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1.
BMC Pregnancy Childbirth ; 23(1): 229, 2023 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-37020182

RESUMO

BACKGROUND: The birth of a child should be a time of celebration. However, for many women, childbirth represents a time of great vulnerability to becoming mentally unwell, a neglected maternal morbidity. This study aimed to determine the prevalence of early postpartum depression (PPD) and its associated risk factors among women giving birth at health facilities in southern Malawi. Identifying women vulnerable to PPD will help clinicians provide appropriately targeted interventions before discharge from the maternity ward. METHOD: We conducted a nested cross-sectional study. Women were screened for early PPD using a locally validated Edinburgh Postpartum Depression Scale (EPDS) as they were discharged from the maternity ward. The prevalence of moderate or severe (EPDS ≥ 6) and severe (EPDS ≥ 9) PPD was determined, including 95% confidence intervals (CI). Data on maternal age, education and marital status, income source, religion, gravidity, and HIV status, among others, were collected during the second trimester of pregnancy, and obstetric and infant characteristics during childbirth were examined as potential risk factors for early PPD using univariable and multivariable logistic regression analyses. RESULTS: Data contributed by 636 women were analysed. Of these women, 9.6% (95% CI; 7.4-12.1%) had moderate to severe early PPD using an EPDS cut-off of ≥ 6, and 3.3% (95% CI; 2.1-5.0%) had severe early PPD using an EPDS cut-off of ≥ 9. Multivariable analyses indicated that maternal anaemia at birth (aOR; 2.65, CI; 1.49-4.71, p-value; 0.001) was associated with increased risk for moderate and/or severe early PPD, while live birth outcome (aOR; 0.15, 95% CI; 0.04-0.54, p-value; 0.004), being single compared to divorced/widowed (aOR; 0.09, 95% CI; 0.02-0.55, p-value; 0.009), and lower education level (aOR; 0.36, 95% CI; 0.20-0.65, p-value; 0.001) were associated with decreased risk. Being HIV positive (aOR; 2.88, 95% CI; 1.08-7.67, p-value; 0.035) was associated with severe PPD only. CONCLUSION: The prevalence of early PPD was slightly lower in our selected sample compared to previous reports in Malawi and was associated with maternal anaemia at birth, non-live birth, being divorced/widowed and HIV-positive status. Therefore, health workers should screen for depressive symptoms in women who are at increased risk as they are discharged from the maternity ward for early identification and treatment.


Assuntos
Depressão Pós-Parto , Criança , Feminino , Humanos , Recém-Nascido , Gravidez , Estudos Transversais , Depressão Pós-Parto/epidemiologia , Malaui/epidemiologia , Prevalência , Fatores de Risco
2.
Curr Opin Hematol ; 20(6): 515-20, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24104412

RESUMO

PURPOSE OF REVIEW: Survival outcomes from haematopoietic stem cell transplantation (HSCT) in severe aplastic anaemia (SAA) have improved steadily over the past decades, largely reflecting progress in supportive care and conditioning regimens. Here we review recently published data that highlight the improvements and current issues. RECENT FINDINGS: Human leukocyte antigen (HLA)-matched sibling donor (MSD) HSCT remains the gold standard for SAA patients younger than 40-50 years, with HLA-matched unrelated donor (MUD) HSCT for second line after failure to respond to immunosuppressive therapy (IST). The use of alternative donor sources for aplastic anaemia patients remains limited and problematic, but novel conditioning regimens, particularly in the haploidentical setting, justify further evaluation. In recent studies when comparing alemtuzumab-based conditioning with standard antithymocyte globulin conditioning regimens, lower rates of acute and chronic graft-versus-host disease and better tolerance in older patients are seen. SUMMARY: Improving outcomes may lead to an expanded frontline HSCT role in the future. In children lacking a MSD, increasingly MUD HSCT is being considered as first-line treatment and is also being considered more for young adults. Further research is needed to advance our understanding of the role HSCT has to play in SAA with particular emphasis on alternative donor sources and identifying optimal conditioning regimens.


Assuntos
Anemia Aplástica/terapia , Transplante de Células-Tronco Hematopoéticas/métodos , Fatores Etários , Antineoplásicos/uso terapêutico , Seleção do Doador , Rejeição de Enxerto/prevenção & controle , Humanos , Condicionamento Pré-Transplante/métodos , Tolerância ao Transplante
3.
Front Physiol ; 15: 1334874, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38784113

RESUMO

Background: High-altitude populations exhibit distinct cellular, respiratory, and cardiovascular phenotypes, some of which provide adaptive advantages to hypoxic conditions compared to populations with sea-level ancestry. Studies performed in populations with a history of high-altitude residence, such as Tibetans, support the idea that many of these phenotypes may be shaped by genomic features that have been positively selected for throughout generations. We hypothesize that such traits observed in Tibetans at high altitude also occur in Tibetans living at intermediate altitude, even in the absence of severe sustained hypoxia. Methodology: We studied individuals of high-altitude ancestry (Tibetans, n = 17 females; n = 12 males) and sea-level ancestry (Han Chinese, n = 6 females; n = 10 males), both who had been living at ∼1300 m (∼4327 ft) for at least 18 months. We measured hemoglobin concentration ([Hb]), hypoxic ventilatory response (HVR), and hypoxic heart rate response (HHRR) with end-tidal CO2 (PetCO2) held constant (isocapnia) or allowed to decrease with hypoxic hyperventilation (poikilocapnia). We also quantified the contribution of CO2 on ventilation and heart rate by calculating the differences of isocapnic versus poikilocapnic hypoxic conditions (Δ V˙I/ΔPetCO2 and ΔHR/ΔPetCO2, respectively). Results: Male Tibetans had lower [Hb] compared to Han Chinese males (p < 0.05), consistent with reports for individuals from these populations living at high altitude and sea level. Measurements of ventilation (resting ventilation, HVR, and PetCO2) were similar for both groups. Heart rate responses to hypoxia were similar in both groups during isocapnia; however, HHRR in poikilocapnia was reduced in the Tibetan group (p < 0.03), and the heart rate response to CO2 in hypoxia was lower in Tibetans relative to Han Chinese (p < 0.01). Conclusion: These results suggest that Tibetans living at intermediate altitude have blunted cardiac responses in the context of hypoxia. Hence, only some of the phenotypes observed in Tibetans living at high altitude are observed in Tibetans living at intermediate altitude. Whereas blunted cardiac responses to hypoxia is revealed at intermediate altitudes, manifestation of other physiological adaptations to high altitude may require exposure to more severe levels of hypoxia.

4.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38734071

RESUMO

INTRODUCTION AND OBJECTIVES: The increasing number of robotic urological procedures observed in recent years highlights the need to expand training opportunities in robotic surgery. Our objective is to investigate the state of robotic training during urology residency in Spain in order to identify significant deficiencies. MATERIALS AND METHODS: A 20-item online survey was conducted among urology residents in Spain who were registered in the database of the Residents and Young Urologists Group of the Spanish Association of Urology. The survey assessed subjective opinions, institutional aspects, training resources, and experience regarding robotic surgery. A total of 455 email invitations were sent throughout the year 2021. Descriptive analysis of the responses was performed. RESULTS: The participation rate reached 30%, with a total of 135 residents. 52% of respondents lacked access to a robotic system in their institution, of which only 48% could compensate for this deficiency through external rotations. Among those with access to a robotic system, 25% and 23% reported having access to theoretical and practical training, respectively. The existence of a formal training program was low (13%). 85% of the respondents considered robotic surgery training in Spain to be deficient. CONCLUSIONS: Training for Spanish residents in robotic urological surgery is perceived as inadequate, emphasizing the crucial need for improvement in training programs in this field.

5.
Rev Esp Quimioter ; 37(4): 285-298, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38515374

RESUMO

Meningococcal meningitis (MM) and invasive meningococcal disease remain a major public health problem that generates enormous public alarm. It is caused by Neisseria meningitidis, a Gram-negative diplococcus with an enormous capacity for acute and rapidly progressive disease, both episodic and epidemic in nature, with early diagnosis and treatment playing a major role. It occurs at any age, but is most common in children under 5 years of age followed by adolescents. Although most cases occur in healthy people, the incidence is higher in certain risk groups. Despite advances in reducing the incidence, it is estimated that in 2017 there were around 5 million new cases of MM worldwide, causing approximately 290,000 deaths and a cumulative loss of about 20,000,000 years of healthy life. In Spain, in the 2021/22 season, 108 microbiologically confirmed cases of MM were reported, corresponding to an incidence rate of 0.23 cases per 100,000 inhabitants. This is a curable and, above all, vaccine-preventable disease, for which the World Health Organisation has drawn up a roadmap with the aim of reducing mortality and sequelae by 2030. For all these reasons, the Illustrious Official College of Physicians of Madrid (ICOMEM) and the Medical Associations of 8 other provinces of Spain, have prepared this opinion document on the situation of MM in Spain and the resources and preparation for the fight against it in our country. The COVID-19 and Emerging Pathogens Committee of ICOMEM has invited experts in the field to participate in the elaboration of this document.


Assuntos
Meningite Meningocócica , Humanos , Espanha/epidemiologia , Meningite Meningocócica/epidemiologia , Meningite Meningocócica/prevenção & controle , Incidência , Vacinas Meningocócicas , Neisseria meningitidis , Criança , Pré-Escolar , Adolescente
6.
Actas Urol Esp (Engl Ed) ; 47(7): 462-469, 2023 09.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37442224

RESUMO

OBJECTIVE: To analyze the current state of women in urology in Spain. MATERIAL AND METHODS: Descriptive study based on the results of an online survey sent between February and April 2020 through the database of the Residents and Young Urologists group (RAEU) of the Spanish Association of Urology (AEU). Characteristics of the survey and its results were analyzed. RESULTS: In total, 257 responses were obtained from 210 women (81.71%) and 47 men (18.29%) belonging to 111 hospitals. Statistically significant differences were observed (p < 0.001) with a higher proportion of men in all categories except for the group of young female and male attendings (29-39 years, p = 0.789), and the group of female residents against male residents (p = 0.814). The number of men was higher in hospitals with subspecialty units except for the Pelvic Floor Unit, where no statistically significant difference was observed (p = 0.06). Regarding positions of responsibility, only 7 out of 111 hospitals had female Department Chiefs. CONCLUSIONS: Women's representation in urology is increasing, mainly due to the younger generations. However, the access of these women to relevant positions is anecdotal.


Assuntos
Urologia , Humanos , Masculino , Feminino , Espanha , Urologistas , Inquéritos e Questionários
7.
Nurse Educ Today ; 116: 105417, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35691112

RESUMO

BACKGROUND: Service learning is an innovative educational approach that enables nursing students to directly participate and engage in the community while providing them and the community with benefits. OBJECTIVES: To summarise the evidence from service learning activities for nursing students, the educational and non-educational benefits derived through implementing this methodology, and the participating students' perceptions. DESIGN: An integrative review including qualitative, quantitative, and mixed methods designs was conducted. DATA SOURCES: The articles were identified through a systematic search in the following electronic databases: PubMed, Cochrane Library Plus, Scopus, CINAHL Complete (EBSCOHost), and Education Source (EBSCOHost). REVIEW METHODS: The search for studies was conducted in December 2020 using the following search terms: "Service learning", "Service-learning partnership", "Nursing", "Benefits" and "Intervention". RESULTS: A total of 22 articles were included. A positive relationship was found between the nursing students participating in service learning programmes and the acquisition of educational benefits, such as theoretical and practical learning, communication skills, and teamwork, and non-educational benefits, such as empathy, questioning prejudices, and commitment. In addition, a wide variety of activities and interventions were found to have been implemented using this academic approach, as well as a positive evaluation by the participating students. CONCLUSIONS: Service learning programmes with the active participation of nursing students generate benefits for both them and the community. First, these interventions receive positive evaluations from participating students. Furthermore, the interventions developed using service learning are varied and require motivation and creativity to implement them. However, there is a need for more experimental studies and the use of larger samples in service learning programmes.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Competência Clínica , Criatividade , Empatia , Humanos , Aprendizagem
8.
Food Secur ; 13(1): 113-128, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33224317

RESUMO

Wheat is one of the three basic cereals providing the necessary calorific intake for most of the world's population. For this reason, its trade is critical to many countries in order to fulfil their internal demand and strategic stocks. In this paper, we use complex network analysis tools to study the international wheat trade network and its evolving characteristics for the period 2009-2013. To understand the vulnerability of each country's dependence on the imports of this crop we have performed different analyses, simulating shocks of varying intensities for the main wheat producers, and observed the population affected by the production drop. As a result, we conclude that globally the network is slightly more resilient than four years previously, although at the same time some developing countries have slipped into a vulnerable situation. We have also analysed the effects of a global shock affecting all major producers, assessing its impact on every country. Some comments on the COVID-19 outbreak and the political decisions taken by governments following the pandemic declaration are included, observing that given their capital-intensive characteristics, no negative effects should currently be expected in the wheat market. Supplementary Information: The online version contains supplementary material available at 10.1007/s12571-020-01117-9.

9.
Nat Food ; 2(10): 819-827, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37117978

RESUMO

The effective utilization of natural variation has become essential in addressing the challenges that climate change and population growth pose to global food security. Currently adopted protracted approaches to introgress exotic alleles into elite cultivars need substantial transformation. Here, through a strategic three-way crossing scheme among diverse exotics and the best historical elites (exotic/elite1//elite2), 2,867 pre-breeding lines were developed, genotyped and screened for multiple agronomic traits in four mega-environments. A meta-genome-wide association study, selective sweeps and haplotype-block-based analyses unveiled selection footprints in the genomes of pre-breeding lines as well as exotic-specific associations with agronomic traits. A simulation with a neutrality assumption demonstrated that many pre-breeding lines had significant exotic contributions despite substantial selection bias towards elite genomes. National breeding programmes worldwide have adopted 95 lines for germplasm enhancement, and 7 additional lines are being advanced in varietal release trials. This study presents a great leap forwards in the mobilization of GenBank variation to the breeding pipelines.

10.
Eur Respir J ; 36(1): 143-50, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19996187

RESUMO

Intermittent hypoxia, a feature of obstructive sleep apnoea, potentiates ventilatory hypoxic responses, alters heart rate variability and produces hypertension, partially owing to an enhanced carotid body responsiveness to hypoxia. Since oxidative stress is a potential mediator of both chemosensory and cardiorespiratory alterations, we hypothesised that an antioxidant treatment may prevent these alterations. Accordingly, we studied the effects of ascorbic acid (1.25 g.L(-1) drinking water) on plasma lipid peroxidation, nitrotyrosine and inducible nitric oxide synthase (iNOS) immunoreactivity in the carotid body, ventilatory and carotid chemosensory responses to acute hypoxia, heart rate variability and arterial blood pressure in male Sprague-Dawley rats exposed to 5% O(2); 12 episodes.h(-1); 8 h.day(-1) or sham condition for 21 days. Intermittent hypoxia increased plasma lipid peroxidation, nitrotyrosine and iNOS expression in the carotid body, enhanced carotid chemosensory and ventilatory hypoxic responses, modified heart rate variability and produced hypertension. Ascorbic acid prevented the increased plasma lipid peroxidation and nitrotyrosine formation within the carotid body, and the enhanced carotid chemosensory and ventilatory responses to hypoxia, as well as heart rate variability alterations and hypertension. The present results support an essential role for oxidative stress in the generation of carotid body chemosensory potentiation and systemic cardiorespiratory alterations induced by intermittent hypoxia.


Assuntos
Antioxidantes/uso terapêutico , Ácido Ascórbico/uso terapêutico , Corpo Carotídeo/efeitos dos fármacos , Hipóxia/prevenção & controle , Apneia Obstrutiva do Sono/complicações , Animais , Ácido Ascórbico/administração & dosagem , Corpo Carotídeo/fisiopatologia , Células Quimiorreceptoras/metabolismo , Células Quimiorreceptoras/fisiologia , Frequência Cardíaca/efeitos dos fármacos , Frequência Cardíaca/fisiologia , Hipertensão/tratamento farmacológico , Hipertensão/metabolismo , Hipertensão/fisiopatologia , Hipóxia/etiologia , Peroxidação de Lipídeos , Lipídeos/sangue , Masculino , Malondialdeído/análise , Óxido Nítrico Sintase Tipo II/análise , Nitrosaminas/análise , Estresse Oxidativo/efeitos dos fármacos , Estresse Oxidativo/fisiologia , Ventilação Pulmonar/efeitos dos fármacos , Ventilação Pulmonar/fisiologia , Ratos , Tirosina/análogos & derivados , Tirosina/análise
11.
Nefrologia ; 30(2): 252-7, 2010.
Artigo em Espanhol | MEDLINE | ID: mdl-20098463

RESUMO

In our Universitary Hospital of Canarias we iniciated in May 2008 a induction therapy protocol for sensitized patients receiving cadaveric renal graft using intravenous immunoglobulins, plasmapheresis and rituximab plus immunosuppression with prednisone, tacrolimus and mycophenolate mofetil. We present the results of four patients. Everyone had anti-HLA antibodies rate (PRA by CDC) more than 75%, were on a waiting list during 4 to 17 years and follow-up time was 10-14 months after transplantation. Patient and graft survival in this period was 100%. Only one patient suffered a humoral acute rejection and another one cellular rejection, in both cases reversible with treatment. During the first year, no evidence of de novo donor-specific antibodies was detected. All patients had significantly reduced the CD19+ cells percentage after infusion of rituximab. Neurological symptoms suggestive of progressive multifocal leukoencephalopathy or serious viral infections after transplantation have not been observed. Additionally, no immediate side effects were observed after administration of medication. In summary, induction therapy by combining immunoglobulin, plasmapheresis and rituximab in hypersensitive patients allows the realization of deceased kidney transplantation with good results in the short and medium-term without serious side effects. It remains to know whether this success will continue in the long term.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Rejeição de Enxerto/prevenção & controle , Antígenos HLA/imunologia , Imunoglobulinas Intravenosas/uso terapêutico , Imunossupressores/uso terapêutico , Transplante de Rim/imunologia , Plasmaferese , Pré-Medicação , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais Murinos , Cadáver , Terapia Combinada , Feminino , Histocompatibilidade , Humanos , Imunização , Imunoglobulinas Intravenosas/administração & dosagem , Imunossupressores/administração & dosagem , Isoanticorpos/sangue , Falência Renal Crônica/imunologia , Falência Renal Crônica/cirurgia , Masculino , Pessoa de Meia-Idade , Ácido Micofenólico/administração & dosagem , Ácido Micofenólico/análogos & derivados , Ácido Micofenólico/uso terapêutico , Prednisona/administração & dosagem , Prednisona/uso terapêutico , Reoperação , Rituximab , Tacrolimo/administração & dosagem , Tacrolimo/uso terapêutico , Doadores de Tecidos
12.
J Int Neuropsychol Soc ; 15(2): 302-6, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19203440

RESUMO

Shared vulnerabilities have been described across disorders of impulse control, including pathological gambling (PG) and bulimia nervosa (BN). Our aim was to compare the executive functioning of PG and BN females in order to confirm their similarity at a neurocognitive level. A total of 15 BN females, 15 PG females, and 15 healthy control (HC) females were administered the Wisconsin Card Sorting Test (WCST) and the Stroop Color and Word Test. Analysis of covariance adjusted for age and education was conducted to compare groups. PG showed the greatest impairment, that is, the highest percentage of WCST perseverative errors (p = .023), the lowest percentage of conceptual-level responses (p = .034), and the highest number of total trials administered (p = .021), while BN showed the highest percentage of WCST nonperseverative errors (p = .003). Both BN and PG females demonstrated executive dysfunction relative to HCs but different specific correlates (i.e., greater vulnerability to distraction in BN, but more cognitive inflexibility in PG).


Assuntos
Bulimia Nervosa/fisiopatologia , Bulimia Nervosa/psicologia , Jogo de Azar/psicologia , Resolução de Problemas/fisiologia , Adulto , Análise de Variância , Feminino , Humanos , Pessoa de Meia-Idade , Testes Neuropsicológicos , Tempo de Reação , Adulto Jovem
13.
Adv Exp Med Biol ; 648: 177-84, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19536479

RESUMO

It has been proposed that histamine is an excitatory transmitter between the glomus cells of the carotid body (CB) and the nerve endings of the petrosal ganglion (PG) neurons. The histamine biosynthetic pathway and the presence of histamine H1, H2 and H3 receptors have been reported in the CB. Thus, histamine meets some of the criteria to be regarded as a transmitter. However, there is no evidence that glomus cells contain histamine, or whether its application produces chemosensory excitation. Therefore, we studied its immunocytochemical localization on cat CB and its effects on chemosensory activity. Using perfused and superfused in vitro CB and PG preparations, we assessed the effects of histamine hydrochloride on chemosensory discharges and of histamine H1, H2 and H3 receptor blockers. We found the presence of histamine immunoreactivity in dense-core vesicles in glomus cells. In an in vitro CB preparation we performed pharmacological experiments to characterize histamine effects. The application of histamine hydrochloride (0.5-1,000 microg) to the CB produces a dose-dependent increase in the carotid sinus nerve activity. The H1 receptor blockade with pyrilamine 500 nM produces partial decrease of the histamine-induced response, whereas the H2 receptor blockade (ranitidine 100microM) fail to abolish the histamine excitatory effects. Antagonism of the H3 receptor results in an increase in carotid body chemosensory activity. On the other hand, application of histamine to the isolated PG had no effect on the carotid nerve discharge. Our results suggest that histamine is a modulator of the carotid body chemoreception through H1 and H3 receptor activation.


Assuntos
Corpo Carotídeo/efeitos dos fármacos , Corpo Carotídeo/metabolismo , Histamina/metabolismo , Histamina/farmacologia , Animais , Gatos , Relação Dose-Resposta a Droga , Antagonistas dos Receptores Histamínicos/farmacologia , Técnicas In Vitro , Masculino , Pirilamina/farmacologia
14.
Adv Exp Med Biol ; 648: 329-35, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19536496

RESUMO

It has been proposed that chronic intermittent hypoxia (CIH) contributes to generate hypertension in patients with obstructive sleep apnea syndrome and animal models, due to an enhanced sympathetic outflow. A possible contributing mechanism to the CIH-induced hypertension is a potentiation of carotid body (CB) chemosensory responses to hypoxia, but early changes that precede the CIH-induced hypertension are not completely known. Since the variability of heart rate (HRV) has been used as an index of autonomic influences on cardiovascular system, we studied the effects of short and long-term CIH exposure on HRV in animals with or without hypertension. In cats exposed to CIH (PO(2) approximately 75 Torr, 10 times/hr during 8 hr) for 4 days, the ventilatory response to acute hypoxia was potentiated, the arterial pressure remained unchanged, but the HRV power spectrum showed a shift towards the low frequency band. Exposure of rats to CIH (PO(2) approximately 37.5 Torr, 12 times/hr during 8 hr) for 12 days enhanced the ventilatory response to acute hypoxia, but did not increase the arterial pressure. After 21 days of CIH, we found a significant increase of arterial pressure and a shift of the HRV power spectrum towards the low frequency band. Thus, our results support the idea that hypertension induced by long-term CIH was preceded by alterations in the autonomic balance of HRV, associated with an enhance CB chemoreflex sensitivity to hypoxia. Therefore, few days of CIH are enough to enhance the CB reactivity to hypoxia, which contribute to the augmented ventilatory response to hypoxia, and to the early alterations in the autonomic balance of HRV.


Assuntos
Adaptação Fisiológica , Sistema Cardiovascular/fisiopatologia , Hipóxia/fisiopatologia , Ventilação Pulmonar , Animais , Pressão Sanguínea , Gatos , Frequência Cardíaca , Hipertensão/fisiopatologia , Masculino , Ratos , Fatores de Tempo
15.
J Gambl Stud ; 25(1): 93-104, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18592357

RESUMO

The aim of this study was to measure the reliability, validity, and classification accuracy of a Spanish translation of a measure of DSM-IV diagnostic criteria for Pathological Gambling (PG). Participants were 263 male and 23 female patients seeking treatment for PG and a matched non-psychiatric control sample of 259 men and 24 women. A Spanish translation of a 19-item measure of DSM-IV diagnostic criteria for PG (Stinchfield 2003) was administered along with other validity measures. The DSM-IV diagnostic criteria were found to be internally consistent with a coefficient alpha of .95 in the combined sample. Evidence of satisfactory convergent validity included moderate to high correlations with other measures of problem gambling. Using the standard DSM-IV cut-score of five, the ten criteria were found to yield satisfactory classification accuracy results with a high hit rate (.95), high sensitivity (.92), high specificity (.99), low false positive (.01), and low false negative rate (.08). Lowering the cut score to four resulted in modest improvements in classification accuracy and reduced the false negative rate from .08 to .05. The Spanish translation of a measure of DSM-IV diagnostic criteria for PG demonstrated satisfactory psychometric properties and a cut score of four improved diagnostic precision.


Assuntos
Comportamento Aditivo/classificação , Comportamento Aditivo/diagnóstico , Manual Diagnóstico e Estatístico de Transtornos Mentais , Jogo de Azar , Inquéritos e Questionários/normas , Tradução , Adulto , Comportamento Aditivo/epidemiologia , Análise Fatorial , Feminino , Jogo de Azar/psicologia , Humanos , Masculino , Modelos Psicológicos , Escalas de Graduação Psiquiátrica , Psicometria , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
17.
Monaldi Arch Chest Dis ; 65(3): 145-51, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17220104

RESUMO

BACKGROUND: Although non-invasive ventilation (NIV) efficacy in the treatment of acute hypercapnic respiratory failure (AHRF) have been previously demonstrated, not all the studies reveal this fact in the same degree, with some variability in the results. This study aimed to analyse variables related to NIV outcome for AHRF. METHODS: A group of consecutive patients requiring NIV due to AHRF were included in a prospective observational cohort study performed in conventional wards. Variables considered included those reported in the literature, as well as staff problems during the management of the ventilators. The study aimed to include all patients during one year, but after the initial results, it had to be suspended. RESULTS: Fifteen patients were included in the study: 10 males, mean age 68+/-12. APACHE-II score was 17.6+/-6.5. pH and pCO2 before NIV were 7.22+/-0.11 and 110+/-72 mmHg respectively. pH, corticosteroids use, APACHE score, and EPAP were found to influence outcome. Besides, an inadequate use of NIV due to lack of personnel training was detected in all patients with NIV failure (RR 3.5; 95% CI: 1.08-11.2; p = 0.007). In the light of these results, the study had to be suspended and patients were transferred to the respiratory ward. CONCLUSIONS: NIV is a life-saving respiratory treatment influenced by several factors, of which staff training is a key one. Centres attending acute respiratory patients should have an area in which this requirement is fulfilled.


Assuntos
Hipercapnia/terapia , Respiração com Pressão Positiva/métodos , Insuficiência Respiratória/terapia , APACHE , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Estudos de Coortes , Interpretação Estatística de Dados , Feminino , Pessoal de Saúde , Humanos , Máscaras Laríngeas , Masculino , Máscaras , Pessoa de Meia-Idade , Seleção de Pacientes , Respiração com Pressão Positiva/efeitos adversos , Respiração com Pressão Positiva/instrumentação , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento
18.
Sci Rep ; 6: 27312, 2016 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-27311707

RESUMO

Genomic and pedigree predictions for grain yield and agronomic traits were carried out using high density molecular data on a set of 803 spring wheat lines that were evaluated in 5 sites characterized by several environmental co-variables. Seven statistical models were tested using two random cross-validations schemes. Two other prediction problems were studied, namely predicting the lines' performance at one site with another (pairwise-site) and at untested sites (leave-one-site-out). Grain yield ranged from 3.7 to 9.0 t ha(-1) across sites. The best predictability was observed when genotypic and pedigree data were included in the models and their interaction with sites and the environmental co-variables. The leave-one-site-out increased average prediction accuracy over pairwise-site for all the traits, specifically from 0.27 to 0.36 for grain yield. Days to anthesis, maturity, and plant height predictions had high heritability and gave the highest accuracy for prediction models. Genomic and pedigree models coupled with environmental co-variables gave high prediction accuracy due to high genetic correlation between sites. This study provides an example of model prediction considering climate data along-with genomic and pedigree information. Such comprehensive models can be used to achieve rapid enhancement of wheat yield enhancement in current and future climate change scenario.


Assuntos
Agricultura , Grão Comestível/genética , Triticum/genética , Pão , Meio Ambiente , Variação Genética/genética , Genoma de Planta/genética , Genótipo , Modelos Estatísticos , Estações do Ano , Tempo (Meteorologia)
19.
Oncogene ; 35(20): 2615-23, 2016 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-26364614

RESUMO

Glioblastoma are malignant highly vascularized brain tumours, which feature large oedema resulting from tumour-promoted vascular leakage. The pro-permeability factor Semaphorin3A (Sema3A) produced within glioblastoma has been linked to the loss of endothelial barrier integrity. Here, we report that extracellular vesicles (EVs) released by patient-derived glioblastoma cells disrupt the endothelial barrier. EVs expressed Sema3A at their surface, which accounted for in vitro elevation of brain endothelial permeability and in vivo vascular permeability, in both skin and brain vasculature. Blocking Sema3A or its receptor Neuropilin1 (NRP1) hampered EV-mediated permeability. In vivo models using ectopically and orthotopically xenografted mice revealed that Sema3A-containing EVs were efficiently detected in the blood stream. In keeping with this idea, sera from glioblastoma multiforme (GBM) patients also contain high levels of Sema3A carried in the EV fraction that enhanced vascular permeability, in a Sema3A/NRP1-dependent manner. Our results suggest that EV-delivered Sema3A orchestrates loss of barrier integrity in glioblastoma and may be of interest for prognostic purposes.


Assuntos
Permeabilidade Capilar , Vesículas Extracelulares/metabolismo , Glioblastoma/metabolismo , Glioblastoma/patologia , Semaforina-3A/metabolismo , Idoso , Idoso de 80 Anos ou mais , Animais , Linhagem Celular Tumoral , Endotélio Vascular/metabolismo , Feminino , Glioblastoma/irrigação sanguínea , Humanos , Masculino , Camundongos , Pessoa de Meia-Idade , Neuropilina-1/metabolismo , Transporte Proteico
20.
Schizophr Res ; 178(1-3): 6-11, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27632907

RESUMO

BACKGROUND: A key finding underlying the continuum of psychosis concept is the presence of psychotic-like experiences (PLEs) in healthy subjects. However, it remains uncertain to what extent these experiences are related to the genetic risk for schizophrenia and how far they actually resemble attenuated forms of psychotic symptoms. METHODS: Forty-nine adults with no history of mental illness in first-degree relatives and 59 siblings of patients with schizophrenia were rated on the psychosis section of the Computerized Diagnostic Interview Schedule IV (C DIS-IV) and the Rust Inventory of Schizotypal Cognitions (RISC). Those who rated positive on the CDIS-IV were re-interviewed using the lifetime version of the Present State Examination 9th edition (PSE-9) and the Structured interview for Schizotypy (SIS). RESULTS: Seventeen (34.69%) of the non-relatives and 22 (37.29%) of the relatives responded positively to one or more of the psychosis questions on the DIS. This difference was not significant. RISC scores were also similar between the groups. At follow-up interview with the PSE-9, 13/40 PLEs (32.50%) in the non-relatives were classified as possible or probable psychotic symptoms compared to 11/46 (23.91%) in the relatives. Using liberal symptom thresholds, 5 of those who attended the follow-up interview (2 non-relatives and 3 relatives) met SIS criteria for schizotypal personality disorder. CONCLUSIONS: Rates of PLEs, however considered, do not differ substantially between relatives and non-relatives of patients with schizophrenia. Only a minority of PLEs picked up by screening interviews resemble attenuated forms of psychotic symptoms.


Assuntos
Família , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologia , Esquizofrenia/epidemiologia , Psicologia do Esquizofrênico , Adulto , Família/psicologia , Feminino , Seguimentos , Predisposição Genética para Doença , Humanos , Entrevista Psicológica , Masculino , Fenótipo , Transtornos Psicóticos/genética , Esquizofrenia/genética , Transtorno da Personalidade Esquizotípica/epidemiologia , Transtorno da Personalidade Esquizotípica/genética , Transtorno da Personalidade Esquizotípica/psicologia
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