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ABSTRACT: Rabal-Pelay, J, Gutiérrez, H, Bascuas, P-J, Pareja-Blanco, F, and Marco-Contreras, LA. Load-velocity relationship in the Bulgarian split-squat exercise. J Strength Cond Res XX(X): 000-000, 2024-The objective of the current research was to analyze the load-velocity relationship in the Bulgarian split-squat (BSS) exercise and to compare these relationships between the dominant and nondominant legs. Twenty-one strength-trained men (age: 27.3 ± 7.3 years) performed a progressive loading test in the BSS exercise using a Smith machine for each leg. The protocol began with a load of 30 kg, incrementally adding 10 kg until the mean propulsive velocity (MPV) fell below 0.4 m·s-1. At that point, 5 kg increments were employed, with a final addition of 2.5 kg for the last estimated attempt one-repetition maximum (1RM). A total of 324 lifts were analyzed. Subjects exhibited a relative strength ratio of 1.23 ± 0.10, a 1RM of 91.3 ± 14.2 kg, and a mean range of motion of 44.7 ± 3.7 cm. Polynomial regression analysis showed a robust relationship with an R2 value of 0.945 (ρ ≤ 0.001) between the relative load (%1RM) and MPV. Despite the differences in 1RM between the dominant and nondominant legs, there were no significant differences in MPV at the %1RM between both legs. These findings suggest that training intensity can be prescribed via the MPV during the BSS exercise. Moreover, the load-velocity relationship is stable between limbs despite the potential differences in absolute strength levels.
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ABSTRACT: Sánchez-Sabaté, J, Gutiérrez, H, Marco-Contreras, LA, Younes-Egana, O, Gonzalo-Skok, O, and Piedrafita, E. Influence of vertical-oriented vs. horizontal-oriented combined strength training in young basketball players. J Strength Cond Res 38(7): 1280-1287, 2024-This study aimed to compare the effects of 8-week combined vertical-oriented vs. horizontal-oriented training interventions in basketball athletes. Eighteen highly trained U-16 basketball players participated in this study and were randomly assigned to either a combined vertical-oriented training group (CVG, n = 9) or a combined horizontal-oriented training group (CHG, n = 9). Bilateral and unilateral vertical jump height, unilateral horizontal jump distance, 5-m, 10-m, and 20-m sprint times, change-of-direction sprint times, and a limb symmetry index were among the measured performance variables. Combined strength training was performed twice a week for 8 weeks. CVG was compounded by the squat exercise (3 sets of 6-8 R at 30-45% 1 repetition maximum [1RM]), jump squats (2 sets of 6 R, at 5-12.5% body mass [BM]), and vertical jumps (3-4 sets × 6 R). CHG included the hip thrust exercise (3 sets of 6-8 R at 30-45% 1RM), sled towing sprints (2-3 R, at 5-12.5% BM), and sprints (3-4 R of 20-m). Within-group differences showed significant ( p < 0.05 and statistical power >80%) improvements in unilateral vertical jumping with the right leg after both training interventions. By contrast, only CHG improved 5-m, 10-m, and 20-m sprint times ( p < 0.05 and statistical power >80%). Significant effects were observed for CHG compared with CVG in 5-m, 10-m, and 20-m sprint times ( p < 0.05 and statistical power >80%). This study reinforces the importance of oriented-combined training based on force-vector specificity target, mainly in horizontal-oriented actions.
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Desempenho Atlético , Basquetebol , Força Muscular , Treinamento Resistido , Humanos , Basquetebol/fisiologia , Treinamento Resistido/métodos , Desempenho Atlético/fisiologia , Adolescente , Masculino , Força Muscular/fisiologia , AtletasRESUMO
Dear Editor: Mesalamine is a medication used widely in the treatment of patients with inflammatory bowel disease. Although mesalamine is considered safe, hepatotoxicity has been reported with an incidence of 0-4%. We present the clinical picture of a patient with hepatotoxicity due to mesalamine. A 79-year-old woman in the context of chronic diarrhea, a left-sided ulcerative colitis diagnosis was made, and treatment was initiated with oral mesalamine 4 g per day, and mesalamine suppositories. Before starting treatment, she had normal liver test results. After three months, she presented with headache, fatigue, and intermittent low fever. Her laboratory tests showed a liver profile with a cholestatic pattern, and elevation of inflammatory parameters. Mesalamine was suspended, and an extensive study was performed. Cholangioresonance reported intra and extrahepatic bile duct dilation without obstruction, and thickening of the intrahepatic bile duct. She progressed with worsening of the liver profile without signs of liver failure. A liver biopsy was performed, which showed chronic non-suppurative cholangitis with granulomas and focal concentric fibrosis related to medium-caliber bile ducts, and IgG4 stain was negative.
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The rapid evolution of 5G and beyond technologies has sparked an unprecedented surge in the need for networking infrastructure that can deliver high speed, minimal latency, and remarkable flexibility. The programmable data plane, which enables the dynamic reconfiguration of network functions and protocols, is becoming increasingly important in meeting these requirements. This paper provides an overview of the current state of the art in programmable data planes implemented in 5G and beyond architectures. It proposes a classification of the reviewed studies based on system architecture and specific use cases. Furthermore, the article surveys the primary applications of programmable devices in emerging telecommunication networks, such as tunneling and forwarding, network slicing, cybersecurity, and in-band telemetry. Finally, this publication summarizes the open research challenges and future directions. In addition to offering a comprehensive review of programmable data plane applications in telecommunication networks, this article aims to guide further research in this promising field for network operators and researchers alike.
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Common Variable Immunodeficiency (CVID) is the most common symptomatic primary immunodeficiency in adults, with non-infectious gastrointestinal involvement present in up to 50% of patients, with the small intestine and colon being the most affected areas. Reports have evaluated the effectiveness of biologic therapy in this scenario. Here, we describe the clinical, endoscopic, and histological findings of a patient who presented a satisfactory response to infliximab.
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INTRODUCTION: retention is the most common adverse event of the small bowel capsule endoscopy procedure. Patency capsule (Medtronic, Dublin, Ireland) and magnetic resonance enterography are two diagnostic methods that can prevent small bowel capsule endoscopy retention. The aim of this study was to evaluate the predictive value of these two diagnostic methods. MATERIAL AND METHODS: a prospective, comparative and observational study was performed in patients with established Crohn's disease. All patients had undergone magnetic resonance enterography and patency capsule procedures. If the patency capsule was not retained, the patient underwent a small bowel capsule endoscopy; otherwise, double balloon enteroscopy was performed to locate the stenosis. Magnetic resonance enterography predictive criteria for retention were analyzed in all cases. Sensitivity, specificity, positive predictive value and negative predictive value of the patency capsule and magnetic resonance enterography compared to small bowel capsule endoscopy or double balloon enteroscopy were calculated. RESULTS: forty patients were included (24 female, 55 ± 13 years old). Retention criteria with capsule endoscopy or double balloon enteroscopy were found in six patients, agreeing in five cases with patency capsule and in three cases with magnetic resonance enterography. Sensitivity, specificity, positive predictive value, negative predictive value and Kappa coefficient for predicting retention with the patency capsule were 83 %, 100 %, 100 % and 97 %, respectively, and 50 %, 91 %, 50 % and 91 %, respectively, with magnetic resonance enterography. CONCLUSIONS: patency capsule has a higher sensitivity and positive predictive value than magnetic resonance enterography for preventing small bowel capsule endoscopy retention in Crohn's disease patients.
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Endoscopia por Cápsula , Doença de Crohn , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Doença de Crohn/diagnóstico , Endoscopia por Cápsula/métodos , Estudos Prospectivos , Intestino Delgado/diagnóstico por imagem , Intestino Delgado/patologia , Espectroscopia de Ressonância MagnéticaRESUMO
The need to develop wearable devices for personal health monitoring, diagnostics, and therapy has inspired the production of innovative on-demand, customizable technologies. Several of these technologies enable printing of raw electronic materials directly onto biological organs and tissues. However, few of them have been thoroughly investigated for biocompatibility of the raw materials on the cellular, tissue, and organ levels or with different cell types. In addition, highly accurate multiday in vivo monitoring using such on-demand, in situ fabricated devices has yet to be done. Presented herein is the first fully biocompatible, on-skin fabricated electronics for multiple cell types and tissues that can capture electrophysiological signals with high fidelity. While also demonstrating improved mechanical and electrical properties, the drawn-on-skin ink retains its properties under various writing conditions, which minimizes the variation in electrical performance. Furthermore, the drawn-on-skin ink shows excellent biocompatibility with cardiomyocytes, neurons, mice skin tissue, and human skin. The high signal-to-noise ratios of the electrophysiological signals recorded with the DoS sensor over multiple days demonstrate its potential for personalized, long-term, and accurate electrophysiological health monitoring.
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Tinta , Dispositivos Eletrônicos Vestíveis , Animais , Eletrônica , Eletrofisiologia , Humanos , Camundongos , PeleRESUMO
BACKGROUND AND AIMS: Gastric peroral endoscopic myotomy (G-POEM) is used for refractory gastroparesis (RG) with good early-term but variable mid- and long-term outcomes. Limited data exist about candidates and long-term clinical and predictive factors. Our aim was to evaluate the 4-year follow-up efficacy and predictive factors in patients with RG. METHODS: Confirmed RG patients were included and evaluated between April 2017 and December 2021. Gastroparesis Cardinal Symptom Index (GCSI) score, retention percentage at 4 hours (RP4H), mean half-emptying time (MHET), and the 36-item short-form survey (SF-36) were performed at 1, 6, 12, 18, 24, 30, 36, 42, and 48 months. RESULTS: After G-POEM, 374 patients with RG were included: 141 patients (37.7%) had diabetic gastroparesis (DG), 115 (30.7%) had idiopathic gastroparesis (IG), 102 (27.3%) had postsurgical gastroparesis (PSG), and 16 (4.3%) had other etiologies. After the 48-month evaluation, 102 patients completed follow-up (DG, 58; IG, 22; PSG, 18; other, 4). Before G-POEM, GCSI score, RP4H, and MHET were 3.84 ± .53, 44% (interquartile range [IQR], 11-68), and 246 minutes (IQR, 150-368), respectively, and after the 48-month evaluation improved to 2.1 ± .70 (P < .001), 15.5% (IQR, 0-36; P = .021), and 135 minutes (IQR, 67-290; P = .045), respectively. At the 48-month evaluation, clinical success was 77.5%. DG showed the best outcomes (DG vs IG vs PSG vs other: 86.5% vs 72.5% [P = .001] vs 72.1% [P = .003] vs 68.8% [P < .001]). Long-term success predictors were DG (odds ratio [OR], 5.113; 95% confidence interval [CI], 1.643-5.981; P = .035), early diagnosis (OR, 2.455; 95% CI, 1.129-3.522; P = .042), nausea/vomiting (OR, 3.541; 95% CI, 1.881-5.511; P = .012), GCSI score at 6 months (1.5-2) (OR, 3.612; 95% CI, 2.122-5.317; P = .022), and RP4H <10% at 6 months (OR, 2.188; 95% CI, 1.435-4.233; P = .039). CONCLUSIONS: G-POEM is an effective 4-year treatment in patients with RG, especially in DG, establishing a potential first-line therapy in these patients. However, randomized controlled clinical trials are needed to confirm these results. (Clinical trial registration number: NTC03126513.).
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Acalasia Esofágica , Gastroparesia , Acalasia Esofágica/cirurgia , Esfíncter Esofágico Inferior , Seguimentos , Esvaziamento Gástrico , Gastroparesia/cirurgia , Humanos , Resultado do TratamentoRESUMO
The association between inflammatory bowel disease (IBD) and anal canal squamous cell carcinoma (SCC) has a low prevalence and is mainly supported by articles that include a series of cases. We describe the clinical, endoscopic and histological findings of a patient with Crohn's disease (CD) who developed SCC while undergoing biological therapy with active disease.
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Neoplasias do Ânus , Carcinoma de Células Escamosas , Doença de Crohn , Doenças Inflamatórias Intestinais , Neoplasias do Ânus/epidemiologia , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/terapia , Doença de Crohn/complicações , Doença de Crohn/terapia , Humanos , Doenças Inflamatórias Intestinais/complicaçõesRESUMO
Microplastics (MPs) are emerging pollutants of widespread concern in aquatic environments. The aim of this study was to evaluate the negative impact of pristine MPs of polystyrene of 100 µm on embryo and larvae of Danio rerio exposed to three environmentally relevant concentrations of polystyrene (3.84 × 10- 6, 3.84 × 10- 7, and 3.84 × 10- 8 g/mL). The exposure effect was evaluated through the general morphology score, biometrics, and integrated biomarker response version 2 index. No mortality was observed but the anatomical structure of fishes was affected showing pigmentation deficiency and alterations in the head region as the main affected endpoints. The general morphology score and the integrated biomarker response values were highly sensitive to address the effect of the three concentrations of MPs used here. Our results provide solid evidence of the negative impact of 100 µm pristine polystyrene MPs exposure on early stages of zebrafish.
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Poliestirenos , Poluentes Químicos da Água , Animais , Poliestirenos/toxicidade , Plásticos , Peixe-Zebra/fisiologia , Poluentes Químicos da Água/toxicidade , Microplásticos/toxicidade , Larva , BiomarcadoresRESUMO
AIM: To establish trends in Implant Dentistry in Latin America in the COVID-19 pandemic. MATERIAL AND METHODS: A steering committee and an advisory group of experts in Implant Dentistry were selected among eighteen countries. An open-ended questionnaire by Delphi methodology was validated including 64 questions, divided in 7 topics, concerning the various trends in dental implantology. The survey was conducted in two rounds, which provided the participants in the second round with the results of the first. The questionnaires were completed on August 2020, and the online meeting conference was held on September 2020. The final prediction was developed through consensus by a selected group of experts. RESULTS: A total of 197 experts from Latin America answered the first and second questionnaire. In the first round, the established threshold for consensus (65%) was achieved in 30 questions (46.87%). In the second round, performed on average 45 days later, this level was achieved in 47 questions (73.43%). Consensus was completely reached on the item "Diagnostic" (100%), the field with the lowest consensus was "Demand for treatment with dental implants" (37.5%). CONCLUSIONS: The present study in Latin America has provided relevant and useful information on the predictions in the education and practice of Implant Dentistry in the COVID-19 era. The consensus points toward a great confidence of clinicians in the biosecurity protocols used to minimize the risk of SARS-CoV-2 transmission. It is foreseen as an important change in education, with introduction of virtual reality and other simulation technologies in implant training.
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COVID-19 , Implantes Dentários , Técnica Delphi , Humanos , América Latina , Pandemias , SARS-CoV-2RESUMO
Network slicing is a powerful paradigm for network operators to support use cases with widely diverse requirements atop a common infrastructure. As 5G standards are completed, and commercial solutions mature, operators need to start thinking about how to integrate network slicing capabilities in their assets, so that customer-facing solutions can be made available in their portfolio. This integration is, however, not an easy task, due to the heterogeneity of assets that typically exist in carrier networks. In this regard, 5G commercial networks may consist of a number of domains, each with a different technological pace, and built out of products from multiple vendors, including legacy network devices and functions. These multi-technology, multi-vendor and brownfield features constitute a challenge for the operator, which is required to deploy and operate slices across all these domains in order to satisfy the end-to-end nature of the services hosted by these slices. In this context, the only realistic option for operators is to introduce slicing capabilities progressively, following a phased approach in their roll-out. The purpose of this paper is to precisely help designing this kind of plan, by means of a technology radar. The radar identifies a set of solutions enabling network slicing on the individual domains, and classifies these solutions into four rings, each corresponding to a different timeline: (i) as-is ring, covering today's slicing solutions; (ii) deploy ring, corresponding to solutions available in the short term; (iii) test ring, considering medium-term solutions; and (iv) explore ring, with solutions expected in the long run. This classification is done based on the technical availability of the solutions, together with the foreseen market demands. The value of this radar lies in its ability to provide a complete view of the slicing landscape with one single snapshot, by linking solutions to information that operators may use for decision making in their individual go-to-market strategies.
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Radar , Tecnologia , Rede SocialRESUMO
ABSTRACT: García-Pinillos, F, Roche-Seruendo, LE, Marcen-Cinca, N, Marco-Contreras, LA, and Latorre-Román, PA. Absolute reliability and concurrent validity of the Stryd system for the assessment of running stride kinematics at different velocities. J Strength Cond Res 35(1): 78-84, 2021-This study aimed to determine the absolute reliability and to evaluate the concurrent validity of the Stryd system for measuring spatiotemporal variables during running at different velocities (8-20 km·h-1) by comparing data with another widely used device (the OptoGait system). Eighteen trained male endurance runners performed an incremental running test (8-20 km·h-1 with 3-minute stages) on a treadmill. Spatiotemporal parameters (contact time [CT], flight time [FT], step length [SL], and step frequency [SF]) were measured using 2 different devices (Stryd and OptoGait systems). The Stryd system showed a coefficient of variation (CV) <3%, except for FT (3.7-11.6%). The OptoGait achieved CV <4%, except for FT (6.0-30.6%). Pearson correlation analysis showed large correlations for CT and FT, and almost perfect for SL and SF over the entire protocol. The intraclass correlation coefficients partially support those results. Paired t-tests showed that CT was underestimated (p < 0.05, effect size [ES] > 0.7; â¼4-8%), FT overestimated (p < 0.05, ES > 0.7; â¼7-65%), whereas SL and SF were very similar between systems (ES < 0.1, with differences <1%). The Stryd is a practical portable device that is reliable for measuring CT, FT, SL, and SF during running. It provides accurate SL and SF measures but underestimates CT (0.5-8%) and overestimates FT (3-67%) compared with a photocell-based system.
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Marcha , Corrida , Fenômenos Biomecânicos , Teste de Esforço , Masculino , Reprodutibilidade dos TestesRESUMO
Leflunomide belongs in the group of disease-modifying anti-rheumatic drugs (DMARDs) used in the treatment of psoriatic, rheumatoid, and reactive arthritis. Approximately 20 % of patients will experience some adverse event, mainly weight loss, abdominal pain, and diarrhea. We describe the clinical, endoscopic, and histological findings in a patient with psoriatic arthritis (PA) who developed severe chronic diarrhea after drug use.
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Antirreumáticos , Artrite Reumatoide , Colite Colagenosa , Antirreumáticos/efeitos adversos , Artrite Reumatoide/tratamento farmacológico , Colite Colagenosa/induzido quimicamente , Colite Colagenosa/tratamento farmacológico , Humanos , Isoxazóis/efeitos adversos , Leflunomida/uso terapêuticoRESUMO
BACKGROUNDS AND AIMS: New mucosal resective and ablative endoscopic procedures based on gastric cardiac remodeling to prevent reflux have appeared. We aimed to evaluate the feasibility of a new ablative technique named antireflux ablation therapy (ARAT) for control of GERD in patients without hiatal hernia. METHODS: Patients with proton pump inhibitor (PPI)-refractory GERD without hiatal hernia underwent ARAT between January 2016 and October 2019. Gastroesophageal Reflux Disease-Health-Related Quality of Life (GERD-HRQL), upper endoscopy, 24-hour pH monitoring, and PPI use were documented at 3, 6, 12, 24, and 36 months after ARAT. RESULTS: One hundred eight patients were included (61 men [56.5%]; median age, 36.5 years; range, 18-78 years). ARAT was performed on all patients. At the 36-month evaluation, 84 patients had completed the protocol. Median ARAT time was 35.5 minutes (range, 22-51 minutes), and median circumference ablation was 300° (range, 270°-320°). No major adverse events occurred, and 14 of 108 patients (12.9%) presented with stenosis that was responsive to balloon dilation (<5 sessions). At the 3-month evaluation, the acid exposure time (AET), DeMeester score, and GERD-HRQL score had decreased from 18.8% to 2.8% (P = .001), 42.5 to 9.1 (P = .001), and 36.5 to 10 (P = .02), respectively, and these values were maintained up to 36 months. Success (AET <4%) was achieved in 89% and 72.2% at 3 and 36 months, respectively. Related factors at 36 months were as follows: pre-ARAT Hill type II (odds ratio [OR], 3.212; 95% confidence interval [CI], 1.431-5.951; P = .033), post-ARAT 3-month Hill type I (OR, 4.101; 95% CI, 1.812-9.121; P = .042), and AET <4% at 3 months (OR, 5.512; 95% CI, 1.451-7.621; P = .021). CONCLUSIONS: ARAT is a feasible, safe, and effective therapy for early and mid-term treatment of GERD in patients without a sliding hiatal hernia. However, longer follow-up evaluations and randomized comparative studies are needed to clarify its real role. (Clinical trial registration number: NCT03548298.).
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Técnicas de Ablação , Fundoplicatura , Refluxo Gastroesofágico , Hérnia Hiatal , Técnicas de Ablação/métodos , Adolescente , Adulto , Idoso , Endoscopia Gastrointestinal , Monitoramento do pH Esofágico , Estudos de Viabilidade , Feminino , Refluxo Gastroesofágico/tratamento farmacológico , Refluxo Gastroesofágico/cirurgia , Hérnia Hiatal/tratamento farmacológico , Hérnia Hiatal/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Inibidores da Bomba de Prótons/uso terapêutico , Qualidade de Vida , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Third-space endoscopy is a novel, safe, and effective method for treating different gastrointestinal conditions. However, several failed endoscopic procedures are attributed to incomplete myotomy. Lighting devices are used to prevent organic injuries. We aimed to investigate the feasibility of using a hand-made LED-probe (LP) in third-space procedures. METHODS: This prospective study was conducted in a tertiary-care center in Mexico between December 2016 and January 2019. We included peroral endoscopic myotomy (POEM) and gastric peroral endoscopic myotomy(G-POEM) procedures. Pseudoachalasia, peptic ulcer, normal gastric emptying scintigraphy (GES) and prepyloric tumors were excluded. LP was used to guide or confirm procedures. Clinical and procedural characteristics were recorded and analyzed. RESULTS: Seventy third-space procedures were included (42POEM,28G-POEM), with an average patient age of 46.7 ± 14.3 and 43.7 ± 10.1 years, respectively. For the POEM and G-POEM groups, respectively, 18/42(42.9%) and 13/28(46.7%) patients were males; median procedure times were 50 (interquartile range [IQR]: 38-71) and 60(IQR: 48-77) min, median LP placement times were 5(IQR: 4-6) and 6(IQR: 5-7) min, mild adverse events occurred in 4(9.4%) and 4(14.2%) of cases, and clinical success at 6 months occurred in 100 and 85.7% of cases. Integrated relaxation pressure (IRP) improved from 27.3 ± 10.8 to 9.5 ± 4.1 mmHg (p < 0.001); retention percentage at 4 h also improved. LP was successfully placed and adequate myotomy confirmed including 14.2 and 17.8% of POEM and G-POEM difficult patients. CONCLUSIONS: Using an LP is promising and allows guiding during third-space procedures either for submucosal tunnel creation or myotomy confirmation, with excellent safety and efficacy in clinical practice.
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Endoscopia do Sistema Digestório/instrumentação , Acalasia Esofágica/cirurgia , Iluminação/instrumentação , Miotomia/instrumentação , Piloromiotomia/instrumentação , Adulto , Endoscopia do Sistema Digestório/métodos , Estudos de Viabilidade , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Boca/cirurgia , Miotomia/métodos , Estudos Prospectivos , Piloromiotomia/métodos , Centros de Atenção Terciária , Resultado do TratamentoRESUMO
BACKGROUND: new alternatives for entry site closure (ESC) in per-oral endoscopy myotomy (POEM) and gastric peroral endoscopy myotomy (G-POEM) have appeared. OBJECTIVE: to compare the over-the-scope-clip (OTSC®) and conventional clips (CC) for ESC in POEM and G-POEM. MATERIAL AND METHODS: a retrospective review of a prospective POEM and G-POEM database was performed between January 2015 and August 2019. A description was made of outcomes, using either OTSC® or CC for submucosal tunnel closure. RESULTS: forty-six POEM and 26 G-POEM were included in the study (23/13 per group [CC/OTSC®]). There were no clinical or procedure differences. ESC was performed with 1 OTSC® vs 5 CC and 1 vs 6 (p = 0.01) for POEM and G-POEM, respectively. Adverse events associated with clips were 21.7% vs 13% (p = 0.01) and 7.7% vs 0% (p = 0.02) for CC and OTSC® in POEM and G-POEM, respectively. CONCLUSION: OTSC® represents a safe and effective alternative for entry site closure in POEM and G-POEM cases. Further studies are needed to recommend OTSC® as the first option for submucosal tunnel closure in these procedures.
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Acalasia Esofágica , Cirurgia Endoscópica por Orifício Natural , Piloromiotomia , Acalasia Esofágica/cirurgia , Esfíncter Esofágico Inferior , Humanos , Estudos Prospectivos , Estudos Retrospectivos , Instrumentos Cirúrgicos , Resultado do TratamentoRESUMO
INTRODUCTION: studies have examined the agreement between capsule endoscopy and double-balloon enteroscopy, with varying results. The aim of this study was to identify factors that predict the visualization of lesions in the small bowel by double-balloon enteroscopy after a positive capsule endoscopy. METHODS: a retrospective, observational and comparative study was performed that evaluated patients that underwent double-balloon enteroscopy after a positive capsule endoscopy, between January 2017 and August 2019. The data studied included demographics, indications, comorbidities and the results of capsule endoscopy and double-balloon enteroscopy, which were evaluated by multiple logistic regression. RESULTS: 91 patients were included (age 58 ± 16.5 years, 53 female). Sixty-two double-balloon enteroscopy (68.1 %) found the same lesions as capsule endoscopy. Predictive factors for a positive double-balloon enteroscopy were multiple lesions (OR 8.10, 1.50-43.78; p = 0.015) and < 15 days between both studies (OR 5.31, 1.19-23.66; p=0.029). In the subgroup of patients with small bowel bleeding (70 patients), the results of 46 double-balloon enteroscopies (65.7 %) agreed with the capsule endoscopy. Predictive factors in this group were multiple lesions (OR 13.51, 1.78-102.22; p = 0.012), < 15 days between both studies (OR 13.51, 1.78-102.22; p = 0.012), > 60 years of age (OR 7.45, 1.51-36.75; p = 0.014) and ulcers (OR 4.67, 1.08-20.22; p = 0.039). CONCLUSIONS: predictive factors for a positive double-balloon enteroscopy after a positive capsule endoscopy were multiple lesions and < 15 days between both procedures. In patients with small bowel bleeding, age over 60 years and the presence of ulcers were also predictive factors.
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Endoscopia por Cápsula , Adulto , Idoso , Enteroscopia de Duplo Balão , Endoscopia Gastrointestinal , Feminino , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemorragia Gastrointestinal/etiologia , Humanos , Intestino Delgado/diagnóstico por imagem , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
INTRODUCTION: The COVID-19 pandemic can have important psychosocial consequences in the population. OBJECTIVE: To determine the levels of anxiety, depression and self-care symptoms during the COVID-19 pandemic in the general population. METHOD: Online survey distributed over three weeks using a non-probability sampling. The PHQ-9 Patient Health Questionnaire, the GAD-7 Generalized Anxiety Disorder Scale and Visual analog scale for self-care behaviors were used. Between-group (anxiety and depression) descriptive and comparison analyses were carried out. RESULTS: Out of 1508 included participants, 20.8% had symptoms of severe anxiety, while 27.5% showed symptoms of severe depression. Being a woman, being single, having no children, having medical comorbidities and a history of mental health care were risk factors for developing symptoms of anxiety and depression; 66 to 80 % of the population complied with self-care recommendations. A need for receiving mental health care was identified in our study population. CONCLUSION: A larger number of individuals with moderate to severe anxiety and depression symptoms were observed than in other pandemics. COVID-19 pandemic psychological effects are considered an emerging public health problem, and implementation of programs for their care is therefore recommended.
INTRODUCCIÓN: La pandemia por COVID-19 puede tener consecuencias psicosociales importantes en la población. OBJETIVO: Determinar los niveles de síntomas de ansiedad, depresión y conductas de autocuidado durante la pandemia de COVID-19 en población general. MÉTODO: Encuesta en línea distribuida durante tres semanas mediante muestreo no probabilístico. Se empleó el Cuestionario sobre la Salud del Paciente PHQ-9, la Escala del Trastorno de Ansiedad Generalizada GAD-7 y la Escala análoga visual de conductas de autocuidado. Se realizaron análisis descriptivos y de comparación entre los grupos con ansiedad y depresión. RESULTADOS: Se incluyeron 1508 participantes, 20.8 % presentó síntomas de ansiedad grave y 27.5 %, síntomas de depresión grave. Ser mujer, soltero(a) no tener hijos, presentar comorbilidad médica y antecedentes de atención a la salud mental estuvieron relacionados con la presencia de mayores niveles de síntomas de ansiedad y depresión; 66 a 80 % de la población cumplía con las recomendaciones de autocuidado. Se identificó la necesidad de recibir atención de salud mental. CONCLUSIÓN: Se observó mayor número de individuos con síntomas de ansiedad y depresión moderadas a graves que en otras pandemias. Los efectos psicológicos de la pandemia de COVID-19 se consideran un problema de salud mental pública emergente, por lo que se recomienda la implementación de programas para su atención.
Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Depressão/epidemiologia , Pneumonia Viral/epidemiologia , Autocuidado/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19 , Infecções por Coronavirus/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/psicologia , Fatores de Risco , Fatores Sexuais , Inquéritos e Questionários , Adulto JovemRESUMO
On renal ischemia-reperfusion (I/R) injury, recruitment of neutrophils during the inflammatory process promotes local generation of oxygen and nitrogen reactive species, which, in turn, are likely to exacerbate tissue damage. The mechanism by which inducible nitric oxide synthase (iNOS) is involved in I/R has not been elucidated. In this work, the selective iNOS inhibitor l- N6-(1-iminoethyl)lysine (l-NIL) and the NOS substrate l-arginine were employed to understand the role of NOS activity on the expression of particular target genes and the oxidative stress elicited after a 30-min of bilateral renal ischemia, followed by 48-h reperfusion in Balb/c mice. The main findings of the present study were that pharmacological inhibition of iNOS with l-NIL during an I/R challenge of mice kidney decreased renal injury, prevented tissue loss of integrity, and improved renal function. Several novel findings regarding the molecular mechanism by which iNOS inhibition led to these protective effects are as follows: 1) a prevention of the I/R-related increase in expression of Toll-like receptor 4 (TLR-4), and its downstream target, IL-1ß; 2) reduced oxidative stress following the I/R challenge; noteworthy, this study shows the first evidence of glutathione S-transferase (GST) inactivation following kidney I/R, a phenomenon fully prevented by iNOS inhibition; 3) increased expression of clusterin, a survival autophagy component; and 4) increased expression of nuclear factor of activated T cells 5 (NFAT-5) and its target gene aquaporin-1. In conclusion, prevention of renal damage following I/R by the pharmacological inhibition of iNOS with l-NIL was associated with the inactivation of proinflammatory pathway triggered by TLR-4, oxidative stress, renoprotection (autophagy inactivation), and NFAT-5 signaling pathway.