dogs during this period has been poorly explored. This study's objectives were to assess the percentage of the French dog population with overweight and obesity, compare the results with a study conducted before the COVID-19 pandemic, and investigate any potential changes in the risk factors. The study collected data through a survey completed by dog owners during their pets' vaccination visits at university veterinary hospitals of Maisons-Alfort (Paris) and Toulouse, in France, between 2020 and 2022. The veterinarian recorded the dog's weight and the body condition score using a 9-point scale. The study included a total of 309 dogs. Of these, 1.6 % were underweight, 63.1 % had an ideal body condition, and 35.3 % were overweight, including 2.3 % of all dogs classified as obese. During the pandemic, French dog diets shifted towards increased commercial food consumption and twice-daily feedings compared to a 2003 study. Factors positively associated with overweight were being female (OR = 3.55; 95 % CI: 1.65-8.01; P=0.002), being senior (OR=4.91; 95 % CI: 2.07-12.2; P<0.001) or geriatric (OR=5.81; 95 % CI: 2.04-17.0; P=0.001) and having an owner underestimating dog's body condition (OR=74.1; 95 % CI: 29.8-215; P<0.001). Recognizing the impact of owner perception enables early intervention strategies, such as educating owners during consultations and conducting teaching sessions at the clinic. This proactive approach could contribute to improved health outcomes and help prevent the onset of obesity-related issues in dogs. The new trends in dogs' diets may have global relevance due to the pandemic's widespread impact. Although no immediate impact on overweight is evident, ongoing research is crucial to understand the pandemic's long-term effects.


Assuntos
COVID-19 , Doenças do Cão , Hospitais Veterinários , Obesidade , Sobrepeso , Cães , Animais , COVID-19/veterinária , COVID-19/epidemiologia , COVID-19/prevenção & controle , Obesidade/veterinária , Obesidade/epidemiologia , Doenças do Cão/epidemiologia , Feminino , Masculino , França/epidemiologia , Prevalência , Sobrepeso/veterinária , Sobrepeso/epidemiologia , Fatores de Risco , SARS-CoV-2 , Humanos , Inquéritos e Questionários
2.
Anaesthesia ; 79(3): 309-317, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38205529

RESUMO

Global warming is a major public health concern. Volatile anaesthetics are greenhouse gases that increase the carbon footprint of healthcare. Modelling studies indicate that total intravenous anaesthesia is less carbon intensive than volatile anaesthesia, with equivalent quality of care. In this observational study, we aimed to apply the findings of previous modelling studies to compare the carbon footprint per general anaesthetic of an exclusive TIVA strategy vs. a mixed TIVA-volatile strategy. This comparative retrospective study was conducted over 2 years in two French hospitals, one using total intravenous anaesthesia only and one using a mixed strategy including both intravenous and inhalation anaesthetic techniques. Based on pharmacy procurement records, the quantity of anaesthetic sedative drugs was converted to carbon dioxide equivalents. The primary outcome was the difference in carbon footprint of hypnotic drugs per intervention between the two strategies. From 1 January 2021 to 31 December 2022, 25,137 patients received general anaesthesia in the hospital using the total intravenous anaesthesia strategy and 22,020 in the hospital using the mixed strategy. The carbon dioxide equivalent footprint of hypnotic drugs per intervention in the hospital using the total intravenous anaesthesia strategy was 20 times lower than in the hospital using the mixed strategy (emissions of 2.42 kg vs. 48.85 kg carbon dioxide equivalent per intervention, respectively). The total intravenous anaesthesia strategy significantly reduces the carbon footprint of hypnotic drugs in general anaesthesia in adult patients compared with a mixed strategy. Further research is warranted to assess the risk-benefit ratio of the widespread adoption of total intravenous anaesthesia.


Assuntos
Anestésicos Gerais , Anestésicos Inalatórios , Propofol , Adulto , Humanos , Propofol/efeitos adversos , Anestesia Intravenosa/métodos , Pegada de Carbono , Dióxido de Carbono , Estudos Retrospectivos , Anestesia Geral , Hipnóticos e Sedativos
3.
BMC Vet Res ; 18(1): 163, 2022 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-35509073

RESUMO

BACKGROUND: Nowadays, more people are treating dogs as family members. This reflects their increased attention towards their nutrition, with renewed interest for non-conventional diets such as Biologically Appropriate Raw Food/ Bones and Raw Food in United States (BARF) or homemade. In previous studies, owners feeding their dog non-conventional diets reported lower levels of trust in veterinary advice. The aim of the study was to identify differences in lifestyle between owners feeding dogs non-conventional diets and those feeding conventional diets (i.e., dry/wet pet food) to give further insight for improving communication between veterinarians and owners. RESULTS: A total of 426 surveys were usable. Fifteen percent of the participants lived in the metropole of Paris and had more than one dog (mean 1.72 dogs). Thirty-eight percent of the survey respondents stated that their dogs were fed exclusively with non-conventional diets, while 55% declared using conventional diets alone (not considering treats). The study canine population was for the most part neutered (63%) and purebred (68%). Amongst owners feeding conventional diets exclusively, 47% determined how much food to feed by consulting the feeding guidelines on the packaging, and only 28% said that the amount of food was prescribed by their veterinarian or veterinary nurse. Out of the participants feeding non-conventional diets, 65% declared that the information for formulating the recipes was gathered on the internet or in non-veterinary books. When compared with owners feeding exclusively conventional diets, those feeding non-conventional diets were living more frequently outside the metropole of Paris, had fewer children (0.23 ± 0.57 vs 0.37 ± 0.78; p = 0.03) and had more frequently other animals. They also dewormed less often their pets, walked their dog more each day (91 vs 78%; p < 0.001) and without leash for more than 6 h per week (46 vs 31%; p = 0.003). CONCLUSIONS: This survey described differences in the habits of owners feeding dogs non-conventional diets in comparison with those feeding conventional diets. Data suggest that owners using non-conventional diets may be more attentive to the ethological needs of their dog which could be a starting point for practitioners for achieving better client-veterinarian communication.


Assuntos
Ração Animal , Médicos Veterinários , Ração Animal/análise , Animais , Dieta/veterinária , Cães , França , Humanos , Animais de Estimação , Inquéritos e Questionários , Estados Unidos
4.
J Insect Sci ; 22(3)2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35640027

RESUMO

The augmentorium is a cost-effective screened enclosure designed to receive fruits infested with insect pests, retain the pests inside but let their natural enemies escape to enhance biological control of pest populations. Screen selection is critical to ensure that an augmentorium is effective for a particular system. Here we tested five types of screens with a mini-augmentorium design and measured the escape of four insect species under laboratory conditions: the pests olive fruit fly Bactocera oleae (Rossi) (Diptera: Tephritidae) and Mediterranean fruit fly Ceratitis capitata (Wiedemann) (Diptera: Tephritidae), and the parasitoids Psyttalia lounsburyi (Silvestri) (Hymenoptera: Braconidae) and Psyttalia ponerophaga (Silvestri) (Hymenoptera: Braconidae). The sex ratio of insects that escaped the screens was compared to the sex ratio of insects that could not escape. Results showed that one screen type ('crystal mesh') was the best for the purpose of designing a functional augmentorium: it retained 90% of B. oleae adults and 100% of C. capitata adults while letting 72% of Psyttalia lounsburyi adults and 94% of P. ponerophaga adults escape. The other screen types tested were suboptimal, either because they let too many flies freely escape or because they retained too many parasitoids. Sex ratio was almost always similar for insects that managed to escape the screens and insects that were retained, except for P. ponerophaga and the screen type 'light mesh'. These results are promising for the development of a functional augmentorium against the olive fruit fly and further implementation against Mediterranean fruit fly.


Assuntos
Ceratitis capitata , Himenópteros , Olea , Controle Biológico de Vetores , Tephritidae , Animais , Drosophila
5.
Rev Neurol (Paris) ; 178(6): 616-623, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34872746

RESUMO

BACKGROUND: Growing numbers of indications for intravenous immunoglobulins (IVIg) in recent years has resulted in an increase in the consumption of these products. A lack of raw material has led to IVIg shortage. The objective of this work was to evaluate the impact of this situation on patient care in one French referral centre considering practice modifications and clinical impact. METHODS: All patients treated with IVIg for chronic inflammatory demyelinating polyneuropathy, multifocal motor neuropathy and myasthenia gravis from October 2017 to October 2018 were included. RESULTS: Out of 142 patients, 111 (78%) had a modification of their IVIg treatment. We noted that 75 (68%) patients had a delay in IVIg treatment, 41 (37%) patients had a decrease in IVIg doses and 31 (28%) experienced IVIg treatment interruption. Thirty percent of patients for whom IVIg treatment was discontinued were switched to other treatments mainly plasma exchange (16%) or corticosteroids (13%). Switches to plasma exchange or corticosteroids were carried out in order to save immunoglobulins for patients who had no other alternatives. Fifty-eight (52%) patients presented a deterioration of their clinical score after IVIg treatment changes including 31 (28%) patients who had a moderate or a clinically significant deterioration. Concerning practice modifications, we noted a substantial though not significant decrease in median IVIg dose for myasthenia gravis and a significant increase in the delay between IVIg courses for chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy (P=0.011 and P=0.018 respectively). CONCLUSION: Our study showed a rather important number of changes in IVIg treatment related to IVIg shortage during the period considered. These changes had a negative impact on the clinical status of some patients.


Assuntos
Miastenia Gravis , Polineuropatias , Polirradiculoneuropatia Desmielinizante Inflamatória Crônica , Corticosteroides/uso terapêutico , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Miastenia Gravis/tratamento farmacológico , Polineuropatias/tratamento farmacológico , Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/diagnóstico , Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/tratamento farmacológico
6.
Clin Exp Dermatol ; 47(4): 765-767, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34856003

RESUMO

An 83-year-old woman was referred to the Dermatology department with a papular eruption on her left arm, occurring below the scar site of a malignant melanoma in situ, which had been excised 6 months previously. On physical examination, multiple, tender, violaceous papules and nodules inferior to the scar were noted, with central pustules in some of the lesions.


Assuntos
Melanoma , Neoplasias Cutâneas , Idoso de 80 Anos ou mais , Feminino , Granuloma , Humanos , Neoplasias Cutâneas/patologia , Supuração , Vacúolos/patologia
7.
Clin Exp Dermatol ; 46(8): 1656-1658, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34505309

RESUMO

This case illustrates a presentation with dystrophic calcinosis cutis recalcitrant to several treatment modalities. Treatment with extracorporeal shockwave lithotripsy was initiated with near complete resolution of calcium deposits.


Assuntos
Calcinose/patologia , Calcinose/terapia , Litotripsia , Dermatopatias/patologia , Dermatopatias/terapia , Idoso , Feminino , Humanos , Resultado do Tratamento
8.
Ludovica pediátr ; 24(1): 48-53, Ene-Jun 2021.
Artigo em Espanhol | LILACS, Redbvs, BINACIS | ID: biblio-1293223

RESUMO

El término escorbuto procede de una palabra del antiguo escandinavo, scorbruck, que significa "hinchazones ulceradas". Es una entidad infrecuente en pediatría, causada por deficiencia nutricional exógena de ácido ascórbico. Los seres humanos, a diferencia de otros seres vivos, no pueden sintetizar la vitamina C y, en consecuencia, dependen estrictamente de su aporte exógeno. El escorbuto puede simular varios desórdenes reumatológicos. Aunque es poco común, puede presentarse como pseudovasculitis o artritis crónica. Para el diagnóstico en pacientes que presentan síntomas músculo esqueléticos se requiere un alto índice de sospecha. Se reporta el caso de un paciente masculino de 9 años que desarrolló la enfermedad por un hábito alimentario selectivo de larga evolución, sin ingesta de frutas ni verduras. El objetivo del presente reporte es alertar al pediatra acerca del desarrollo de escorbuto como potencial consecuencia de las dietas restrictivas, y la importancia de realizar una anamnesis alimentaria completa ante la sospecha diagnóstica


The term scurvy comes from a word from the old Scandinavian, scorbruck, which means ulcerated swellings. Scurvy is an infrequent entity in pediatrics caused by exogenous nutritional deficiency of ascorbic acid. Human beings, unlike other living beings, can not synthesize vitamin C and, consequently, they depend strictly on their exogenous contribution. Scurvy can simulate several rheumatological disorders. Although it is uncommon, it can present as pseudovasculitis or chronic arthritis. A high index of suspicion is required to diagnose patients with musculoskeletal symptoms. We report a case of a 9-year-old male patient who developed the disease due to a long-term selective eating habit, without fruits or vegetables intake. The objective of this report is to alert the pediatrician about the development of scurvy as a potential consequence of restrictive diets, and the importance of performing a complete dietary history to suspect diagnosis


Assuntos
Humanos , Criança , Ácido Ascórbico , Escorbuto , Dietoterapia
9.
J Intellect Disabil Res ; 65(8): 795-800, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33880800

RESUMO

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a common co-morbidity that affects up to 44% of children with Down syndrome (DS). There is a need for reliable, good quality research on the use of methylphenidate within this population. The objective of this study is to report our experience regarding the management of ADHD in these children using methylphenidate. METHODS: This study is a retrospective observation of 21 children with DS, followed at Jérôme Lejeune Institute between 2000 and 2018. The diagnosis of ADHD was made using the Diagnostic and Statistical Manual of Mental Disorders criteria. Efficacy was measured as response or non-response on two main symptoms: attention/concentration and hyperactivity/impulsivity. Safety was evaluated by the presence or absence of side effects. RESULTS: Sixteen out of the 21 children (76%) showed improvement with methylphenidate. The average age of treatment onset in responding children was 8 years and 10 months versus 6 years and 3 months in non-responders (P = 0.05). Average dose/weight was significantly different in responders and non-responders (0.82 vs. 0.54 mg/kg/day, respectively; P = 0.03). Twelve children out of 21 (57%) experienced side effects; only three experienced side effects severe enough to require treatment interruption. Most common side effects were loss of appetite and difficulties in falling asleep. CONCLUSION: Methylphenidate was effective and safe in treating ADHD in 76% of cases in children with DS, with few serious side effects to report. Early diagnosis of ADHD is important to improve the quality of life, learning, inclusion and socialisation of children with DS.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Estimulantes do Sistema Nervoso Central , Síndrome de Down , Metilfenidato , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Estimulantes do Sistema Nervoso Central/efeitos adversos , Criança , Síndrome de Down/complicações , Síndrome de Down/epidemiologia , Humanos , Metilfenidato/efeitos adversos , Qualidade de Vida , Estudos Retrospectivos , Resultado do Tratamento
10.
Langmuir ; 36(39): 11411-11421, 2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-32911931

RESUMO

We studied the dependence of solid deposit shape obtained by free drying of sessile drops on particle concentration and Derjaguin-Landau-Verwey-Overbeek (DLVO) particle/substrate interaction. In contrast to previous contributions using pH as a control parameter of interactions, we investigated an unprecedentedly wide range of concentrations and particle/substrate DLVO forces by modifying the nature of the substrate and particles as well as their size and surface chemistry, whereas long-distance repulsive interactions between particles were maintained for most of the drying time. Our main result is that the different shapes of deposits obtained by modifying the particle concentration are the same in the different regimes of concentration regardless of particle/substrate interaction in the studied range of DLVO forces and particle concentrations. The second result is that, contrary to expectations, the dominant morphology of dry patterns at low particle concentration always shows a dotlike pattern for all the studied systems.

11.
Gynecol Obstet Fertil Senol ; 48(11): 820-826, 2020 11.
Artigo em Francês | MEDLINE | ID: mdl-32565387

RESUMO

Development of genetic testing direct-to-consumer (DTC) for recreational purposes, although prohibited in France, is a real challenge to the current practice of gamete donation. Indeed, anonymity is a fundamental principle contributing to the ethics of donation. This principle is weakened due to the availability to the general public of these tests on the Internet. Several thousands of people are conceived by gamete donation worldwide, some of whom do not know how they were conceived. Gamete donors should be informed that their anonymity is no longer guaranteed, as they can be found by homologies of their DNA, or that of a parent or a child, potentially available in databases. Thus, adults conceived by gamete donation but not informed by their parents can discover their way of conception. Recipients of gamete donation should also be informed that their child's DNA will establish the biological discrepancy and they should be encouraged to disclose the conception to their child. Several countries now allow children conceived by donation to obtain donor's identity. In France, the Bioethics Law is currently being finalized and will now allow access to donor's identity for people conceived by gamete donation.


Assuntos
Doação de Oócitos , Doadores de Tecidos , Adulto , Criança , França , Testes Genéticos , Células Germinativas , Humanos
12.
Animal ; 14(1): 78-85, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31218981

RESUMO

Oxidative stress occurs when oxidant production exceeds the antioxidant capacity to detoxify the reactive intermediates or to repair the resulting damage. Feed efficiency has been associated with mitochondrial function due to its impact on cell energy metabolism. However, mitochondria are also recognized as a major source of oxidants. The aim of this study was to determine lipid and protein oxidative stress markers, and gene and protein expression as well as activity of antioxidant enzymes in the liver of steers of divergent residual feed intake (RFI) phenotypes. Hereford steers (n = 111) were evaluated in post-weaning 70 days standard test for RFI. Eighteen steers exhibiting the greatest (n = 9; high-RFI) and the lowest (n = 9; low-RFI) RFI values were selected for this study. After the test, steers were managed together under grazing conditions until slaughter when they reached the slaughter body weight. At slaughter, hepatic samples were obtained, were snap-frozen in liquid nitrogen and stored at -80°C until analyses. Hepatic thiobarbituric acid reactive species and protein carbonyls were greater (P = 0.05) and hepatic 4-hydroxynonenal protein adducts tended (P = 0.10) to be greater for high- than low-RFI steers. Hepatic gene expression glutathione peroxidase 4, glutamate-cysteine ligase catalytic subunit and peroxiredoxin 5 mRNA was greater (P ≤ 0.05) and glutathione peroxidase 3 mRNA tended (P = 0.10) to be greater in low- than high-RFI steers. Hepatic protein expression and enzyme activity of manganese superoxide dismutase and glutathione peroxidase enzyme activity tended (P ≤ 0.10) to be greater for low- than high-RFI steers. High-efficiency steers (low-RFI) probably had better hepatic oxidative status which was strongly associated with greater antioxidant ability near to the oxidant production site and, therefore, reduced oxidative stress of the liver. Decreased hepatic oxidative stress would reduce maintenance requirements due to a lower protein and lipid turnover and better efficiency in the use of energy.


Assuntos
Ração Animal/análise , Bovinos/fisiologia , Metabolismo Energético , Fígado/metabolismo , Estresse Oxidativo , Animais , Bovinos/genética , Masculino , Oxirredução , Fenótipo
14.
Enferm. univ ; 16(3): 259-268, jul.-sep. 2019. tab
Artigo em Espanhol | LILACS-Express | LILACS, BDENF - Enfermagem | ID: biblio-1090108

RESUMO

Resumen Introducción Los estudiantes de enfermería deben adquirir conocimientos, habilidades, actitudes y valores, para proporcionar cuidados de calidad. Las prácticas clínicas son el contexto ideal para lograr algunas de las competencias requeridas. Objetivo Explorar las percepciones de los estudiantes sobre sus vivencias durante sus prácticas clínicas. Método Abordaje metodológico descriptivo de tipo cualitativo y con un encuadre sociocrítico. Se analizaron los 45 portafolios de estudiantes de 4º curso de la Escuela Universitaria de Enfermería (EUE) Cruz Roja, donde explican sus vivencias en prácticas. Se optó por un portafolio semiestructurado en función de la competencia a demostrar definiendo previamente las tareas o evidencias Se realizó un análisis de contenido que comprendía las siguientes fases: reducción de los datos; categorización-codificación, presentación de datos y conclusiones/verificación de los datos. Se alcanzó saturación en la información sobre las categorías presentadas. Resultados Del análisis de los datos emergen distintas unidades de significado que se engloban en tres categorías: aprendizaje en prácticas, dificultades del entorno, crecimiento personal y profesional. Conclusiones El estudio evidencia la importancia de las prácticas clínicas para los estudiantes dentro del plan de estudios, ya que es donde aplican lo que han aprendido en el aula y son conscientes de la realidad a la que se enfrentan. El entorno clínico y la relación que se establezca entre este y el estudiante determina en muchas ocasiones el aprendizaje. Queda patente que los estudiantes durante sus prácticas clínicas toman conciencia de aquellos conocimientos del saber, saber hacer y saber estar.


Abstract Introduction Nursing students need specific knowledge, skills, attitudes and values in order to provide quality of care; and the clinical practices represent an ideal context to develop some of these required competences. Objective To explore the perceptions of nursing students about their own experiences in their clinical practices. Method This a qualitative descriptive study with social and critical focus. 45 practice-files from nursing students in the 4th course of a Mexico Red Cross School of Nursing were analyzed considering the following stages: data reduction, categorization-coding, data presentation, and data verification and conclusions. Data saturation was reached from the identified categories. Results From the data analysis, diverse units of meaning emerged within three main categories: learning in practices, difficulties in the environment, and personal and professional growth. Conclusions The study highlights the importance of clinical practices since it is there where students apply in real life what they learn in the classroom. The relationship between the student and the clinical environment greatly determines the quality of learning. So, it is suggested that students keep in mind reflecting on their to know, to know how, and to know how to be.


Resumo Introdução Os estudantes de enfermagem devem adquirir conhecimentos, habilidades, atitudes e valores, para proporcionar cuidados de qualidade. As práticas clínicas são o contexto ideal para atingir algumas das competências requeridas. Objetivo Explorar as percepções dos estudantes sobre suas vivências durante suas práticas clínicas. Método Abordagem metodológica descritiva de tipo qualitativo e com um enfoque sociocrítico. Analisaram-se os 45 portfolios de estudantes de 4º curso da Escuela Universitaria de Enfermería (EUE) Cruz Roja, onde explicam suas vivências em práticas. Optou-se por um portfólio semiestruturado em função da competência a demostrar definindo previamente as tarefas ou evidências. Realizou-se uma análise de conteúdo que compreendia as seguintes fases: redução dos dados; categorização-codificação, apresentação de dados e conclusões/verificação dos dados. Atingiu-se saturação na informação sobre as categorias apresentadas. Resultados Da análise dos dados emergem distintas unidades de significado que abrangem três categorias: aprendizagem em práticas, dificuldades do entorno, crescimento pessoal e profissional. Conclusões O estudo evidencia a importância das práticas clínicas para os estudantes dentro do plano de estudos, já que é onde aplicam o que aprenderam na aula e são conscientes da realidade à que se enfrentam. O entorno clínico e a relação que se estabeleça entre este e o estudante determina em muitas ocasiões a aprendizagem. É evidente que os estudantes durante suas práticas clínicas tomam consciência daqueles conhecimentos do saber, saber fazer e saber estar.

16.
Gynecol Oncol ; 153(2): 223-229, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30765148

RESUMO

BACKGROUND: Intraperitoneal (IP) chemotherapy can improve outcomes for women with optimally cytoreduced epithelial ovarian cancer but toxicities are a concern. We conducted 2 phase 2 trials of an IV/IP regimen using carboplatin and paclitaxel without (Trial A) and with bevacizumab (Trial B). METHODS: Both trials consisted of carboplatin AUC 6 day 1, and paclitaxel 60 mg/m2 on days 1,8, 15 of a 21-day cycle; in Trial B, patients received IV bevacizumab 15 mg/kg every cycle starting cycle 2. Chemotherapy was administered IV for cycle 1 and then IP for all subsequent cycles. Primary objectives included safety and tolerability, pathologic CR rate (Trial A), and the rate of completion of IP cycles of therapy (Trial B). Progression-free (PFS), overall survival (OS), and pharmacokinetic analysis were secondary endpoints. RESULTS: 81 patients were treated on both trials (n = 40 and 41 in trials A and B, respectively). Median age for trials A and B was 59 (range, 36-76) and 55 (range, 19-69) years, respectively. 68% and 85% of patients, respectively for A and B, completed at least 4 cycles of treatment in both trials. Treatment with bevacizumab resulted in higher rates of grade 3 fatigue (37 versus 33%) and grade 3-4 diarrhea (22 versus 8%). Median PFS was 23.5 (95%CI 16.2-35.3) and 25 (95%CI 16.4-42.7) months, respectively; median OS was 68 (95%CI 49.5-NR) and 79.7 (95%CI 59.0-79.7) months, respectively for Trial A and B. CONCLUSIONS: Weekly administered IP carboplatin and IP paclitaxel is tolerable and safe with similar activity with and without concommittant bevacizumab in these 2 trials.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Carcinoma Epitelial do Ovário/terapia , Neoplasias Ovarianas/terapia , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Bevacizumab/administração & dosagem , Bevacizumab/efeitos adversos , Carboplatina/administração & dosagem , Carboplatina/efeitos adversos , Carcinoma Epitelial do Ovário/mortalidade , Carcinoma Epitelial do Ovário/patologia , Quimioterapia Adjuvante/métodos , Procedimentos Cirúrgicos de Citorredução/métodos , Esquema de Medicação , Feminino , Humanos , Infusões Intravenosas , Infusões Parenterais , Pessoa de Meia-Idade , Ductos Paramesonéfricos/patologia , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/patologia , Ovariectomia/métodos , Paclitaxel/administração & dosagem , Paclitaxel/efeitos adversos , Intervalo Livre de Progressão , Adulto Jovem
17.
J Biomol NMR ; 72(1-2): 29-38, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30117038

RESUMO

Pseudocontact shifts (PCS) generated by lanthanide chelating tags yield valuable restraints for investigating protein structures, dynamics and interactions in solution. In this work, dysprosium-, thulium- and terbium-complexes of eight-fold methylated 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid tags [DOTA-M8-(4R4S)-SSPy] are presented that induce large pseudocontact shifts up to 5.5 ppm and adopt exclusively the square antiprismatic conformation. This is in contrast to our earlier findings on complexes of the stereoisomeric DOTA-M8-(8S)-SSPy, where significant amounts of the twisted square antiprismatic conformer for the Dy tag were observed. The Dy-, Tm-, Tb- and Lu-complexes of DOTA-M8-(4R4S)-SSPy were conjugated to ubiquitin S57C and selectively 15N leucine labeled human carbonic anhydrase II S50C, resulting in only one set of signals. Furthermore, we investigated the conformation of the thulium- and dysprosium-complexes in vacuo and with implicit water solvent using density functional theory calculations. The calculated energy differences between the two different conformations (7.0-50.5 kJ/mol) and experimental evidence from the corresponding ytterbium- and yttrium-complexes clearly suggest a SAP [Λ(δδδδ)] geometry for the complexes presented in this study. The lanthanide chelating tag studied in this work offer insights into the solution structure of proteins by inducing strong pseudocontact shifts, show different tensor properties compared to its predecessor, enables a convenient assignment procedure, is accessed by a more economic synthesis than its predecessor and constitutes a highly promising starting point for further developments of lanthanide chelating tags.


Assuntos
Quelantes/química , Elementos da Série dos Lantanídeos/química , Ressonância Magnética Nuclear Biomolecular/métodos , Coloração e Rotulagem/métodos , Anidrase Carbônica II/química , Compostos Heterocíclicos com 1 Anel , Humanos , Modelos Moleculares , Conformação Proteica , Ubiquitina/química , Água/química
18.
J Biomed Inform ; 84: 31-41, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29935347

RESUMO

BACKGROUND: Rapid advancements in biomedical research have accelerated the number of relevant electronic documents published online, ranging from scholarly articles to news, blogs, and user-generated social media content. Nevertheless, the vast amount of this information is poorly organized, making it difficult to navigate. Emerging technologies such as ontologies and knowledge bases (KBs) could help organize and track the information associated with biomedical research developments. A major challenge in the automatic construction of ontologies and KBs is the identification of words with its respective sense(s) from a free-text corpus. Word-sense induction (WSI) is a task to automatically induce the different senses of a target word in the different contexts. In the last two decades, there have been several efforts on WSI. However, few methods are effective in biomedicine and life sciences. METHODS: We developed a framework for biomedical entity sense induction using a mixture of natural language processing, supervised, and unsupervised learning methods with promising results. It is composed of three main steps: (1) a polysemy detection method to determine if a biomedical entity has many possible meanings; (2) a clustering quality index-based approach to predict the number of senses for the biomedical entity; and (3) a method to induce the concept(s) (i.e., senses) of the biomedical entity in a given context. RESULTS: To evaluate our framework, we used the well-known MSH WSD polysemic dataset that contains 203 annotated ambiguous biomedical entities, where each entity is linked to 2-5 concepts. Our polysemy detection method obtained an F-measure of 98%. Second, our approach for predicting the number of senses achieved an F-measure of 93%. Finally, we induced the concepts of the biomedical entities based on a clustering algorithm and then extracted the keywords of reach cluster to represent the concept. CONCLUSIONS: We have developed a framework for biomedical entity sense induction with promising results. Our study results can benefit a number of downstream applications, for example, help to resolve concept ambiguities when building Semantic Web KBs from biomedical text.


Assuntos
Pesquisa Biomédica , Infecções por HIV/diagnóstico , Informática Médica/métodos , Algoritmos , Inteligência Artificial , Teorema de Bayes , Análise por Conglomerados , Bases de Dados Factuais , Infecções por HIV/epidemiologia , Bases de Conhecimento , Idioma , Aprendizado de Máquina , Processamento de Linguagem Natural , Web Semântica , Semântica , Unified Medical Language System , Vocabulário Controlado
19.
Pharmazie ; 73(5): 251-259, 2018 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-29724289

RESUMO

The observed increase in cancer led to a continuous rise in anticancer drug preparations in Hospital Centres. The quality and security of these preparations are essential to ensure the efficacy and to limit the risk of iatrogenic toxicity. Several methods have been described to secure the process of preparation (i.e. non-analytical methods for the control during the fabrication; analytical methods for the final product evaluation). These different methods have been presented in many studies, in particular in descriptive studies, but in practice, selecting a method is difficult and related to needs and hospital priorities. Therefore, we decided to conduct this present review focused on various existing methods allowing enhancement in security of anti-cancer drugs preparation process. A proactive hazard analysis method was applied, considering preparation and control steps, to discuss the choice of a method in terms of quality and security and to identify potential risks of failure. The results show that none method is perfect. Methods with the lowest criticality score are the robotization closely followed by Drugcam® in the case of re-labelling of all containers. According to these elements a University Hospital Centre could consider these risk indexesimplementing control methods.


Assuntos
Antineoplásicos/administração & dosagem , Antineoplásicos/química , Composição de Medicamentos/métodos , Antineoplásicos/efeitos adversos , Técnicas de Química Analítica/métodos , Humanos , Medicina de Precisão/métodos , Avaliação de Processos em Cuidados de Saúde , Controle de Qualidade , Gestão de Riscos/métodos , Robótica , Gestão da Segurança/métodos
20.
Int Nurs Rev ; 65(3): 392-399, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29266302

RESUMO

AIM: To explore the primary healthcare needs and health service use of homeless men in inner Sydney. BACKGROUND: People experiencing homelessness have greater health needs than the general population and place high demands on tertiary care, which is expensive and may not be the optimum service for their needs. Accessible, approachable and affordable primary healthcare services could improve the health of homeless persons and potentially decrease costs to the healthcare system. METHODS: A multimethod design using a cross-sectional survey (n = 40) and administrative data (n = 2 707 daily summaries) collected from a nurse-led primary healthcare clinic for homeless men in Sydney. FINDINGS: Survey respondents were aged 27-76 years. Health problems reflected multimorbidity, with mental health issues present in almost all respondents. The majority had attended the clinic more than 20 times in the past year and said the services, treatments and referrals helped them avoid the emergency department. Administrative data indicated that medication administration was the most frequent service provided. Referrals to other health services doubled over the 7-year period. DISCUSSION: Multiple morbidities, particularly mental health issues, are associated with homelessness. A proactive approach by nurses including preventative services appeared to overcome barriers to health service use. CONCLUSION: This nurse-led primary healthcare clinic highlights the importance of providing services to homeless men with multiple comorbidities. Respect and trust in addition to easy access to health services appear to be important facilitators of health service use. IMPLICATIONS FOR NURSING, AND IMPLICATIONS FOR HEALTH POLICY: A greater number of primary health services that collaborate with specialist services, including nurse-led clinics, may facilitate health care for persons who are homeless, reducing the burden on acute services.


Assuntos
Política de Saúde , Pessoas Mal Alojadas , Avaliação das Necessidades , Padrões de Prática em Enfermagem/organização & administração , Atenção Primária à Saúde/organização & administração , Adulto , Idoso , Austrália , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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