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1.
Front Psychiatry ; 15: 1255073, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38881547

RESUMO

Schizophrenia is a persistent mental health condition that, while presenting challenges, underscores the dynamic nature of cognitive functions and encourages a unique perspective on how individuals engage with their surroundings. Social networks, as a means of communication of great importance at the present time, are for this type of people a way of interacting with their environment with a high level of security. The aim is to find out how schizophrenia is dealt with in different social networks and to differentiate between different types of articles dealing with the use of Facebook, X (former Twitter), YouTube, TikTok, Instagram, and Weibo. A total of 45 articles to i) Social networks used, ii) Country of analyzed users, iii) age of the users analyzed, iv) focus of the analyzed manuscript (mental health literacy, stigmatization, detection of patterns associated with schizophrenia, and Harmful substance use). It was observed that 45.45% of the studies analyzed were conducted in the USA population, followed by UK and China (13.64%). The most analyzed social networks were those based on audiovisual communication (60%). Furthermore, the two main foci addressed in these articles were: stigmatization of schizophrenia with 16 articles (35.55%), following by the prediction of schizophrenia-detecting patterns with 15 articles (33.33%) and the use of social networks to stigmatize people with schizophrenia (38%) and only 14 articles (31.11%) were focused on mental health literacy. Likewise, it was found that there is great potential in the use of the analysis of the content generated, as possible predictors of the presence of this disease, which would allow rapid detection and intervention for psychosis and schizophrenia.

2.
J Clin Med ; 13(11)2024 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-38892834

RESUMO

Introduction: Although stentrievers (SRs) have been a mainstay of mechanical thrombectomy (MT), and current guidelines recommend the use of SRs in the treatment of large vessel occlusion stroke (LVO), there is a paucity of studies in the literature comparing SRs directly against each other in terms of mechanical and functional properties. Timely access to endovascular therapy and the ability to restore intracranial flow in a safe, efficient, and efficacious manner have been critical to the success of MT. This study aimed to investigate the impact of contemporary SR characteristics, including model, brand, size, and length, on the first-pass effect (FPE) in patients with acute ischemic stroke. Methods: Consecutive patients with M1 occlusion treated with a single SR+BGC were recruited from the ROSSETTI registry. The primary outcome was the FPE that was defined as modified (mFPE) or true (tFPE) for the achievement of modified thrombolysis in cerebral infarction (mTICI) grades 2b-3 or 3 after a single device pass, respectively. We compared patients who achieved mFPE with those who achieved tFPE according to SR characteristics. Results: We included 610 patients (52.3% female and 47.7% male, mean age 75.1 ± 13.62 years). mFPE was achieved in 357 patients (58.5%), whereas tFPE was achieved in 264 (43.3%). There was no significant association between SR characteristics and mFPE or tFPE. Specifically, the SR size did not show a statistically significant relationship with improvement in FPE. Similarly, the length of the SR did not yield significant differences in the mFPE and tFPE, even when the data were grouped. Conclusions: Our data indicate that contemporary SR-mediated thrombectomy characteristics, including model, brand, size, and length, do not significantly affect the FPE.

3.
Transplant Cell Ther ; 30(5): 538.e1-538.e10, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38331195

RESUMO

Cytomegalovirus (CMV) reactivations cause significant morbidity in allogeneic hematopoietic stem cell transplantation (HSCT) recipients. Graft-versus-host disease (GVHD) prophylaxis with post-transplantation cyclophosphamide (PTCy) is associated with an increased risk of CMV infections. Data are limited comparing HSCT with PTCy performed from matched sibling donors (MSDs), matched unrelated donors (MUDs), and haploidentical (Haplo) donors. In the present study, we aimed to characterize CMV reactivation and recurrence in patients with hematologic malignancies undergoing HSCT from MSD, MUD, and Haplo donors using PTCy as GVHD prophylaxis in the pre-letermovir era. We also analyzed risk factors of CMV reactivation, including GVHD as a time-dependent variable, on the incidence and mortality associated with CMV infections. We analyzed CMV reactivation in patients undergoing HSCT from 160 MSDs, 124 MUDs, and 82 Haplo donors from a single institution. Uniform GVHD prophylaxis with PTCy, sirolimus, and mycophenolate mofetil was given irrespective of donor type. Overall, 46% of patients had at least 1 CMV reactivation. The 1-year cumulative incidence of CMV infection was 39% for MSD, 44% for MUD, and 62% for Haplo donors (P < .001), with 96% of reactivations occurring before day +100. Multivariate analysis identified factors associated with the first CMV reactivation, including Haplo donor, positive recipient CMV serology, older patient age, and grade II-IV acute GVHD. The 1-year cumulative incidence of second reactivation from HSCT was 13%. Recipient CMV seropositivity, older patient age, and grade II-IV acute GVHD, but not type of donor, were identified as adverse factors for second CMV reactivation in multivariate analysis. The 1-year cumulative incidence of a third reactivation post HSCT was 4.4%. Ten cases of CMV disease were recorded, with no attributable deaths. Nevertheless, the risk for nonrelapse mortality was greater for patients who experienced CMV reactivation in multivariate time-dependent Cox model analysis. CMV reactivation is frequent in HSCT with PTCy in patients not receiving letermovir prophylaxis. Identified risk factors include the use of a Haplo donor, recipient CMV seropositivity, and grade II-IV acute GVHD. The prevalence of recurrent CMV reactivations is a noteworthy issue, especially after acute GVHD, warranting trials of secondary prophylaxis strategies.


Assuntos
Ciclofosfamida , Infecções por Citomegalovirus , Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Ativação Viral , Humanos , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Ativação Viral/efeitos dos fármacos , Ciclofosfamida/uso terapêutico , Ciclofosfamida/efeitos adversos , Doença Enxerto-Hospedeiro/prevenção & controle , Infecções por Citomegalovirus/prevenção & controle , Infecções por Citomegalovirus/epidemiologia , Transplante Homólogo/efeitos adversos , Citomegalovirus/imunologia , Citomegalovirus/efeitos dos fármacos , Idoso , Adulto Jovem , Doadores de Tecidos , Adolescente , Transplante Haploidêntico/efeitos adversos , Fatores de Risco , Imunossupressores/uso terapêutico , Imunossupressores/efeitos adversos , Neoplasias Hematológicas/terapia , Doadores não Relacionados , Antígenos HLA/imunologia , Irmãos
4.
Stroke ; 53(7): 2211-2219, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35360928

RESUMO

BACKGROUND: The Advanced Neurovascular Access (ANA) thrombectomy system is a novel stroke thrombectomy device comprising a self-expanding funnel designed to reduce clot fragmentation by locally restricting flow while becoming as wide as the lodging artery. Once deployed, the ANA device allows distal aspiration combined with a stent retriever to mobilize the clot into the funnel where it remains copped during extraction. We investigated the safety and efficacy of ANA catheter system. METHODS: SOLONDA (Solitaire in Combination With the ANA Catheter System as Manufactured by Anaconda) was a prospective, open, single-arm, multicenter trial with blinded assessment of the primary outcome by an independent core lab. Patients with anterior circulation vessel occlusion admitted within 8 hours from symptom onset were eligible. The primary end point was successful reperfusion (modified Thrombolysis in Cerebral Infarction score 2b-3) with ≤3 passes of the ANA device in combination with stent retriever, before the use of rescue therapy in the intention to treat population. Primary predefined analysis was noninferiority as compared to the performance end point observed in HERMES (High Effective Reperfusion Using Multiple Endovascular Devices). RESULTS: After enrollment of 74 patients, an interim analysis was conducted, and the trial Steering Committee decided to terminate recruitment due to safety and performance objectives were reached. Mean age was 71.6 (SD 8.9) years, 46.6% women and median National Institutes of Health Stroke Scale on admission 14 (interquartile range, 10-19). Successful reperfusion within 3 passes before rescue therapy was achieved in 60/72 (83.3% [95% CI, 74.7%-91.9%]) with a rate of complete reperfusion (modified Thrombolysis in Cerebral Infarction score 2c-3) of 60% (95% CI, 48.4%-71.1%; 43/72 patients). After noninferiority was confirmed (P<0.01), the ANA device also showed superiority in the rate of successful reperfusion with ≤3 passes (P=0.02). First-pass successful recanalization rate was 55.6% (95% CI, 44.1%-67.0%), with a first-pass complete recanalization rate of 38.9% (95% CI, 27.6%-50.1%). Rescue therapy to obtain a modified Thrombolysis in Cerebral Infarction score 2b-3 was needed in 12/72 (17%) patients. At 90 days, the rate of favorable functional outcome (modified Rankin Scale score 0-2) was 57.5% (95% CI, 46.2%-68.9%), and the rate of excellent functional outcome (modified Rankin Scale score 0-1) was 45.2% (95% CI, 33.8%-56.6%). The rate of severe adverse device related was 1.4%. CONCLUSIONS: In this clinical experience, the ANA device achieved a high rate of complete recanalization with a preliminary good safety profile and favorable 90 days clinical outcomes. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT04095767.


Assuntos
Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Idoso , Isquemia Encefálica/etiologia , Isquemia Encefálica/cirurgia , Catéteres , Infarto Cerebral/etiologia , Feminino , Humanos , Masculino , Estudos Prospectivos , Stents , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/cirurgia , Trombectomia/métodos , Resultado do Tratamento
5.
Front Neurol ; 11: 664, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32695066

RESUMO

With the rapid pace and scale of the emerging coronavirus 2019 (COVID-19) pandemic, a growing body of evidence has shown a strong association of COVID-19 with pre- and post- neurological complications. This has necessitated the need to incorporate targeted neurological care for this subgroup of patients which warrants further reorganization of services, healthcare workforce, and ongoing management of chronic neurological cases. The social distancing and the shutdown imposed by several nations in the midst of COVID-19 have severely impacted the ongoing care, access and support of patients with chronic neurological conditions such as Multiple Sclerosis, Epilepsy, Neuromuscular Disorders, Migraine, Dementia, and Parkinson disease. There is a pressing need for governing bodies including national and international professional associations, health ministries and health institutions to harmonize policies, guidelines, and recommendations relating to the management of chronic neurological conditions. These harmonized guidelines should ensure patient continuity across the spectrum of hospital and community care including the well-being, safety, and mental health of the patients, their care partners and the health professionals involved. This article provides an in-depth analysis of the impact of COVID-19 on chronic neurological conditions and specific recommendations to minimize the potential harm to those at high risk.

7.
J Infect ; 78(5): 393-401, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30797790

RESUMO

OBJECTIVES: To date no definitive cut-off value for cytomegalovirus (CMV) DNA load in bronchoalveolar lavage (BAL) fluid specimens has been established to discriminate between CMV pneumonia and pulmonary CMV DNA shedding in allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients. METHODS: The current retrospective study is aimed at assessing the range of CMV DNA loads quantified in BAL fluid specimens from allo-HSCT patients with pneumonia in which different microorganisms were causally involved. RESULTS: A total of 144 BAL specimens from 123 patients were included. CMV DNA was detected in 56 out of 144 BAL fluid specimens and the median CMV DNA load from patients in whom CMV pneumonia was unlikely or could be tentatively ruled out was 1210 (31-68, 920) IU/ml. The frequency of CMV DNA detection and median CMV DNA loads were comparable, irrespective of the attributable cause of pneumonia. Detection of CMV DNA loads in BAL fluid specimens >500 IU/ml was independently associated with pneumonia-attributable mortality. CONCLUSIONS: The current study highlights the difficulty in establishing universal CMV DNA load thresholds in BAL fluid specimens for distinguishing between CMV pneumonia and pulmonary CMV DNA shedding, and suggests that the presence of CMV DNA in BAL fluid specimens beyond a certain level may have a deleterious impact on patient outcome.


Assuntos
Líquido da Lavagem Broncoalveolar/virologia , Infecções por Citomegalovirus/diagnóstico , Citomegalovirus/isolamento & purificação , DNA Viral/isolamento & purificação , Pneumonia Viral/diagnóstico , Transplantados , Eliminação de Partículas Virais , Adulto , Idoso , Idoso de 80 Anos ou mais , Citomegalovirus/genética , Infecções por Citomegalovirus/virologia , DNA Viral/genética , Feminino , Transplante de Células-Tronco Hematopoéticas , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/virologia , Estudos Retrospectivos , Transplante Homólogo , Carga Viral
8.
Clin Infect Dis ; 68(11): 1894-1903, 2019 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-30239624

RESUMO

BACKGROUND: Vaccination is the primary method for preventing influenza respiratory virus infection (RVI). Although the influenza vaccine is able to achieve serological responses in some allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients, its clinical benefits are still uncertain. METHODS: In this prospective, cross-sectional study, we retrospectively analyzed the effect of inactivated trivalent influenza vaccination on the prevalence of influenza RVI in a consecutive cohort of 136 allo-HSCT adult recipients who developed 161 RVI over 5 flu seasons (from 2013 to 2018). Respiratory viruses in upper- and/or lower-respiratory tract specimens were tested using multiplex polymerase chain reaction panel assays. RESULTS: Overall, we diagnosed 74 episodes (46%) of influenza RVI in 70 allo-HSCT recipients. Influenza RVI occurred in 51% of the non-vaccinated compared to 36% of the vaccinated recipients (P = .036). A multivariate analysis showed that influenza vaccination was associated with a lower prevalence of influenza RVI (odds ratio [OR] 0.39, P = .01). A multivariate risk factor analysis of lower-respiratory tract disease (LRTD) identified 2 conditions associated with the probability of influenza RVI progression: influenza vaccination (OR 0.12, 95% confidence interval [CI] 0.014-1, P = .05) and a high-risk immunodeficiency score (OR 36, 95% CI 2.26-575, P = .011). Influenza vaccination was also associated with a lower likelihood of an influenza-related hospital admission (14% vs 2%, P = .04). CONCLUSIONS: This study shows that influenza vaccination may have a clinical benefit in allo-HSCT recipients with virologically-confirmed RVI, in terms of a lower influenza RVI prevalence, slower LRTD progression, and lower likelihood of hospital admission.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Vacinas contra Influenza/administração & dosagem , Vacinas contra Influenza/imunologia , Influenza Humana/prevenção & controle , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Hospitalização , Humanos , Hospedeiro Imunocomprometido , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , Espanha , Transplante Homólogo , Resultado do Tratamento , Adulto Jovem
9.
Transpl Infect Dis ; 20(4): e12926, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29809298

RESUMO

Risk factors (RFs) and mortality data of community-acquired respiratory virus (CARVs) lower respiratory tract disease (LRTD) with concurrent pulmonary co-infections in the setting of allogeneic hematopoietic stem cell transplantation (allo-HSCT) is scarce. From January 2011 to December 2017, we retrospectively compared the outcome of allo-HSCT recipients diagnosed of CARVs LRTD mono-infection (n = 52, group 1), to those with viral, bacterial, or fungal pulmonary CARVs LRTD co-infections (n = 15, group 2; n = 20, group 3, and n = 11, group 4, respectively), and with those having bacterial pneumonia mono-infection (n = 19, group 5). Overall survival (OS) at day 60 after bronchoalveolar lavage (BAL) was significantly higher in group 1, 2, and 4 compared to group 3 (77%, 67%, and 73% vs 35%, respectively, P = .012). Recipients of group 5 showed a trend to better OS compared to those of group 3 (62% vs 35%, P = .1). Multivariate analyses showed bacterial co-infection as a RF for mortality (hazard ratio[HR] 2.65, 95% C.I. 1.2-6.9, P = .017). We identified other 3 RFs for mortality: lymphocyte count <0.5 × 109 /L (HR 2.6, 95% 1.1-6.2, P = .026), the occurrence of and CMV DNAemia requiring antiviral therapy (CMV-DNAemia-RAT) at the time of BAL (HR 2.32, 95% C.I. 1.1-4.9, P = .03), and the need of oxygen support (HR 8.3, 95% C.I. 2.9-35.3, P = .004). CARV LRTD co-infections are frequent and may have a negative effect in the outcome, in particular in the context of bacterial co-infections.


Assuntos
Líquido da Lavagem Broncoalveolar/microbiologia , Coinfecção/mortalidade , Infecções Comunitárias Adquiridas/mortalidade , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Infecções Respiratórias/mortalidade , Adulto , Idoso , Antivirais/uso terapêutico , Bactérias/isolamento & purificação , Lavagem Broncoalveolar , Coinfecção/microbiologia , Coinfecção/terapia , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/terapia , Feminino , Fungos/isolamento & purificação , Humanos , Pulmão/microbiologia , Masculino , Pessoa de Meia-Idade , Infecções Respiratórias/microbiologia , Infecções Respiratórias/terapia , Estudos Retrospectivos , Fatores de Risco , Transplante Homólogo/efeitos adversos , Vírus/isolamento & purificação
10.
Rev. cuba. hematol. inmunol. hemoter ; 31(3): 267-287, jul.-set. 2015. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-761915

RESUMO

Introducción: la drepanocitosis es una enfermedad hematológica hereditaria y crónica. Se caracteriza por anemia crónica y diferentes trastornos asociados al proceso frecuente de la vasoclusión. Su gravedad es variable y su evolución puede afectar el desarrollo psicosocial de quien la padece. Es la hemoglobinopatía más frecuente en Cuba y la incidencia de portador de la hemoglobina S es del 3,08 por ciento. Objetivo: determinar la calidad de vida relacionada con la salud (CVRS) de los pacientes adultos con drepanocitosis que se atienden en el Instituto de Hematología e Inmunología (IHI). Métodos: se aplicó el cuestionario SF-36 a 492 sujetos; de ellos, 187 con drepanocitosis y edad entre los 16 y 75 años. Sus resultados se compararon con los de 183 personas sanas, 74 hemofílicos y 48 mujeres con menorragia. Se obtuvieron criterios sobre la confiabilidad y la validez de este instrumento. Resultados: las puntuaciones obtenidas por los pacientes con drepanocitosis fueron significativamente inferiores a las de las personas sanas y superiores a los reportados en otros países para estos enfermos. Los hombres con drepanocitosis se diferenciaron de los hemofílicos en las escalas rol físico y función física. Las mujeres estudiadas resultaron diferentes a las diagnosticadas con menorragia en: función física, función social, salud mental y vitalidad. La prueba no discriminó los diferentes genotipos de la drepanocitosis. Los índices de Cronbach de las escalas en el grupo con drepanocitosis resultaron superiores a 0,70; menos función social (0,67). Conclusiones: los pacientes con drepanocitosis poseen una pobre calidad de vida como consecuencia de la enfermedad. El cuestionario SF-36 se mostró confiable y con aceptable validez discriminante en este estudio(AU)


Introduction: Sickle cell disease (SCD) is chronic and inherited. It is characterized by chronic anemia and several disorders related to vasoocclusion process. Its severity is variable and the evolution can affect the psychosocial development of the patients. SCD is the most frequent hemolytic anemia genetically determined in Cuba and the incidence of hemoglobin S is 3.08 percent. Objective: To determine the health related quality of life (HRQoL) in SCD adult patients attending the Institute of Hematology and Immunology. Methods: SF-36 questionnaire was administered to 492 subjects, 187 of them with SCD, ages between 16 and 75 years old. Their results were compared to 183 healthy subjects, 74 hemophiliacs and 48 women with menorrhagia. The reliability and validity of the SF-36 was analyzed. Results: Patients with SCD scored significantly worse than healthy people and better than reports from other countries for this kind of patients. Men with SCD scored different to hemophiliacs in physical functioning and role-physical scales. Women with SCD scored different compared to menorrhagiacs. in physical function, social function, mental health and vitality. The test did not distinguish among different genotypes of SCD. The Cronbach´s index obtained in the scales of SCD patients were higher than 0.70, except for social function (0.67). Conclusions: Patients with SCD have a poor health related quality of life. In this study the SF-36 showed reliability and acceptable discriminant validity


Assuntos
Humanos , Masculino , Feminino , Qualidade de Vida , Traço Falciforme/complicações
11.
Rev. cuba. hematol. inmunol. hemoter ; 29(1): 73-81, ene.-mar. 2013.
Artigo em Espanhol | LILACS | ID: lil-666714

RESUMO

Introducción: se ha comunicado afectación neurocognitiva como secuela a largo plazo en pacientes curados de leucemia linfoide aguda que fueron irradiados durante el tratamiento. Más recientemente esto se plantea también para los tratados solo con quimioterapia. Sobre estos últimos no se conocen antecedentes en Cuba de estudios de este tipo. Métodos: se estudió el rendimiento intelectual de 77 pacientes entre 6 y 32 años (54 con tratamiento y 23 con sobrevida de más de 5 años) que no recibieron radiaciones durante su tratamiento, y de un grupo (n=20) de adolescentes sanos. Se utilizó la escala de inteligencia de Wechsler para niños (Wisc) y para adultos (Wais). Resultados: los resultados mostraron que las escalas totales, tanto de los enfermos como de los curados, se encontraba dentro de parámetros normales. Sin embargo, se obtuvieron notaciones significativamente más bajas en los pacientes curados que en los sanos en las pruebas de semejanzas, dígitos, ordenar figuras y diseño de bloques; también en el factor de distractibilidad. Los pacientes que se encontraban enfermos en la evaluación obtuvieron puntuación más baja que los normales solo en la prueba de dígitos. Conclusiones: estos resultados sugieren afectaciones subclínicas específicas relacionadas con la capacidad de asociación de conceptos verbales, memoria inmediata, capacidad de planeamiento estratégico, organización visoespacial, análisis y síntesis como procesos del pensamiento, así como una dificultad atencional en los pacientes curados como secuela de la quimioterapia


Introduction: neurocognitive disorders have been reported as long-term side effects in patients free from acute lymphoid leukemia that had undergone radiotherapy. These disorders have been likewise reported in those cases in which the patients had undergone chemotherapy. No antecedents about previous study on the latter in Cuba are known. Methods: the intellectual performance of 77 patients who did not undergo radiotherapy during their treatment, ages between 6 and 32 years old, was studied (54 of them under treatment and 23 had survived for more than 5 years); and the intellectual performance of a group of healthy teenagers (n=20). The Wechsler intelligence scales for children (WISC) and for adults (WAIS) were used. Results: the results showed that the Intelligence Quotient of the sick patients and of those already recovered was among standard parameters. However, the recovered patients obtained results significantly lower than those of healthy patients in the Similarity, Digit, Figures Arrangement and Design of Blocks subtests, as well as in the distractibility factor. The patients that were ill during the tests obtained lower results than the healthy ones only in the Digit subtest. Conclusions: these results suggest the presence of specific subclinical disorders related to the capacity of associating verbal concepts, short-term memory, capacity of strategic planning, visualspatial organization, analysis and synthesis such as thinking processes as well as an attention difficulty in recovered patients as a result of chemotherapy


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Leucemia-Linfoma Linfoblástico de Células Precursoras/radioterapia , Testes Neuropsicológicos/estatística & dados numéricos , Transtornos Cognitivos/induzido quimicamente , Baixo Rendimento Escolar
12.
Rev. cuba. hematol. inmunol. hemoter ; 28(4): 385-397, oct.-dic. 2012.
Artigo em Espanhol | LILACS | ID: lil-663862

RESUMO

Los estudios sobre calidad de vida relacionada con salud (CVRS) en drepanocitosis son escasos y no existen instrumentos específicos en español para su evaluación. En este artículo se describe el desarrollo y validación del breve cuestionario específico sobre calidad de vida en drepanocitosis (CEB-S) que ha sido creado para evaluar la calidad de vida de pacientes con drepanocitosis a partir de la valoración que estos hacen de cuánto la enfermedad afecta la calidad de sus vidas. El desarrollo de este instrumento incluyó las fases: creación de preguntas, estudio piloto y estudio de campo. La versión preliminar estuvo formada por 33 preguntas cerradas tipo Likert que se aplicó a 20 hombres y 20 mujeres con drepanocitosis. De su análisis se obtuvo una segunda versión de 30 preguntas en 4 escalas que se aplicó a 104 pacientes. El análisis psicométrico incluyó: evaluación de confiabilidad, validez, sensibilidad, especificidad y eficiencia. Se determinó la confiabilidad del cuestionario en términos de consistencia interna por el índice de Crombach (área física 0,82; área social 0,82; área emocional 0,76; dolor 0,85 y total 0,92). En 69 enfermos se obtuvo un fuerte criterio de validez convergente con el cuestionario de salud SF-36. Se demostró la validez discriminante del CEB-S, al comparar los resultados obtenidos por los pacientes con cualquier tipo de síntoma relacionado con la enfermedad, con los alcanzados por los asintomáticos y también con la estratificación de los enfermos según la gravedad de la anemia en el momento de su aplicación. Esta versión fue considerada como la definitiva


Studies related to quality of life (HRQOL) in sickle cell disease are scarce and there are no specific tools for assessment in Spanish. This article described the development and validation of a brief specific questionnaire on quality of life in sickle cell disease (CEB-S), which has been created to assess the quality of life in patients with sickle cell disease on the basis of their own assessment on how this disease affects their quality of life. The development of this instrument included stages: creation of questions, pilot study and field study. The draft consisted of 33 Likert-type closed questions applied to 20 men and 20 women with sickle cell disease. After an analysis, a second 4-scale thirty question version was accomplished and then applied to 104 patients. Psychometric analysis included: evaluation of reliability, validity, sensitivity, specificity, and efficiency. The reliability of this questionnaire in terms of internal consistency by Cronbach index (physical area 0.82; social area 0.82; emotional area 0.76; pain 0.85 and total 0.92) was determined. Sixty nine patients yielded strong validity criterion consistent with the SF-36 health questionnaire. CEB-S discriminant validity was demonstrated, by comparing the results obtained in patients with any symptoms related to this disease, with those obtained in asymptomatic patients and with the stratification of patients according to the severity of anemia at the time of application. This version was considered final


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Pessoa de Meia-Idade , Anemia Falciforme/epidemiologia , Qualidade de Vida/psicologia , Saúde do Adulto , Projetos Piloto , Inquéritos e Questionários
13.
Aten Primaria ; 44(5): 250-6, 2012 May.
Artigo em Espanhol | MEDLINE | ID: mdl-21733598

RESUMO

OBJECTIVES: To study incidence, epidemiological characteristics and types of domestic and leisure accidents in Castilla y León during 2009. DESIGN: A descriptive study using a prospective sample design. EMPLACEMENT: Health Primary Care Centres of Castilla y León. PARTICIPANTS: The Nurse Registry is made up of 130 nurses selected by conglomerates analysis. They cover 5% of the population. PRINCIPAL MEASUREMENTS: The information was obtained by means of an anonymous form. The studied variables were sex, age, type, place, type and origin of the accident. A descriptive analysis was performed using χ(2), Fischer, χ(2) of trends and t Student tests, with 95% confidence intervals. RESULTS: The annual cumulative incidence was 2651 cases/100000 inhabitants, there being slightly higher percentage of men (50.4%). The ≤ 15 and ≥ 65 years age groups had more accidents. The time of day of 49.2% of the accidents was during the morning and 71.7% were on a working day. The majority (57.1%) took place in the home, 16,8% in the street, and 7.3% in schools. The most common accidents types were falls to the same level (40.4%) and use of cutting and sharp objects (22.7%). CONCLUSIONS: Most accidents took place within the home, on a working day and by falls. The most affected were the ≤ 15 and ≥ 65 years old age groups.


Assuntos
Acidentes/classificação , Acidentes/estatística & dados numéricos , Atividades de Lazer , Acidentes Domésticos/classificação , Acidentes Domésticos/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Humanos , Incidência , Lactente , Pessoa de Meia-Idade , Estudos Prospectivos , Vigilância de Evento Sentinela , Espanha/epidemiologia
14.
Diversitas perspectiv. psicol ; 6(2): 309-319, dic. 2010. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-635589

RESUMO

El estudio de la ocurrencia de los delitos sexuales implica una visión tripartita en la que se involucran elementos que interactúan de manera constante y en ocasiones de manera desventajosa. Por un lado, se considera la reivindicación y reparación para con la víctima como receptora del daño; por otro, el tratamiento y la aplicación de justicia al victimario, y finalmente, los procesos de regulación e impartición del sistema penal en su intento por representar el mecanismo regulador que restablezca las repercusiones creadas a partir de la victimización. Debido, entonces, a la complejidad de los delitos, así como a la discusión acerca del equilibrio que requiere la reinserción para evitar la revictimización, en el presente documento se hace referencia a los perfiles empíricos descriptivos en muestras de población penitenciaria españolas y mexicanas, y su implicación en la reincidencia o riesgo victimal, enfatizando que el diagnóstico en el área criminológica es una herramienta fundamental que requiere de medios de evaluación específica, válida y confiable para tener aproximaciones reales acerca de la disposición de una persona a la hora de cometer conductas antisociales; relevante desde una perspectiva de política criminal, y con la finalidad del estudio psicológico del agresor, estudio que en última instancia apoyaría al tratamiento penitenciario y a la prevención del delito.


The study of the occurrence of the sexual crimes has a tripartite implication in which there are interfered elements that interact quite frequently, and occasionally in a disadvantageous way. On one hand, the recovery and repair of the victim, as the recipient of the damage, is considered; and on the other, the treatment of and the criminal proceedings against the aggressor; and finally, the processes of regulation and imparting of the Penal System in its attempt for representing the regulatory mechanism which restores the repercussions created by the aggression. Complexes are both, crimes, as well as the discussion about the balance needed by the rehabilitation to avoid the re-victimization. The paper describes empirically the profiles of inmates in Spanish and Mexican penitentiary system. It analyses their implication for repetition or for victim risk. It emphasizes the diagnosis in the criminological area as a fundamental tool. This tool needs of specific, valid and reliable evaluation means to having real approximations about the personal disposition to commit antisocial behaviors, which is relevant not only from a criminal politics perspective, with the goal of the psychological study in aggressors, study that among others could contribute to the safety of victims.

15.
Mol Immunol ; 43(6): 570-8, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-15941589

RESUMO

Ole e 1 is a major allergen from olive pollen with an IgE-binding frequency around 80% among allergic population. Its diagnostic value has been demonstrated, and cross-reactive allergens have been found in ash, lilac and privet. We sought to determine IgE- and IgG-binding regions of Ole e 1. Ole e 1-specific polyclonal antiserum and sera from patients allergic to olive pollen were used to analyze IgG and IgE epitopes, respectively. Short overlapping synthetic peptides covering the complete sequence of Ole e 1 and point mutants of these peptides bound to membranes, as well as long recombinant peptides fused to GST were used in dot blot immunostaining and ELISA. Skin prick tests were performed on 14 allergic patients to assay the response in vivo to the recombinant fusion peptides. Residues at positions 8-11, 29, 32, 33, 55-59, 70, 107-110, 112, 120, 123, 141 of Ole e 1 sequence were found to be antigenically relevant in the IgG-binding. Although amino acids K137, L138, G139, Y141 and P142 were involved in the IgE-recognition of a pool of sera from allergic individuals, the response to the IgEs seemed to be preferentially conformational. IgE-binding capability of recombinant GST-fused peptide T114-M145 was demonstrated by in vivo (prick test) and in vitro (ELISA) experiments. Major IgG and IgE-binding regions of Ole e 1 have been identified being the C-terminal an immunodominant region. These data could help to design hypoallergenic forms of the allergen.


Assuntos
Alérgenos/imunologia , Linfócitos B , Epitopos de Linfócito B/imunologia , Epitopos Imunodominantes/química , Imunoglobulina E/imunologia , Imunoglobulina G/imunologia , Proteínas de Plantas/imunologia , Sequência de Aminoácidos , Antígenos de Plantas , Linfócitos B/imunologia , Mapeamento de Epitopos , Humanos , Imunoensaio , Imunoglobulina E/química , Imunoglobulina G/química , Olea , Pólen/imunologia , Conformação Proteica , Rinite Alérgica Sazonal/sangue
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