Point-of-care prediction model of loop gain in patients with obstructive sleep apnea: development and validation.

BACKGROUND: High loop gain (unstable ventilatory control) is an important-but difficult to measure-contributor to obstructive sleep apnea (OSA) pathogenesis, predicting OSA sequelae and/or treatment response. Our objective was to develop and validate a clinical prediction tool of loop gain. METHODS: A retrospective cohort of consecutive adults with OSA (apnea-hypopnea index, AHI > 5/hour) based on in-laboratory polysomnography 01/2017-12/2018 was randomly split into a training and test-set (3:1-ratio). Using a customized algorithm ("reference standard") loop gain was quantified from raw polysomnography signals on a continuous scale and additionally dichotomized (high > 0.7). Candidate predictors included general patient characteristics and routine polysomnography data. The model was developed (training-set) using linear regression with backward selection (tenfold cross-validated mean square errors); the predicted loop gain of the final linear regression model was used to predict loop gain class. More complex, alternative models including lasso regression or random forests were considered but did not meet pre-specified superiority-criteria. Final model performance was validated on the test-set. RESULTS: The total cohort included 1055 patients (33% high loop gain). Based on the final model, higher AHI (beta = 0.0016; P < .001) and lower hypopnea-percentage (beta = -0.0019; P < .001) predicted higher loop gain values. The predicted loop gain showed moderate-to-high correlation with the reference loop gain (r = 0.48; 95% CI 0.38-0.57) and moderate discrimination of patients with high versus low loop gain (area under the curve = 0.73; 95% CI 0.67-0.80). CONCLUSION: To our knowledge this is the first prediction model of loop gain based on readily-available clinical data, which may facilitate retrospective analyses of existing datasets, better patient selection for clinical trials and eventually clinical practice.

Emotional regulation processes: influence on pain and disability in fibromyalgia patients.

OBJECTIVES: Fibromyalgia (FM) is a chronic syndrome characterised by widespread musculoskeletal pain associated with other symptoms, including psychological distress. While negative mood (anxiety, depression, and anger) has been widely explored in FM, few studies have investigated emotional dysregulation. Our purpose was to evaluate problems in the processes of emotional regulation and to explore their influence on the severity of pain and disability. METHODS: Emotional regulations, anxiety, depression, anger, pain and disability were evaluated in 47 FM patients and 47 healthy subjects. Regression analyses were performed to evaluate the role that emotional regulation processes have on pain severity and disability of FM patients. RESULTS: Results showed that although FM patients do not differ in terms of the attention paid to their emotional states, FM patients had greater difficulties in the emotional regulation process. In addition, emotional rejection and interference are two variables that influence the pain severity and disability. CONCLUSIONS: FM patients need to be trained in strategies for regulating their emotions, in order to achieve a reduction in negative mood states, as well as their impact in pain and disability.

Povidone-Iodine as a Pre-Procedural Mouthwash to Reduce the Salivary Viral Load of SARS-CoV-2: A Systematic Review of Randomized Controlled Trials.

The use of pre-procedural rinses has been investigated to reduce the number of viral particles and bacteria in aerosols, potentially decreasing the risk of cross-infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during medical and dental procedures. This review aims to confirm whether there is evidence in the literature describing a reduction in salivary load of SARS-CoV-2 when povidone-iodine (PVP-I) is used as a pre-intervention mouthwash. An search of the MEDLINE, Embase, SCOPUS, and the Cochrane library databases was conducted. The criteria used followed the PRISMA® Statement guidelines. Randomized controlled trials investigating the reduction of salivary load of SARS-CoV-2 using PVP-I were included. Ultimately, four articles were included that met the established criteria. According to the current evidence, PVP-I is effective against SARS-CoV-2 in saliva and could be implemented as a rinse before interventions to decrease the risk of cross-infection in healthcare settings.

Brain functional connectivity after cognitive-bias modification and behavioral changes in abstinent alcohol-use disorder patients.

The use of the cognitive-bias modification (CBM) method has emerged as a therapeutic complement in the treatment of alcoholism, producing changes at behavioral and brain level. Nevertheless, the impact of the CBM procedure could be improved by the memory retrieval-extinction process (REP). Different studies have demonstrated that the retrieval of drug memories before extinction training later reduced the reinstatement of drug-seeking behavior. The main aim of this work was to study the effect of the CBM procedure itself, as well as in combination with the activation of alcohol-related memories, on the brain oscillatory activity of abstinent patients with alcohol-use disorder. The study sample comprised 33 patients divided into three groups: A-CBM (alcohol-related memory activation + CBM), N-CBM (neutral memory activation + CBM) and N-INT (no-intervention) groups. A resting-state EEG was obtained before and after each protocol, along with the assessment of the automatic action tendencies. A-CBM group showed a general alpha synchronization increase after the protocol, while the other groups did not show any significant change. Besides, A-CBM group showed significant intra and inter-group differences in the automatic action tendencies after the protocol, reflected in higher avoidance bias toward appetitive, aversive and without context alcohol-related stimuli. The alpha phase synchronization increase could be the neural manifestation of the conditioning produced between the alcohol-related stimuli and the automatic avoidance response. Moreover, the activation of the alcohol-related memories favors this conditioning with those alcohol-related stimuli associated with the activated memories, because it increases their threat level for the abstinence maintenance.

Conhecimento de equipes de enfermagem quanto às manifestações clínicas e grupo de risco para COVID-19 / Knowledge of nursing teams regarding clinical manifestations and risk group for COVID-19 / Conocimiento de los equipos de enfermería sobre manifestaciones clínicas y grupos de riesgo para COVID-19

Objetivo: comparar o conhecimento de enfermeiros e técnicos de enfermagem atutentes em Unidades de Pronto Atendimento quanto ao reconhecimento de manifestações clínicas e grupos de risco para o desenvolvimento da forma grave da COVID-19. Método: estudo descritivo, realizado com 53 profissionais de três unidades de pronto atendimento, com coleta de dados realizada por meio de questionário autorrespondido. Dados analisados por meio de estatística descritiva e inferencial (testes t-student e qui-quadrado). Protocolo de pesquisa aprovado pelo Comitê de Ética em Pesquisa da instituição. Resultados: destaca-se uma associação entre a citação de manifestações clínicas como náuseas e vômitos, grupos de risco e a função, enfermeiros ou técnicos de enfermagem (p<0,05) e o nível de formação, ou seja, os enfermeiros relataram com maior frequência a presença desses sintomas que os técnicos de enfermagem. Conclusão: os profissionais de enfermagem apresentam conhecimento quanto a sintomatologia e grupos de risco, ainda que haja diferença entre o nível profissional(AU)

Objective: to compare the knowledge of nurses and nursing technicians working in Emergency Care Units regarding the recognition of clinical manifestations and risk groups for the development of the severe form of COVID-19. Method: descriptive study, carried out with 53 professionals from three emergency care units, with data collection carried out through a self-answered questionnaire. Data analyzed using descriptive and inferential statistics (t-student and chi-square tests). Research protocol approved by the institution's Research Ethics Committee. Results: an association stands out between the mention of clinical manifestations such as nausea and vomiting, risk groups and the role, nurses or nursing technicians (p<0.05) and the level of training, that is, nurses reported with the presence of these symptoms was more frequent than nursing technicians. Conclusion: nursing professionals have knowledge regarding symptoms and risk groups, even if there is a difference between the professional level(AU)

Objetivo: comparar los conocimientos de enfermeros y técnicos de enfermería que trabajan en Unidades de Atención de Emergencia sobre el reconocimiento de manifestaciones clínicas y grupos de riesgo para el desarrollo de la forma grave de COVID-19. Método: estudio descriptivo, realizado con 53 profesionales de tres unidades de atención de emergencia, con recolección de datos realizada a través de un cuestionario auto respondido. Datos analizados mediante estadística descriptiva e inferencial (pruebas t de Student y chi-cuadrado). Protocolo de investigación aprobado por el Comité de Ética en Investigación de la institución. Resultados: se destaca asociación entre la mención de manifestaciones clínicas como náuseas y vómitos, grupos de riesgo y el rol, enfermeros o técnicos de enfermería (p<0,05) y el nivel de formación, es decir, los enfermeros reportaron la presencia de estos síntomas. fue más frecuente que los técnicos de enfermería. Conclusión: los profesionales de enfermería tienen conocimientos sobre síntomas y grupos de riesgo, aunque exista diferencia entre el nivel profesional(AU)

Caracterización microbiológica de Salmonella en alimentos de venta callejera en un sector universitario de Bogotá, Colombia. Julio a octubre de 2010 / Microbiological characterization of Salmonella in Street-vended foods an university sector in Bogotá, Colombia. july-october 2010

Introducción. Salmonella spp. perteneciente a la familia Enterobacteriaceae, es uno de los principales microorganismos implicados en las enfermedades transmitidas por alimentos. La infección conocida como salmonelosis se puede manifestar como dos procesos patológicos diferentes, la fiebre tifoidea o la gastroenteritis. El objetivo de esta investigación fue demostrar la presencia de Salmonella spp. en alimentos de venta callejera en un sector universitario delimitado de la ciudad de Bogotá y su posterior caracterización por medio de técnicas de microbiología clínica. Materiales y Métodos. Estudio observacional descriptivo de corte transversal. Se recolectaron 42 muestras de alimentos en ventas callejeras a través de un muestreo no probabilístico. Para el aislamiento y caracterización de Salmonella spp. se realizó el método propuesto por la Food and Drug Administration, empleando pruebas bioquímicas, de serotipificación para Salmonella spp. y realizando la prueba de susceptibilidad antimicrobiana. Resultados. Se detectó crecimiento microbiano en un total de 18 muestras (42,9%), de las cuales solo dos fueron positivas por serotipificación para Salmonella entérica con un 11,1%, 11 de estas 18 muestras fueron positivas para otras bacterias pertenecientes a la familia Enterobacteriaceae (61,1%) y cinco muestras no pudieron ser identificadas (27,8%). Las cepas sometidas a antibiograma fueron susceptibles a Ciprofloxacina, y resistentes al Trimetoprim-Sulfametoxazol, Cloramfenicol y Ampicilina. Conclusiones. Esta investigación permitió identificar la presencia de Salmonella enterica y otras enterobacterias en alimentos de venta callejera, lo cual puede representar un alto riesgo para la salud de los habitantes y la población estudiantil de un sector universitario en Bogotá, Colombia...

Introduction. Salmonella belongs to the Enterobacteriaceae family, and is one of the main microorganisms involved in foodborne disease. It produces a clinical entity known as salmonelosis can manifest as two different pathological processes, typhoid fever or gastroenteritis. The objective of this research was to demonstrate the presence of Salmonella spp. in street-vended foods in an area bounded by Universities in the city of Bogotá and its subsequent characterization by means of clinical microbiology techniques. Materials and Methods. Observational cross sectional study. Was analyze 42 samples of street-vended foods obtained through a non-probability sampling, the isolation of Salmonella spp. was performed following the method proposed by the Food and Drug Administration, performing biochemical identification and serological tests for Salmonella spp. and antimicrobial susceptibility testing. Results. Growth was detected in a total of 18 samples (42.9%), of which only 2 were positive for Salmonella enterica with a 11.1%, 11 out of 18 samples were positive for other bacteria belonging to the family Enterobacteriaceae (61.1%) and 5 samples without profile identified (27.8%). The samples tested were susceptible to ciprofloxacin susceptibility, showing resistance to Trimethoprim-Sulfamethoxazole, Chloramphenicol and Ampicillin. Conclusions. This investigation established the presence of Salmonella enterica and other Enterobacteriaceae in street-vended foods, showing a high risk to the health of residents and student population of a university sector in the city of Bogotá, Colombia...