Analysis of long COVID in health personnel: comparing gender and work factors.

INTRODUCTION: This study aimed to describe the reported prevalence of post-COVID-19 syndrome and its characteristics by gender, profession, and other determinants among health care workers. METHODS: A cross-sectional study was conducted among health workers with a history of COVID-19 in Latin America, and the 2030 responses from Argentina were selected for this analysis. Sociodemographic information, as well as data on initial course of COVID-19, and the persistence of 21 symptoms beyond the first month, their severity, clinical evolution, and health care demands were collected. RESULTS: The reported prevalence of post-COVID-19 syndrome was higher in women for each of the symptom clusters studied. Severity of the initial symptoms, female gender, nursing profession, multi-employment, and working in emergency areas were all independent variables. DISCUSSION: The greater strain of health care workers during the pandemic -highly feminized- and the associated gender conditions may partially explain these findings.

Introducción: El objetivo del estudio fue describir la prevalencia del reporte de síndrome post-COVID-19 y sus características según género, profesión y otros determinantes sociales, en personal de salud. Métodos: Se realizó un estudio de corte transversal en profesionales de salud con antecedentes de COVID-19 en América Latina, y para este análisis se seleccionaron las 2030 respuestas de Argentina. Se recolectaron datos sociodemográficos, información sobre el curso inicial de la enfermedad COVID-19, y persistencia de 21 síntomas más allá del primer mes, su gravedad, evolución clínica y requerimiento de servicios de salud. Resultados: Se identificó que la prevalencia reportada de síndrome post-COVID-19 fue mayor en mujeres para cada uno de los grupos de síntomas explorados. La gravedad del cuadro inicial, el género femenino, la profesión de enfermería, el multiempleo y trabajar en áreas de emergencia fueron variables independientes. Discusión: La mayor sobrecarga del personal de salud durante la pandemia ­altamente feminizado­ y las determinaciones de género asociadas podrían explicar parcialmente estos hallazgos.

Congenital myasthenic syndrome secondary to pathogenic variants in the SLC5A7 gene: report of two cases.

BACKGROUND: Congenital Myasthenic Syndromes (CMS) are rare genetic diseases, which share as a common denominator muscle fatigability due to failure of neuromuscular transmission. A distinctive clinical feature of presynaptic CMS variants caused by defects of the synthesis of acetylcholine is the association with life-threatening episodes of apnea. One of these variants is caused by mutations in the SLC5A7 gene, which encodes the sodium-dependent HC-3 high-affinity choline transporter 1 (CHT1). To our knowledge there are no published cases of this CMS type in Latin America. CASE PRESENTATION: We present two cases of CHT1-CMS. Both patients were males presenting with repeated episodes of apnea, hypotonia, weakness, ptosis, mild ophthalmoparesis, and bulbar deficit. The first case also presented one isolated seizure, while the second case showed global developmental delay. Both cases, exhibited incomplete improvement with treatment with pyridostigmine. CONCLUSIONS: This report emphasizes the broad incidence of CMS with episodic apnea caused by mutations in the SLC5A7 gene and the frequent association of this condition with serious manifestations of central nervous system involvement.

Clinical usage and potential benefits of a continuous glucose monitoring Predict app.

Continuous glucose monitoring (CGM) has become an increasingly important tool for self-management in people with diabetes mellitus (DM). In this paper, we discuss recommendations on how to implement predictive features provided by the Accu-Chek SmartGuide Predict app in clinical practice. The Predict app's features are aimed at ultimately reducing diabetes stress and fear of hypoglycemia in people with DM. Furthermore, we explore the use cases and potential benefits of continuous glucose prediction, predictions of low glucose, and nocturnal hypoglycemia.

Early Occupational Therapy Intervention post-stroke (EOTIPS): A randomized controlled trial.

BACKGROUND: Occupational therapy (OT) is an effective evidence-based intervention that positively influences stroke patients'independence recovery, leading to new opportunities for better quality of life outcomes. OBJECTIVES: To explore the effectiveness of an early OT intervention program (EOTIPS) in the process of hospital to home discharge after stroke in Spain. MATERIAL AND METHODS: We conducted a prospective, randomized controlled clinical trial that included 60 adults who suffered a stroke and were discharged home. Participants assigned to the experimental group (n = 30) were included in EOTIPS and compared with a control group (n = 30). Evaluations assessed quality of life (Stroke and Aphasia Quality of Life Scale [SAQOL-39]), functional independence (Modified Rankin Scale [mRS], Barthel Index [BI] and Stroke Impact Scale-16 [SIS-16]), perceptual-cognitive skills (Montreal Cognitive Assessment [MoCA]), upper limb function (Fugl Meyer Assessment [FMA]), mobility (Berg Balance Scale [BBS] and Timed Up & Go [TUG]), communication skills (Communicative Activity Log [CAL]) and mood disorders (Beck Depression Inventory-II [BDI-II] and Hamilton Anxiety Scale [HAM-A]); they were completed within two weeks post-stroke and after three months follow-up. Statistical analysis included intent-to-treat analysis, considering all participants (dropouts as failures), and efficacy analysis, considering only end-of-treatment participants. RESULTS: Participants in the intervention group showed a significant better evolution in the main outcome measure of quality of life (SAQOL-39 p = .029), as well as for independence (mRSp = .004), perceptual-cognitive skills (MoCA p = .012)and symptoms of depression (BDI-II p = .011) compared to the control group. CONCLUSIONS: EOTIPS was effective in improving quality of life, as well as enhancing perceptual-cognitive skills, independence and reducing levels of depression for patients who suffered a stroke in a Spanish cohort and could be considered as an applicable non-pharmacologic therapeutic tool that can lead to patients' positive outcomes after stroke. This study was registered on ClinicalTrials.gov with the identifier NCT04835363.

Cell-specific gene networks and drivers in rheumatoid arthritis synovial tissues.

Rheumatoid arthritis (RA) is a common autoimmune and inflammatory disease characterized by inflammation and hyperplasia of the synovial tissues. RA pathogenesis involves multiple cell types, genes, transcription factors (TFs) and networks. Yet, little is known about the TFs, and key drivers and networks regulating cell function and disease at the synovial tissue level, which is the site of disease. In the present study, we used available RNA-seq databases generated from synovial tissues and developed a novel approach to elucidate cell type-specific regulatory networks on synovial tissue genes in RA. We leverage established computational methodologies to infer sample-specific gene regulatory networks and applied statistical methods to compare network properties across phenotypic groups (RA versus osteoarthritis). We developed computational approaches to rank TFs based on their contribution to the observed phenotypic differences between RA and controls across different cell types. We identified 18 (fibroblast-like synoviocyte), 16 (T cells), 19 (B cells) and 11 (monocyte) key regulators in RA synovial tissues. Interestingly, fibroblast-like synoviocyte (FLS) and B cells were driven by multiple independent co-regulatory TF clusters that included MITF, HLX, BACH1 (FLS) and KLF13, FOSB, FOSL1 (B cells). However, monocytes were collectively governed by a single cluster of TF drivers, responsible for the main phenotypic differences between RA and controls, which included RFX5, IRF9, CREB5. Among several cell subset and pathway changes, we also detected reduced presence of Natural killer T (NKT) cells and eosinophils in RA synovial tissues. Overall, our novel approach identified new and previously unsuspected Key driver genes (KDG), TF and networks and should help better understanding individual cell regulation and co-regulatory networks in RA pathogenesis, as well as potentially generate new targets for treatment.

Familial hemiplegic migraine.

Hemiplegic migraine consists of attacks of migraine with aura that includes reversible motor weakness. It is classified as familial or sporadic depending on the involvement or not of a first or second degree relative. The most described subtypes of familial hemiplegic migraine include FHM1, FHM2, and FHM3. These have been demonstrated to have a mutation in either CACNA1A, ATP1A2 or SCN1A, which encode different subunits of channels, involving P/Q-type calcium channel, Na/K pump and Na channel, respectively, located in neurons and glial cells. Mutations localized in different genes are defined as "other loci." Patients with a known mutation can have different genetic penetrance, and may present a more complex and disabling phenotype that develops earlier in life. The clinical manifestations can be similar in the three mutations, including neurologic comorbidities other than muscular weakness, such as episodes of loss of consciousness, epilepsy, gait or limb ataxia or movement disorders, among others. Treatment includes antiepileptics such as lamotrigine, valproate or topiramate, calcium blockers such as flunarizine or verapamil and acetazolamide.

MiRNA-449 family is epigenetically repressed and sensitizes to doxorubicin through ACSL4 downregulation in triple-negative breast cancer.

Despite progress in breast cancer treatment, a significant portion of patients still relapse because of drug resistance. The involvement of microRNAs in cancer progression and chemotherapy response is well established. Therefore, this study aimed to elucidate the dysregulation of the microRNA-449 family (specifically, microRNA-449a, microRNA-449b-5p, and microRNA-449c-5p) and its impact on resistance to doxorubicin, a commonly used chemotherapeutic drug for the treatment of triple-negative breast cancer. We found that the microRNA-449 family is downregulated in triple-negative breast cancer and demonstrated its potential as a diagnostic biomarker. Besides, our findings indicate that the downregulation of the microRNA-449 family is mediated by the microRNAs-449/SIRT1-HDAC1 negative feedback loop. Moreover, it was found that the microRNA-449 family dysregulates the fatty acid metabolism by targeting ACSL4, which is a potential prognostic biomarker that mediates doxorubicin response through regulation of the drug extrusion pump ABCG2. Altogether, our results suggest that the microRNA-449 family might be a potential therapeutic target for the treatment of triple-negative breast cancer since it is implicated in doxorubicin response through ACSL4/ABCG2 axis regulation. Ultimately, our results also highlight the value of microRNAs-449 and ACSL4 as diagnostic and prognostic biomarkers in triple-negative breast cancer. Proposed model of miRNAs-449 downregulation in TNBC and doxorubicin response. MiRNAs-449 are downregulated in TNBC through a negative feedback loop with SIRT1 and HDAC1. Moreover, ACSL4 increases ABCG2 expression, thus diminishing the intracellular doxorubicin concentration and promoting doxorubicin resistance. MiRNAs-449 overexpression downregulates the ACSL4/ABCG2 axis and sensitizes doxorubicin-resistant cells to doxorubicin. Created with BioRender. TNBC: triple-negative breast cancer; DOX: doxorubicin; SIRT1: Sirtuin 1; HDAC1: Histone deacetylase 1; ACSL4: Acyl-CoA Synthetase Long-Chain Family Member 4; ABCG2: ATP-binding cassette superfamily G member 2.

Identification of copy-number variants in patients with overgrowth disorders.

Overgrowth syndromes (OGS) comprise a heterogeneous group of disorders whose main characteristic is that the weight, height or the head circumference are above the 97th centile or 2-3 standard deviations above the mean for age, gender, and ethnic group. Several copy-number variants (CNVs) have been associated with the development of OGS, such as the 5q35 microdeletion or the duplication of the 15q26.1-qter, among many others. In this study, we have applied 850K SNP-arrays to 112 patients and relatives with OGS from the Spanish OverGrowth Registry Initiative. We have identified CNVs associated with the disorder in nine individuals (8%). Subsequently, whole genome sequencing (WGS) analysis was performed in these nine samples in order to better understand these genomic imbalances. All the CNVs were detected by both techniques, settling that WGS is a useful tool for CNV detection. We have found six patients with genomic abnormalities associated with previously well-established disorders and three patients with CNVs of unknown significance, which may be related to OGS, based on scientific literature. In this report, we describe these findings and comment on genes associated with OGS that are located within the CNV regions.

Nivolumab plus platinum-doublet chemotherapy in treatment-naive patients with advanced grade 3 Neuroendocrine Neoplasms of gastroenteropancreatic or unknown origin: The multicenter phase 2 NICE-NEC trial (GETNE-T1913).

The prognosis of patients with advanced high-grade (G3) digestive neuroendocrine neoplasms (NENs) is rather poor. The addition of immune checkpoint inhibition to platinum-based chemotherapy may improve survival. NICE-NEC (NCT03980925) is a single-arm, phase II trial that recruited chemotherapy-naive, unresectable advanced or metastatic G3 NENs of gastroenteropancreatic (GEP) or unknown origin. Patients received nivolumab 360 mg intravenously (iv) on day 1, carboplatin AUC 5 iv on day 1, and etoposide 100 mg/m2/d iv on days 1-3, every 3 weeks for up to six cycles, followed by nivolumab 480 mg every 4 weeks for up to 24 months, disease progression, death or unacceptable toxicity. The primary endpoint was the 12-month overall survival (OS) rate (H0 50%, H1 72%, ß 80%, α 5%). Secondary endpoints were objective response rate (ORR), duration of response (DoR), progression-free survival (PFS), and safety. From 2019 to 2021, 37 patients were enrolled. The most common primary sites were the pancreas (37.8%), stomach (16.2%) and colon (10.8%). Twenty-five patients (67.6%) were poorly differentiated carcinomas (NECs) and/or had a Ki67 index >55%. The ORR was 56.8%. Median PFS was 5.7 months (95%CI: 5.1-9) and median OS 13.9 months (95%CI: 8.3-Not reached), with a 12-month OS rate of 54.1% (95%CI: 40.2-72.8) that did not meet the primary endpoint. However, 37.6% of patients were long-term survivors (>2 years). The safety profile was consistent with previous reports. There was one treatment-related death. Nivolumab plus platinum-based chemotherapy was associated with prolonged survival in over one-third of chemonaïve patients with G3 GEP-NENs, with a manageable safety profile.

Pharmacophore Identification and Structure-Activity Relationship Analysis of a Series of Substituted Azaindoles as Inhibitors of Trypanosoma brucei.

Human African trypanosomiasis is among the World Health Organization's designated neglected tropical diseases. Repurposing strategies are often employed in academic drug discovery programs due to financial limitations, and in this instance, we used human kinase inhibitor chemotypes to identify substituted 4-aminoazaindoles, exemplified by 1. Structure-activity and structure-property relationship analysis, informed by cheminformatics, identified 4s as a potent inhibitor of Trypanosoma brucei growth. While 4s appeared to be fast acting and cidal in the in vitro assays, it failed to cure a murine model of infection. Preliminary efforts to identify the potential mechanism of action of the series pointed to arginine kinase, though, as we demonstrate, this does not appear to be the sole target of our compounds. This comprehensive approach to drug discovery, encompassing cheminformatics, structure-potency and structure-property analysis, and pharmacophore identification, highlights our multipronged efforts to identify novel lead compounds for this deadly disease.

Cancer stage and consideration of cannabis use among adult cancer survivors in Southern California.

BACKGROUND: The benefits of cannabis in symptom management among cancer survivors are widely acknowledged; however, patterns of cannabis use by cancer stage at diagnosis are unknown. METHODS: Here, we examined the association between cancer stage at diagnosis and consideration of cannabis use since diagnosis. We analyzed cross-sectional survey data from 954 cancer survivors, weighted to be representative of a National Cancer Institute-Designated Comprehensive Cancer Center's patient population. We used survey-weighted multivariable logistic regression to examine the association between cancer stage at diagnosis (advanced [III/IV] versus non-advanced [I/II]) and consideration of cannabis use (yes versus no) since diagnosis. RESULTS: Sixty percent of the population was diagnosed with non-advanced stages of cancer, and 42% had considered using cannabis since diagnosis. The odds of consideration of cannabis use were 63% higher (odds ratio = 1.63, 95% confidence interval = 1.06 to 2.49) among cancer survivors diagnosed at stages III/IV than among those diagnosed at stages I/II. CONCLUSION: Cancer stage may be a predictor of consideration of cannabis use after diagnosis.

Chemical and Protein Characterization of Two Varieties of Chickpea (Cicer Arietinum): Costa 2004 and El Patrón.

The objective of this study was to evaluate the chemical composition of two chickpea varieties, 'Costa 2004' and 'El Patrón', and to characterize their proteins to determine their technological potential for the food industry. For this purpose, chickpea samples of both varieties from the 2019 harvest region of Guanajuato, Mexico, were obtained and chemically characterized to determine the protein fractions using electrophoretic and amino acid profiling. The chickpea variety 'Costa 2004' contained 3% less protein and 7% less dietary fiber content than the variety 'El Patrón'; whereas, the carbohydrate content of 'Costa 2004' was 4% greater. Additionally, the chickpeas demonstrated an antioxidant capacity ranging from 319 to 387 µMET/g and total phenol levels exceeding 500 mg/g. Among the protein fractions, globulins represented the highest proportion in both varieties of chickpea, at approximately 8.73 g/100 g ('Costa 2004') and 10.42 g/100 g ('El Patrón'), followed by albumin, at approximately 1.24 g/100 g and 1.47 g/100 g, respectively. The chickpea proteins ranged in molecular weight between 100 and 25 kDa, with particularly strong signals in the albumin and globulin bands. Regarding the amino acid profile, histidine was predominant in both varieties. In conclusion, both varieties of chickpea have high nutritional value and broad potential for technological use in the food industry.

Causal attributions of impulsive and compulsive behaviors.

Introduction: Aggression, and therefore gender-based violence, can be an impulsive or compulsive behavior, depending on the consumption of alcohol and/or drugs. In Europe, the prevalence of gender-based violence is 16 to 23%. This prevalence shows that there is a need to make further progress in the treatment of aggression against women. Qualitative techniques allow us to understand perceptions and attributions holistically by analyzing what people who commit the crime say, why they say it and how they say it. Aim: To explore the experience of physical and verbal aggression by a partner, dependent on the presence or absence of alcohol and drug use, in the prison population. Method: A mixed methodology was used (combining qualitative and quantitative techniques). The sample was made up of 140 men divided into two focus groups [with alcohol and/or drug consumption (SAD) and without alcohol and/or drug consumption (NSAD)] who completed the Demographic, Criminal and Behavioral Interview in Penitentiary Institutions; the Gender Violence Questionnaire (both developed for this study) and the MultiCAGE CAD-4 Questionnaire. Qualitative data were analyzed using thematic analysis and quantitative data were obtained using contingency tables. Results: It was found that the SAD group attributed the crime committed to alcohol and/or drug consumption, while the NSAD group attributed it to jealousy and to their partner. The SAD group revealed that the consequence of the physical aggressions was to get what they were looking for from their partner and the consequences of the verbal aggressions was regret, unlike the NSAD group that did not get anything from the aggressions. The SAD group recognized that to avoid future aggressions they would have to avoid alcohol and/or drug use, while the NSAD group mentioned that they would have to avoid contact with their partner. Discussion: The need to include perceptions and attributions as well as the use of alcohol and/or drugs is emphasized when assessing individuals who commit the crime of gender-based violence.

Outcomes of an extracorporeal cardiopulmonary resuscitation (ECPR) program for in- and out-of-hospital cardiac arrest in a tertiary hospital in Spain.

OBJECTIVE: To analyze if the implementation of a multidisciplinary extracorporeal cardiopulmonary resuscitation (ECPR) program in a tertiary hospital in Spain is feasible and could yield survival outcomes similar to international published experiences. DESIGN: Retrospective observational cohort study. SETTING: One tertiary referral university hospital in Spain. PATIENTS: All adult patients receiving ECPR between January 2019 and April 2023. INTERVENTIONS: Prospective collection of variables and follow-up for up to 180 days. MAIN VARIABLES OF INTEREST: To assess outcomes, survival with good neurological outcome defined as a Cerebral Performance Categories scale 1-2 at 180 days was used. Secondary variables were collected including demographics and comorbidities, cardiac arrest and cannulation characteristics, ROSC, ECMO-related complications, survival to ECMO decannulation, survival at Intensive Care Unit (ICU) discharge, survival at 180 days, neurological outcome, cause of death and eligibility for organ donation. RESULTS: Fifty-four patients received ECPR, 29 for OHCA and 25 for IHCA. Initial shockable rhythm was identified in 27 (50%) patients. The most common cause for cardiac arrest was acute coronary syndrome [29 (53.7%)] followed by pulmonary embolism [7 (13%)] and accidental hypothermia [5 (9.3%)]. Sixteen (29.6%) patients were alive at 180 days, 15 with good neurological outcome. Ten deceased patients (30.3%) became organ donors after neuroprognostication. CONCLUSIONS: The implementation of a multidisciplinary ECPR program in an experienced Extracorporeal Membrane Oxygenation center in Spain is feasible and can lead to good survival outcomes and valid organ donors.

Comorbidities and use of health services in people with diabetes mellitus according to risk levels by adjusted morbidity groups.

BACKGROUND: People with diabetes mellitus frequently have other comorbidities and involve greater use of primary and hospital care services. The aim of this study was to describe the comorbidities and use of primary and hospital care services of people with diabetes according to their risk level by adjusted morbidity groups (AMG) and to analyse the factors associated with the utilisation of these services. METHODS: Cross-sectional study. People with diabetes were identified within the population of patients with chronic conditions of an urban health care centre by the AMG stratification tool integrated into the primary health care electronic clinical record of the Community of Madrid. Sociodemographic, functional, clinical characteristics and annual health care services utilisation variables were collected. Univariate, bivariate and Poisson regression analyses were performed. RESULTS: A total of 1,063 people with diabetes were identified, representing 10.8% of patients with chronic conditions within the health centre. A total of 51.4% were female, the mean age was 70 years, 94.4% had multimorbidity. According to their risk level, 17.8% were high-risk, 40.6% were medium-risk and 41.6% were low-risk. The most prevalent comorbidities were hypertension (70%), dyslipidaemia (67%) and obesity (32.4%). Almost 50% were polymedicated. Regarding health services utilisation, 94% were users of primary care, and 59.3% were users of hospital care. Among the main factors associated with the utilisation of both primary and hospital care services were AMG risk level and complexity index. In primary care, utilisation was also associated with the need for primary caregivers, palliative care and comorbidities such as chronic heart failure and polymedication, while in hospital care, utilisation was also associated with comorbidities such as cancer, chronic obstructive pulmonary disease or depression. CONCLUSIONS: People with diabetes were older, with important needs for care, many associated comorbidities and polypharmacy that increased in parallel with the patient's risk level and complexity. The utilisation of primary and hospital care services was very high, being more frequent in primary care. Health services utilization were principally associated with functional factors related to the need of care and with clinical factors such as AMG medium and high-risk level, more complexity index, some serious comorbidities and polymedication.

Significant tricuspid regurgitation is associated with adverse outcomes in patients with transthyretin amyloid cardiomyopathy.

Objectives: Patients diagnosed with transthyretin amyloid cardiomyopathy (ATTR-CM) often experience poor outcomes due to the development of heart failure (HF). Tricuspid regurgitation (TR) has been found to be correlated with adverse outcomes in patients with HF. This study aims to assess whether the presence of significant TR is associated to adverse cardiac outcomes in patients diagnosed with ATTR-CM. Materials and methods: Retrospective study of ATTR-CM patients enrolled in the Institutional Registry of Amyloidosis (NCT01347047). Patients were categorized based on the presence of significant TR (moderate or severe according to current guidelines criteria) or absence of significant TR. All patients were followed up for 2 years to assess the incidence of the composite outcome of death or HF hospitalization. Results: A total of 93 ATTR-CM patients were included. The mean age at diagnosis was 82.5 [IQR 75 - 86] years, 86% were male, and the mean left ventricular ejection fraction was 52% [IQR 43 - 60]. Among them, 32.3% (n = 30) patients had significant TR. Patients with significant TR had higher NTpro-BNP values (5308 vs 2454, pg/mL, p = 0.004), and a lower left ventricular ejection fraction (44 vs. 56%, p = 0.0002) compared to patients without significant TR. The incidence of the primary outcome was higher in patients with significant TR (77% vs. 30%, p<0.001). In a multivariate Cox regression analysis, only NTpro-BNP, as a numerical variable (HR 1.00, 95% CI 1.00005-1.0002, p = 0.001), and significant TR (HR 2.23, 95% CI 1.12-4.42, p=0.021) were independently associated with the composite outcome of death or HF hospitalization. Conclusions: In patients diagnosed with ATTR-CM, the presence of significant TR was associated with worse outcomes.

Objetivos: Los pacientes con diagnóstico de miocardiopatía amiloidótica por transtiretina (ATTR) suelen presentar mal pronóstico, principalmente por el desarrollo de insuficiencia cardiaca (IC). Se ha descrito que la insuficiencia tricúspidea (IT) está relacionada con peor pronóstico en pacientes con IC. Este estudio tiene como objetivo evaluar el impacto pronóstico de la IT significativa en pacientes con diagnóstico de amiloidosis ATTR. Materiales y métodos: Estudio de cohorte retrospectiva. Se incluyeron pacientes con diagnóstico de amiloidosis ATTR pertenecientes al registro institucional de amiloidosis de nuestra institución (NCT01347047). Los pacientes fueron divididos según la presencia o no de IT significativa (moderada o severa, de acuerdo a las guías de práctica clínica actuales). Se realizó un seguimiento con censura a los 2 años para evaluar la incidencia del punto final primario combinado de muerte u hospitalizaciones por IC. Resultados: Se incluyeron 93 pacientes con diagnóstico de amiloidosis ATTR. La mediana de edad fue de 82,5 años [RIC 75-85], 86% fueron hombres. La mediana de fracción de eyección ventricular izquierda fue de 52% [RIC 43-60]. El 32,3% (n=30) de pacientes presentaron IT significativa al momento del diagnóstico de la amiloidosis ATTR. Aquellos con IT significativa tuvieron valores superiore de NT-proBNP (5308 vs. 2454, pg/mL, p=0.004) y menor mediana de fracción de eyección ventricular izquierda (44% vs. 56%, p=0,0002) comparado con los pacientes sin IT significativa. En el seguimiento a 2 años, la incidencia del punto final primario combinado fue mayor en pacientes con IT significativa (77% vs. 30%, p<0,001). En un modelo de regresión de Cox multivariada, solo el NT-proBNP (HR 1,00, 95% CI 1,00005-1,0002, p=0,001) y la IT significativa (HR 2.23, 95% CI 1.12-4.42, p=0.021) estuvieron asociadas de forma independiente con la ocurrencia del punto final primario combinado. Conclusiones: En pacientes con diagnóstico de miocardiopatía amiloidótica por ATTR, la presencia de IT significativa se asoció a peor pronóstico en el seguimiento.

Psychological distress, health-promoting lifestyle and sociodemographic factors in Honduran university students: a structural equation model.

This study sought to analyze an explanatory model on the relationship among sociodemographic factors, health-promoting lifestyle behaviors and psychological distress (depression, anxiety and stress) in college students. This is an observational, analytical and cross-sectional study conducted on a national sample of 4203 students who entered a macro university in Honduras in 2021, 2022 and 2023. We used a sociodemographic survey, the Health-Promoting Lifestyle Profile (HPLP-II) and the Depression, Anxiety and Stress Scales (DASS-21). Univariate analysis and a multivariate structural equation model were conducted. The average HPLP-II score was 117.45 (±â€…23.41), and the average DASS-21 score was 20.06 (±â€…14.16). The multivariate model showed a good data fit (comparative fit index = 0.951; Tucker-Lewis index = 0.957; root mean square error of approximation = 0.067 [90% CI = 0.067-0.068]). Results indicate that being a woman (ß = 0.11; p < 0.001) and being enrolled in biological and health sciences (ß = 0.09; p < 0.001) significantly predict HPLP-II scores. Furthermore, being a woman (ß = 0.17; p < 0.001), age (ß = 0.10; p < 0.001) and having pre-existing medical conditions (ß = 0.16; p < 0.001) significantly explain part of the variance of DASS-21. A significant reverse relationship between health-promoting behavior and psychological distress was shown (r = -0.36; p < 0.001). This study identifies protective and risky sociodemographic factors linked to health-promoting lifestyle behaviors and psychological distress. Our findings have implications for developing comprehensive intervention policies and strategies to promote health in higher education settings.