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1.
Nanoscale Adv ; 6(10): 2722-2727, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38752134

RESUMO

Zn2GeO4 is considered a very promising alternative to current luminescent semiconductors. Previous results suggest that its emitted wavelength may depend on different variables, such as particle size and morphology, among others. In this work, we have prepared pure and highly homogeneous Zn2GeO4 nanorods under hydrothermal synthesis conditions with a willemite-like structure. Their luminescent properties have been explored and their band gap is estimated, which are distinct from those of previously reported Zn2GeO4 bulk particles. Therefore, our results identify particle morphology as a crucial factor for maximizing and fine-tuning the luminescence of Zn2GeO4 nano-phosphors.

3.
Am J Hum Biol ; 35(12): e23963, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37493343

RESUMO

BACKGROUND: With regard to the origin of its population and microevolutionary processes, Uruguay exhibits distinctive features that distinguish it from other countries in Latin America, while at the same time sharing several similarities. In this article, we will focus on the variability of paternal genetic lineages in two geographical regions with different histories that can be considered as examples of distinct populations for the continent. In general terms, the genetic diversity is a result of different demographic processes related to the American conquest and colonisation. These resulted in distinct ancestral components which vary geographical and depend on the distribution by sex within these components. In Uruguay, native maternal haplogroups are significantly more frequent in the North. Although there are several studies about the geneticvariability of Uruguay, little is known about male genetic lineages. AIMS: The aim of this work is to present an updated study of the male genetic variability of the Uruguayan population. METHODS: We analyzed 13 biallelic markers and 27 STRs located in the male-specific region of the Y chromosome for 157 males: 98 from the capital, Montevideo, and 59 from Tacuarembó. RESULTS: Almost all haplogroups found in both locations are European (99% and 93.2% respectively). One Sub-Saharan African haplogroup was found in Montevideo (1%) and 2 in Tacuarembó (3%), while Native haplogroups were found only in Tacuarembó, evidencing a strong sex-biased admixture. By crossing genetic and genealogical information we could relate European haplogroups with different waves and times of migrations. DISCUSSION: Network analysis indicated a very diverse male population, suggesting that European migrants came from heterogeneous geographic locations and in different waves. Tacuarembó has closer population affinities with Iberian populations while Montevideo is more diverse. Male population expansion expansion, can be explained by the large number of migrants that arrived during the XIX century and the first half of the XX century. CONCLUSIONS: The Uruguayan male gene pool is the result of several migration waves with diverse origins, with strong sex-biased admixture that can be explained by the European migration, the violence against the indigenous males, and the segregation of the Africansadmixture that can be explained due to European migration, violence against Natives, and segregation against African males.admixture that can be explained due to European migration, violence against Natives, and segregation against African males.admixture that can be explained due to European migration, violence against Natives, and segregation against African males.admixture that can be explained due to European migration, violence against Natives, and segregation of hte Africans.


Assuntos
Cromossomos Humanos Y , Genética Populacional , Humanos , Masculino , Cromossomos Humanos Y/genética , Haplótipos , Uruguai/epidemiologia
4.
Nanomaterials (Basel) ; 13(5)2023 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-36903762

RESUMO

Polymorphous WO3 micro- and nanostructures have been synthesized by the controlled Joule heating of tungsten wires under ambient conditions in a few seconds. The growth on the wire surface is assisted by the electromigration process and it is further enhanced by the application of an external electric field through a pair of biased parallel copper plates. In this case, a high amount of WO3 material is also deposited on the copper electrodes, consisting of a few cm2 area. The temperature measurements of the W wire agrees with the values calculated by a finite element model, which has allowed us to establish the threshold density current to trigger the WO3 growth. The structural characterization of the produced microstructures accounts for the γ-WO3 (monoclinic I), which is the common stable phase at room temperature, along with low temperature phases, known as δ-WO3 (triclinic) on structures formed on the wire surface and ϵ-WO3 (monoclinic II) on material deposited on external electrodes. These phases allow for a high oxygen vacancies concentration, which is interesting in photocatalysis and sensing applications. The results could help to design experiments to produce oxide nanomaterials from other metal wires by this resistive heating method with scaling-up potential.

5.
Artigo em Inglês | MEDLINE | ID: mdl-36901155

RESUMO

(1) Abstract: Wound monitoring is an essential aspect in the evaluation of wound healing. This can be carried out with the multidimensional tool HELCOS, which develops a quantitative analysis and graphic representation of wound healing evolution via imaging. It compares the area and tissues present in the wound bed. This instrument is used for chronic wounds in which the healing process is altered. This article describes the potential use of this tool to improve the monitoring and follow-up of wounds and presents a case series of various chronic wounds with diverse etiology treated with an antioxidant dressing. (2) Methods: A secondary analysis of data from a case series of wounds treated with an antioxidant dressing and monitored with the HELCOS tool. (3) Results: The HELCOS tool is useful for measuring changes in the wound area and identifying wound bed tissues. In the six cases described in this article, the tool was able to monitor the healing of the wounds treated with the antioxidant dressing. (4) Conclusions: the monitoring of wound healing with this multidimensional HELCOS tool offers new possibilities to facilitate treatment decisions by healthcare professionals.


Assuntos
Antioxidantes , Bandagens , Tecnologia Digital , Cicatrização , Ferimentos e Lesões , Humanos , Ferimentos e Lesões/diagnóstico por imagem
6.
Artigo em Inglês | MEDLINE | ID: mdl-36981954

RESUMO

This study analyzes the quality and reliability of videos related to nutrition and cancer on YouTube. STUDY DESIGN: An observational, retrospective, cross-sectional, time-limited study analyzing activity on the social network YouTube was proposed. METHODS: The information from the videos was extracted through an API search tool, using the NodeXL software. The criteria to select the videos on YouTube were the keywords "real food", "realfood", and "cancer" and the hashtags #realfood and #cancer were present, videos in English and videos available on 1 December 2022. RESULTS: The DISCERN value in the total number of videos viewed was 2.25 (±0.88) points, indicating low reliability. The videos uploaded by HRU represented only 20.8%. Videos suggesting that the use of foods defined as "real food" could cure cancer without the intervention of any other treatment accounted for 12.5%. Videos that provided external links to scientific/technical evidence verifying the information represented only 13.89% of the total number of videos. Of these videos, 70% corresponded to HRU. The DISCERN value for videos from HRU users was 3.05 (0.88), a value that reflects a good reliability of videos from these users. CONCLUSIONS: This study provides information on the content and quality of the videos that we can find on YouTube. We found videos of non-health users who do not base their content on any scientific evidence, with the danger that this entails for the population, but it also highlights that the videos published by HRU have greater reliability and quality, being better perceived by the population, so it is important to encourage healthcare professionals and health institutions to share verified information on YouTube.


Assuntos
Neoplasias , Mídias Sociais , Humanos , Estudos Transversais , Reprodutibilidade dos Testes , Estudos Retrospectivos , Gravação em Vídeo , Disseminação de Informação
7.
Healthcare (Basel) ; 11(2)2023 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-36673583

RESUMO

Social media represents a powerful tool for disseminating verified health information on topics such as colostomy, and the roles of healthcare professionals and institutions to ensure the veracity of the information conveyed is increasingly relevant. The main objectives of this study were to analyze the roles of these healthcare professionals and institutions in the conversation about colostomy, without being framed in a specific health communication campaign, and to know the use of reliable information in the conversation. The study was carried out by analyzing Twitter messages containing the hashtag "colostomy" and "Chron" between the 1 January and the 30 April 2022. It was conducted using the NodeXL software, focusing on content analysis of tweets and users' accounts. The results show that accounts with healthcare activity influence the impressions generated on the network (p = 0.018), finding that nurses are the most active healthcare professionals (22.24%) also having a significant effect on the overall network interactions (p = 0.022). In contrast, we found that institutions do not actively participate on the network. We emphasize the responsibility of institutions for health education and the need for professionals to improve communication skills on social networks, but also the need to improve communication skills on social media to support public health campaigns through these increasingly important channels.

8.
Am J Hum Biol ; 35(6): e23868, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36695417

RESUMO

Uruguay has one of the highest per capita milk intakes worldwide, even with a limited supply of lactose-free products; furthermore, the admixed nature of its population is well known, and various frequencies of lactase persistence (LP) are observed in the source populations. We aimed to contribute to the understanding of the relation between allelic variants associated with LP, milk consumption, digestive symptoms, and genetic ancestry in the Uruguayan population. Samples of saliva or peripheral blood were collected from 190 unrelated individuals from two regions of Uruguay, genotypes for polymorphic sites in a fragment within the LCT enhancer were determined and allelic frequencies calculated in all of them. Data were collected on frequency of milk and dairy consumption and self-reported symptoms in a subsample of 153 individuals. Biparental and maternal ancestry was determined by analyzing individual ancestry markers and mitochondrial DNA. Twenty-nine percentage of individuals reported symptoms attributed to the ingestion of fresh milk, with abdominal pain, bloating and flatulence being the most frequent. European LP-associated allele T-13910 showed a frequency of 33%, while other LP-associated alleles like G-13915 and T-14011 were observed in very low frequencies. Associations between self-reported symptoms, fresh milk intake, and C/T-13910 genotype were statistically significant. No evidence of association between genetic ancestry and C/T-13910 was found, although individuals carrying one T-13910 allele appeared to have more European ancestry. In conclusion, the main polymorphism capable of predicting lactose intolerance in Uruguayans is C/T-13910, although more studies are required to unravel the relation between genotype and lactase activity, especially in heterozygotes.


Assuntos
Intolerância à Lactose , Humanos , Animais , Intolerância à Lactose/epidemiologia , Intolerância à Lactose/genética , Leite , Lactase/genética , Uruguai , Genótipo , DNA Mitocondrial , Polimorfismo de Nucleotídeo Único
9.
Nanomaterials (Basel) ; 14(1)2023 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-38202460

RESUMO

This study focuses on the fabrication of polymer nanocomposite films using polyvinyl alcohol (PVA)/graphene quantum dots (GQDs). We investigate the relationship between the structural, thermal, and nanoscale morphological properties of these films and their photoluminescent response. Although according to X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FT-IR), and differential thermal analysis (DTA), the incorporation of GQDs does not significantly affect the percentage crystallinity of the PVA matrix, for a range of added GQD concentrations, atomic force microscopy (AFM) showed the formation of islands with apparent crystalline morphology on the surface of the PVA/GQD films. This observation suggests that GQDs presumably act as nucleating agents for island growth. The incorporation of GQDs also led to the formation of characteristic surface pores with increased stiffness and frictional contrast, as indicated by ultrasonic force microscopy (UFM) and frictional force microscopy (FFM) data. The photoluminescence (PL) spectra of the films were found to depend both on the amount of GQDs incorporated and on the film morphology. For GQD loads >1.2%wt, a GQD-related band was observed at ~1650 cm-1 in FT-IR, along with an increase in the PL band at lower energy. For a load of ~2%wt GQDs, the surface morphology was characterized by extended cluster aggregates with lower stiffness and friction than the surrounding matrix, and the PL signal decreased.

10.
J Tissue Viability ; 31(4): 575-578, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36175255

RESUMO

AIM: To develop a diagnostic algorithm to differentiate dependence-related skin injuries (avoidable) from severe life-threatening skin injuries (unavoidable). METHOD: A nominal group technique was used. Six experts with extensive knowledge of these types of injuries were selected for the group. All were nurses with a PhD in wound research and had more than 15 years of experience in wound care. The experts were asked only one question: In your opinion, what are the basic and indispensable aspects to differentiate a dependence-related skin injury (DR-SI) from a severe life-threatening skin injury (SLT-SI)? RESULTS: The experts identified three basic elements to differentiate DL-SI and SLT-SI (clinical situation, provision of care, and clinical characteristics of the lesions). A diagnostic algorithm was developed to differentiate the two types of skin lesions using the three basic elements identified, a literature review, and what was published in the two articles that define DR-SI and STL-SI. CONCLUSION: We developed a diagnostic algorithm to differentiate dependence-related skin injuries (avoidable) from severe life-threatening skin injuries (unavoidable). The algorithm also facilitates the identification of the subtypes of these injuries, depending on its location and characteristics.


Assuntos
Lesões dos Tecidos Moles , Humanos , Diagnóstico Diferencial , Algoritmos
11.
Vaccines (Basel) ; 10(8)2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-36016126

RESUMO

This study aims to analyze the role of bots in the dissemination of health information, both in favor of and opposing vaccination against COVID-19. Study design: An observational, retrospective, time-limited study was proposed, in which activity on the social network Twitter was analyzed. Methods: Data related to pro-vaccination and anti-vaccination networks were compiled from 24 December 2020 to 30 April 2021 and analyzed using the software NodeXL and Botometer. The analyzed tweets were written in Spanish, including keywords that allow identifying the message and focusing on bots' activity and their influence on both networks. Results: In the pro-vaccination network, 404 bots were found (14.31% of the total number of users), located mainly in Chile (37.87%) and Spain (14.36%). The anti-vaccination network bots represented 16.19% of the total users and were mainly located in Spain (8.09%) and Argentina (6.25%). The pro-vaccination bots generated greater impact than bots in the anti-vaccination network (p < 0.000). With respect to the bots' influence, the pro-vaccination network did have a significant influence compared to the activity of human users (p < 0.000). Conclusions: This study provides information on bots' activity in pro- and anti-vaccination networks in Spanish, within the context of the COVID-19 pandemic on Twitter. It is found that bots in the pro-vaccination network influence the dissemination of the pro-vaccination message, as opposed to those in the anti-vaccination network. We consider that this information could provide guidance on how to enhance the dissemination of public health campaigns, but also to combat the spread of health misinformation on social media.

12.
Prehosp Disaster Med ; 37(4): 502-508, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35678389

RESUMO

INTRODUCTION: In recent years, the use of drones in health emergencies has increased. Among their main benefits are avoiding endangering rescuers, travelling long distances in a short time, or contacting victims in risky situations; but despite their multiple advantages, their use has not been fully demonstrated. STUDY OBJECTIVE: This study aims to identify the available evidence on the use of drones in emergency health care compared to traditional health care. METHODS: Systematic review of the literature was conducted. Search protocols were developed to locate studies that met the established selection criteria. Six experimental or quasi-experimental studies with high methodological quality published from the beginning of indexing until 2020 were included. RESULTS: Drones covered a significantly larger area than other traditional tracking methods and were very useful for performing preliminary triage, determining needs, and knowing the scene prior to the arrival of rescuers. In addition, drones reduced the time required to locate the victim. CONCLUSIONS: Drones are an element to be taken into account when attending health emergencies as they significantly improve the distance travelled to locate accident victims, have the possibility of performing triage prior to the arrival of the health care units, and improve the time and quality of the care provided.


Assuntos
Serviços Médicos de Emergência , Dispositivos Aéreos não Tripulados , Serviços Médicos de Emergência/métodos , Humanos
13.
J Prof Nurs ; 39: 101-108, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35272816

RESUMO

BACKGROUND: The increase in the number of people with Alzheimer's disease and Related Dementias (ADRD) will results in an increased need for nurses with up-to-date knowledge of ADRD and who are well-educated in ADRD care. Therefore, it is important to be sure that this topic is covered in the undergraduate nursing curriculum. PURPOSE: To assess undergraduate nursing students' knowledge of Alzheimer's disease and related dementias care. METHOD: Cross-sectional study carried out among nursing students at two universities in southern Spain. The University of Jaen (UJA)-Alzheimer's Care scale was used to measure their knowledge. RESULTS: The mean age of the students was 21.39 years, and 83.2% of the 678 students were women. For students, the UJA-Alzheimer's Care scale has a good fit and reliability of 0.99 for the items and 0.74 for the persons, according to the Rasch model. The mean knowledge score of nursing students was 15.33 (SD 3.69) out of 23; (95%CI: 15.06-15.61). The value of the latent variable (theta) was 1.16 (SD 1.21); (95%CI: 1.06-1.25). The factors positively associated with students' knowledge were the number of years in the program, experience in caring for a patient with ADRD during their placements, and the education on ADRD received in the nursing program as self-rated by the students. CONCLUSION: The UJA-Alzheimer's Care scale is a useful tool for measuring knowledge of ADRD care among nursing students in Spain and other Spanish-speaking countries. Nursing students at the two universities reached moderate scores in the knowledge of ADRD care. More years in the nursing program, practical experience in clinical placements, and higher self-rated level of education on ADRD received during the program were associated with higher scores on knowledge.


Assuntos
Doença de Alzheimer , Bacharelado em Enfermagem , Estudantes de Enfermagem , Adulto , Doença de Alzheimer/terapia , Estudos Transversais , Bacharelado em Enfermagem/métodos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Reprodutibilidade dos Testes , Adulto Jovem
14.
Artigo em Inglês | MEDLINE | ID: mdl-36612345

RESUMO

Health misinformation about nutrition and other health aspects on social media is a current public health concern. Healthcare professionals play an essential role in efforts to detect and correct it. The present study focuses on analyzing the use of competencies associated with training in methodology, health literacy, and critical lecture in order to detect sources of health misinformation that use scientific articles to support their false information. A qualitative study was conducted between 15 and 30 January 2022, wherein the participants were recruited from active users from a nutrition conversation on Twitter, diets, and cancer and defined themselves as healthcare professionals. This study demonstrates that health literacy and critical lecture competencies allow for the detection of more misinformation messages and are associated with a high rate of responses to users that spread the misinformation messages. Finally, this study proposes the necessity of developing actions to improve health literacy and critical lecture competencies between healthcare professionals. However, in order to achieve this, health authorities must develop strategies to psychologically support those healthcare professionals faced with bullying as a result of their activity on social media debunking health hoaxes.


Assuntos
Letramento em Saúde , Mídias Sociais , Humanos , Comunicação , Saúde Pública/métodos , Atenção à Saúde
15.
J Nurs Manag ; 30(1): 135-143, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34498335

RESUMO

AIM: To describe nurses and ward managers' experiences with nursing leadership in the implementation of evidence-based practice. BACKGROUND: The implementation of evidence-based practice requires to identify the most suitable styles of nursing leadership for the successful application. DESIGN: A qualitative descriptive study. METHODS: The study was carried out with 57 nurses (clinical nurses and ward managers) in eight focus groups from five public hospitals. Template analysis, using the Promoting Action on Research Implementation in Health Services framework, was used. The Consolidated Criteria for Reporting Qualitative Research guide was followed in planning and reporting this research. RESULTS: Three types of nursing leadership were identified: traditional leadership, medium leadership and transformational leadership. Traditional leadership was the most frequent, with a predominance of bureaucratic tasks for ward managers, so implementation of evidence-based practice is difficult. CONCLUSION: Nurses do not feel empowered and they perceive the changes as an imposition. In the absence of strong leadership for evidence-based practice, a natural leader emerges. IMPLICATIONS FOR NURSING MANAGEMENT: Clinical nurses demand more empowerment for decision-making, and ward managers need clarity of roles. To create an environment favourable to evidence-based practice, it is necessary consider the role of the transformational leader.


Assuntos
Liderança , Enfermeiros Administradores , Prática Clínica Baseada em Evidências , Hospitais Públicos , Humanos , Pesquisa Qualitativa
16.
J Nurs Scholarsh ; 54(1): 72-80, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34741398

RESUMO

PURPOSE: To create a conceptual framework for skin injuries developing in patients whose lives are severely compromised or who are expected to die within a short period of time. To name and classify these types of skin injuries. To describe the clinical features of the different types of skin injuries that may occur in terminally ill and/or dying patients. DESIGN: A sequential design with several different phases (a literature review, a nominal group, and a consensus conference) was used. METHODS: Six experts with extensive knowledge of these types of injuries were selected for the nominal group. The traditional eight-phase nominal group technique was followed. The consensus conference consisted of participants voting on different options based on the statements elaborated with the expert panel summarizing the best scientific evidence available. FINDINGS: Using all these elements, a conceptual framework was constructed to identify skin injuries associated with severe life-threatening situations (SI-SLTSs), defined as unpredictable and therefore unpreventable injuries indicating a serious threat to life or even imminent death. These injuries can occur in two forms: (a) as skin injuries associated with multiple organ dysfunction syndrome (SI-MODSs) or (b) as skin injuries associated with severe vasoconstriction (SI-ESVs). SI-MODSs develop very quickly and suddenly. They progress from superficial to deep stages abruptly, even within hours. The severity of the injuries does not reflect the care provided to the patient. Individuals suffering from these injuries have an irreversible clinical condition. SI-ESVs also appear in individuals who are in a very critical, even terminal, clinical condition. They are frequently treated in the ICU and may exhibit severe vasoconstriction due to their disease process (e.g., shock), sometimes exacerbated by vasoconstriction caused by various drugs (e.g., noradrenaline). CONCLUSIONS: We have developed a conceptual framework for skin injuries developing in patients whose lives are severely compromised or who are expected to die within a short period of time and have named them SI-SLTSs, distinguishing between SI-MODSs and SI-ESVs. CLINICAL RELEVANCE: This new conceptual framework may help clinicians understand the mechanisms and the pathophysiology of skin injuries that develop in terminally ill and/or dying patients associated with multi-organ failure. Through this new framework these injuries can be identified and differentiated from pressure injuries or other dependence-related skin lesions.

17.
Heart ; Heart;107(18): 319489, Sept. 2021.
Artigo em Inglês | BIGG, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1252925

RESUMO

In elderly (75 years or older) patients living in Latin America with severe symptomatic aortic stenosis candidates for transfemoral approach, the panel suggests the use of transcatheter aortic valve implant (TAVI) over surgical aortic valve replacement (SAVR). This is a conditional recommendation, based on moderate certainty in the evidence. This recommendation does not apply to patients in which there is a standard of care, like TAVI for patients at very high risk for cardiac surgery or inoperable patients, or SAVR for non-elderly patients (eg, under 65 years old) at low risk for cardiac surgery. The suggested age threshold of 75 years old is based on judgement of limited available literature and should be used as a guide rather than a determinant threshold. The conditional nature of this recommendation means that the majority of patients in this situation would want a transfemoral TAVI over SAVR, but some may prefer SAVR. For clinicians, this means that they must be familiar with the evidence supporting this recommendation and help each patient to arrive at a management decision integrating a multidisciplinary team discussion (Heart Team), patient's values and preferences through shared decision-making, and available resources. Policymakers will require substantial debate and the involvement of various stakeholders to implement this recommendation.


Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Estenose da Valva Aórtica/cirurgia , Substituição da Valva Aórtica Transcateter/reabilitação , Estenose da Valva Aórtica/diagnóstico , América Latina
18.
J Clin Med ; 10(16)2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34441854

RESUMO

(1) Background: Reactive oxygen species (ROS) play a crucial role in the preparation of the normal wound healing response. Therefore, a correct balance between low or high levels of ROS is essential. Antioxidant dressings that regulate this balance are a target for new therapies. The purpose of this review is to identify the compounds with antioxidant properties that have been tested for wound healing and to summarize the available evidence on their effects. (2) Methods: A literature search was conducted and included any study that evaluated the effects or mechanisms of antioxidants in the healing process (in vitro, animal models or human studies). (3) Results: Seven compounds with antioxidant activity were identified (Curcumin, N-acetyl cysteine, Chitosan, Gallic Acid, Edaravone, Crocin, Safranal and Quercetin) and 46 studies reporting the effects on the healing process of these antioxidants compounds were included. (4) Conclusions: this review offers a map of the research on some of the antioxidant compounds with potential for use as wound therapies and basic research on redox balance and oxidative stress in the healing process. Curcumin, NAC, quercetin and chitosan are the antioxidant compounds that shown some initial evidence of efficacy, but more research in human is needed.

19.
Heart ; 107(18): 1450-1457, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34127541

RESUMO

In elderly (75 years or older) patients living in Latin America with severe symptomatic aortic stenosis candidates for transfemoral approach, the panel suggests the use of transcatheter aortic valve implant (TAVI) over surgical aortic valve replacement (SAVR). This is a conditional recommendation, based on moderate certainty in the evidence (⨁⨁⨁Ο).This recommendation does not apply to patients in which there is a standard of care, like TAVI for patients at very high risk for cardiac surgery or inoperable patients, or SAVR for non-elderly patients (eg, under 65 years old) at low risk for cardiac surgery. The suggested age threshold of 75 years old is based on judgement of limited available literature and should be used as a guide rather than a determinant threshold.The conditional nature of this recommendation means that the majority of patients in this situation would want a transfemoral TAVI over SAVR, but some may prefer SAVR. For clinicians, this means that they must be familiar with the evidence supporting this recommendation and help each patient to arrive at a management decision integrating a multidisciplinary team discussion (Heart Team), patient's values and preferences through shared decision-making, and available resources. Policymakers will require substantial debate and the involvement of various stakeholders to implement this recommendation.


Assuntos
Estenose da Valva Aórtica/cirurgia , Guias de Prática Clínica como Assunto , Substituição da Valva Aórtica Transcateter/normas , Estenose da Valva Aórtica/diagnóstico , Implante de Prótese de Valva Cardíaca/normas , Humanos , América Latina , Índice de Gravidade de Doença
20.
Skeletal Radiol ; 50(11): 2293-2297, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33944967

RESUMO

Vaccination injection site adverse reactions are usually mild and transient, and post-vaccination musculoskeletal symptoms, such as myalgia and arthralgia, are very common. Shoulder injury related to vaccine administration (SIRVA), defined as shoulder pain and limited range of motion occurring after the administration of a vaccine intended for intramuscular administration in the upper arm, is a well-established condition in the medical literature, yet underreported. In such cases, subacromial-subdeltoid bursitis may occur, leading to shoulder dysfunction and ongoing pain. Millions of doses of vaccines for the prevention of COVID-19 have been administered to adults worldwide during the pandemic. We report a case of subacromial-subdeltoid bursitis after COVID-19 vaccination, related to the unintentional injection of vaccine solution into the bursa resulting in a robust immune-mediated inflammatory reaction.


Assuntos
Bursite , COVID-19 , Lesões do Ombro , Vacinas , Adulto , Vacinas contra COVID-19 , Humanos , SARS-CoV-2 , Dor de Ombro/etiologia , Vacinação/efeitos adversos
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