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1.
Chemistry ; 30(14): e202303939, 2024 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-38116945

RESUMEN

Performing transition metal-catalyzed reactions in cells and living systems has equipped scientists with a toolbox to study biological processes and release drugs on demand. Thus far, an impressive scope of reactions has been performed in these settings, but many are yet to be introduced. Nitrene transfer presents a rather unexplored new-to-nature reaction. The reaction products are frequently encountered motifs in pharmaceuticals, presenting opportunities for the controlled, intracellular synthesis of drugs. Hence, we explored the transition metal-catalyzed sulfimidation reaction in water for future in vivo application. Two Cu(I) complexes containing trispyrazolylborate ligands (Tpx ) were selected, and the catalytic system was evaluated with the aid of three fitness factors. The excellent nitrene transfer reactivity and high chemoselectivity of the catalysts, coupled with good biomolecule compatibility, successfully enabled the sulfimidation of thioethers in aqueous media. We envision that this copper-catalyzed sulfimidation reaction could be an interesting starting point to unlock the potential of nitrene transfer catalysis in vivo.

2.
Transpl Infect Dis ; 26(2): e14250, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38375958

RESUMEN

BACKGROUND AND METHODS: Heart transplant recipients (HTr) have a higher probability of suffer from severe coronavirus disease-2019 (COVID-19) in comparison to general population, but their risk has changed over the course of the pandemic in relation to various factors. We conducted a prospective study including all HTr at risk of COVID-19 in a tertiary center between February 2020 and October 2022. The aim was to analyze how the prognosis (incidence of pneumonia and mortality) of COVID-19 in HTr has evolved over time, contextualizing variants, vaccination, and other treatments. RESULTS: Of 308 HTr included, 124 got the infection (39.2%). COVID and non-COVID HTr had similar baseline characteristics. COVID-19 patients with pneumonia had a poorer prognosis than those with less severe presentations, with a higher rate of hospitalization (93.3 vs. 14.1%, p < .001) and death (41.0 vs. 1.2%, p < .001). Multivariate analysis identified age ≥60 years (odds ratio [OR] 3.65, 95% confidence interval [CI] 1.16-11.49, p = .027), and chronic kidney disease ≥3a (OR 4.95, 95% CI 1.39-17.54, p = .014) as predictors of pneumonia. Two-dose vaccination (OR 0.20, CI 95% 0.05-0.72, p = .02) and early remdesivir administration (OR 0.17, CI 0.03-0.90, p = .037) were protective factors. Over the course of the pandemic considering three periods in the follow-up (prevaccination February-December 2020, postvaccination January-December 2021, and post early remdesivir indication January-October 2022), we observed a reduction in pneumonia incidence from 62% to 19% (p < .001); and mortality (from 23% to 4%, p < .001). CONCLUSIONS: The prognosis of COVID-19 in HTr has improved over time, likely due to vaccination and early administration of remdesivir.


Asunto(s)
COVID-19 , Trasplante de Corazón , Humanos , Persona de Mediana Edad , COVID-19/epidemiología , COVID-19/prevención & control , Pandemias , SARS-CoV-2 , Estudios Prospectivos , Trasplante de Corazón/efectos adversos , Receptores de Trasplantes
3.
Actas Esp Psiquiatr ; 52(3): 192-203, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38863054

RESUMEN

BACKGROUND: Treatment of Substance Use Disorder (SUD) is complex and therefore including patients in the therapeutic process is needed. Patient-Centered Care (PCC) and Shared Decision-Making (SDM) have been associated with greater satisfaction, self-control, and less substance use. However, correlates of SDM have not been investigated in this population. METHOD: A cross-sectional analysis was carried out in 214 SUD patients to identify sociodemographic, clinical and psychological correlates of preferences and perceptions about participation in SDM and degree of activation. The Control Preference Scale (CPS), the Shared Decision-Making Questionnaire (SDM-9-Q) and the Patient Activation Measure (PAM) were used to assess the PCC elements. Multinomial logistic regression was used to analyze the correlates of the CPS variables (preferred role, perceived role, and role matching). For SDM-9-Q and PAM, multilevel linear regression was used. RESULTS: Preferring an active role, compared to a shared one, was significantly associated with higher educational level, lower neuroticism, absence of affective and alcohol use disorders, and higher quality of life. Perceiving greater participation was significantly associated with not being a new patient, having fewer legal problems, higher severity of alcohol consumption, not presenting polydrug use and main substance use different than opioids or sedatives. Activation was associated with higher scores in the personality trait activity, a preference for an active role and greater perception of being involved in the decision process. CONCLUSIONS: Patients with milder clinical profiles prefer an active role compared to a shared one. Patients who prefer or perceive a shared or passive role did not show relevant differences. Greater activation was related to preference for an active role and the perception of having been involved in decisions.


Asunto(s)
Participación del Paciente , Trastornos Relacionados con Sustancias , Humanos , Estudios Transversales , Masculino , Trastornos Relacionados con Sustancias/psicología , Femenino , Participación del Paciente/psicología , Adulto , Persona de Mediana Edad , Prioridad del Paciente/psicología , Toma de Decisiones Conjunta , Atención Dirigida al Paciente , Toma de Decisiones , Encuestas y Cuestionarios
4.
Angew Chem Int Ed Engl ; 63(8): e202314773, 2024 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-38055325

RESUMEN

Molecular Dynamics (MD) simulations constitute a powerful tool that provides a 3D perspective of the dynamical behavior of chemical systems. Herein the first MD study of the dynamics of a catalytic organometallic system, in micellar media, is presented. The challenging methane catalytic functionalization into ethyl propionate through a silver-catalyzed process has been targeted as the case study. The intimate nature of the micelles formed with the surfactants sodium dodecylsulfate (SDS) and potassium perfluorooctane sulfonate (PFOS) has been ascertained, as well as the relative distribution of the main actors in this transformation, namely methane, the diazo reagent and the silver catalyst, the latter in two different forms: the initial compound and a silver-carbene intermediate. Catalyst deactivation occurs with halide containing surfactants dodecyltrimethylammonium chloride (DTAC) and Triton X-100. Computed simulations allow explaining the experimental results, indicating that micelles behave differently regarding the degree of accumulation and the local distribution of the reactants and their effect in the molecular collisions leading to net reaction.

5.
Curr Heart Fail Rep ; 20(3): 157-167, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37222949

RESUMEN

PURPOSE OF THE WORK: Although sex-specific differences in heart failure (HF) or kidney disease (KD) have been analyzed separately, the predominant cardiorenal phenotype by sex has not been described. This study aims to explore the sex-related differences in cardiorenal syndrome (CRS) in a contemporary cohort of outpatients with HF. FINDINGS: An analysis of the Cardiorenal Spanish registry (CARDIOREN) was performed. CARDIOREN Registry is a prospective multicenter observational registry including 1107 chronic ambulatory HF patients (37% females) from 13 Spanish HF clinics. Estimated Glomerular Filtration Rate (eGFR) < 60 ml/min/1.73 m2 was present in 59.1% of the overall HF population, being this prevalence higher in the female population (63.2% vs. 56.6%, p = 0.032, median age: 81 years old, IQR:74-86). Among those with kidney dysfunction, women displayed higher odds of showing HF with preserved ejection fraction (HFpEF) (odds ratio [OR] = 4.07; confidence interval [CI] 95%: 2.65-6.25, p < 0.001), prior valvular heart disease (OR = 1.76; CI 95%:1.13-2.75, p = 0.014), anemia (OR: 2.02; CI 95%:1.30-3.14, p = 0.002), more advanced kidney disease (OR for CKD stage 3: 1.81; CI 95%:1.04-3.13, p = 0.034; OR for CKD stage 4: 2.49, CI 95%:1.31-4.70, p = 0.004) and clinical features of congestion (OR:1.51; CI 95%: 1.02-2.25, p = 0.039). On the contrary, males with cardiorenal disease showed higher odds of presenting HF with reduced ejection fraction (HFrEF) (OR:3.13; CI 95%: 1.90-5.16, p < 0.005), ischemic cardiomyopathy (OR:2.17; CI 95%: 1.31-3.61, p = 0.003), hypertension (OR = 2.11; CI 95%:1.18-3.78, p = 0.009), atrial fibrillation (OR:1.71; CI 95%: 1.06-2.75, p = 0.025), and hyperkalemia (OR:2.43, CI 95%: 1.31-4.50, p = 0.005). In this contemporary registry of chronic ambulatory HF patients, we observed sex-related differences in patients with combined heart and kidney disease. The emerging cardiorenal phenotype characterized by advanced CKD, congestion, and HFpEF was predominantly observed in women, whereas HFrEF, ischemic etiology, hypertension, hyperkalemia, and atrial fibrillation were more frequently observed in men.


Asunto(s)
Fibrilación Atrial , Síndrome Cardiorrenal , Insuficiencia Cardíaca , Hiperpotasemia , Hipertensión , Insuficiencia Renal Crónica , Humanos , Masculino , Femenino , Síndrome Cardiorrenal/epidemiología , Insuficiencia Cardíaca/complicaciones , Insuficiencia Cardíaca/epidemiología , Volumen Sistólico , Pronóstico , Fibrilación Atrial/complicaciones , Estudios Prospectivos , Caracteres Sexuales , Hipertensión/complicaciones , Insuficiencia Renal Crónica/epidemiología , Sistema de Registros , Estudios Multicéntricos como Asunto
6.
Arch Gynecol Obstet ; 307(5): 1641-1642, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-35488896

RESUMEN

Malignant mesenchymal tumors of the female genital tract are uncommon gynecological cancers, particularly in the vagina. They are typically aggressive and often relapse, both locally and at distant sites. The treatment of choice for primary tumors is surgical excision as they are generally refractory to chemotherapy and radiotherapy. We describe the case of a vaginal leiomyosarcoma in a 43-year-old woman who presented with abnormal genital bleeding and discharge. The tumor was excised but recurred locally after just 11 months. It was removed by hysterectomy with double adnexectomy and partial vaginal excision.


Asunto(s)
Leiomiosarcoma , Neoplasias Vaginales , Femenino , Humanos , Adulto , Leiomiosarcoma/cirugía , Leiomiosarcoma/patología , Vagina/patología , Neoplasias Vaginales/cirugía , Neoplasias Vaginales/patología , Histerectomía
7.
Angew Chem Int Ed Engl ; 62(5): e202215163, 2023 Jan 26.
Artículo en Inglés | MEDLINE | ID: mdl-36345831

RESUMEN

The trapping of the elusive vinylogous position of a vinyl carbene with an aliphatic C(sp3 )-H bond has been achieved for the first time during a silver-catalyzed carbene/alkyne metathesis (CAM) process. A Tpx -containing silver complex first promotes the generation of a donor-acceptor silver carbene which triggers CAM, generating a subsequent donor-donor vinyl silver carbene species, which then undergoes a selective vinylogous C(sp3 )-H bond insertion, leading to the synthesis of a new family of benzoazepines. Density functional theory (DFT) calculations unveil the reaction mechanism, which allows proposing that the C-H bond insertion reaction takes place in a stepwise manner, with the hydrogen shift being the rate determining step.

8.
J Am Chem Soc ; 144(51): 23275-23279, 2022 Dec 28.
Artículo en Inglés | MEDLINE | ID: mdl-36512728

RESUMEN

Control of the regioselectivity in the functionalization of C-H bonds of linear alkanes C2H2n+2 via carbene transfer from diazo compounds is restricted to the use of rhodium-based catalysts, which govern the reaction outcome employing donor-acceptor diazo reagents. At variance with that catalyst-controlled strategy, we present an alternative approach in which employing the appropriate silver complexes containing trispyrazolylborate ligands as catalysts with large differences in their steric and electronic properties, the regioselection is mainly governed by the diazo reagent, which leads to the functionalization of primary or secondary sites of linear alkanes (lacking any activating or directing groups). Donor-acceptor aryl diazoacetates exclusively provide the functionalization of the secondary sites of hexane or pentane, whereas acceptor ethyl diazoacetate leads to an unprecedented level of primary functionalization.

9.
J Am Chem Soc ; 144(23): 10608-10614, 2022 06 15.
Artículo en Inglés | MEDLINE | ID: mdl-35648453

RESUMEN

The direct functionalization of Si-H bonds by the nitrene insertion methodology is described. A copper(I) complex bearing a trispyrazolylborate ligand catalyzes the transfer of a nitrene group from PhI═NTs to the Si-H bond of silanes, disilanes, and siloxanes, leading to the exclusive formation of Si-NH moieties in the first example of this transformation. The process tolerates other functionalities in the substrate such as several C-H bonds and alkyne and alkene moieties directly bonded to the silicon center. Density functional theory (DFT) calculations provide a mechanistic interpretation consisting of a Si-H homolytic cleavage and subsequent rebound to the Si-centered radical.


Asunto(s)
Iminas , Silanos , Aminación , Catálisis , Iminas/química , Silanos/química
10.
BMC Psychiatry ; 22(1): 487, 2022 07 20.
Artículo en Inglés | MEDLINE | ID: mdl-35858887

RESUMEN

BACKGROUND: Non-adherence to medication is a major obstacle in the treatment of depressive disorders. We systematically reviewed the literature to evaluate the effectiveness of interventions aimed at improving adherence to medication among adults with depressive disorders with emphasis on initiation and implementation phase. METHODS: We searched Medline, EMBASE, The Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, Social Science Citation Index and Science Citation Index for randomized or non-randomized controlled trials up to January 2022. Risk of bias was assessed using the criteria of the Cochrane Collaboration. Meta-analyses, cumulative and meta-regression analyses for adherence were conducted. RESULTS: Forty-six trials (n = 24,324) were included. Pooled estimate indicates an increase in the probability of adherence to antidepressants at 6 months with the different types of interventions (OR 1.33; 95% CI: 1.09 to 1.62). The improvement in adherence is obtained from 3 months (OR 1.62, 95% CI: 1.25 to 2.10) but it is attenuated at 12 months (OR 1.25, 95% CI: 1.02 to 1.53). Selected articles show methodological differences, mainly the diversity of both the severity of the depressive disorder and intervention procedures. In the samples of these studies, patients with depression and anxiety seem to benefit most from intervention (OR 2.77, 95% CI: 1.74 to 4.42) and collaborative care is the most effective intervention to improve adherence (OR 1.88, 95% CI: 1.40 to 2.54). CONCLUSIONS: Our findings indicate that interventions aimed at improving adherence to medication among adults with depressive disorders are effective up to six months. However, the evidence on the effectiveness of long-term adherence is insufficient and supports the need for further research efforts. TRIAL REGISTRATION: International Prospective Register for Systematic Reviews (PROSPERO) number: CRD42017065723 .


Asunto(s)
Trastorno Depresivo , Cumplimiento de la Medicación , Adulto , Antidepresivos/uso terapéutico , Ansiedad , Trastorno Depresivo/tratamiento farmacológico , Humanos , Revisiones Sistemáticas como Asunto
11.
Eur Addict Res ; 28(4): 243-254, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35038702

RESUMEN

INTRODUCTION: COVID-19 has had a great impact on mental health in the general population. However, few studies have focused on patients with substance use disorders (SUDs). This research aimed to compare the clinical status and substance use patterns of SUD outpatients, before and during confinement due to the COVID-19 pandemic. METHODS: This multicentre study recruited 588 patients (29.2% women; M age = 47.4 ± 11.7 years) in thirteen centres for addiction treatment in Catalonia, Spain. All subjects were evaluated with validated instruments and ad hoc questionnaires. The sample was divided into 3 groups according to how the substance consumption pattern changed during lockdown (maintained pattern, worsened pattern, and improved pattern). RESULTS: More than 62% of the patients maintained or worsened their consumption pattern during confinement, and about 38% improved throughout this time. Diverse factors were associated with the changes in pattern like age, addiction severity, psychological distress during lockdown, social and familial issues, and therapeutic variables. CONCLUSION: The home lockdown during the COVID-19 pandemic was associated with major implications for substance consumption and psychiatric distress among SUD outpatients. Considering this, the need to plan appropriate interventions in cases of similar health crises is highlighted.


Asunto(s)
COVID-19 , Trastornos Relacionados con Sustancias , Adulto , Control de Enfermedades Transmisibles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pacientes Ambulatorios , Pandemias , SARS-CoV-2 , Trastornos Relacionados con Sustancias/epidemiología
12.
J Dual Diagn ; 18(2): 71-80, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35324373

RESUMEN

Objective COVID-19 and lockdown measures impacted mental health globally and had a particular impact on patients with substance use disorders (SUD). However, the impact of gender, age, and dual diagnosis on consumption patterns and mental health during COVID-19 lockdown among patients with SUD has not been analyzed in depth. Therefore, this study aimed to examine substance use and mental health status during COVID-19 lockdown considering gender, age, and previous dual diagnosis in patients with SUD treated in different outpatient addiction clinics in Catalonia. Methods: Thirteen clinics participated and 588 patients were enrolled in the study, of whom 70.7% were men and 29.3% were women. The mean age was 48 ± 11.3 years, and 63.2% had dual diagnoses. Results: Men reported significantly more frequent alcohol and cocaine consumption during lockdown, while women experienced more anxiety and depressive symptoms. Younger patients more frequently reported consuming cocaine and cannabis, breaking the lockdown rule, worsened family relationships, and reduced incomes. Older patients more frequently reported maintaining abstinence. Previous dual diagnosis was more often associated with benzodiazepine use disorder, less active working during lockdown, and more anxiety and depressive symptoms than not having previous dual diagnosis. Conclusions: Both new psychiatric symptoms and general worsening of existing symptoms were frequent during the lockdown. Differences based on the gender, age, and dual diagnosis of outpatients treated for substance use disorders should be considered in the planning of protection measures such as home confinement.


Asunto(s)
COVID-19 , Cocaína , Trastornos Relacionados con Sustancias , Adulto , Control de Enfermedades Transmisibles , Diagnóstico Dual (Psiquiatría) , Femenino , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Pacientes Ambulatorios , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/terapia
13.
Int J Mol Sci ; 24(1)2022 Dec 28.
Artículo en Inglés | MEDLINE | ID: mdl-36613959

RESUMEN

Nanoparticles have proven to be biocompatible and suitable for many biomedical applications. Currently, hyperthermia cancer treatments based on Fe nanoparticle infusion excited by alternating magnetic fields are commonly used. In addition to this, MRI-based image-guided radiotherapy represents, nowadays, one of the most promising accurate radiotherapy modalities. Hence, assessing the feasibility of combining both techniques requires preliminary characterization of the corresponding dosimetry effects. The present work reports on a theoretical and numerical simulation feasibility study aimed at pointing out preliminary dosimetry issues. Spatial dose distributions incorporating magnetic nanoparticles in MRI-based image-guided radiotherapy have been obtained by Monte Carlo simulation approaches accounting for all relevant radiation interaction properties as well as charged particles coupling with strong external magnetic fields, which are representative of typical MRI-LINAC devices. Two main effects have been evidenced: local dose enhancement (up to 60% at local level) within the infused volume, and non-negligible changes in the dose distribution at the interfaces between different tissues, developing to over 70% for low-density anatomical cavities. Moreover, cellular uptakes up to 10% have been modeled by means of considering different Fe nanoparticle concentrations. A theoretical temperature-dependent model for the thermal enhancement ratio (TER) has been used to account for radiosensitization due to hyperthermia. The outcomes demonstrated the reliability of the Monte Carlo approach in accounting for strong magnetic fields and mass distributions from patient-specific anatomy CT scans to assess dose distributions in MRI-based image-guided radiotherapy combined with magnetic nanoparticles, while the hyperthermic radiosensitization provides further and synergic contributions.


Asunto(s)
Hipertermia Inducida , Nanopartículas , Neoplasias , Radioterapia Guiada por Imagen , Humanos , Reproducibilidad de los Resultados , Radiometría/métodos , Imagen por Resonancia Magnética , Método de Montecarlo , Dosificación Radioterapéutica , Neoplasias/diagnóstico por imagen , Neoplasias/radioterapia
14.
J Stroke Cerebrovasc Dis ; 31(4): 106200, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34865967

RESUMEN

BACKGROUND: Various anthropometric measurements have been inversely associated with atherosclerosis, giving rise to the concept of an "obesity paradox" However, inconsistent study results make it difficult to determine the best anthropometric measurement with which to assess such inverse relationship. Height has been inversely associated with atherosclerosis and it is unlikely to be associated with unexpected biases. In this study, we aimed to assess the association between height and other anthropometric measurements and intracranial atherosclerotic disease (ICAD). METHODS: Community-dwelling older adults enrolled in the Three Villages Study received anthropometric measurements, high-resolution head CT (to evaluate calcium content in carotid siphons) and time-of-flight MRA (to assess stenosis of large intracranial arteries). Logistic regression models were fitted to assess the independent association between each anthropometric measurements and the presence of ICAD, after adjusting for relevant confounders. Estimated adjusted proportions were used to show how increases of different anthropometric measurements impacted ICAD log odds and corresponding odds ratios. RESULTS: A total of 581 individuals were enrolled. Height was the single variable inversely associated with ICAD at the mean of other anthropometric measurements (OR: 0.954; 95% C.I.: 0.918 - 0.991; p=0.016). Every additional cm of height reduced by 4.6% the probability of having ICAD. The significance of other anthropometric measurements vanished in multivariate models with height as an independent variable. CONCLUSIONS: This study demonstrates a robust inverse association between height and ICAD in Amerindians and opens new avenues of research for a better understanding of the obesity paradox in diverse ethnic groups.


Asunto(s)
Aterosclerosis , Arteriosclerosis Intracraneal , Anciano , Aterosclerosis/complicaciones , Biomarcadores , Humanos , Vida Independiente , Arteriosclerosis Intracraneal/complicaciones , Obesidad/complicaciones , Obesidad/diagnóstico
15.
Int J Mol Sci ; 24(1)2022 Dec 22.
Artículo en Inglés | MEDLINE | ID: mdl-36613650

RESUMEN

Posterior polymorphous corneal dystrophy (PPCD), a rare, bilateral, autosomal-dominant, inherited corneal dystrophy, affects the Descemet membrane and corneal endothelium. We describe an unusual presentation of PPCD associated with a previously unknown genetic alteration in the ZEB1 gene. The proband is a 64-year-old woman diagnosed with keratoconus referred for a corneal endothelium study who presented endothelial lesions in both eyes suggestive of PPCD, corectopia and iridocorneal endothelial synechiae in the right eye and intrastromal segments in the left eye. The endothelial count was 825 in the right eye and 1361 in the left eye, with typical PPCD lesions visible under specular and confocal microscopy. In the next generation sequencing genetic analysis, a heterozygous c.1A > C (p.Met1Leu) mutation was found in the ZEB1 gene (TCF8). The PPCD3 subtype is associated with corneal ectasia, and both can appear due to a pathogenic mutation in the ZEB1 gene (OMIM #189909). However, our patient had a previously unreported mutation in the ZEB1 gene, which mediates the transition between cell lines and provides a pathogenic explanation for the epithelialisation of the corneal endothelium, a characteristic of PPCD.


Asunto(s)
Distrofias Hereditarias de la Córnea , Proteínas de Homeodominio , Femenino , Humanos , Persona de Mediana Edad , Proteínas de Homeodominio/genética , Proteínas de Homeodominio/metabolismo , Factores de Transcripción/metabolismo , Homeobox 1 de Unión a la E-Box con Dedos de Zinc/genética , Homeobox 1 de Unión a la E-Box con Dedos de Zinc/metabolismo , Distrofias Hereditarias de la Córnea/genética , Distrofias Hereditarias de la Córnea/patología , Endotelio Corneal/metabolismo , Mutación
16.
Orbit ; 41(2): 235-240, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34157948

RESUMEN

PURPOSE: Many surgical approaches have been described for achieving satisfactory functionality in patients with facial paralysis, to ensure the protection of the cornea and the highest degree of physiological blinking. Out of all those available, dynamic techniques are indicated when motion recovery and synchrony are the goals pursued. Orbicularis oculi transposition (OOT) allows a genuine restoration of blinking by means of contralateral reinnervation, with minimal insult for the donor site. METHODS: We present the case of a 64-year-old man with unilateral facial paralysis. A physical examination revealed a lagophthalmos of more than 5 mm. A neurophysiological study showed a mild-to-moderate axonal injury of the left facial nerve. Contralateral OOT was indicated as the first therapy option since it can restore involuntary blinking. The orbicularis muscle flap was not divided into branches, as described previously by other authors; the whole flap was transposed to the paralysed upper eyelid to achieve the highest level of potential reinnervation. RESULTS: Lagophthalmos was fully corrected after the surgery. The patient reported subjective improvement of symptoms, less frequent instillation of artificial tear drops and, especially, synchronous blinking with significant improvement in involuntarity. These improvements were maintained after 1 year of follow-up. Postoperative electromyographic studies confirmed the improvement in neural function. CONCLUSIONS: OOT can be a safe and effective option for the treatment of patients with peripheral facial paralysis, as it achieves a good restoration of blinking function with minimal morbidity in the healthy donor eye.


Asunto(s)
Parálisis Facial , Estética , Párpados , Músculos Faciales/cirugía , Nervio Facial/cirugía , Parálisis Facial/cirugía , Humanos , Masculino , Persona de Mediana Edad , Músculos
17.
Entropy (Basel) ; 24(2)2022 Jan 27.
Artículo en Inglés | MEDLINE | ID: mdl-35205491

RESUMEN

Medical data includes clinical trials and clinical data such as patient-generated health data, laboratory results, medical imaging, and different signals coming from continuous health monitoring. Some commonly used data analysis techniques are text mining, big data analytics, and data mining. These techniques can be used for classification, clustering, and machine learning tasks. Machine learning could be described as an automatic learning process derived from concepts and knowledge without deliberate system coding. However, finding a suitable machine learning architecture for a specific task is still an open problem. In this work, we propose a machine learning model for the multi-class classification of medical data. This model is comprised of two components-a restricted Boltzmann machine and a classifier system. It uses a discriminant pruning method to select the most salient neurons in the hidden layer of the neural network, which implicitly leads to a selection of features for the input patterns that feed the classifier system. This study aims to investigate whether information-entropy measures may provide evidence for guiding discriminative pruning in a neural network for medical data processing, particularly cancer research, by using three cancer databases: Breast Cancer, Cervical Cancer, and Primary Tumour. Our proposal aimed to investigate the post-training neuronal pruning methodology using dissimilarity measures inspired by the information-entropy theory; the results obtained after pruning the neural network were favourable. Specifically, for the Breast Cancer dataset, the reported results indicate a 10.68% error rate, while our error rates range from 10% to 15%; for the Cervical Cancer dataset, the reported best error rate is 31%, while our proposal error rates are in the range of 4% to 6%; lastly, for the Primary Tumour dataset, the reported error rate is 20.35%, and our best error rate is 31%.

18.
Actas Esp Psiquiatr ; 50(5): 208-215, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36273380

RESUMEN

Alexithymia is highly prevalent in patients with substance use disorders (SUDs) and has been implied in SUD pathogenesis and treatment outcomes. However, the psychometric properties of the most-used instrument for evaluating alexithymia (the 20-item Toronto Alexithymia Scale, TAS-20) have been scarcely studied in relation to SUD patients.


Asunto(s)
Síntomas Afectivos , Trastornos Relacionados con Sustancias , Humanos , Síntomas Afectivos/complicaciones , Síntomas Afectivos/diagnóstico , Análisis Factorial , Psicometría , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/diagnóstico
19.
Gac Med Mex ; 158(6): 410-415, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36657129

RESUMEN

INTRODUCTION: Genetic variants related to bone morphogenetic proteins (BMP2, BMP4, GREM1, SMAD7) signaling pathway have been associated with colorectal cancer, mainly in Caucasian populations. OBJECTIVE: To describe the association of variants in members of the BMP signaling pathway in a Mexican population, characterized by its indigenous American and Caucasian ancestry. METHODS: Genotyping of 1,000 colorectal cancer cases and 1,043 control individuals recruited in Mexico City, Monterrey, and Torreón was carried out using the Sequenom platform. Associations between colorectal cancer and variants were studied with univariate and multivariate analyses. RESULTS: Variants rs4444235, rs12953717 and rs4939827 replicated the association with the neoplasm (p ≤ 0.05). Caucasian ancestry showed association with the tumor. CONCLUSIONS: The study replicated the associations between colorectal cancer and SMAD7 and BMP4 variants, with an association being observed with the Caucasian component of the ethnic mix.


INTRODUCCIÓN: Variantes génicas relacionadas con la vía de señalización de las proteínas morfogenéticas óseas (BMP2, BMP4, GREM1, SMAD7) se han asociado a cáncer colorrectal, principalmente en poblaciones caucásicas. OBJETIVO: Describir la asociación de variantes en miembros de la vía BMP en población mexicana, caracterizada por su ancestría indoamericana y caucásica. MÉTODOS: Se realizó el genotipado de 1000 casos de cáncer colorrectal y 1043 individuos de control reclutados en la Ciudad de México, Monterrey y Torreón mediante la plataforma Sequenom. Con análisis univariados y multivariados se estudiaron las asociaciones entre cáncer colorrectal y variantes. RESULTADOS: Las variantes rs4444235, rs12953717 y rs4939827 replicaron la asociación con la neoplasia (p ≤ 0.05). La ascendencia caucásica mostró asociación con el tumor. CONCLUSIONES: El estudio mostró las asociaciones entre cáncer colorrectal y las variantes SMAD7 y BMP4, así como con el componente caucásico de la mezcla étnica.


Asunto(s)
Proteínas Morfogenéticas Óseas , Neoplasias Colorrectales , Predisposición Genética a la Enfermedad , Humanos , Estudios de Casos y Controles , Neoplasias Colorrectales/genética , Neoplasias Colorrectales/epidemiología , Estudio de Asociación del Genoma Completo , México , Polimorfismo de Nucleótido Simple , Transducción de Señal , Proteínas Morfogenéticas Óseas/genética
20.
Adicciones ; 0(0): 1754, 2022 Oct 01.
Artículo en Inglés, Español | MEDLINE | ID: mdl-36200231

RESUMEN

Problematic Gambling or Gambling Disorder (GD) can act by initiating and maintaining the problem of substance addiction. Despite this, there are no rapid screening tools validated in Spanish. The Brief Problem Gambling Screen (BPGS) has proven to be one of the most sensitive tools for detecting GD and populations at risk. This study aims to validate the Spanish version of the original five-item BPGS. A sample of 100 Spanish-speaking adults with substance use disorder were recruited from an addiction treatment center. The participants were administered the Spanish version of BPGS. It showed strong item reliability properties (Ω = 0.93). Sensitivity and specificity values were excellent (0.93 each), also positive (0.7) and negative (0.99) predictive values suggest high discriminant power when compared to non-GD subjects. Statistically significant strong correlation with a gold-standard measure (Problem Gambling Severity Index) was found (r = 0.8, p < 0.01). Similar psychometric properties were found in at-risk gambler patients. In conclusion, the BPGS seems to be an adequate screening instrument in Spanish-speaking clinical population, and also identifies at-risk of GD subjects.


El juego patológico (JP) puede actuar iniciando y manteniendo el problema de la adicción a sustancias. A pesar de ello, no existen herramientas de cribado rápido validadas en español. La Breve evaluación del juego problemático (BPGS) ha demostrado ser una de las herramientas más sensibles para detectar JP y poblaciones en riesgo. Este estudio tiene como objetivo validar la versión en español de la BPGS original de cinco factores. Se reclutó una muestra de 100 adultos hispanohablantes con trastorno por uso de sustancias de un centro de tratamiento de adicciones. A los participantes se les administró la versión en español de la BPGS. El instrumento mostró propiedades de fiabilidad de los ítems evaluados (Ω = 0,93). Los valores de sensibilidad y especificidad fueron excelentes (0,93 cada uno), también los valores predictivos positivos (0,7) y negativos (0,99) sugieren un alto poder discriminante en comparación con los sujetos sin JP. Se encontró una fuerte correlación significativa con la medida gold-estándar (índice de severidad del juego problemático, PGSI) (r = 0,8, p < 0,01). Se encontraron propiedades psicométricas similares en pacientes en riesgo de JP. En conclusión, la BPGS parece un buen instrumento de cribado en la población clínica española, y también identifica a los sujetos en riesgo de desarrollar JP.

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