Chronic ecologically relevant stress effects on reverse-translated touchscreen assays of reward responsivity and attentional processes in male rats: Implications for depression.

Stagnation in the development of novel therapeutic strategies for treatment-resistant depression has encouraged continued interest in improving preclinical methods. One tactic prioritizes the reverse translation of behavioral tasks developed to objectively quantify depressive phenotypes in patient populations for their use in laboratory animals via touchscreen technology. After cross-species concordance in task outcomes under healthy conditions is confirmed, construct validity can be further enhanced by identifying environmental stressors that reliably produce deficits in task performance that resemble those in depressive participants. The present studies characterized in male rats the ability of two chronic ecologically relevant stressors, inescapable ice water or isolated restraint, to produce depressive-like behavioral phenotypes in the Probabilistic Reward Task (PRT) and Psychomotor Vigilance Task (PVT). These tasks previously have been reverse-translated using touchscreen technology for rodents and nonhuman primates to objectively quantify, respectively, reward responsivity (anhedonia) and attentional processes (impaired cognitive function), each of which are core features of major depressive disorder. In the PRT, both inescapable ice water and isolated restraint produced persistent anhedonic phenotypes compared to non-stressed control performance (i.e., significantly blunted response bias for the richly rewarded stimulus). In the PVT, both chronic stressors impaired attentional processing, revealed by increases in titrated reaction times; however, these deficits largely subsided by the end of the chronic condition. Taken together, these findings confirm the ability of reverse-translated touchscreen tasks to effectively generate behavioral phenotypes that exhibit expected deficits in performance outcomes following exposure to chronic ecologically relevant stress. In turn, this approach is well positioned to appraise the ability of candidate therapeutics to attenuate or reverse such behavioral deficits and, thereby, contribute to preclinical medications development for treatment-resistant depression.

Unveiling the intersection: exploring obstetric violence in the Era of COVID-19 in Ecuador.

INTRODUCTION: Changes to healthcare delivery organization that have occurred to protect people from the virus COVID-19 may have led to harmful consequences to pregnant women intensifying obstetric violence. Prevalence of obstetric violence in Ecuador is high with a range between 30 and 70% approximately. METHODS: This cross-sectional study was performed with the participation of 1298 women who answered EPREVO questionnaire from June 2021 to January 2022. Obstetrics characteristics' relationship before and during COVID-19 were examined using Fisher exact test. RESULTS: From 1598 respondents, 1284 (80.4%) gave birth before March 2020 Most of the participants (73.6%; CI:73.59-73.61) experienced obstetric violence during childbirth. Vaginal examination, enemas and genital shaving, episiotomy and cesarean section decreased significantly as well as rooming with the baby during the pandemic. Half of the women did not breastfeed the baby in the first hour but there were not statistically significant differences between giving birth before or during the infection from COVID-19. CONCLUSIONS: Levels of obstetric violence in Ecuador remains high but without major differences due to the COVID-19 pandemic, however some harmful medical practices considered as obstetric violence decreased but maybe to the fear to be infected by the virus.

Nursing diagnoses and hospital readmission of patients with respiratory diseases: Findings from a case-control study.

AIM: The rate of readmission after hospitalisation for respiratory diseases has become a common and challenging clinical problem. Social and functional patient variables could help identify cases at high risk of readmission. The aim was to identify the nursing diagnoses that were associated with readmission after hospitalisation for respiratory disease in Spain. DESIGN: Case-control study within the cohort of patients admitted for respiratory disease during 2016-19 in a tertiary public hospital in Spain (n = 3781). METHODS: Cases were patients who were readmitted within the first 30 days of discharge, and their controls were the remaining patients. All nursing diagnoses (n = 130) were collected from the electronic health record. They were then grouped into 29 informative diagnostic categories. Clinical confounder-adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using logistic regression models. RESULTS: The readmission rate was 13.1%. The nursing diagnoses categories 'knowledge deficit' (OR: 1.61; 95%CI: 1.13-2.31), 'impaired skin integrity and risk of ulcer infection' (OR: 1.45; 95%CI: 1.06-1.97) and 'activity intolerance associated with fatigue' (OR: 1.56; 95%CI: 1.21-2.01) were associated with an increased risk of suffering an episode of hospital readmission rate at 30% after hospital discharge, and this was independent of sociodemographic background, care variables and comorbidity. PATIENT OR PUBLIC CONTRIBUTION: The nursing diagnoses assigned as part of the care plan of patients during hospital admission may be useful for predicting readmissions.

Thyroid abnormalities in patients with Hodgkin lymphoma: The importance of close surveillance.

INTRODUCTION: Survival in paediatric patients with Hodgkin lymphoma (HL) has increased over the last decades. However, these patients are at increased risk of developing late thyroid sequelae due to the treatment with irradiation and alkylating agents. METHODS: We conducted an observational and retrospective study in patients with a diagnosis of HL between 2007 and 2022, in a hospital that is a paediatric oncology reference centre, through the review of electronic health records. We collected data on demographic (age, sex), clinical, radiological and histopathological variables, the dosage of alkylating agents and radiotherapy (RT) and on thyroid disorders using Microsoft Excel. The data analysis was conducted with SPSS version 17, using the Fisher exact test for qualitative data, a nonparametric test for quantitative data and Kaplan-Meier curves. RESULTS: Sixty patients received a diagnosis of HL from 2007 to 2022. The median duration of follow-up was 78.5 months. There were 4 detected cases of hypothyroidism, 5 of thyroid nodules and 1 of subclinical hyperthyroidism. Treatment with RT was significantly associated with the development of hypothyroidism (P= .026), thyroid nodules (P= .01) and thyroid disease overall (P= .003). We estimated that the risk of thyroid disease increased 8-fold with each additional Grey received (hazard ratio, 1.081; 95% CI, 1.014-1.152; P= .017). CONCLUSION: Hodgkin lymphoma patients treated with RT are at increased risk of late thyroid disorders, mainly hypothyroidism and malignancy. This risk is greater the higher the RT dosage and the longer the follow-up. We did not find evidence of an association between the use of alkylating agents and an increase in the risk of thyroid disease.

Epidemiological characteristics of a Zika outbreak in Portoviejo, Ecuador, 2016

[ABSTRACT]. Objective. To estimate the number and percentage of cases with Zika diagnosis at a hospital in Portoviejo, Manabí, Ecuador. Methods. This was a hospital-based, retrospective, observational, descriptive, cross-sectional study conducted at the Dr. Verdi Cevallos Balda Hospital from January – August 2016. A secondary analysis of a database was performed to estimate the number and percentage of patients positive for Zika virus, by sex, age group, ethnicity, and type of medical care. Prevalence and odds ratios with 95% Confidence Intervals were calculated using the Mantel and Haenszel method. Laboratory diagnostics included assays for the detection of Zika, chikungunya, dengue, and others. Results. In all, 467 suspected cases of Zika were identified based on clinical criteria. Of these, 148 cases (31.7%) were confirmed by detection of ZIKV RNA. The peak of the outbreak was documented in May – July 2016 during the rainy season, following the earthquake of April 2016. The adjusted odds ratios indicated that Zika virus was less likely in men and in subjects < 20 years of age. Most of the infected pregnant women (61%) were in the second trimester of pregnancy. No cases of microcephaly were reported. Conclusions. Because Zika was more likely to occur among women and those ≥ 20 years of age, surveillance of these groups is imperative to avoid transmission to newborns. Future studies that address the research gap and inform the country’s Zika control efforts are recommended.

[RESUMEN]. Objetivo. Estimar el número y porcentaje de casos con diagnóstico de infección por el virus del Zika en un hospital de Puertoviejo (Manabí, Ecuador). Métodos. Este fue un estudio retrospectivo basado en un hospital, transversal, descriptivo, de observación, realizado en el Hospital Dr. Verdi Cevallos Balda entre enero y agosto del 2016. Se llevó a cabo un análisis secundario de una base de datos para estimar el número y porcentaje de pacientes positivos para el virus del Zika por sexo, grupo etario, etnicidad y tipo de atención médica. Se calcularon la prevalencia y la razón de posibilidades, con intervalos de confianza de 95%, por el método de Mantel y Haenszel. Los métodos diagnósticos de laboratorio incluyeron análisis para la detección de los virus del Zika, el chikunguña y el dengue, entre otros. Resultados. En total, se detectaron 467 casos presuntos de infección por el virus del Zika con base en criterios clínicos. De ellos, 148 casos (31,7%) se confirmaron por detección de ARN del virus. El punto máximo del brote se documentó entre mayo y julio del 2016, durante la temporada de lluvias, después del terremoto de abril del 2016. La razón de posibilidades no ajustada indicó que fue menos probable la infección por el virus del Zika en los hombres y en las personas menores de 20 años. La mayoría de las embarazadas infectadas (61%) estaban en el segundo trimestre del embarazo. No se notificaron casos de microcefalia. Conclusiones. Dado que fue más probable la infección por el virus del Zika en las mujeres y las personas de 20 años en adelante, es indispensable la vigilancia de estos grupos para prevenir la transmisión a los recién nacidos. Se recomiendan estudios ulteriores que subsanen las deficiencias en la investigación y den sustento a las medidas de control del virus del Zika en el país.

[RESUMO]. Objetivo. Estimar o número e o percentual de casos diagnosticados com vírus zika em um hospital em Portoviejo, Manabí, Equador. Métodos. Estudo observacional transversal descritivo e retrospectivo sediado em um hospital (Hospital Dr. Verdi Cevallo Balda) conduzido de janeiro a agosto de 2016 na cidade de Portoviejo (Manabí), no Equador. Foi realizada uma análise secundária de uma base de dados para estimar o número e o percentual de casos de pacientes infectados pelo vírus zika, desagregada por sexo, faixa etária, grupo étnico e tipo de atenção médica prestada. A prevalência e as razões de chances, com os respectivos intervalos de confiança de 95%, foram calculados com o uso do método de Mantel e Haenszel. Os exames de diagnóstico laboratorial incluíram ensaios para a detecção dos vírus zika, chikungunya e dengue, entre outros. Resultados. Ao todo, 467 casos suspeitos de zika foram identificados segundo criterios clínicos. Destes, 148 casos (31,7%) foram confirmados com a detecção do RNA do vírus. Documentou-se a ocorrência do pico do surto entre maio e julho de 2016 durante a estação de chuvas, após o terremoto ocorrido em abril daquele ano. As razões de chances ajustadas indicaram menor probabilidade de infeção no sexo masculino e em indivíduos com idade inferior a 20 anos. A maioria das gestantes infectadas (61%) estava no segundo trimestre de gestação. Nenhum caso de microcefalia foi notificado. Conclusões. Visto que se verificou uma maior probabilidade de ocorrência de zika no sexo feminino e em indivíduos com idade acima de 20 anos, é imprescindível a vigilância desses grupos a fim de prevenir a transmissão aos recém-nascidos. Recomenda-se realizar outros estudos para contemplar a lacuna de pesquisa e subsidiar os esforços de controle da zika no país.

Epidemiological characteristics of a Zika outbreak in Portoviejo, Ecuador, 2016 / Características epidemiológicas de un brote de infección por el virus del Zika en Portoviejo, Ecuador, en el 2016 / Características epidemiológicas de um surto de zika em Portoviejo, Equador, 2016

ABSTRACT Objective To estimate the number and percentage of cases with Zika diagnosis at a hospital in Portoviejo, Manabí, Ecuador. Methods This was a hospital-based, retrospective, observational, descriptive, cross-sectional study conducted at the Dr. Verdi Cevallos Balda Hospital from January - August 2016. A secondary analysis of a database was performed to estimate the number and percentage of patients positive for Zika virus, by sex, age group, ethnicity, and type of medical care. Prevalence and odds ratios with 95% Confidence Intervals were calculated using the Mantel and Haenszel method. Laboratory diagnostics included assays for the detection of Zika, chikungunya, dengue, and others. Results In all, 467 suspected cases of Zika were identified based on clinical criteria. Of these, 148 cases (31.7%) were confirmed by detection of ZIKV RNA. The peak of the outbreak was documented in May - July 2016 during the rainy season, following the earthquake of April 2016. The adjusted odds ratios indicated that Zika virus was less likely in men and in subjects < 20 years of age. Most of the infected pregnant women (61%) were in the second trimester of pregnancy. No cases of microcephaly were reported. Conclusions Because Zika was more likely to occur among women and those ≥ 20 years of age, surveillance of these groups is imperative to avoid transmission to newborns. Future studies that address the research gap and inform the country's Zika control efforts are recommended.

RESUMEN Objetivo Estimar el número y porcentaje de casos con diagnóstico de infección por el virus del Zika en un hospital de Puertoviejo (Manabí, Ecuador). Métodos Este fue un estudio retrospectivo basado en un hospital, transversal, descriptivo, de observación, realizado en el Hospital Dr. Verdi Cevallos Balda entre enero y agosto del 2016. Se llevó a cabo un análisis secundario de una base de datos para estimar el número y porcentaje de pacientes positivos para el virus del Zika por sexo, grupo etario, etnicidad y tipo de atención médica. Se calcularon la prevalencia y la razón de posibilidades, con intervalos de confianza de 95%, por el método de Mantel y Haenszel. Los métodos diagnósticos de laboratorio incluyeron análisis para la detección de los virus del Zika, el chikunguña y el dengue, entre otros. Resultados En total, se detectaron 467 casos presuntos de infección por el virus del Zika con base en criterios clínicos. De ellos, 148 casos (31,7%) se confirmaron por detección de ARN del virus. El punto máximo del brote se documentó entre mayo y julio del 2016, durante la temporada de lluvias, después del terremoto de abril del 2016. La razón de posibilidades no ajustada indicó que fue menos probable la infección por el virus del Zika en los hombres y en las personas menores de 20 años. La mayoría de las embarazadas infectadas (61%) estaban en el segundo trimestre del embarazo. No se notificaron casos de microcefalia. Conclusiones Dado que fue más probable la infección por el virus del Zika en las mujeres y las personas de 20 años en adelante, es indispensable la vigilancia de estos grupos para prevenir la transmisión a los recién nacidos. Se recomiendan estudios ulteriores que subsanen las deficiencias en la investigación y den sustento a las medidas de control del virus del Zika en el país.

RESUMO Objetivo Estimar o número e o percentual de casos diagnosticados com vírus zika em um hospital em Portoviejo, Manabí, Equador. Métodos Estudo observacional transversal descritivo e retrospectivo sediado em um hospital (Hospital Dr. Verdi Cevallo Balda) conduzido de janeiro a agosto de 2016 na cidade de Portoviejo (Manabí), no Equador. Foi realizada uma análise secundária de uma base de dados para estimar o número e o percentual de casos de pacientes infectados pelo vírus zika, desagregada por sexo, faixa etária, grupo étnico e tipo de atenção médica prestada. A prevalência e as razões de chances, com os respectivos intervalos de confiança de 95%, foram calculados com o uso do método de Mantel e Haenszel. Os exames de diagnóstico laboratorial incluíram ensaios para a detecção dos vírus zika, chikungunya e dengue, entre outros. Resultados Ao todo, 467 casos suspeitos de zika foram identificados segundo critérios clínicos. Destes, 148 casos (31,7%) foram confirmados com a detecção do RNA do vírus. Documentou-se a ocorrência do pico do surto entre maio e julho de 2016 durante a estação de chuvas, após o terremoto ocorrido em abril daquele ano. As razões de chances ajustadas indicaram menor probabilidade de infeção no sexo masculino e em indivíduos com idade inferior a 20 anos. A maioria das gestantes infectadas (61%) estava no segundo trimestre de gestação. Nenhum caso de microcefalia foi notificado. Conclusões Visto que se verificou uma maior probabilidade de ocorrência de zika no sexo feminino e em indivíduos com idade acima de 20 anos, é imprescindível a vigilância desses grupos a fim de prevenir a transmissão aos recém-nascidos. Recomenda-se realizar outros estudos para contemplar a lacuna de pesquisa e subsidiar os esforços de controle da zika no país.