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1.
Cureus ; 16(9): e68674, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39371703

ABSTRACT

A solitary extraosseous plasmacytoma is a rare type of plasma cell neoplasm. Its occurrence in the stomach is particularly unusual and can easily be mistaken for more common types of tumors. We describe a case involving a solitary extraosseous plasmacytoma in a patient who experienced weight loss as the sole symptom. Initially, the condition was misdiagnosed as gastric adenocarcinoma based on endoscopic biopsy results, leading to a gastrectomy after neoadjuvant chemotherapy. Subsequent examination of the pathological specimen revealed the presence of plasma cell neoplasia alongside a gastric adenocarcinoma in situ.

2.
Biomolecules ; 14(9)2024 Aug 24.
Article in English | MEDLINE | ID: mdl-39334816

ABSTRACT

BACKGROUND: Diagnosis of acute kidney injury (AKI) relies on serum creatinine (SCr) changes. This study investigated if urinary aminopeptidases are early and predictive biomarkers of cardiac surgery-associated AKI (CSA-AKI). METHODS: Glutamyl aminopeptidase (GluAp), alanyl aminopeptidase (AlaAp), dipeptidyl peptidase-4 (DPP4), proteinuria, albuminuria, N-acetyl-ß-D-glucosaminidase (NAG), and neutrophile gelatinase-associated lipocalin (NGAL) were measured in urine samples from 44 patients at arrival in the intensive care unit (ICU) after cardiac surgery. Sensitivity, specificity, and positive and negative predictive value for diagnosis of stages 1, 2, and 3 of AKI were analyzed for the highest quartile of each marker. We also studied the relationship with SCr after surgery, 6- and 12-month glomerular filtration rates (GFRs), and other long-term events over the next 5 years. RESULTS: GluAp diagnosed the maximal number of patients that developed stage 2 or 3 of AKI, increasing diagnostic sensitivity from 0% to 75%. In addition, GluAp and DPP4 were related to the decrease in GFR at 6 or 12 months after surgery. CONCLUSIONS: Urinary aminopeptidases are a potential tool for the early diagnosis of CSA-AKI, with GluAp being the most effective marker for diagnosing stage 2 or 3 of AKI at ICU admission. GluAp and DPP4 serve as predictive biomarkers for a decrease in GFR.


Subject(s)
Acute Kidney Injury , Biomarkers , Cardiac Surgical Procedures , Humans , Acute Kidney Injury/urine , Acute Kidney Injury/diagnosis , Acute Kidney Injury/blood , Acute Kidney Injury/etiology , Biomarkers/urine , Biomarkers/blood , Male , Female , Cardiac Surgical Procedures/adverse effects , Aged , Middle Aged , Glomerular Filtration Rate , Dipeptidyl Peptidase 4/blood , Dipeptidyl Peptidase 4/urine , Dipeptidyl Peptidase 4/metabolism , Aminopeptidases/urine , Aminopeptidases/blood , Aminopeptidases/metabolism , Creatinine/blood , Creatinine/urine , Lipocalin-2/urine , Lipocalin-2/blood , Acetylglucosaminidase/urine
3.
Behav Sci (Basel) ; 14(9)2024 Sep 02.
Article in English | MEDLINE | ID: mdl-39335985

ABSTRACT

Sexual satisfaction is an important dimension of sexual health. Despite there being evidence about its relations with sexual arousal, this association has not been addressed considering arousal as a trait and as a state. Therefore, the goal of this laboratory study was to examine, in young women with different levels of sexual satisfaction in their relationships, sexual arousal as a trait (i.e., propensity for sexual excitation/inhibition) and as a state (i.e., genital response and self-reported sexual arousal to a video with explicit sexual content). The sample was composed of 45 Spanish heterosexual women with a partner, from 18 to 25 years old. In the first phase, we evaluated the propensity for sexual inhibition/excitation and sexual satisfaction of the participants. In the second phase-in the context of a sexuality laboratory-the vaginal pulse amplitude, the rating of sexual arousal, and the rating of genital sensations were evaluated. The participants, distributed in three groups with different levels of sexual satisfaction (p < 0.001), were compared based on the different measures of sexual arousal. The results indicated that the group with lower sexual satisfaction, compared to the group with higher sexual satisfaction, reported more sexual inhibition due to the threat of performance failure (p = 0.011) and due to the threat of performance consequences (p = 0.038). However, no significant differences in sexual arousal status were found between the three groups. In conclusion, the negative association between sexual satisfaction and propensity for sexual inhibition in young women with a partner is supported, but not the positive association between trait/state sexual arousal and sexual satisfaction.

5.
Nurs Adm Q ; 48(4): 336-346, 2024.
Article in English | MEDLINE | ID: mdl-39213407

ABSTRACT

Nursing is a profession with high rates of workplace injuries, hazards, and turnover. Improving the health and safety of nurses at work is vital to retain and grow the workforce to meet future demands. The purpose of this study was to describe the breadth of pain among American nurses and explore the relationships between this pain and modifiable work factors and perceived work performance. We used a cross-sectional descriptive design of 2312 nurses from across the United States. Nurses completed a survey containing questions about demographics, the presence of pain in the past week, the number of pain sites, pain locations, severity, and the impact on work performance. The median number of pain locations reported was 2, back pain was the most reported pain site, and average pain severity ranged from 4 to 5. Significant modifiable work factors associated with pain were average patient load and shift length. Many participants indicated that their pain impacted work performance, while a smaller proportion acknowledged that their pain impacted patient care. Pain among nurses spans multiple locations, is moderately severe, and impacts work performance. Addressing related modifiable work factors may decrease pain and the impact on the health, safety, and work performance of the nursing workforce.


Subject(s)
Nurses , Work Performance , Humans , Cross-Sectional Studies , Male , Adult , Female , United States/epidemiology , Middle Aged , Surveys and Questionnaires , Work Performance/standards , Work Performance/statistics & numerical data , Nurses/statistics & numerical data , Nurses/psychology , Workplace/standards , Workplace/psychology , Workplace/statistics & numerical data , Pain/epidemiology
6.
PLOS Glob Public Health ; 4(8): e0003406, 2024.
Article in English | MEDLINE | ID: mdl-39173045

ABSTRACT

BACKGROUND: The COVID-19 pandemic has reshaped healthcare delivery worldwide. OBJECTIVE: To explore potential changes in the reasons for visits and modality of care in primary care settings through the International Consortium of Primary Care Big Data Researchers (INTRePID). METHODS: We conducted a cross-sectional, retrospective study from 2018-2021. We examined visit volume, modality, and reasons for visits to primary care in Argentina, Australia, Canada, China, Peru, Norway, Singapore, Sweden, and the USA. The analysis involved a comparison between the pre-pandemic and pandemic periods. RESULTS: There were more than 215 million visits from over 38 million patients during the study period in INTRePID primary care settings. Most INTRePID countries experienced a decline in monthly visit rates during the first year of the pandemic, with rate ratios (RR) and 95% confidence intervals (CI) ranging from RR:0.57 (95%CI:0.49-0.66) to RR:0.90 (95%CI:0.83-0.98), except for in Canada (RR:0.99, 95%CI:0.94-1.05) and Norway (RR:1.00, 95%CI:0.92-1.10), where rates remained stable and in Australia where rates increased (RR:1.19, 95%CI:1.11-1.28). Argentina, China, and Singapore had limited or no adoption of virtual care, whereas the remaining INTRePID countries varied in the extent of virtual care utilization. In Peru, virtual visits accounted for 7.34% (95%CI:7.33%-7.35%) of all interactions in the initial year of the pandemic, dipping to 5.22% (95%CI:5.21%-5.23%) in the subsequent year. However, in Canada 75.30% (95%CI:75.20%-75.40%) of the visits in the first year were virtual, decreasing to 62.77% (95%CI:62.66%-62.88%) in the second year. Diabetes, hypertension and/or hyperlipidemia and general health exams were in the top 10 reasons for visits in 2019 for all countries. Anxiety, depression and/or other mental health related reasons were among the top 10 reasons for virtual visits in all countries that had virtual care. CONCLUSIONS: The pandemic resulted in changes in reasons for visits to primary care, with virtual care mitigating visit volume disruptions in many countries.

7.
Farm Hosp ; 2024 Jul 19.
Article in English, Spanish | MEDLINE | ID: mdl-39033073

ABSTRACT

The objective of regulatory authorities is to ensure a favorable risk-benefit balance for medicines in their licensed indication, without seeking to establish their place in the therapeutic armamentarium beyond that. The licensed indication covers heterogeneous subpopulations and often does not sufficiently specify the characteristics of the patients who may benefit. The regulatory information does not always show the benefit over the standard treatments; moreover, it only reacts to the conditions specified in the developer's application, and lacks an assessment of the clinical relevance of the benefit and its uncertainties. Many cases highlight the need to establish a more specific therapeutic benefit scenario than the licensed indication. For example, abemaciclib was approved in the adjuvant setting for high-risk patients with early breast cancer, but the appropriate level of risk and how to assess it needs to be specified. Also, pembrolizumab is approved for neoadjuvant plus adjuvant treatment in lung cancer; but it remains to be analyzed whether it is superior to nivolumab in neoadjuvant treatment alone, which involves less treatment and economic burden. As therapeutic positioning is always a necessary decision, whether made at a national, regional, local or individual level, it must be made in the most appropriate way. The absence of a multidisciplinary discussion and consensus, relying only on individual decisions to determine positioning from the outset, underestimates information gaps, inter-individual variability and the influence of drug promotion. It can be harmful and costly. To properly manage the introduction of new medicines, it is essential to establish their benefit scenario in a multidisciplinary way. This, together with consideration of the clinical benefit provided versus the appropriate alternatives and the uncertainties of the benefit, constitutes the objective of the clinical assessment and the basis for designing a well-focused economic analysis. This allows policy makers to make the most appropriate decisions on pricing and funding new treatments. In an ideal situation, the benefit scenario considered for the new medicine would coincide with the one established for funding, but costs that are difficult to bear may lead to restrictions and affect the final positioning after the economic and budgetary impact assessment.

8.
Front Med (Lausanne) ; 11: 1343646, 2024.
Article in English | MEDLINE | ID: mdl-38952865

ABSTRACT

Objectives: The majority of patients with respiratory illness are seen in primary care settings. Given COVID-19 is predominantly a respiratory illness, the INTernational ConsoRtium of Primary Care BIg Data Researchers (INTRePID), assessed the pandemic impact on primary care visits for respiratory illnesses. Design: Definitions for respiratory illness types were agreed on collectively. Monthly visit counts with diagnosis were shared centrally for analysis. Setting: Primary care settings in Argentina, Australia, Canada, China, Norway, Peru, Singapore, Sweden and the United States. Participants: Over 38 million patients seen in primary care settings in INTRePID countries before and during the pandemic, from January 1st, 2018, to December 31st, 2021. Main outcome measures: Relative change in the monthly mean number of visits before and after the onset of the pandemic for acute infectious respiratory disease visits including influenza, upper and lower respiratory tract infections and chronic respiratory disease visits including asthma, chronic obstructive pulmonary disease, respiratory allergies, and other respiratory diseases. Results: INTRePID countries reported a marked decrease in the average monthly visits for respiratory illness. Changes in visits varied from -10.9% [95% confidence interval (CI): -33.1 to +11.3%] in Norway to -79.9% (95% CI: -86.4% to -73.4%) in China for acute infectious respiratory disease visits and - 2.1% (95% CI: -12.1 to +7.8%) in Peru to -59.9% (95% CI: -68.6% to -51.3%) in China for chronic respiratory illness visits. While seasonal variation in allergic respiratory illness continued during the pandemic, there was essentially no spike in influenza illness during the first 2 years of the pandemic. Conclusion: The COVID-19 pandemic had a major impact on primary care visits for respiratory presentations. Primary care continued to provide services for respiratory illness, although there was a decrease in infectious illness during the COVID pandemic. Understanding the role of primary care may provide valuable information for COVID-19 recovery efforts and planning for future global emergencies.

9.
Molecules ; 29(12)2024 Jun 17.
Article in English | MEDLINE | ID: mdl-38930937

ABSTRACT

Polyphenols from agro-food waste represent a valuable source of bioactive molecules that can be recovered to be used for their functional properties. Another option is to use them as starting material to generate molecules with new and better properties through semi-synthesis. A proanthocyanidin-rich (PACs) extract from avocado peels was used to prepare several semi-synthetic derivatives of epicatechin by acid cleavage in the presence of phenol and thiol nucleophiles. The adducts formed by this reaction were successfully purified using one-step centrifugal partition chromatography (CPC) and identified by chromatographic and spectroscopic methods. The nine derivatives showed a concentration-dependent free radical scavenging activity in the DPPH assay. All compounds were also tested against a panel of pathogenic bacterial strains formed by Listeria monocytogenes (ATCC 7644 and 19115), Staphylococcus aureus (ATCC 9144), Escherichia coli (ATCC 11775 and 25922), and Salmonella enterica (ATCC 13076). In addition, adducts were tested against two no-pathogenic strains, Limosilactobacillus fermentum UCO-979C and Lacticaseibacillus rhamnosus UCO-25A. Overall, thiol-derived adducts displayed antimicrobial properties and, in some specific cases, inhibited biofilm formation, particularly in Listeria monocytogenes (ATCC 7644). Interestingly, phenolic adducts were inactive against all the strains and could not inhibit its biofilm formation. Moreover, depending on the structure, in specific cases, biofilm formation was strongly promoted. These findings contribute to demonstrating that CPC is a powerful tool to isolate new semi-synthetic molecules using avocado peels as starting material for PACc extraction. These compounds represent new lead molecules with antioxidant and antimicrobial activity.


Subject(s)
Antioxidants , Catechin , Persea , Proanthocyanidins , Persea/chemistry , Antioxidants/pharmacology , Antioxidants/chemistry , Antioxidants/chemical synthesis , Proanthocyanidins/chemistry , Proanthocyanidins/pharmacology , Proanthocyanidins/chemical synthesis , Proanthocyanidins/isolation & purification , Catechin/chemistry , Catechin/pharmacology , Plant Extracts/chemistry , Plant Extracts/pharmacology , Microbial Sensitivity Tests , Anti-Infective Agents/pharmacology , Anti-Infective Agents/chemistry , Anti-Infective Agents/chemical synthesis , Sulfhydryl Compounds/chemistry , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/chemistry , Anti-Bacterial Agents/chemical synthesis , Anti-Bacterial Agents/isolation & purification , Phenols/chemistry , Phenols/pharmacology , Phenols/isolation & purification , Phenols/chemical synthesis
10.
Behav Sci (Basel) ; 14(6)2024 May 22.
Article in English | MEDLINE | ID: mdl-38920764

ABSTRACT

Adolescence is recognised as a notoriously vulnerable period in the human life cycle. Influenced by a complex interplay of biological, psychological and social factors, adolescents show a marked propensity to engage in risk behaviours. A systematic review was conducted of studies published in the Web of Science, PsycInfo and MEDLINE databases over the last decade, with the aim of collecting studies on the relationship between self-esteem and risk behaviour in individuals aged 12-18 years. The aim was to confirm the role of high self-esteem as a consistent protective factor against risk behaviour. The results show that self-esteem is negatively related to risk behaviour. Our results also reflect the need for further research on how sociodemographic factors, among others, affect the relationship between self-esteem and risk behaviours. This review highlights the relevance of implementing specific educational interventions to strengthen self-esteem in adolescents, with the aim of preventing various risk behaviours that may emerge during adolescence and persist throughout life if not addressed early.

11.
Animals (Basel) ; 14(12)2024 Jun 13.
Article in English | MEDLINE | ID: mdl-38929395

ABSTRACT

Equine Assisted Interventions (EAIs) integrate the active participation of horses in therapeutic or educational interventions. A bibliometric analysis was carried out on this topic, using traditional bibliometric laws and recommendations. For this purpose, a search on the Web of Science (WoS) Core Collection database was carried out, obtaining 333 documents. Annual publications followed an exponentially increasing trend (R2 = 86%), pointing out that this topic is a growing interest among researchers, publishers, and journals. The USA was the most productive country worldwide and Jeong-yi Kwon and Ji Lee were the prolific co-authors. The WoS category with the highest number of papers was Rehabilitation (84 papers). The Journal of Alternative and Complementary Medicine, and Pediatric Physical Therapy were the journals with the highest number of publications. The most cited paper was "State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy". The most used author keywords were rehabilitation, balance, and those related to specific populations such as Cerebral Palsy and Autism Spectrum Disorder. These results suggest that EAIs is a topic of increasing interest for researchers, editors, and professionals.

12.
J Chem Phys ; 160(21)2024 Jun 07.
Article in English | MEDLINE | ID: mdl-38828812

ABSTRACT

CNDOL is an a priori, approximate Fockian for molecular wave functions. In this study, we employ several modes of singly excited configuration interaction (CIS) to model molecular excitation properties by using four combinations of the one electron operator terms. Those options are compared to the experimental and theoretical data for a carefully selected set of molecules. The resulting excitons are represented by CIS wave functions that encompass all valence electrons in the system for each excited state energy. The Coulomb-exchange term associated to the calculated excitation energies is rationalized to evaluate theoretical exciton binding energies. This property is shown to be useful for discriminating the charge donation ability of molecular and supermolecular systems. Multielectronic 3D maps of exciton formal charges are showcased, demonstrating the applicability of these approximate wave functions for modeling properties of large molecules and clusters at nanoscales. This modeling proves useful in designing molecular photovoltaic devices. Our methodology holds potential applications in systematic evaluations of such systems and the development of fundamental artificial intelligence databases for predicting related properties.

13.
14.
J Clin Med ; 13(10)2024 May 08.
Article in English | MEDLINE | ID: mdl-38792311

ABSTRACT

Background/Objectives: The burnout syndrome in nurses has been related to the development of mental health problems. On the contrary, resilience is related to adequately coping with stressful situations and better mental health. The objective was to analyze the relationship between resilience and mental health problems in nurses and estimate the proportion mediated by burnout in the association. Methods: In 2021, a total of 1165 Spanish nurses were selected through a stratified random sampling method. Participants anonymously filled in the Resilience Scale (RS-14), the Maslach Burnout Inventory Survey, and the General Health Questionnaire. To test the hypothesis proposed and explain the mediating effect of burnout empirically, structural equation modeling (SEM) was applied. A latent mediation model was computed. Results: Resilience was negatively related to burnout and mental health problems. The direct relationship between burnout and the latent health variable was positive. In addition, in view of the total effect of resilience on mental health problems and the magnitude of the indirect effect, we stated that the proportion of this effect mediated by burnout ranged from 0.486 to 0.870. Conclusions: This study reveals that fostering resilience in nurses directly and indirectly reduces burnout and improves their mental health. The implementation of resilience programs and supportive institutional policies is recommended to improve working conditions and the quality of patient care.

15.
Int J Biol Sci ; 20(7): 2339-2355, 2024.
Article in English | MEDLINE | ID: mdl-38725853

ABSTRACT

Chronic cholestatic damage is associated to both accumulation of cytotoxic levels of bile acids and expansion of adult hepatic progenitor cells (HPC) as part of the ductular reaction contributing to the regenerative response. Here, we report a bile acid-specific cytotoxic response in mouse HPC, which is partially impaired by EGF signaling. Additionally, we show that EGF synergizes with bile acids to trigger inflammatory signaling and NLRP3 inflammasome activation in HPC. Aiming at understanding the impact of this HPC specific response on the liver microenvironment we run a proteomic analysis of HPC secretome. Data show an enrichment in immune and TGF-ß regulators, ECM components and remodeling proteins in HPC secretome. Consistently, HPC-derived conditioned medium promotes hepatic stellate cell (HSC) activation and macrophage M1-like polarization. Strikingly, EGF and bile acids co-treatment leads to profound changes in the secretome composition, illustrated by an abolishment of HSC activating effect and by promoting macrophage M2-like polarization. Collectively, we provide new specific mechanisms behind HPC regulatory action during cholestatic liver injury, with an active role in cellular interactome and inflammatory response regulation. Moreover, findings prove a key contribution for EGFR signaling jointly with bile acids in HPC-mediated actions.


Subject(s)
Bile Acids and Salts , ErbB Receptors , Inflammation , Liver , Signal Transduction , Animals , Male , Mice , Bile Acids and Salts/metabolism , ErbB Receptors/metabolism , Hepatic Stellate Cells/metabolism , Inflammation/metabolism , Liver/metabolism , Liver/pathology , Macrophages/metabolism , Mice, Inbred C57BL , Proteomics , Stem Cells/metabolism
16.
Physiol Behav ; 280: 114560, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38631544

ABSTRACT

BACKGROUND: This study aimed to investigate the physical and psychological benefits of an alternative cardiac rehabilitation program based on therapeutic groups during physical exercise sessions and to compare the results with those of a conventional cardiac rehabilitation program. METHOD: The sample included 112 patients from the cardiac rehabilitation unit of a medical center, 91.1 % of whom were male. The control group consisted of 47 subjects, with a mean age of 57.89 ± 12.30 and the experimental group consisted of 65 subjects, with a mean age of M = 58.38 ± 9.86. Quality of life, psychological well-being, health-related quality of life, body mass index, blood pressure, abdominal circumference and resting heart rate were measured before starting and at the end of the cardiac rehabilitation program. RESULTS: The experimental group improved significantly more than the control group in body mass index, systolic and diastolic blood pressure, abdominal circumference, and resting heart rate (p value < 0.005). In addition, the experimental group had significantly greater improvements in quality of life, psychological well-being, and health-related quality of life than the control group (p-value < 0.001). CONCLUSIONS: A cardiac rehabilitation program based on simultaneous aerobic training and psychosocial support improved the physical function, health-related quality of life and well-being.


Subject(s)
Cardiac Rehabilitation , Exercise Therapy , Heart Rate , Quality of Life , Aged , Female , Humans , Male , Middle Aged , Blood Pressure , Body Mass Index , Cardiac Rehabilitation/methods , Cardiac Rehabilitation/psychology , Exercise Therapy/methods , Heart Rate/physiology , Psychological Well-Being , Social Support , Treatment Outcome
17.
Psicothema ; 36(2): 154-164, 2024 05.
Article in English | MEDLINE | ID: mdl-38661162

ABSTRACT

BACKGROUND: The Sexual Inhibition/Sexual Excitation Scales-Short Form (SIS/SES-SF) is a brief instrument for assessing the propensity for sexual excitement and inhibition in men and women. The aim of the present study was to provide evidence for the validity and reliability of the Spanish version of the SIS/SES-SF scores by examining invariance, reliability (information function and internal consistency), the relationship between the scores and sexual functioning, and presenting its standard scores. METHOD: A total of 2,223 Spanish heterosexuals (43.41% men and 56.59% women) aged 18 to 83 years (M = 39.94, SD = 11.95), distributed across age groups (18-34, 35-49, ≥ 50 years old) participated. RESULTS: The three-factor structure of the Spanish version of SIS/SES-SF showed weak measurement invariance by sex and strict measurement invariance by age. The scores explained the dimensions of sexual functioning, especially sexual arousal and erection/lubrication. In addition, men and women without difficulties in sexual functioning demonstrated more propensity for sexual excitation and less sexual inhibition. The standard scores are presented by sex and age group. CONCLUSIONS: The study provides evidence of the validity and reliability of the SIS/SES-SF measures, confirming its usefulness for assessing propensity to sexual excitation and inhibition.


Subject(s)
Sexual Behavior , Humans , Male , Female , Middle Aged , Adult , Aged , Young Adult , Reproducibility of Results , Adolescent , Aged, 80 and over , Spain , Sexual Arousal , Inhibition, Psychological , Surveys and Questionnaires/standards , Sexual Dysfunctions, Psychological/psychology , Sexual Dysfunctions, Psychological/diagnosis , Psychometrics
18.
Diabetol Metab Syndr ; 16(1): 94, 2024 Apr 25.
Article in English | MEDLINE | ID: mdl-38664823

ABSTRACT

BACKGROUND: The SARS-CoV-2 pandemic brought a radical shift in the healthcare system and suboptimal care for vulnerable patients, such as those with Type 2 Diabetes Mellitus (T2D). Therefore, we compared metabolic control and macro/microvascular complications of patients with T2D before and throughout the three-year SARS-CoV-2 pandemic. RESEARCH DESIGN AND METHODS: A retrospective observational cohort of subjects with T2D studied from 2018 to 2022 in Northern Mexico was treated by a dynamic multidisciplinary team. Levels of Glycated hemoglobin (HbA1c), fasting serum glucose (FG), LDL-Cholesterol (LDL-C), blood pressure (BP), albuminuria, triglycerides, Body Mass Index (BMI), and FIB-4 score, micro and macrovascular complications were evaluated. RESULTS: A total of 999 patients were studied, 51.7% males with a mean (SD) age of 60.1 (12.7) years. Adequate glycemic control based on HbA1c increased by 15.2% and 42.3% in FSG (p < 0.001) between the beginning 2018 and the end of 2022. LDL-C control decreased by 5.1% between 2018 and 2022 (p < 0.001). Systolic BP control decreased by 2.6% (p < 0.001), whereas diastolic BP control increased by 1.8% (p = 0.01) between 2018 and 2022. Albuminuria control increased by 8.5% (p = 0.002). When comparing the Area Under the Curve (AUC) of metabolic parameters between patients who developed SARS-CoV-2 vs. those who did not, AUC was statistically higher in those who developed SARS-CoV-2 (p < 0.05). Diabetic neuropathy was the most prevalent microvascular complication (n = 35; 3.6%); ischemic heart disease was the most frequent macrovascular complication (n = 11;1.1%). CONCLUSIONS: A multidisciplinary dynamic team that adapts to the pandemic SARS-CoV-2 maintains and increases metabolic control in subjects with type 2 diabetes in Mexico. This represents a low percentage of chronic complications. The AUC of metabolic parameters of subjects with SARS-CoV-2 infection is higher, reflecting more variability in metabolic control.

19.
EClinicalMedicine ; 70: 102533, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38495523

ABSTRACT

Background: The COVID-19 pandemic impacted mental health disorders, affecting both individuals with pre-existing conditions and those with no prior history. However, there is limited evidence regarding the pandemic's impact on mental health visits to primary care physicians. The International Consortium of Primary Care Big Data Researchers (INTRePID) explored primary care visit trends related to mental health conditions in Argentina, Australia, Canada, China, Norway, Peru, Singapore, Sweden, and the USA. Methods: We conducted an interrupted time series analysis in nine countries to examine changes in rates of monthly mental health visits to primary care settings from January 1st, 2018, to December 31st, 2021. Sub-group analysis considered service type (in-person/virtual) and six categories of mental health conditions (anxiety/depression, bipolar/schizophrenia/other psychotic disorders, sleep disorders, dementia, ADHD/eating disorders, and substance use disorder). Findings: Mental health visit rates increased after the onset of the pandemic in most countries. In Argentina, Canada, China, Norway, Peru, and Singapore, this increase was immediate ranged from an incidence rate ratio of 1·118 [95% CI 1.053-1.187] to 2.240 [95% CI 2.057-2.439] when comparing the first month of pandemic with the pre-pandemic trend. Increases in the following months varied across countries. Anxiety/depression was the leading reason for mental health visits in most countries. Virtual visits were reported in Australia, Canada, Norway, Peru, Sweden, and the USA, accounting for up to 40% of the total mental health visits. Interpretation: Findings suggest an overall increase in mental health visits, driven largely by anxiety/depression. During the COVID-19 pandemic, many of the studied countries adopted virtual care in particular for mental health visits. Primary care plays a crucial role in addressing mental ill-health in times of crisis. Funding: Canadian Institutes of Health Research grant #173094 and the Rathlyn Foundation Primary Care EMR Research and Discovery Fund.

20.
Birth Defects Res ; 116(3): e2322, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38441368

ABSTRACT

INTRODUCTION: Body wall anomalies comprise a wide range of malformations. Limb-Body wall complex (LBWC) represents the most severe presentation of this group, with life threatening malformations in practically all the cases, including craniofacial, body wall defects, and limb anomalies. There is no consensus about its etiology and folding and gastrulation defects have been involved. Also, impaired angiogenesis has been proposed as a causative process. CASE REPORT: We present the case of a masculine stillborn, product of the first pregnancy in a 15-year-old, apparently healthy mother. He was delivered at 31 weeks of gestation due to an early rupture of membranes. He presented with multiple malformations including a wide body wall defect with multiple organ herniation and meromelia of the lower right limb. DISCUSSION AND CONCLUSIONS: LBWC represents a severe and invariably fatal pathology. There are no described risk factors, nevertheless, this case presented in a teenage mother, a well-described risk factor for other body wall anomalies. Its diagnosis allows us to discriminate between other pathologies that require prenatal or postnatal specialized treatment.


Subject(s)
Abnormalities, Multiple , Limb Deformities, Congenital , Male , Female , Pregnancy , Adolescent , Humans , Gastrulation , Gravidity , Limb Deformities, Congenital/diagnosis , Mothers
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