RESUMO
It has been determined that quality of life in epilepsy is closely related to the perceived disability experienced by individuals with the diagnosis. However, this measure is seldom considered in healthcare processes. The objective of the present study is to establish the psychometric properties of the Perceived Disability Questionnaire in individuals diagnosed with epilepsy within a Latin American context. A cross-sectional, analytical study was conducted involving 325 participants, aged 12 years and older (M 40.42 years), individuals diagnosed with epilepsy in Colombia. The main psychometric properties of the instrument were explored to account for its factorial validity and reliability. The Perceived Disability Questionnaire exhibits high reliability (α = 0.878) and the three subscales comprising the final version of the questionnaire (Dissatisfaction, Pessimism, and Self-Disdain) explain 45.393 % of the total variance in relation to beliefs of disability associated with the diagnosis of epilepsy; the questionnaire significantly correlates with the Quality of Life in Epilepsy Inventory (QOLIE-10). Adequate psychometric properties of the instrument are found, which allows for its proposal as a tool in epilepsy care processes within the Colombian context.
Assuntos
Pessoas com Deficiência , Epilepsia , Psicometria , Qualidade de Vida , Humanos , Epilepsia/psicologia , Epilepsia/diagnóstico , Feminino , Masculino , Inquéritos e Questionários , Adulto , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Transversais , Adolescente , Adulto Jovem , Criança , Pessoas com Deficiência/psicologia , Idoso , Colômbia , Avaliação da DeficiênciaRESUMO
Objectives: Mental, neurological, and substance use (MNS) disorders have a high prevalence in Colombia and there is a treatment gap. The World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP) has various components. The mhGAP 2.0 Intervention Guide, aimed at improving primary health care, is a guide for the assessment and management of MNS disorders based on clinical decision-making protocols. The objective of this study was to determine the barriers that may hinder the program implementation process. Methods: A qualitative study with content analysis was conducted in three phases: i) study preparation, organization, and presentation; ii) open coding, categorization, and abstraction of contents; and iii) information analysis. The study included semi-structured interviews with 21 people involved in the provision of mental health services in Chocó (Colombia): five medical doctors, seven nurses, and three psychologists, as well as six professionals working in the administrative area of the department's health secretariats. The perceptions of these stakeholders were explored. Open-ended questions were asked to explore experiences with the process, as well as the barriers identified in practice. Results: Four different thematic categories were identified: intersectoral action, long-standing challenges, opportunities, and suitability of tools. Conclusions: A theoretical model of barriers to implementation of the mhGAP program was constructed, based on stakeholder perceptions. Controlling barriers is perceived as a possible way to contribute significantly to population health.
Objetivo: Os transtornos mentais, neurológicos e por uso de substâncias psicoativas são muito prevalentes, e há uma lacuna na atenção a esses transtornos na Colômbia. O Programa de Ação para Reduzir as Lacunas em Saúde Mental (mhGAP, na sigla em inglês) da Organização Mundial da Saúde (OMS) consta de vários componentes. Um deles é o Manual de Intervenções mhGAP 2.0, elaborado para aprimorar a atenção primária à saúde. O documento contém orientações para avaliação e manejo de transtornos mentais, neurológicos e por uso de substâncias psicoativas e foi elaborado com base em protocolos para a tomada de decisões clínicas. O objetivo do estudo foi determinar as barreiras que podem surgir no processo de implementação do programa. Métodos: Estudo qualitativo com enfoque de análise de conteúdo desenvolvido em três fases: i) preparação, organização e apresentação do estudo; ii) codificação aberta, categorização e abstração do conteúdo; e iii) análise das informações. O estudo incluiu entrevistas semiestruturadas com 21 pessoas envolvidas na prestação de serviços de saúde mental em Chocó (Colômbia): cinco profissionais da medicina, sete de enfermagem e três de psicologia, bem como seis profissionais que trabalham na área administrativa das secretarias de saúde do departamento. As percepções das partes interessadas, ou seja, do pessoal assistencial e administrativo do setor de saúde no departamento de Chocó, foram exploradas. Foram feitas perguntas abertas a fim de investigar suas experiências com o processo de atenção e as barreiras identificadas na prática. Resultados: Foram identificadas quatro categorias temáticas: intersetorialidade, desafios de longa data, possibilidades e adequação das ferramentas. Conclusões: Elaborou-se um modelo teórico sobre as barreiras de implementação do Programa mhGAP com base nas percepções das partes interessadas. O controle das barreiras é visto como uma possível forma de contribuir significativamente para a saúde da população.
RESUMO
INTRODUCTION: Hispanic/Latinx smokers in the United States are often treated as a homogeneous group. However, population-based studies suggest that cigarette use differs among Hispanic/Latinx subgroups by sociodemographic or sociocultural characteristics. This secondary analysis aimed to advance the limited literature by examining differences in smoking-related variables. AIMS AND METHODS: We used baseline data from a randomized controlled trial testing a self-help Spanish-language smoking cessation intervention. Puerto Rican (PR), Mexican, and Cuban, the three largest Hispanic/Latinx subgroups in the sample (N = 1028), were first compared on sociodemographic and sociocultural variables (acculturation and familism). Primary analyses assessed subgroup differences in cigarette use variables (eg, cigarettes per day [CPD], nicotine dependence [Fagerström Test for Nicotine Dependence], and daily smoking) and smoking-related cognitive constructs (motivation to quit, smoking outcome expectancies, and abstinence self-efficacy) controlling for sociodemographic and sociocultural variables. Additional analyses explored differences between men and women within subgroups. RESULTS: Mexicans exhibited the lowest levels of daily smoking (90% vs. 95% Cubans and 96% PR; p = .001), CPD (M = 13.5, SD = 9.5 vs. M = 20.1, SD = 9.9 Cubans and M = 16.7, SD = 10.1 PR; p = .016), and nicotine dependence (M = 4.2, SD = 2.3 vs. M = 6.0, SD = 2.1 Cubans and M = 5.7, SD = 2.2 PR; p < .001), with no differences between PRs and Cubans. Within-subgroup comparisons between men and women showed the most differences among PRs (eg, men were more nicotine dependent [M = 6.0, SD = 1.9] than women [M = 5.4, SD = 2.3; p = .041]) and Cubans (eg, men smoked more CPD [M = 22.2, SD = 12.2] than women [M = 19.3, SD = 12.0; p = .042]), and the fewest among Mexicans. CONCLUSIONS: Findings support heterogeneity within Hispanic/Latinx smokers and highlight the potential utility of examining sociodemographic, sociocultural, and smoking characteristics important for developing salient cessation interventions. IMPLICATIONS: Findings demonstrate that treatment-seeking Hispanic/Latinx smokers in the United States differ in sociodemographic, sociocultural, and smoking-related variables (cigarette use and smoking-related cognitive constructs) by subgroup (ie, PR, Mexican, and Cuban) and within subgroups by sex. These differences suggest that heterogeneity among subgroups should be considered when developing cessation interventions for Hispanics/Latinxs. Future research should examine how differences in sociodemographic and smoking-related variables impact intervention outcomes and explore the role of sociocultural factors (eg, acculturation and familism) as determinants of cessation.
Assuntos
Abandono do Hábito de Fumar , Tabagismo , Feminino , Hispânico ou Latino , Humanos , Masculino , Nicotina , Fumar/epidemiologia , Abandono do Hábito de Fumar/psicologia , Tabagismo/psicologia , Estados Unidos/epidemiologiaRESUMO
Small vessel strokes (SVS) and intracerebral haemorrhages (ICH) are acute outcomes of cerebral small vessel disease (SVD). Genetic studies combining both phenotypes have identified three loci associated with both traits. However, the genetic cis-regulation at the protein level associated with SVD has not been studied before. We performed a proteome-wide association study (PWAS) using FUSION to integrate a genome-wide association study (GWAS) and brain proteomic data to discover the common mechanisms regulating both SVS and ICH. Dorsolateral prefrontal cortex (dPFC) brain proteomes from the ROS/MAP study (N = 376 subjects and 1443 proteins) and the summary statistics for the SVS GWAS from the MEGASTROKE study (N = 237,511) and multi-trait analysis of GWAS (MTAG)-ICH−SVS from Chung et al. (N = 240,269) were selected. We performed PWAS and then a co-localization analysis with COLOC. The significant and nominal results were validated using a replication dPFC proteome (N = 152). The replicated results (q-value < 0.05) were further investigated for the causality relationship using summary data-based Mendelian randomization (SMR). One protein (ICA1L) was significantly associated with SVS (z-score = −4.42 and p-value = 9.6 × 10−6) and non-lobar ICH (z-score = −4.8 and p-value = 1.58 × 10−6) in the discovery PWAS, with a high co-localization posterior probability of 4. In the validation PWAS, ICA1L remained significantly associated with both traits. The SMR results for ICA1L indicated a causal association of protein expression levels in the brain with SVS (p-value = 3.66 × 10−5) and non-lobar ICH (p-value = 1.81 × 10−5). Our results show that the association of ICA1L with SVS and non-lobar ICH is conditioned by the cis-regulation of its protein levels in the brain.
Assuntos
Proteoma , Acidente Vascular Cerebral , Hemorragia Cerebral/complicações , Hemorragia Cerebral/genética , Estudo de Associação Genômica Ampla , Humanos , Proteoma/genética , Proteômica , Acidente Vascular Cerebral/etiologiaRESUMO
The study of phenotypic variation patterns among populations is fundamental to elucidate the drivers of evolutionary processes. Empirical evidence that supports ongoing genetic divergence associated with phenotypic variation remains very limited for marine species where larval dispersal is a common homogenizing force. We present a genome-wide analysis of a marine fish, Labrus bergylta, comprising 144 samples distributed from Norway to Spain, a large geographical area that harbours a gradient of phenotypic differentiation. We analysed 39,602 biallelic single nucleotide polymorphisms and found a clear latitudinal gradient of genomic differentiation strongly correlated with the variation in phenotypic morph frequencies observed across the North Atlantic. We also detected a strong association between the latitude and the number of loci that appear to be under divergent selection, which increased with differences in coloration but not with overall genetic differentiation. Our results demonstrate that strong reproductive isolation is occurring between sympatric colour morphs of L. bergylta found at the southern areas and provide important new insights into the genomic changes shaping early stages of differentiation that might precede speciation with gene flow.
Assuntos
Fluxo Gênico , Polimorfismo de Nucleotídeo Único , Animais , Cor , Genômica , Noruega , Polimorfismo de Nucleotídeo Único/genética , EspanhaRESUMO
PURPOSE: To evaluate the characteristics of lymph node assessment in the Spanish Colorectal Metastasectomy Registry (GECMP-CCR) and to analyze and compare the survival of patients with pathological absence or presence of lymph node metastases (LNM) with the survival of those with uncertain lymph node status (uLNs). METHODS: A total of 522 patients with lung metastases from colorectal carcinoma were prospectively registered from 2008 to 2010. To confirm the pathologic absence of LNM, systematic nodal dissection or systematic sampling was required, or the lymph node status was coded as uncertain. Disease-specific survival and disease-free survival were calculated by the Kaplan-Meier method with the log-rank test for comparisons. RESULTS: Lymphadenectomy was performed in 250 (48%) patients. LNM was found in 25 (10%) of the patients who had lymph node assessment done. The 3- and 5-year disease-specific survival rates according to lymph node status were 73.5 and 58.3% in the absence of LNM, 50.5 and 24.8% when LNM was confirmed, and 69 and 44% for those with uLNs, respectively (p = 0.006). CONCLUSIONS: The presence of LNM and uLNs is associated with an increased risk of death. The association of nodal assessment at the time of metastasectomy to identify LNM helps us to refine the postoperative prognosis; therefore, its impact should be properly studied in a prospective clinical trial.
Assuntos
Carcinoma/secundário , Carcinoma/cirurgia , Neoplasias Colorretais/patologia , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/cirurgia , Excisão de Linfonodo , Idoso , Carcinoma/mortalidade , Neoplasias Colorretais/mortalidade , Feminino , Humanos , Neoplasias Pulmonares/mortalidade , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Pneumonectomia , Prognóstico , Estudos Prospectivos , Taxa de SobrevidaRESUMO
Multiple Sclerosis (MS) significantly impacts daily living activities, including car driving. To investigate driving difficulties experienced with MS, we compared 50 MS patients with minor or moderate disability and 50 healthy controls (HC) using computerized driving tests (the ASDE driver test and the Useful Field of View (UFOV) test) and neuropsychological tests. Inclusion criteria included being active drivers. We evaluated whether cognitive deterioration in MS is associated with the results of driving tests by comparing MS patients without cognitive deterioration with HC. The results indicated that the MS patients performed worse than the HCs in attention, information processing, working memory and visuomotor coordination tasks. Furthermore, MS patients with cognitive impairments experienced more difficulties in the driving tests than did the non-impaired MS patients. Motor dysfunction associated with MS also played an important role in this activity. The results of this study suggest that MS should be assessed carefully and that special emphasis should be placed on visuomotor coordination and executive functions because patients with minor motor disability and subtle cognitive impairments can pass measures predictive of driving safety.
Assuntos
Condução de Veículo/psicologia , Transtornos Cognitivos/etiologia , Aconselhamento , Transtornos das Habilidades Motoras/etiologia , Esclerose Múltipla/complicações , Esclerose Múltipla/psicologia , Atividades Cotidianas , Adulto , Transtornos Cognitivos/diagnóstico , Avaliação da Deficiência , Função Executiva , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos das Habilidades Motoras/diagnóstico , Testes Neuropsicológicos , Sensibilidade e Especificidade , Estatísticas não ParamétricasRESUMO
BACKGROUND: People with epilepsy have multiple barriers to recovering their quality of life. The objective of the present study was to determine the impact of a community group intervention focused on the components of mutual aid and human rights, to improve the quality of life in people with epilepsy. METHODS: Prospective quasi-experimental study, incorporating pre- and post-intervention evaluations. There were 102 people who underwent an intervention focused on the central components of mutual aid groups (Active agency, Coping strategies, Emotion recognition and management, Problem solving, Supportive interaction, Identity construction, Trust, and Social networks) and in the QualityRights strategy. As evaluation instruments, scales were used to determine quality of life (QOLIE-10), treatment adherence (Morisky Test), self-care behaviors, perception of disability and quality in the provision of health services. RESULTS: Correlations were shown between the variables proposed for quality of life. The intervention showed an improvement in all variables and a moderate to large effect in the self-care domain. There was a significant effect size in the self-care and quality of life variables with the intervention. Pharmacological adherence showed a moderate effect size in young people, adults and older adults. Regarding the perception of disability, the effect size was found only in adults. The pharmacological adherence variable also had a moderate effect size. This does specify the age groups, but not in the general sample. CONCLUSION: Seizure-free time constitutes a fundamental element in recovery. However, psychosocial conditions constitute key elements to achieve a better quality of life in people with epilepsy.
Assuntos
Epilepsia , Qualidade de Vida , Autocuidado , Grupos de Autoajuda , Humanos , Epilepsia/terapia , Epilepsia/psicologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Direitos Humanos , Pessoas com Deficiência , Estudos Prospectivos , Idoso , AdolescenteRESUMO
Introduction: Neuroprotective drugs such as citicoline could improve cognitive performance and quality of life. We studied the effect of citicoline treatment and its association with Vascular Risk Factors (VRF) and APOE on cognition in patients with Subjective Cognitive Complaints (SCC) and Mild Cognitive Impairment (MCI). Methods: This is an observational and prospective study with citicoline during 12 months follow-up. Eighty-one subjects who met criteria for SCC/MCI, aged 50-75 years with VRF were included and prescribed citicoline 1g/day. Subjects with previous cognitive impairment and any other central nervous system affection were excluded. Wilcoxon Signed Ranks test and paired samples t-test were used to analyze the change in neuropsychological performance. Results: Mean age of the sample was 68.2 (SD 6.8) years and 26 (32.09%) were females. Fifteen subjects (24.6%) were APOE-ε4 carriers, fifty-six (76.7%) had hypertension, fifty-eight (79.5%) had dyslipidemia, twenty-one (28.8%) had diabetes mellitus and twenty-six (35.6%) had cardiopathy. Thirty-two (43.8%) subjects were diagnosed as SCC and forty-one (56.16%) as MCI. During the follow-up, Tweny-six patients (81.25%) in the group of SCC remained stable, six subjects (18.8%) converted to MCI. Twelve patients (29.9%) with MCI reverted to SCC and twenty-nine patients (70.7%) remained stable. At follow-up, SCC subjects had an improvement in the global language domain (p=0.03), naming (p<0.001), attention (p=0.01) and visuospatial abilities (p<0.01). MCI group showed an improvement in the screening test (p=0.03), delayed memory (p<0.01), global cognition (p=0.04) and in cognitive flexibility (p=0.03). Presence of APOE-ε4 had no impact on the above findings. Discussion: SCC subjects showed an improvement in language and attention domains, while those with MCI performed better after 12 months in total scores of MoCA and RBANS domains, some converting back to SCC. This supports the idea that citicoline may prevent cognitive decline in patients with cognitive deficits.
Assuntos
Transtornos Cerebrovasculares , Disfunção Cognitiva , Feminino , Humanos , Idoso , Masculino , Citidina Difosfato Colina , Estudos Prospectivos , Qualidade de Vida , Apolipoproteínas ERESUMO
Introduction: Little is known about facilitators and barriers to smoking cessation among Hispanics seeking treatment. This secondary analysis examined attributions for abstinence or smoking among participants in a nationwide randomized controlled trial testing a self-help smoking cessation intervention among Spanish-speaking Hispanics in the United States (US). Methods: At each follow-up assessment (6, 12, 18, and 24 months), participants (N = 1,417) responded to open-ended items regarding reasons for either abstinence or smoking. A content analysis was conducted using NVivo on the responses from 1,035 participants. Results: Mood Management (e.g., stress and anxiety) was the most frequent reason for smoking across all timepoints. Concern for personal health and wellbeing was the most frequent reason cited for abstinence across all timepoints. Important barriers (e.g., financial stressors, environmental disasters) and facilitators (e.g., family, faith) were also identified. Quantitative subgroup analyses revealed differences in the frequency of abstinence and smoking attributions by sex, marital status, and annual household income. Conclusion: The identified facilitators and barriers to abstinence support and expand findings from previous studies by using a geographically and ethnically diverse sample of treatment seeking, Spanish-preferring smokers. They also provide specific targets for tailoring cessation and relapse prevention interventions designed to improve cessation outcomes and reduce tobacco-related health disparities among Hispanics in the US.
RESUMO
Estimating the burden of tuberculosis disease is relevant for assessing and identifying population health status and progress in policies and programs aimed at epidemic control. The objective of this study was to estimate disability-adjusted life years attributable to Tuberculosis in Colombia 2010-2018. A longitudinal descriptive study was conducted. The variables, sex, age groups and origin were studied. This study included 110,475 cases of morbidity and 8514 cases of mortality. Indicators of years of life lost, years of life with disability and disability-adjusted life years at the subnational level were determined using the methodology of the World Health Organization. With the results of this last indicator, an epidemiological risk stratification was carried out. The DALY rate of the study period was 684 (95% CI 581.2-809.1) per 100,000 inhabitants. According to sex, 68.4% occurred in men; for every DALY in women, 2.21 occur in men. People of productive age (15 to 69 years) account for 56% of DALYs. Amazonas (1857.1 CI 95% 1177.1-2389.6) was the territorial entity with the highest rate. A total of 51.5% of the territorial entities of departmental order of the country are of high burden for Tuberculosis. For the first time in Colombia, a comprehensive assessment of the status of the disease burden at a subnational (departmental) territorial level attributable to Tuberculosis is being carried out using the updated World Health Organization methodology. The results obtained allow us to specify that there is a knowledge gap in terms of the realization and clear understanding of the burden of the disease in Colombia. There are territorial gaps that are necessary to know in order to plan, develop, implement and redirect policies to improve health and eliminate disparities according to the territorial context.
RESUMO
Pediatric tuberculosis is a serious infectious disease and a hidden global epidemic. The objective of this study was to describe the epidemiological situation of tuberculosis mortality in children under 15 years of age in Colombia in the period 2010-2018. A longitudinal descriptive study was conducted. The variables sex, age groups, and origin were studied. This study had 260 cases for analysis and was carried out in three phases. The first phase was the determination of the sociodemographic and clinical characteristics. The second phase was the construction of indicators by territorial entities. The third phase was stratification into four epidemiological situations according to the mortality rate and years of life lost. The median age was 7 years (range 0-14), 66.5% of cases were pulmonary tuberculosis (97.7% without bacteriological confirmation), 14.3781 years of life lost were recorded (95% CI: 142.811-168.333), and in children under 10-14 years, the loss was 110,057. Amazonas had the highest adjusted YLL rate (3979.7). In total, 36.4% of the territories had a high mortality, and 30.3% adjusted to the situation designated as 1. This is the first study that has used composite indicators to address the problem of premature mortality from childhood tuberculosis in Colombia. Our results allow us to specify that this disease remains a challenge for public health. It requires models of care and differential strategies by region. It also requires ensuring opportunities in diagnosis with sensitive methods, as well as intersectoral work for the optimal approach.
RESUMO
INTRODUCTION: Hispanic smokers face multiple cultural and socioeconomic barriers to cessation that lead to prominent health disparities, including a lack of language-appropriate, culturally relevant, evidence-based smoking cessation interventions. This systematic review will examine the literature on smoking cessation interventions for Hispanic adults in the USA to assess (1) the availability of interventions, (2) the methodological quality of the studies evaluating the interventions and (3) the efficacy of the interventions. METHODS AND ANALYSIS: A systematic literature search will be conducted, in English with no date limits, through the following databases starting at year of inception: Medical Allied Health Literature, Embase, American Psychology Association Psychology Articles, Cumulative Index to Nursing and Allied Health Literature Complete, ScienceDirect, Health & Medicine Collection and Web of Science Core Collection. Trial registries and grey literature sources will be searched to identify ongoing or unpublished studies. Literature search will be rerun prior to eventual submission of the review to ensure the inclusion of relevant studies. Quantitative studies evaluating the efficacy of a smoking cessation intervention (ie, smoking cessation as a measured outcome) for Hispanic adult smokers in the USA will be included in the systematic review. Two authors will independently identify relevant studies, extract data and conduct quality and risk of bias assessments. Discrepancies in coding will be discussed between the two reviewers and pending disagreements will be resolved by a third reviewer. First, the quality of all studies will be assessed, then randomised controlled trials (RCTs) will be further evaluated for risk of bias using Cochrane's Risk of Bias Tool. All eligible studies will be summarised descriptively. If data allow, the efficacy of smoking cessation interventions tested in RCTs, with a minimum follow-up of 6 months, will be quantitatively estimated using ORs and 95% CIs. The association between intervention type/modality and efficacy will be assessed via subgroup analyses. PROSPERO REGISTRATION NUMBER: CRD42022291068.
Assuntos
Abandono do Hábito de Fumar , Adulto , Humanos , Abandono do Hábito de Fumar/métodos , Terapia Comportamental , Comportamentos Relacionados com a Saúde , Hispânico ou Latino , Revisões Sistemáticas como Assunto , Metanálise como AssuntoRESUMO
INTRODUCTION: The number of lung metastases (M1) of colorectal carcinoma (CRC) in relation to the findings of computed tomography (CT) is the object of study. METHODS: Prospective and multicenter study of the Spanish Group for Surgery of CRC lung metastases (GECMP-CCR). The role of CT in the detection of pulmonary M1 is evaluated in 522 patients who underwent a pulmonary metastasectomy for CRC. We define M1/CT as the ratio between metastatic nodules and those found on preoperative CT. Disease-specific survival (DSS), disease-free survival (DFS), and surgical approach were analyzed using the Kaplan-Meier method. RESULTS: 93 patients were performed by video-assisted surgery (VATS) and 429 by thoracotomy. In 90%, the M1/CT ratio was ≤1, with no differences between VATS and thoracotomy (94.1% vs 89.7%, p=0.874). In the remaining 10% there were more M1s than those predicted by CT (M1/CT>1), with no differences between approaches (8.6% vs 10%, p=0.874). 51 patients with M1/CT>1, showed a lower median DSS (35.4 months vs 55.8; p=0.002) and DFS (14.2 months vs 29.3; p=0.025) compared to 470 with M1/CT≤1. No differences were observed in DSS and DFS according to VATS or thoracotomy. CONCLUSIONS: Our study shows equivalent oncological results in the resection of M1 of CRC using VATS or thoracotomy approach. The group of patients with an M1/CT ratio >1 have a worse DSS and DFS, which may mean a more advanced disease than predicted preoperatively.
Assuntos
Neoplasias Colorretais , Neoplasias Pulmonares , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Estudos Prospectivos , Cirurgia Torácica Vídeoassistida/métodos , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: The real predictive prognostic capacity of cellular indices (or ratios) is unclear in SARS-CoV-2 infection. This study aimed to assess the prognostic role of previously well-known laboratory indices and new ones in hospitalized COVID-19 patients. METHODS: A retrospective observational study from March to May 2022 evaluated laboratory indices on admission (neutrophil to lymphocyte-, derived neutrophil to lymphocyte-, platelet to lymphocyte-, CRP to lymphocyte-, CRP to albumin-, fibrinogen to lymphocyte-, d-dimer to lymphocyte-, ferritin to lymphocyte-, LDH to lymphocyte-, and IL-6 to lymphocyte ratios), in patients hospitalized due to SARS-CoV2 infection to determine the association with mortality, admission to an intensive care unit (ICU), need for non-invasive mechanical ventilation (NIMV), orotracheal intubation (OTI), or combined event at 30 days follow-up. RESULTS: A total of 1113 COVID-19 patients were evaluated with a mean age of 64.1 ± 15.9 years (58.49% male), 166 (14.91%) patients died, 58 (5.21%) required ICU admission, 73 (6.56%) needed NIMV, 46 (4.23%) needed OTI, and 247 (22.19%) presented the combined event. All the ratios evaluated in this study showed statistical significance in the univariate analysis for mortality and combined event; however, only d-dimer to lymphocyte ratio >0.6 presented an independent association in the multivariate analysis for 30-day mortality (adjusted OR 2.32; p = .047) and 30-day combined event (adjusted OR 2.62; p = .014). CONCLUSIONS: Laboratory indices might be a potential biomarker for better prognosis stratification in hospitalized COVID-19 patients. d-Dimer to lymphocyte ratio presents an independent association for 30-day mortality and 30-day adverse outcomes in hospitalized COVID-19 patients.
Assuntos
COVID-19 , Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Feminino , SARS-CoV-2 , Interleucina-6 , RNA Viral , Biomarcadores , Ferritinas , Albuminas , Estudos RetrospectivosRESUMO
Fishes are the only vertebrates that undergo sex change during their lifetime, but even within this group, a unique reproductive strategy is displayed by only 1.5% of the teleosts. This lability in alternating sexual fate is the result of the simultaneous suppression and activation of opposing male and female networks. Here, we provide a brief review summarizing recent advances in our understanding of the environmental cues that trigger sex change and their perception, integration, and translation into molecular cascades that convert the sex of an individual. We particularly focus on molecular events underpinning the complex behavioral and morphological transformation involved in sex change, dissecting the main molecular players and regulatory networks that shape the transformation of one sex into the opposite. We show that histological changes and molecular pathways governing gonadal reorganization are better described than the neuroendocrine basis of sex change and that, despite important advances, information is lacking for the majority of hermaphrodite species. We highlight significant gaps in our knowledge of how sex change takes place and suggest future research directions.
Assuntos
Sinais (Psicologia) , Transtornos do Desenvolvimento Sexual , Animais , Transtornos do Desenvolvimento Sexual/metabolismo , Feminino , Peixes , Gônadas/metabolismo , Masculino , VertebradosRESUMO
INTRODUCTION: The number of lung metastases (M1) of colorectal carcinoma (CRC) in relation to the findings of computed tomography (CT) is the object of study. METHODS: Prospective and multicenter study of the Spanish Group for Surgery of CRC lung metastases (GECMP-CCR). The role of CT in the detection of pulmonary M1 is evaluated in 522 patients who underwent a pulmonary metastasectomy for CRC. We define M1/CT as the ratio between metastatic nodules and those found on preoperative CT. Disease-specific survival (DSS), disease-free survival (DFS), and surgical approach were analyzed using the Kaplan-Meier method. RESULTS: 93 patients were performed by video-assisted surgery (VATS) and 429 by thoracotomy. In 90%, the M1/CT ratio was ≤1, with no differences between VATS and thoracotomy (94.1% vs 89.7%, p=0.874). In the remaining 10% there were more M1s than those predicted by CT (M1/CT>1), with no differences between approaches (8.6% vs 10%, p=0.874). 51 patients with M1/CT>1, showed a lower median DSS (35.4 months vs 55.8; p=0.002) and DFS (14.2 months vs 29.3; p=0.025) compared to 470 with M1/CT≤1. No differences were observed in DSS and DFS according to VATS or thoracotomy. CONCLUSIONS: Our study shows equivalent oncological results in the resection of M1 of CRC using VATS or thoracotomy approach. The group of patients with an M1/CT ratio >1 have a worse DSS and DFS, which may mean a more advanced disease than predicted preoperatively.
RESUMO
The reports of testate amoebae species in Colombia are limited to a few studies in lentic and peat bog systems; however, the diversity in lotic systems has been poorly investigated. Zooplankton sampling was performed in lotic environments of the Piedemonte Llanero in Colombia. Ten individuals of the species Arcella gandalfi were identified to document the first record of A. gandalfi from the Piedemonte Llanero in Colombia, expanding its distribution from Brazil to Colombia. This finding corroborates the status of A. gandalfi as a flagship species from the South America continent.
Assuntos
Distribuição Animal , Lobosea/classificação , Colômbia , Rios , Especificidade da EspécieRESUMO
In the present work, an analytical approximate solution of mixed electroosmotic/pressure driven flow of viscoelastic fluids between a parallel plates microchannel is reported. Inserting the Oldroyd, Jaumann, or both time derivatives into the Maxwell model, important differences in the velocity profiles were found. The presence of the shear and normal stresses is only close to the wall. This model can be used as a tool to understand the flow behavior of low viscosity fluids, as most of them experiment on translation, deformation and rotation of the flow. For practical applications, the volumetric flow rate can be controlled with two parameters, namely the gradient pressure and the electrokinetic parameter, once the fluid has been rheologically characterized.
RESUMO
Abnormal regulation of DNA methylation and its readers has been associated with a wide range of cellular dysfunction. Disruption of the normal function of DNA methylation readers contributes to cancer progression, neurodevelopmental disorders, autoimmune disease and other pathologies. One reader of DNA methylation known to be especially important is MeCP2. It acts a bridge and connects DNA methylation with histone modifications and regulates many gene targets contributing to various diseases; however, much remains unknown about how it contributes to cancer malignancy. We and others previously described novel MeCP2 post-translational regulation. We set out to test the hypothesis that MeCP2 would regulate novel genes linked with tumorigenesis and that MeCP2 is subject to additional post-translational regulation not previously identified. Herein we report novel genes bound and regulated by MeCP2 through MeCP2 ChIP-seq and RNA-seq analyses in two breast cancer cell lines representing different breast cancer subtypes. Through genomics analyses, we localize MeCP2 to novel gene targets and further define the full range of gene targets within breast cancer cell lines. We also further examine the scope of clinical and pre-clinical lysine deacetylase inhibitors (KDACi) that regulate MeCP2 post-translationally. Through proteomics analyses, we identify many additional novel acetylation sites, nine of which are mutated in Rett Syndrome. Our study provides important new insight into downstream targets of MeCP2 and provide the first comprehensive map of novel sites of acetylation associated with both pre-clinical and FDA-approved KDACi used in the clinic. This report examines a critical reader of DNA methylation and has important implications for understanding MeCP2 regulation in cancer models and identifying novel molecular targets associated with epigenetic therapies.