10 research outputs found

    Dynamics of trace metal sorption by an ion-exchange chelating resin described by a mixed intraparticle/film diffusion transport model. The Cd/Chelex case

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    The time-evolution of Cd2+ ion sorption by Chelex 100 resin was studied in batch experiments as a function of time, pH, ionic strength, stirring rate, mass of resin and initial metal ion concentration. In the experimental conditions, the amount of resin sites are in excess with respect to the amount of metal ion, leading to extensive depletion of metal in bulk solution when equilibrium is reached. The data were described using a mixed control mass transport model in finite volume conditions (MCM) that includes explicitly both intraparticle and film diffusion steps. Exact numerical computations and a new approximate analytical expression of this model are reported here. MCM successfully predicts the influence of pH and ionic strength on the experimental Cd(II)/Chelex kinetic profiles (which cannot be justified by a pure film diffusion controlled mechanism) with a minimum number of fitting parameters. The overall diffusion coefficient inside the resin was modelled in terms of the Donnan factor and the resin/cation binding stability constant. The values of the latter coefficient as a function of pH and ionic strength were estimated from the Gibbs-Donnan model. Even though MCM is numerically more involved than models exclusively restricted to film or intraparticle diffusion control, it proves to be accurate in a wider range of values of the mass transfer Biot number and solution/resin metal ratios.The authors gratefully acknowledge support for this research from the Spanish Ministry MINECO (Projects CTM2013-48967 and CTM2016-78798) and by the “Comissionat d'Universitats i Recerca de la Generalitat de Catalunya” (2014SGR1132). FQ acknowledges a grant from AGAUR

    Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia

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    Estudos agrários: a complexidade do rural contemporâneo

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    Esta obra reúne trabalhos de pesquisadores de três universidades públicas brasileiras apresentados durante o I Colóquio de Pesquisas do Núcleo de Estudos Agrários da Unesp de Rio Claro, realizado em outubro de 2010. Organizada por Darlene Aparecida de Oliveira Ferreira, Enéas Rente Ferreira e Adriano Corrêa Maia, pretende compreender a realidade agrária brasileira contemporânea a partir de suas principais características, considerando o passado e o presente. A obra mostra que a diversidade espacial é umas das marcas importantes do sistema, com o mundo rural organizado distintamente em contextos regionais e atrelando culturas a áreas específicas. Por isso, os trabalhos tratam também de contextos espaciais historicamente construídos, dos quais emergem novos atores sociais ou se consolidam os detentores de estruturas passadas. As pesquisas identificam principalmente as características e as tendências da geografia agrária no Brasil do início do século XXI, os processos, como produção e migração, os usos modernos do espaço agrícola (como o turismo rural) e o papel atual das pequenas propriedades na agricultura brasileira

    Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part one

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    Proceedings Of The 23Rd Paediatric Rheumatology European Society Congress: Part Two

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    Drug Prescription and Delirium in Older Inpatients: Results From the Nationwide Multicenter Italian Delirium Day 2015-2016

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    Objective: This study aimed to evaluate the association between polypharmacy and delirium, the association of specific drug categories with delirium, and the differences in drug-delirium association between medical and surgical units and according to dementia diagnosis. Methods: Data were collected during 2 waves of Delirium Day, a multicenter delirium prevalence study including patients (aged 65 years or older) admitted to acute and long-term care wards in Italy (2015-2016); in this study, only patients enrolled in acute hospital wards were selected (n = 4,133). Delirium was assessed according to score on the 4 "A's" Test. Prescriptions were classified by main drug categories; polypharmacy was defined as a prescription of drugs from 5 or more classes. Results: Of 4,133 participants, 969 (23.4%) had delirium. The general prevalence of polypharmacy was higher in patients with delirium (67.6% vs 63.0%, P =.009) but varied according to clinical settings. After adjustment for confounders, polypharmacy was associated with delirium only in patients admitted to surgical units (OR = 2.9; 95% CI, 1.4-6.1). Insulin, antibiotics, antiepileptics, antipsychotics, and atypical antidepressants were associated with delirium, whereas statins and angiotensin receptor blockers exhibited an inverse association. A stronger association was seen between typical and atypical antipsychotics and delirium in subjects free from dementia compared to individuals with dementia (typical: OR = 4.31; 95% CI, 2.94-6.31 without dementia vs OR = 1.64; 95% CI, 1.19-2.26 with dementia; atypical: OR = 5.32; 95% CI, 3.44-8.22 without dementia vs OR = 1.74; 95% CI, 1.26-2.40 with dementia). The absence of antipsychotics among the prescribed drugs was inversely associated with delirium in the whole sample and in both of the hospital settings, but only in patients without dementia. Conclusions: Polypharmacy is significantly associated with delirium only in surgical units, raising the issue of the relevance of medication review in different clinical settings. Specific drug classes are associated with delirium depending on the clinical setting and dementia diagnosis, suggesting the need to further explore this relationship

    Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia

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    Objectives: Few studies have analyzed factors associated with delirium subtypes. In this study, we investigate factors associated with subtypes of delirium only in patients with dementia to provide insights on the possible prevention and treatments. Design: This is a cross-sectional study nested in the \u201cDelirium Day\u201d study, a nationwide Italian point-prevalence study. Setting and Participants: Older patients admitted to 205 acute and 92 rehabilitation hospital wards. Measures: Delirium was evaluated with the 4-AT and the motor subtypes with the Delirium Motor Subtype Scale. Dementia was defined by the presence of a documented diagnosis in the medical records and/or prescription of acetylcholinesterase inhibitors or memantine prior to admission. Results: Of the 1057 patients with dementia, 35% had delirium, with 25.6% hyperactive, 33.1% hypoactive, 34.5% mixed, and 6.7% nonmotor subtype. There were higher odds of having venous catheters in the hypoactive (OR 1.82, 95% CI 1.18-2.81) and mixed type of delirium (OR 2.23, CI 1.43-3.46), whereas higher odds of urinary catheters in the hypoactive (OR 2.91, CI 1.92-4.39), hyperactive (OR 1.99, CI 1.23-3.21), and mixed types of delirium (OR 2.05, CI 1.36-3.07). We found higher odds of antipsychotics both in the hyperactive (OR 2.87, CI 1.81-4.54) and mixed subtype (OR 1.84, CI 1.24-2.75), whereas higher odds of antibiotics was present only in the mixed subtype (OR 1.91, CI 1.26-2.87). Conclusions and Implications: In patients with dementia, the mixed delirium subtype is the most prevalent followed by the hypoactive, hyperactive, and nonmotor subtype. Motor subtypes of delirium may be triggered by clinical factors, including the use of venous and urinary catheters, and the use of antipsychotics. Future studies are necessary to provide further insights on the possible pathophysiology of delirium in patients with dementia and to address the optimization of the management of potential risk factors

    Drug prescription and delirium in older inpatients: Results from the nationwide multicenter Italian Delirium Day 2015-2016

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    Objective: This study aimed to evaluate the association between polypharmacy and delirium, the association of specific drug categories with delirium, and the differences in drug-delirium association between medical and surgical units and according to dementia diagnosis. Methods: Data were collected during 2 waves of Delirium Day, a multicenter delirium prevalence study including patients (aged 65 years or older) admitted to acute and long-term care wards in Italy (2015-2016); in this study, only patients enrolled in acute hospital wards were selected (n = 4,133). Delirium was assessed according to score on the 4 "A's" Test. Prescriptions were classified by main drug categories; polypharmacy was defined as a prescription of drugs from 5 or more classes. Results: Of 4,133 participants, 969 (23.4%) had delirium. The general prevalence of polypharmacy was higher in patients with delirium (67.6% vs 63.0%, P =.009) but varied according to clinical settings. After adjustment for confounders, polypharmacy was associated with delirium only in patients admitted to surgical units (OR = 2.9; 95% CI, 1.4-6.1). Insulin, antibiotics, antiepileptics, antipsychotics, and atypical antidepressants were associated with delirium, whereas statins and angiotensin receptor blockers exhibited an inverse association. A stronger association was seen between typical and atypical antipsychotics and delirium in subjects free from dementia compared to individuals with dementia (typical: OR = 4.31; 95% CI, 2.94-6.31 without dementia vs OR = 1.64; 95% CI, 1.19-2.26 with dementia; atypical: OR = 5.32; 95% CI, 3.44-8.22 without dementia vs OR = 1.74; 95% CI, 1.26-2.40 with dementia). The absence of antipsychotics among the prescribed drugs was inversely associated with delirium in the whole sample and in both of the hospital settings, but only in patients without dementia. Conclusions: Polypharmacy is significantly associated with delirium only in surgical units, raising the issue of the relevance of medication review in different clinical settings. Specific drug classes are associated with delirium depending on the clinical setting and dementia diagnosis, suggesting the need to further explore this relationship
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