Browsing by Issue Date, starting with "2022-12-18"
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- β-Lactam Dosing in Critical Patients: A Narrative Review of Optimal Efficacy and the Prevention of Resistance and ToxicityPublication . Pereira, João Gonçalves; Fernandes, Joana; Duarte, Ana Rita; Fernandes, Susana MendesAntimicrobial prescription in critically ill patients represents a complex challenge due to the difficult balance between infection treatment and toxicity prevention. Underexposure to antibiotics and therapeutic failure or, conversely, drug overexposure and toxicity may both contribute to a worse prognosis. Moreover, changes in organ perfusion and dysfunction often lead to unpredictable pharmacokinetics. In critically ill patients, interindividual and intraindividual real-time -lactam antibiotic dose adjustments according to the patient’s condition are critical. The continuous infusion of -lactams and the therapeutic monitoring of their concentration have both been proposed to improve their efficacy, but strong data to support their use are still lacking. The knowledge of the pharmacokinetic/pharmacodynamic targets is poor and is mostly based on observational data. In patients with renal or hepatic failure, selecting the right dose is even more tricky due to changes in drug clearance, distribution, and the use of extracorporeal circuits. Intermittent usage may further increase the dosing conundrum. Recent data have emerged linking overexposure to -lactams to central nervous system toxicity, mitochondrial recovery delay, and microbiome changes. In addition, it is well recognized that -lactam exposure facilitates resistance selection and that correct dosing can help to overcome it. In this review, we discuss recent data regarding real-time -lactam antibiotic dose adjustment, options in special populations, and the impacts on mitochondria and the microbiome.
- Os Passos de um Gigante - ORQUESTRA SINFÓNICA METROPOLITANAPublication . Leitão, Rui Campos; Neves, Pedro Miguel Pires de OliveiraBrochura de sala do concerto realizado pela Orquestra Sinfónica Metropolitana a 18 de Dezembro de 2022 na Igreja Matriz de Loures no âmbito da Temporada 2022/2023 da Metropolitana. O programa do concerto foi preenchido com obras de Beethoven e Brahms. O concerto foi dirigido pelo Maestro Pedro Neves. A integração dos alunos da Orquestra Académica da Metropolitana à Orquestra Metropolitana de Lisboa, formando uma orquestra sinfónica, permite aos alunos da ANSO beneficiarem de uma experiência regular de trabalho, lado a lado com profissionais que guiam o desempenho do aluno, sob a direção de maestros de referência no panorama nacional e internacional.
- Promoção do Pensamento Científico em Crianças de Educação Pré-escolar e 1º Ciclo do Ensino BásicoPublication . Santos de Oliveira, Rita Filipa; Farinho, Paula