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1.
J Adv Nurs ; 80(3): 1212-1221, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37811667

RESUMEN

INTRODUCTION: During the Coronavirus (COVID-19) pandemic, healthcare providers have overcome difficult experiences such as workplace violence. Nurses are particularly vulnerable to workplace violence. The objective of this study was to characterize violence and aggression against nurses during the COVID-19 pandemic in Latin America. METHODS: An electronic cross-sectional survey was conducted in 19 Latin American countries to characterize the frequency and type of violent actions against front-line healthcare providers. RESULTS: Of the original 3544 respondents, 16% were nurses (n = 567). The mean age was 39.7 ± 9.0 years and 79.6% (n = 2821) were women. In total, 69.8% (n = 2474) worked in public hospitals and 81.1% (n = 2874) reported working regularly with COVID-19 patients. Overall, about 68.6% (n = 2431) of nurses experienced at least one episode of workplace aggression during the pandemic. Nurses experienced weekly aggressions more frequently than other healthcare providers (45.5% versus 38.1%, p < .007). Nurses showed a trend of lower reporting rates against the acts of aggression suffered (p = .076). In addition, nurses were more likely to experience negative cognitive symptoms after aggressive acts (33.4% versus 27.8%, p = .028). However, nurses reported considering changing their work tasks less frequently compared to other healthcare providers after an assault event (p = .005). CONCLUSION: Workplace violence has been a frequent problem for all healthcare providers during COVID-19 pandemic in Latin America. Nurses were a particularly vulnerable subgroup, with higher rates of aggressions and cognitive symptoms and lower rate of complaints than other healthcare providers who suffered from workplace violence. It is imperative to develop strategies to protect this vulnerable group from aggressions during their tasks.


Asunto(s)
COVID-19 , Cardiología , Violencia Laboral , Humanos , Femenino , Adulto , Persona de Mediana Edad , Masculino , Agresión/psicología , América Latina/epidemiología , Pandemias , Estudios Transversales , COVID-19/epidemiología , Violencia Laboral/psicología , Lugar de Trabajo/psicología , Encuestas y Cuestionarios
2.
Sensors (Basel) ; 21(12)2021 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-34205808

RESUMEN

The aim of this study was to model and evaluate the Specific Energy Absorption Rate (SAR) values in humans in proximity to fixed multi-antenna I-RFID readers of passive tags under various scenarios mimicking exposure when they are incorporated in Real-Time Location Systems (RTLS), or used to monitor Personal Protective Equipment (PPE). The sources of the electromagnetic field (EMF) in the modelled readers were rectangular microstrip antennas at a resonance frequency in free space of 866 MHz from the ultra-high frequency (UHF) RFID frequency range of 865-868 MHz. The obtained results of numerical modelling showed that the SAR values in the body 5 cm away from the UHF RFID readers need consideration with respect to exposure limits set by international guidelines to prevent adverse thermal effects of exposure to EMF: when the effective radiated power exceeds 5.5 W with respect to the general public/unrestricted environments exposure limits, and with respect to occupational/restricted environments exposure limits, when the effective radiated power exceeds 27.5 W.


Asunto(s)
Equipo de Protección Personal , Dispositivo de Identificación por Radiofrecuencia , Campos Electromagnéticos , Humanos , Monitoreo Fisiológico
3.
Sensors (Basel) ; 21(24)2021 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-34960513

RESUMEN

The densification of multiple wireless communication systems that coexist nowadays, as well as the 5G new generation cellular systems advent towards the millimeter wave (mmWave) frequency range, give rise to complex context-aware scenarios with high-node density heterogeneous networks. In this work, a radiofrequency electromagnetic field (RF-EMF) exposure assessment from an empirical and modeling approach for a large, complex indoor setting with high node density and traffic is presented. For that purpose, an intensive and comprehensive in-depth RF-EMF E-field characterization study is provided in a public library study case, considering dense personal mobile communications (5G FR2 @28 GHz) and wireless 802.11ay (@60 GHz) data access services on the mmWave frequency range. By means of an enhanced in-house deterministic 3D ray launching (3D-RL) simulation tool for RF-EMF exposure assessment, different complex heterogenous scenarios of high complexity are assessed in realistic operation conditions, considering different user distributions and densities. The use of directive antennas and MIMO beamforming techniques, as well as all the corresponding features in terms of radio wave propagation, such as the body shielding effect, dispersive material properties of obstacles, the impact of the distribution of scatterers and the associated electromagnetic propagation phenomena, are considered for simulation. Discussion regarding the contribution and impact of the coexistence of multiple heterogeneous networks and services is presented, verifying compliance with the current established international regulation limits with exposure levels far below the aforementioned limits. Finally, the proposed simulation technique is validated with a complete empirical campaign of measurements, showing good agreement. In consequence, the obtained datasets and simulation estimations, along with the proposed RF-EMF simulation tool, could be a reference approach for the design, deployment and exposure assessment of the current and future wireless communication technologies on the mmWave spectrum, where massive high-node density heterogeneous networks are expected.


Asunto(s)
Campos Electromagnéticos , Exposición a Riesgos Ambientales , Comunicación , Ondas de Radio , Tecnología Inalámbrica
4.
J Med Internet Res ; 22(12): e23518, 2020 12 18.
Artículo en Inglés | MEDLINE | ID: mdl-33156803

RESUMEN

BACKGROUND: COVID-19 is one of the biggest pandemics in human history, along with other disease pandemics, such as the H1N1 influenza A, bubonic plague, and smallpox pandemics. This study is a small contribution that tries to find contrasted formulas to alleviate global suffering and guarantee a more manageable future. OBJECTIVE: In this study, a statistical approach was proposed to study the correlation between the incidence of COVID-19 in Spain and search data provided by Google Trends. METHODS: We assessed the linear correlation between Google Trends search data and the data provided by the National Center of Epidemiology in Spain-which is dependent on the Instituto de Salud Carlos III-regarding the number of COVID-19 cases reported with a certain time lag. These data enabled the identification of anticipatory patterns. RESULTS: In response to the ongoing outbreak, our results demonstrate that by using our correlation test, the evolution of the COVID-19 pandemic can be predicted in Spain up to 11 days in advance. CONCLUSIONS: During the epidemic, Google Trends offers the possibility to preempt health care decisions in real time by tracking people's concerns through their search patterns. This can be of great help given the critical, if not dramatic need for complementary monitoring approaches that work on a population level and inform public health decisions in real time. This study of Google search patterns, which was motivated by the fears of individuals in the face of a pandemic, can be useful in anticipating the development of the pandemic.


Asunto(s)
COVID-19/diagnóstico , COVID-19/epidemiología , Salud Pública/tendencias , Motor de Búsqueda/tendencias , Brotes de Enfermedades , Progresión de la Enfermedad , Humanos , Incidencia , Internet , Estudios Longitudinales , Modelos Estadísticos , Pandemias , Vigilancia en Salud Pública/métodos , España/epidemiología
5.
Sensors (Basel) ; 20(24)2020 Dec 12.
Artículo en Inglés | MEDLINE | ID: mdl-33322725

RESUMEN

The aim of this study was to evaluate the absorption in a user's head of an electromagnetic field (EMF) emitted by the Wi-Fi and/or Bluetooth module of a wearable small Internet of Things (IoT) electronic device (emitting EMF of up to 100 mW), in order to test the hypothesis that EMF has an insignificant influence on humans, and to compare the levels of such EMF absorption in various scenarios when using this device. The modelled EMF source was a meandered inverted-F antenna (MIFA)-type antenna of the ESP32-WROOM-32 radio module used in wearable devices developed within the reported study. To quantify the EMF absorption, the specific energy absorption rate (SAR) values were calculated in a multi-layer ellipsoidal model of the human head (involving skin, fat, skull bones and brain layers). The obtained results show up to 10 times higher values of SAR from the MIFA located in the headband, in comparison to its location on the helmet. Only wearable IoT devices (similar in construction and way of use to the investigated device) emitting at below 3 mW equivalent isotropically radiated power (EIRP) from Wi-Fi/Bluetooth communications modules may be considered environmentally insignificant EMF sources.


Asunto(s)
Campos Electromagnéticos , Dispositivos Electrónicos Vestibles , Cabeza , Humanos , Internet , Lugar de Trabajo
6.
Molecules ; 25(6)2020 Mar 13.
Artículo en Inglés | MEDLINE | ID: mdl-32182996

RESUMEN

The asymmetric synthesis of a compound with the cyclopentan[c]pyran core of iridoid natural products in four steps and 40% overall yield is reported. Our methodology includes a one-pot tandem domino reaction which provides a trisubstituted cyclopentane with five new completely determined stereocenters, which were determined through 2D homo and heteronuclear NMR and n.O.e. experiments on different compounds specially designed for this purpose, such as a dioxane obtained from a diol. Due to their pharmaceutical properties, including sedative, analgesic, anti-inflammatory, CNS depressor or anti-conceptive effects, this methodology to produce the abovementioned iridoid derivatives, is an interesting strategy in terms of new drug discovery as well as pharmaceutical development.


Asunto(s)
Productos Biológicos/síntesis química , Ciclopentanos/síntesis química , Iridoides/síntesis química , Piranos/síntesis química , Benzaldehídos/química , Productos Biológicos/química , Espectroscopía de Resonancia Magnética con Carbono-13 , Ciclopentanos/química , Iridoides/química , Oxidación-Reducción , Espectroscopía de Protones por Resonancia Magnética , Piranos/química , Estereoisomerismo
7.
Pediatr Crit Care Med ; 20(3): e160-e169, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30664591

RESUMEN

OBJECTIVES: Staff in PICUs shows high burnout, posttraumatic stress disorder symptoms, and posttraumatic growth levels. However, their levels of satisfaction with life and how positive and negative posttrauma outcomes relate to each other and contribute to predict satisfaction with life remain unknown. Thus, we attempted to explore these aspects and to compare the findings with data from pediatric professionals working in noncritical units. DESIGN: This is an observational multicentric, cross-sectional study. SETTING: The PICU of nine hospitals in Spain, and other pediatric units in the same hospitals. SUBJECTS: Two hundred ninety-eight PICU workers (57 physicians, 177 nurses, and 64 nursing assistants) and 189 professionals working in noncritical pediatric units (53 physicians, 104 nurses, and 32 nursing assistants). INTERVENTION: Participants completed the Maslach Burnout Inventory, the Trauma Screening Questionnaire, the Posttraumatic Growth Inventory, and the Satisfaction With Life Scale. MEASUREMENTS AND MAIN RESULTS: Of PICU staff, 16.4% were very satisfied with their lives, 34.2% were satisfied, 34.6% showed average satisfaction with life, and 14.8% were below average. No differences were found between PICU and non-PICU workers. Women reported lower satisfaction with life than men, and physicians reported higher satisfaction with life than other professional groups. The correlation between posttraumatic stress disorder and posttraumatic growth was low, but significant and positive. According to the path analysis with latent variables, 20% of the variance satisfaction with life could be predicted from burnout, posttraumatic stress disorder symptoms, and posttraumatic growth. Higher distress was inversely associated to satisfaction with life, whereas posttraumatic growth contributed to higher satisfaction with life. CONCLUSIONS: Posttraumatic growth can moderate the negative effect of traumatic work-related experiences in satisfaction with life. PICU and non-PICU workers were equally satisfied with their lives. Positive and negative impact of work-related potentially traumatic events can coexist in the same person. Interventions aimed at reducing distress and fostering posttraumatic growth could impact in an improvement in pediatric health professionals' satisfaction with life.


Asunto(s)
Agotamiento Profesional/epidemiología , Personal de Salud/psicología , Satisfacción Personal , Crecimiento Psicológico Postraumático , Trastornos por Estrés Postraumático/epidemiología , Adulto , Factores de Edad , Estudios Transversales , Ambiente , Femenino , Humanos , Unidades de Cuidado Intensivo Pediátrico , Satisfacción en el Trabajo , Masculino , Persona de Mediana Edad , Factores Sexuales , Factores Socioeconómicos , España , Lugar de Trabajo/psicología
8.
Sensors (Basel) ; 20(1)2019 Dec 30.
Artículo en Inglés | MEDLINE | ID: mdl-31905869

RESUMEN

The aim is to evaluate specific absorption rate (SAR) values from exposure near handheld ultra-high frequency radiofrequency identification readers (UHF RFID guns-small electronic devices, or even portable computers with relevant accessories-emitting up to several watts of electromagnetic field (EMF) to search for RFID sensors (tags) attached to marked objects), in order to test the hypothesis that they have an insignificant environmental influence. Simulations of SAR in adult male and female models in seven exposure scenarios (gun near the head, arm, chest, hip/thigh of the operator searching for tags, or near to the chest and arm of the scanned person or a bystander). The results showed EMF exposure compliant with SAR limits for general public exposure (ICNIRP/European Recommendation 1999/519/EC) at emissions up to 1 W (reading range 3.5-11 m, depending on tag sensitivity). In the worst-case scenario, guns with a reading range exceeding 5 m (>2 W emission) may cause an SAR exceeding the general public limits in the palm of the user and the torso of the user, a bystander, or a scanned person; occupational exposure limits may be exceeded when emission >5 W. Users of electronic medical implants and pregnant women should be treated as individuals at particular risk in close proximity to guns, even at emissions of 1 W. Only UHF RFID guns emitting below 1 W may be considered as environmentally insignificant EMF sources.

9.
Int J Mol Sci ; 18(8)2017 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-28758988

RESUMEN

Galectin-3 (Gal-3) is involved in cardiovascular fibrosis and aortic valve (AV) calcification. We hypothesized that Gal-3 pharmacological inhibition with modified citrus pectin (MCP) could reduce aortic and AV remodeling in normotensive rats with pressure overload (PO). Six weeks after aortic constriction, vascular Gal-3 expression was up-regulated in male Wistar rats. Gal-3 overexpression was accompanied by an increase in the aortic media layer thickness, enhanced total collagen, and augmented expression of fibrotic mediators. Further, vascular inflammatory markers as well as inflammatory cells content were greater in aorta from PO rats. MCP treatment (100 mg/kg/day) prevented the increase in Gal-3, media thickness, fibrosis, and inflammation in the aorta of PO rats. Gal-3 levels were higher in AVs from PO rats. This paralleled enhanced AV fibrosis, inflammation, as well as greater expression of calcification markers. MCP treatment prevented the increase in Gal-3 as well as fibrosis, inflammation, and calcification in AVs. Overall, Gal-3 is overexpressed in aorta and AVs from PO rats. Gal-3 pharmacological inhibition blocks aortic and AV remodeling in experimental PO. Gal-3 could be a new therapeutic approach to delay the progression and the development of aortic remodeling and AV calcification in PO.


Asunto(s)
Aorta , Estenosis de la Válvula Aórtica , Válvula Aórtica/patología , Calcinosis , Galectina 3 , Regulación de la Expresión Génica/efectos de los fármacos , Pectinas/farmacología , Animales , Aorta/metabolismo , Aorta/fisiopatología , Válvula Aórtica/efectos de los fármacos , Válvula Aórtica/metabolismo , Válvula Aórtica/fisiopatología , Estenosis de la Válvula Aórtica/metabolismo , Estenosis de la Válvula Aórtica/patología , Estenosis de la Válvula Aórtica/fisiopatología , Calcinosis/metabolismo , Calcinosis/patología , Calcinosis/fisiopatología , Modelos Animales de Enfermedad , Galectina 3/antagonistas & inhibidores , Galectina 3/biosíntesis , Masculino , Ratas , Ratas Wistar
10.
Biochemistry ; 55(12): 1873-86, 2016 Mar 29.
Artículo en Inglés | MEDLINE | ID: mdl-26901070

RESUMEN

DREAM (also known as K(+) channel interacting protein 3 and calsenilin) is a calcium binding protein and an active modulator of KV4 channels in neuronal cells as well as a novel Ca(2+)-regulated transcriptional modulator. DREAM has also been associated with the regulation of Alzheimer's disease through the prevention of presenilin-2 fragmentation. Many interactions of DREAM with its binding partners (Kv4, calmodulin, DNA, and drugs) have been shown to be dependent on calcium. Therefore, understanding the structural changes induced by binding of metals to DREAM is essential for elucidating the mechanism of signal transduction and biological activity of this protein. Here, we show that the fluorescence emission and excitation spectra of the calcium luminescent analogue, Tb(3+), are enhanced upon binding to the EF-hands of DREAM due to a mechanism of energy transfer between Trp and Tb(3+). We also observe that unlike Tb(3+)-bound calmodulin, the luminescence lifetime of terbium bound to DREAM decays as a complex multiexponential (τaverage ∼ 1.8 ms) that is sensitive to perturbation of the protein structure and drug (NS5806) binding. Using isothermal calorimetry, we have determined that Tb(3+) binds to at least three sites with high affinity (Kd = 1.8 µM in the presence of Ca(2+)) and displaces bound Ca(2+) through an entropically driven mechanism (ΔH ∼ 12 kcal mol(-1), and TΔS ∼ 22 kcal mol(-1)). Furthermore, the hydrophobic probe 1,8-ANS shows that Tb(3+), like Ca(2+), triggers the exposure of a hydrophobic surface on DREAM, which modulates ligand binding. Analogous to Ca(2+) binding, Tb(3+) binding also induces the dimerization of DREAM. Secondary structural analyses using far-UV circular dichroism and trapped ion mobility spectrometry-mass spectrometry reveal that replacement of Ca(2+) with Tb(3+) preserves the folding state with minimal changes to the overall structure of DREAM. These findings pave the way for further investigation of the metal binding properties of DREAM using lanthanides as well as the study of DREAM-protein complexes by lanthanide resonance energy transfer or nuclear magnetic resonance.


Asunto(s)
Proteínas de Interacción con los Canales Kv/química , Proteínas de Interacción con los Canales Kv/fisiología , Proteínas Represoras/química , Proteínas Represoras/fisiología , Terbio/química , Terbio/fisiología , Termodinámica , Secuencia de Aminoácidos , Animales , Ratones , Datos de Secuencia Molecular , Unión Proteica/fisiología , Estructura Secundaria de Proteína , Estructura Terciaria de Proteína
11.
Bioelectromagnetics ; 36(2): 118-32, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25399935

RESUMEN

Personal exposure meters (PEMs) used for measuring exposure to electromagnetic fields (EMF) are typically used in epidemiological studies. As is well known, these measurement devices cause a perturbation of real EMF exposure levels due to the presence of the human body in the immediate proximity. This paper aims to model the alteration caused by the body shadow effect (BSE) in motion conditions and in indoor enclosures at the Wi-Fi frequency of 2.4 GHz. For this purpose, simulation techniques based on ray-tracing have been carried out, and their results have been verified experimentally. A good agreement exists between simulation and experimental results in terms of electric field (E-field) levels, and taking into account the cumulative distribution function (CDF) of the spatial distribution of amplitude. The Kolmogorov-Smirnov (KS) test provides a P-value greater than 0.05, in fact close to 1. It has been found that the influence of the presence of the human body can be characterized as an angle of shadow that depends on the dimensions of the indoor enclosure. The CDFs show that the E-field levels in indoor conditions follow a lognormal distribution in the absence of the human body and under the influence of BSE. In conclusion, the perturbation caused by BSE in PEMs readings cannot be compensated for by correction factors. Although the mean value is well adjusted, BSE causes changes in CDF that would require improvements in measurement protocols and in the design of measuring devices to subsequently avoid systematic errors.


Asunto(s)
Electricidad , Exposición a Riesgos Ambientales/análisis , Simulación por Computador , Electricidad/efectos adversos , Campos Electromagnéticos/efectos adversos , Diseño de Equipo , Cuerpo Humano , Humanos
12.
J Oral Maxillofac Surg ; 73(2): 203-10, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25432448

RESUMEN

PURPOSE: There is limited information on hemorrhagic complications during invasive dental procedures in patients treated with double antiplatelet therapy. The objective of this study is to assess the frequency of hemorrhagic complications of patients taking dual antiplatelet medication undergoing dental extractions. PATIENTS AND METHODS: An observational, multicenter, prospective, cohort study was performed in 11 oral and dental care units of primary care. The study sample was derived from the population of patients aged 18 years or older who were undergoing double antiplatelet therapy and presented to the oral and dental care units requiring dental extraction. Double antiplatelet therapy is the combination of 100 mg per day of acetylsalicylic acid and a second antiplatelet agent. The predictor variables were type of extraction performed, number of extracted teeth, number of extracted roots, and presence of inflammation. The primary outcome variable was intraoperative hemorrhage, and the secondary outcome variables were hemorrhage at 24 hours and hemorrhage at 10 days. First, a univariate analysis that considered all studied variables was performed. All variables with P < .25 in the univariate analysis were included in a multivariate analysis. The association between hemorrhage severity and its relevant factors was evaluated using logistic regression analysis. RESULTS: The study included 181 patients. Light hemorrhage (<30 minutes) was observed in 165 patients (91.2%). Intraoperative hemorrhage lasted more than 30 minutes in 15 patients (8.3%) and more than 60 minutes in only 1 patient, whose hemorrhage was controlled by local hemostatic measures. The presence of inflammation and 3-root extractions increased the probability of hemorrhage persisting for more than 30 minutes by factors of 10 and 7.3, respectively. CONCLUSIONS: In 8.3% of patients treated with dual antiplatelet therapy, dental extractions cause hemorrhagic complications lasting more than 30 minutes are resolved using local hemostatic measures. The results of this study support the safety of dental extraction without withdrawal double antiplatelet therapy.


Asunto(s)
Inhibidores de Agregación Plaquetaria/uso terapéutico , Extracción Dental/efectos adversos , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
13.
Electromagn Biol Med ; 34(1): 19-28, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24460417

RESUMEN

A high number of wireless technologies can be found operating in vehicular environments with the aim of offering different services. The dosimetric evaluation of this kind of scenarios must be performed in order to assess their compatibility with current exposure limits. In this work, a dosimetric evaluation inside a conventional car is performed, with the aid of an in-house 3D Ray Launching computational code, which has been compared with measurement results of wireless sensor networks located inside the vehicle. These results can aid in an adequate assessment of human exposure to non-ionizing radiofrequency fields, taking into account the impact of the morphology and the topology of the vehicle for current as well as for future exposure limits.


Asunto(s)
Vehículos a Motor , Ondas de Radio , Radiometría/métodos , Teléfono Celular , Radiometría/instrumentación , Tecnología Inalámbrica
14.
Electromagn Biol Med ; 33(4): 252-63, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-23915231

RESUMEN

In this article, the impact of topology as well as morphology of a complex indoor environment such as a commercial aircraft in the estimation of dosimetric assessment is presented. By means of an in-house developed deterministic 3D ray-launching code, estimation of electric field amplitude as a function of position for the complete volume of a commercial passenger airplane is obtained. Estimation of electromagnetic field exposure in this environment is challenging, due to the complexity and size of the scenario, as well as to the large metallic content, giving rise to strong multipath components. By performing the calculation with a deterministic technique, the complete scenario can be considered with an optimized balance between accuracy and computational cost. The proposed method can aid in the assessment of electromagnetic dosimetry in the future deployment of embarked wireless systems in commercial aircraft.


Asunto(s)
Aeronaves , Campos Electromagnéticos , Ondas de Radio , Radiometría/métodos , Protección Radiológica , Radiometría/instrumentación , Tecnología Inalámbrica
15.
Pediatr Pulmonol ; 2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38721899

RESUMEN

INTRODUCTION: The aims of this study were to update our experience with biodegradable polydioxanone (PDO) airway stents in children, focusing on effectiveness and safety, and to analyze the factors involved in the different outcomes observed. MATERIALS AND METHODS: Retrospective study of patients managed with PDO stents from 2012 to 2023. Variables collected: demographics, comorbidities, indication, clinical baseline, stent size, location, complications, clinical outcome, and time of follow-up. Statistical analyses were performed to detect the eventual contribution of variables in the different outcomes observed. RESULTS: Fifty-four PDO stents were placed in 26 patients (median age, 4 months). All showed severe symptoms of central airway obstruction due to tracheomalacia in nine patients, bronchomalacia five, tracheobronchomalacia 10, and tracheal stenosis two. Stent placement was uneventful in every case: 29 stents in the trachea and 25 in the main bronchi. 53.8% of patients needed successive stenting, and all exhibited comorbidities. Complete clinical resolution was observed in eight cases (30.7%), partial improvement in 13 (50%), unchanged in 4 (15.3%), and worsened in one. Age had a significant positive impact on outcome (6 vs. 3 months; p = 0.024). Additionally, smaller stents were associated with a better outcome (20 vs. 26 mm; p = 0.044). Granulation tissue was the most frequent complication (34.6%). Five patients (19.2%) died due to severe comorbidities, follow-up was complete in survivors (median, 58 months). CONCLUSIONS: PDO stents are safe and effective when dealing with severe tracheobronchial obstruction. Stent-related granulation tissue continues to be a relevant matter of concern. This issue, together with increased degradation times, deserves further research.

16.
Sci Total Environ ; 915: 169475, 2024 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-38199355

RESUMEN

Telecommunications industries are rapidly deploying the fifth generation (5G) spectrum and there is public concern about the safety and health impacts of this type of Radio Frequency Radiation (RFR), in part because of the lack of comparable scientific evidence. In this study we have used a validated commercially available setting producing a uniform field to expose zebrafish embryos (ZFe) to unmodulated 700 and 3500 MHz frequencies. We have combined a battery of toxicity, developmental and behavioral assays to further explore potential RFR effects. Our neurobehavioral profiles include a tail coiling assay, a light/dark activity assay, two thigmotaxis anxiety assays (auditory and visual stimuli), and a startle response - habituation assay in response to auditory stimuli. ZFe were exposed for 1 and 4 h during the blastula period of development and endpoints evaluated up to 120 hours post fertilization (hpf). Our results show no effects on mortality, hatching or body length. However, we have demonstrated specific organ morphological effects, and behavioral effects in activity, anxiety-like behavior, and habituation that lasted in larvae exposed during the early embryonic period. A decrease in acetylcholinesterase activity was also observed and could explain some of the observed behavioral alterations. Interestingly, effects were more pronounced in ZFe exposed to the 700 MHz frequency, and especially for the 4 h exposure period. In addition, we have demonstrated that our exposure setup is robust, flexible with regard to frequency and power testing, and highly comparable. Future work will include exposure of ZFe to 5G modulated signals for different time periods to better understand the potential health effects of novel 5G RFR.


Asunto(s)
Acetilcolinesterasa , Pez Cebra , Animales , Conducta Animal , Larva , Embrión no Mamífero
17.
Glob Med Genet ; 11(1): 59-68, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38348157

RESUMEN

Immunoglobulin heavy chain variable ( IGHV ) region mutations, TP53 mutation, fluorescence in situ hybridization (FISH), and cytogenetic analysis are the most important prognostic biomarkers used in chronic lymphocytic leukemia (CLL) patients in our daily practice. In real-life environment, there are scarce studies that analyze the correlation of these factors with outcome, mainly referred to time to first treatment (TTFT) and overall survival (OS). This study aimed to typify IGHV mutation status, family usage, FISH aberrations, and complex karyotype (CK) and to analyze the prognostic impact in TTFT and OS in retrospective study of 375 CLL patients from a Spanish cohort. We found unmutated CLL (U-CLL) was associated with more aggressive disease, shorter TTFT (48 vs. 133 months, p < 0.0001), and shorter OS (112 vs. 246 months, p < 0.0001) than the mutated CLL. IGHV3 was the most frequently used IGHV family (46%), followed by IGHV1 (30%) and IGHV4 (16%). IGHV5-51 and IGHV1-69 subfamilies were associated with poor prognosis, while IGHV4 and IGHV2 showed the best outcomes. The prevalence of CK was 15% and was significantly associated with U-CLL. In the multivariable analysis, IGHV2 gene usage and del13q were associated with longer TTFT, while VH1-02, +12, del11q, del17p, and U-CLL with shorter TTFT. Moreover, VH1-69 usage, del11q, del17p, and U-CLL were significantly associated with shorter OS. A comprehensive analysis of genetic prognostic factors provides a more precise information on the outcome of CLL patients. In addition to FISH cytogenetic aberrations, IGHV and TP53 mutations, IGHV gene families, and CK information could help clinicians in the decision-making process.

20.
Telemed J E Health ; 16(7): 818-26, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20815749

RESUMEN

OBJECTIVE: The objective of this study was to determine already reported cases of transmission/reception failure and interferences to evaluate the safety and security of the new mobile home telemedicine systems. MATERIALS AND METHODS: The literature published in the last 10 years (1998-2009) has been reviewed, by searching in several databases. Searches on transmission effectiveness and electromagnetic compatibility were made manually through journals, conference proceedings, and also the healthcare technology assessment agencies' Web pages. RESULTS: Search strategies developed through electronic databases and manual search identified a total of 886 references, with 44 finally being included in the results. They have been divided by technology in the transmission/reception effectiveness studies, and according to the type of medical device in the case of electromagnetic interferences studies. CONCLUSIONS: The study reveals that there are numerous publications on telemedicine and home-monitoring systems using wireless networks. However, literature on effectiveness in terms of connectivity and transmission problems and electromagnetic interferences is limited. From the collected studies, it can be concluded that there are transmission failures, low-coverage areas, errors in the transmission of packets, and so on. Moreover, cases of serious interferences in medical instruments have also been reported. These facts highlight the lack of studies and specific recommendations to be followed in the implementation of biomonitoring systems in domestic environments using wireless networks.


Asunto(s)
Seguridad Computacional/instrumentación , Campos Electromagnéticos , Servicios de Atención de Salud a Domicilio/organización & administración , Telemedicina/instrumentación , Desfibriladores Implantables , Atención a la Salud/organización & administración , Seguridad de Equipos , Humanos , España , Telemedicina/organización & administración
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