A doença falciforme é caracterizada por apresentar várias alterações clinicas e fisiopatológicas nos pacientes que por ela são acometidos. Uma dessas alterações é presença de úlceras de perna ...dolorosas e de difícil cicatrização, sendo necessário o apoio de equipe multiprofissional no seu manejo e tratamento. Com o objetivo de reduzir a dor associada a úlcera de perna, o paciente falcêmico faz uso de opioides parenterais e enterais que normalmente estão associados a efeitos colaterais indesejados. Com o objetivo de reduzir o uso desses opioides sistêmicos, avaliamos um gel de morfina, de fácil manipulação e baixo custo, que foi utilizado antes e após o processo de troca de curativo das úlceras de perna dos pacientes falcêmicos atendidos em nossa instituição. Baseados na escala analógica da dor foi avaliado o efeito analgésico do gel em 28 pacientes. Todos apresentavam dor grau 7 ou 8 antes da aplicação do gel. Vinte e quatro pacientes (85,7%) apresentaram total ausência de dor por um período de 24 horas, não sendo necessário o uso de analgésicos sistêmicos. Em três pacientes (10,7%) a ausência de dor durou um periodo de 12horas. Somente um paciente (3,6%) não relatou analgesia apos o uso do gel. Os resultados demonstraram que o gel é altamente eficaz no controle da dor das úlceras de perna de pacientes falcêmicos.Sickle cell disease is characterized by several clinical and pathophysiological changes including painful leg ulcers. These are difficult to heal and require the support of a multidisciplinary team in their management. The treatment of pain in these patients usually involves the use of opioids. In order to reduce the use of systemic opioids, we evaluated an easy-to-use low-cost morphine gel (0.12%) that was applied before and after changing leg ulcer dressings of sickle cell patients treated in Hemorio hospital. Based on the Analogue Pain Scale (APS) we evaluated the analgesic effect of the gel with 28 patients. All presented with a degree of pain of 7 or 8 before applying the gel. A total absence of pain was observed by 24 patients (85.7%) within thirty minutes of applying the gel, with the analgesia effect being maintained for a period of 24 hours and thus the use of other analgesics was not requiring. In 3 patients (10.7%) no pain was reported for a period of 12 hours. Only 1 patient (3.6%) reported no analgesic effect thirty minutes after the application of the gel. Our results indicate that the morphine gel was effective in controlling the pain of leg ulcers in this group of sickle cell patients. A controlled study should be designed to assess this important subject.
OBJECTIVE: The oxidative stress in 20 sickle cell anemia patients taking hydroxyurea and 13 sickle cell anemia patients who did not take hydroxyurea was compared with a control group of 96 ...individuals without any hemoglobinopathy. METHODS: Oxidative stress was assessed by thiobarbituric acid reactive species production, the Trolox-equivalent antioxidant capacity and plasma glutathione levels. RESULTS: Thiobarbituric acid reactive species values were higher in patients without specific medication, followed by patients taking hydroxyurea and the Control Group (p < 0.0001). The antioxidant capacity was higher in patients taking hydroxyurea and lower in the Control Group (p = 0.0002 for Trolox-equivalent antioxidant capacity and p < 0.0292 for plasma glutathione). Thiobarbituric acid reactive species levels were correlated with higher hemoglobin S levels (r = 0.55; p = 0.0040) and lower hemoglobin F concentrations(r = -0.52; p = 0.0067). On the other hand, plasma glutathione levels were negatively correlated with hemoglobin S levels (r = -0.49; p = 0.0111) and positively associated with hemoglobin F values (r = 0.56; p = 0.0031). CONCLUSION: Sickle cell anemia patients have high oxidative stress and, conversely, increased antioxidant activity. The increase in hemoglobin F levels provided by hydroxyurea and its antioxidant action may explain the reduction in lipid peroxidation and increased antioxidant defenses in these individuals.
In Parkinson's disease, rapid eye movement sleep behaviour disorder is an early non-dopaminergic syndrome with nocturnal violence and increased muscle tone during rapid eye movement sleep that can ...precede Parkinsonism by several years. The neuronal origin of rapid eye movement sleep behaviour disorder in Parkinson's disease is not precisely known; however, the locus subcoeruleus in the brainstem has been implicated as this structure blocks muscle tone during normal rapid eye movement sleep in animal models and can be damaged in Parkinson's disease. Here, we studied the integrity of the locus coeruleus/subcoeruleus complex in patients with Parkinson's disease using combined neuromelanin-sensitive, structural and diffusion magnetic resonance imaging approaches. We compared 24 patients with Parkinson's disease and rapid eye movement sleep behaviour disorder, 12 patients without rapid eye movement sleep behaviour disorder and 19 age- and gender-matched healthy volunteers. All subjects underwent clinical examination and characterization of rapid eye movement sleep using video-polysomnography and multimodal imaging at 3 T. Using neuromelanin-sensitive imaging, reduced signal intensity was evident in the locus coeruleus/subcoeruleus area in patients with Parkinson's disease that was more marked in patients with than those without rapid eye movement sleep behaviour disorder. Reduced signal intensity correlated with the percentage of abnormally increased muscle tone during rapid eye movement sleep. The results confirmed that this complex is affected in Parkinson's disease and showed a gradual relationship between damage to this structure, presumably the locus subcoeruleus, and abnormal muscle tone during rapid eye movement sleep, which is the cardinal marker of rapid eye movement sleep behaviour disorder. In longitudinal studies, the technique may also provide early markers of non-dopaminergic Parkinson's disease pathology to predict the occurrence of Parkinson's disease.
In this study, the production of fermentable sugars and biogas from thermally pretreated brewer’s spent grains (BSGs) was investigated. There were two autohydrolysis conditions (C1-1S: 180 ºC, ...30 min, 5 mLH2O gBSG−1 and C2-1S: 180 ºC, 60 min, 5 mLH2O gBSG−1) which were evaluated, with and without a previous low severity pretreatment (80 ºC, 10 min, 10 mLH2O gBSG−1). The highest specific methane production (302.4 NLCH4 kgCOD−1) and enzymatic hydrolysis yield (EHY of 98%, 50 FPU gBSG−1) were obtained from the two-stage pretreatment, with the second stage operated at 180 °C for 60 min, 5 mLH2O gBSG−1. However, in the integrated process, the two-stage pretreatment with the second stage performed at 180 °C for 30 min, and 5 mLH2O gBSG−1 was the best condition to produce fermentable sugars from enzymatic hydrolysis of pretreated BSGs, using a lower enzyme loading (EHY of 93%, 25 FPU gBSG−1). The burning of biogas produced from an anaerobic digestion of liquid fractions (hydrolysates) generated after two-stage thermal pretreatment in a combined heat and power system can produce a net thermal energy of 1.71 MJ kgBSG dry basis−1 and electrical energy of 0.392 kW h kgBSG dry basis−1.
Display omitted
•Co-production of fermentable sugars and biogas from BSGs proved to be promising.•Two-stage thermal pretreatment of BSGs improved the enzymatic hydrolysis yield (EHY).•C1-2S condition (180 ºC, 30 min, 5 mLH2O gBSG−1) showed an EHY of 93%.•The biogas produced by C1-1S could generate 1.71 MJ kgBSG−1 and 0.392 kW h kgBSG−1.•BSG pretreatment showed potential to add value to it in a circular biobased economy.
This study aimed to investigate the production of biobased volatile fatty acids (VFAs) from pretreated olive mill solid waste (OMSW). Three hydrothermal pretreatment (HP) conditions (D1: 125 ºC, ...53 min; D2: 161 ºC, 62 min; D3: 191 ºC, 83 min) were selected. The pretreated olive mill solid fraction (OMSF), pretreated olive mill liquid fraction (OMLF), and pretreated OMSW were evaluated as potential substrates for acidification in the anaerobic digestion (AD) in liquid (L-AD), semi-solid (Ss-AD), and solid (S-AD) phases. The best acidification efficiency (AE) observed in this study was 65%, for L-AD and HP condition D2 (161 ºC, 62 min). However, the HP condition D2 applied to the Ss-AD provided a VFA concentration of 18218 mg L−1, about 6-fold higher than that observed in the L-AD system. Polyphenols changed the profile of VFAs, increasing the production of longer chain VFAs in the L-AD and S-AD systems. Also, the influence of the typology of the AD system and HP severity on the microbial community was evaluated. Proteobacteria and Firmicutes were the most representative phyla in acidogenic fermentation of OMSW substrates and the genera Enterobacter, Pseudomonas, Achromobacter, Clostridium, Ochrobactrum, and Peptoclostridium played an important role in the pretreated OMSW fermentation and, consequently, in the VFAs production profile.
Display omitted
•HP applied to Ss-AD had the best potential profitability: US$ 130 per ton of raw OMSW.•The best AE was 65% for L-AD and HP condition D2 (161 ºC, 62 min).•Type of AD system and HP severity had great influence on VFAs production profile.•Phenolics changed the metabolic pathway for the production of longer chain VFAs.•Proteobacteria and Firmicutes were the dominant phyla in AD of the solid wastes.
The anodic oxidation method has been applied to the preparation of multinanoporous TiO2 thin films. The experimental parameters, including the electrolyte nature, oxidation voltage, and oxidation ...time have been carefully controlled. Their influence on the structure, morphology and photocatalytic activity of the prepared TiO2 films has been evaluated by measuring the current density. The result showed that there was a relatively wide range of preparation conditions, and the internal relationship between the structure and the photocatalytic properties of the TiO2 films was analyzed.
The anodic oxidation method has been applied to the preparation of multinanoporous TiO2 thin films. The experimental parameters, including the electrolyte nature, oxidation voltage, and oxidation ...time have been carefully controlled. Their influence on the structure, morphology and photocatalytic activity of the prepared TiO2 films has been evaluated by measuring the current density. The result showed that there was a relatively wide range of preparation conditions, and the internal relationship between the structure and the photocatalytic properties of the TiO2 films was analyzed.
PDF
