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1.
Heliyon ; 10(9): e29781, 2024 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-38698978

RESUMEN

Supermarkets are significant consumers of electricity and contribute to the generation of associated pollutant emissions. This will help to mitigate the impact of increased energy costs on the prices of products sold in supermarkets. Therefore, it is essential to reduce energy consumption, starting with the equipment that consumes the most electricity, such as refrigeration, and using the residual thermal energy generated in supermarkets. This paper discusses the impact of rising energy costs in the post-Covid era and during the energy crisis. It evaluates the environmental and energy benefits of implementing energy improvements and utilizing residual energy in real supermarkets. The analysis takes into account the socio-economic characteristics of the EU-27 countries, which affect the economic feasibility of these measures. This would prevent the release of 122 tons of CO2 per year for each supermarket, resulting in energy savings of around 70 % or 305 kWh/m2. The required investments would have a payback period of 4 years.

2.
Waste Manag ; 181: 101-113, 2024 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-38603994

RESUMEN

Significant quantities of Posidonia oceanica deposit on some beaches and coastlines every year, which generates high costs associated with the disposal of this waste. Pyrolysis may be an adequate way for its valorization. However, it would imply to know how the process takes place and if the removal of its natural detrital inorganic matter (epiphytes, marine salt and sand) is necessary, which are the objectives of this research. Pyrolysis by thermogravimetry-mass spectrometry was carried out on both the washed and unwashed samples. During this waste pyrolysis, the following occurs: (i) the high alkali metal chloride content promotes fragmentation reactions of carbohydrates and O formation, which increases HCOOH intensities at temperatures between 250 and 360 °C; (ii) from 500 °C to 650 °C, Fe2O3 and decomposition of carbonates seem to be involved in reactions that produce O release and steam and CO2 reforming of hydrocarbons and oxygenated organic compounds with H2 generation; (iii) from 650 °C to 750 °C, Fe2O3, high alkali metal content and carbonate decomposition generate char gasification, an increase in O release, SO2 capture and HCOOH formation. In general, the abundance of inorganic matter (chlorides, carbonates, etc.) minimizes the release of various compounds during pyrolysis, including SO2 and HCl, while increasing HCOOH production. Thus, this high content of inorganic matter may represent an advantage for its pyrolysis, producing value-added chemical products with a reduced environmental impact. Therefore, this study may be the starting point for defining the optimal pyrolysis conditions for this waste valorisation.


Asunto(s)
Alismatales , Pirólisis , Dióxido de Azufre , Alismatales/química , Dióxido de Azufre/química , Ácido Clorhídrico/química , Termogravimetría , Oxígeno/química
3.
Materials (Basel) ; 17(6)2024 Mar 16.
Artículo en Inglés | MEDLINE | ID: mdl-38541514

RESUMEN

Invisible orthodontic aligners are having a great impact on tooth movement in an aesthetic and effective way. Different techniques, models, and clinical aspects have been studied for their proper use. However, the aim of this research has been to determine the effect of the shaping process on mechanical properties and their bacterial behavior. For this study, 40 original polyurethane plates and 40 identical models, obtained by hot forming the original plates, were used. The static tensile mechanical properties were studied with a Zwick testing machine using testing speeds of 5 mm/min at a temperature of 37 °C. The original plate and the aligner have been studied with a creep test by subjecting the samples to a constant tension of 30 N, and determining the elongation using a long-distance, high-resolution microscope at different time periods between 1 and 720 h. Studies of water absorption has been realized with artificial saliva for 5 h. Bacterial cultures of Streptococcus oralis and Actinomyces viscosus strains were grown on the original plates and on new and used models, to determine the proliferation of each bacterium through metabolic activity, colony-forming units, and LIVE/DEAD assays. The mechanical results showed an increase in the strength of the inserts with respect to the models obtained from 3.44 to 3.95 MPa in the elastic limit and a lower deformation capacity. It has been proven that the transition zone in the creep curves lasts longer in the original plate, producing the rapid increase in deformation at a shorter time (400 h) in the aligner. Therefore, the shaping process reduces the time of dental correction exerted by the aligner. The results of the bacterial culture assays show an increase in the number of bacterial colonies when the aligners have been used and when the polyurethane is conformed due to the internal energy of the model, with respect to the original polyurethane. It has been observed that between the original plate and the aligner there are no statistically significant differences in water absorption and therefore the forming process does not affect water absorption. A slight increase in water absorption can be observed, but after five hours of exposure, the increase is very small.

4.
Arch Gerontol Geriatr ; 117: 105276, 2024 02.
Artículo en Inglés | MEDLINE | ID: mdl-37984196

RESUMEN

BACKGROUND: This study aims to describe the distribution and temporal trends of the centenarian population and their hospital admissions in Spain over the past two decades, focusing on regional and sex-based differences. METHODS: A retrospective study was conducted using data from the Spanish National Health System's Hospital Discharge Records-Minimum Basic Data Set. The analysis included all hospitalized patients ≥100 years between January 2004 and December 2020. The crude annual centenarian population and admission rates were calculated. Joinpoint regression analysis and cross-correlation analysis were used to identify trends and associations. RESULTS: From 2004 to 2020, the centenarian population in Spain increased by 89.0 %, with a larger increase observed in women (86.6 %) than men (32.9 %). Significant geographic variability was found, with rates from 1.1 to 5.2 × 10,000 inhabitants per year across different regions. Joinpoint analysis identified three trends: a decline from 2004 to 2008, an increase from 2008 to 2015, and a slower increase from 2015 to 2020. Hospital admissions of centenarians increased by 121.5 %, with a larger increase in women than men (212.1% vs 90.7 %); women represented 75.4 % of admissions. The proportion of centenarian admissions to total hospitalizations showed an upward trend until 2015 and then stabilized; it also varied among regions. CONCLUSION: There was a significant increase in the centenarian population and hospital admissions of centenarians in Spain. There are regional disparities in their distribution, with women representing a larger proportion of centenarians and hospital admissions. Understanding these trends and differences is crucial for implementing interventions that ensure adequate healthcare for centenarians.


Asunto(s)
Centenarios , Hospitalización , Masculino , Anciano de 80 o más Años , Humanos , Femenino , Estudios Retrospectivos , España/epidemiología , Dinámica Poblacional , Hospitales
5.
Rev Esp Cardiol (Engl Ed) ; 76(12): 1021-1031, 2023 Dec.
Artículo en Inglés, Español | MEDLINE | ID: mdl-37863184

RESUMEN

INTRODUCTION AND OBJECTIVES: This article presents the annual activity report of the Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC) for the year 2022. METHODS: All Spanish centers with catheterization laboratories were invited to participate. Data were collected online and were analyzed by an external company in collaboration with the members of the board of the ACI-SEC. RESULTS: A total of 111 centers participated. The number of diagnostic studies increased by 4.8% compared with 2021, while that of percutaneous coronary interventions (PCI) remained stable. PCIs on the left main coronary artery increased by 22%. The radial approach continued to be preferred for PCI (94.9%). There was an upsurge in the use of drug-eluting balloons, as well as in intracoronary imaging techniques, which were used in 14.7% of PCIs. The use of pressure wires also increased (6.3% vs 2021) as did plaque modification techniques. Primary PCI continued to grow and was the most frequent treatment (97%) in ST-segment elevation myocardial infarction. Most noncoronary procedures maintained their upward trend, particularly percutaneous aortic valve implantation, atrial appendage closure, mitral/tricuspid edge-to-edge therapy, renal denervation, and percutaneous treatment of pulmonary arterial disease. CONCLUSIONS: The Spanish cardiac catheterization and coronary intervention registry for 2022 reveals a rise in the complexity of coronary disease, along with a notable growth in procedures for valvular and nonvalvular structural heart disease.


Asunto(s)
Cardiología , Enfermedad de la Arteria Coronaria , Intervención Coronaria Percutánea , Humanos , Cateterismo Cardíaco , Sistema de Registros
6.
Front Pharmacol ; 14: 1252184, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37767403

RESUMEN

Introduction: Perinatal asphyxia (PA) represents a major problem in perinatology and may cause visual losses, including blindness. We, and others, have shown that hypothermia prevents retinal symptoms associated to PA. In the present work, we evaluate whether a hypothermia mimetic small molecule, zr17-2, has similar effects in the context of PA. Methods: Four experimental groups were studied in male rats: Naturally born rats as controls (CTL), naturally born rats injected s.c. with 50 µL of 330 nmols/L zr17-2 (ZR), animals that were exposed to PA for 20 min at 37°C (PA), and rats that were exposed to PA and injected with zr17-2 (PA-ZR). Forty-five days after treatment, animals were subjected to electroretinography. In addition, morphological techniques (TUNEL, H&E, multiple immunofluorescence) were applied to the retinas. Results: A reduction in the amplitude of the a- and b-wave and oscillatory potentials (OP) of the electroretinogram (ERG) was detected in PA animals. Treatment with zr17-2 resulted in a significant amelioration of these parameters (p < 0.01). In PA animals, a large number of apoptotic cells was found in the GCL. This number was significantly reduced by treatment with the small molecule (p < 0.0001). In a similar way, the thickness of the inner retina and the intensity of GFAP immunoreactivity (gliosis) increased in PA retinas (p < 0.0001). These parameters were corrected by the administration of zr17-2 (p < 0.0001). Furthermore, injection of the small molecule in the absence of PA did not modify the ERG nor the morphological parameters studied, suggesting a lack of toxicity. Discussion: In conclusion, our results indicate that a single s.c. injection of zr17-2 in asphyctic neonates may provide a novel and efficacious method to prevent the visual sequelae of PA.

7.
Intern Emerg Med ; 18(6): 1665-1671, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37261558

RESUMEN

Advanced heart failure (HF) with congestive symptoms refractory to diuretic treatment worsens the patient's prognosis and quality of life. Peritoneal ultrafiltration (PUF) attempts to improve symptoms and reduce HF-related events. This study analyzes the impact of PUF on older adult patients with significant comorbidity and advanced HF. Eighteen patients with advanced HF attended to in the Internal Medicine HF Unit of the Lucus Augusti University Hospital of Lugo, Spain, who started PUF between 2014 and 2021 were analyzed. The number of admissions and instances in which diuretic rescue treatment was used in the year before and after starting PUF were compared. The evolution of renal function, complications secondary to the technique, and survival were also analyzed. The median age was 80 (SD 5.8) years and 72.2% were men. Comparing the year after starting PUF to the year before starting PUF, hospital admissions due to HF (4 vs 20, p = 0.01) and the use of intravenous diuretic rescue treatment declined (4 vs 118, p < 0.001). There was no significant deterioration in renal function during the first year of follow-up or major complications associated with the technique. Survival was 72% at 1 year. In older adult patients with comorbidity, advanced HF, and refractory congestive symptoms, PUF reduced hospital admissions and the use of intravenous diuretic rescue treatment, without major complications.


Asunto(s)
Insuficiencia Cardíaca , Diálisis Peritoneal , Masculino , Humanos , Anciano , Anciano de 80 o más Años , Femenino , Ultrafiltración , Diálisis Peritoneal/métodos , Calidad de Vida , Diuréticos/uso terapéutico
8.
J Refract Surg ; 39(5): 347-353, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-37162395

RESUMEN

PURPOSE: To evaluate the keratometry agreement between two swept-source devices for healthy and post-refractive surgery eyes and compare them. METHODS: One hundred volunteers between 20 and 55 years of age were recruited for this study including both healthy and post-refractive surgery eyes. Three consecutive measurements of simulated keratometry (Sim K), posterior keratometry (PK), and total keratometry (TK) were obtained with the IOLMaster 700 and Anterion. The agreement was assessed through the Bland-Altman method. Limits of agreement (LoA) were calculated as mean difference ±1.96·SD and it represents the 95% of the differences between devices. RESULTS: For both groups, Sim K measurements exhibited a mean difference close to 0 and within a range of ±0.30 and ±0.36 diopters (D) for the control and post-refractive surgery groups, respectively. Meanwhile, the IOLMaster 700 provided flatter PK values (0.30 D on average) for both groups. In general, the post-refractive surgery group exhibited slightly greater mean differences and wider 95% LoA than the control group for Sim K and PK. Steeper TK values were obtained by the IOLMaster in both groups (control = 0.50 D and post-refractive surgery = 0.75 D). TK differences between devices were significantly greater in the post-refractive surgery group (ranging from 0.38 to 1.14 D) compared to the control group (ranging from 0.15 to 0.85 D). CONCLUSIONS: The IOLMaster 700 and Anterion are not interchangeable for TK measurements and eyes that had corneal refractive surgery even decreased the agreement between devices. Differences between devices for Sim K and PK measurements should be clinically judged, particularly in eyes with previous corneal surgery. [J Refract Surg. 2023;39(5):347-353.].


Asunto(s)
Queratomileusis por Láser In Situ , Tomografía de Coherencia Óptica , Humanos , Topografía de la Córnea/métodos , Córnea , Queratomileusis por Láser In Situ/métodos , Estudios Prospectivos , Reproducibilidad de los Resultados , Biometría/métodos
9.
Sci Rep ; 13(1): 4068, 2023 03 11.
Artículo en Inglés | MEDLINE | ID: mdl-36906719

RESUMEN

A collaborative project in different areas of Spain and Portugal was designed to find out the variables that influence the mortality after discharge and develop a prognostic model adapted to the current healthcare needs of chronic patients in an internal medicine ward. Inclusion criteria were being admitted to an Internal Medicine department and at least one chronic disease. Patients' physical dependence was measured through Barthel index (BI). Pfeiffer test (PT) was used to establish cognitive status. We conducted logistic regression and Cox proportional hazard models to analyze the influence of those variables on one-year mortality. We also developed an external validation once decided the variables included in the index. We enrolled 1406 patients. Mean age was 79.5 (SD = 11.5) and females were 56.5%. After the follow-up period, 514 patients (36.6%) died. Five variables were identified as significantly associated with 1 year mortality: age, being male, lower BI punctuation, neoplasia and atrial fibrillation. A model with such variables was created to estimate one-year mortality risk, leading to the CHRONIBERIA. A ROC curve was made to determine the reliability of this index when applied to the global sample. An AUC of 0.72 (0.7-0.75) was obtained. The external validation of the index was successful and showed an AUC of 0.73 (0.67-0.79). Atrial fibrillation along with an advanced age, being male, low BI score, or an active neoplasia in chronic patients could be critical to identify high risk multiple chronic conditions patients. Together, these variables constitute the new CHRONIBERIA index.


Asunto(s)
Fibrilación Atrial , Neoplasias , Femenino , Humanos , Masculino , Anciano , Reproducibilidad de los Resultados , Estudios Prospectivos , Pronóstico , Hospitalización
10.
Andrology ; 11(1): 24-31, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36375449

RESUMEN

BACKGROUND: Ample evidence indicates a sex-related difference in severity of COVID-19, with less favorable outcomes observed in men. Genetic factors have been proposed as candidates to explain this difference. The polyglutamine (polyQ) polymorphism in the androgen receptor gene has been recently described as a genetic biomarker of COVID-19 severity. OBJECTIVE: To test the association between the androgen receptor polyQ polymorphism and COVID-19 severity in a large cohort of COVID-19 male patients. MATERIALS AND METHODS: This study included 1136 male patients infected with SARS-CoV-2 as confirmed by positive PCR. Patients were retrospectively and prospectively enrolled from March to November 2020. Patients were classified according to their severity into three categories: oligosymptomatic, hospitalized and severe patients requiring ventilatory support. The number of CAG repeats (polyQ polymorphism) at the androgen receptor was obtained by PCR and patients were classified as either short (<23 repeats) or long (≥23 repeats) allele carriers. The association between polyQ alleles (short or long) and COVID-19 severity was assessed by Chi-squared (Chi2 ) and logistic regression analysis. RESULTS: The mean number of polyQ CAG repeats was 22 (±3). Patients were classified as oligosymptomatic (15.5%), hospitalized (63.2%), and severe patients (21.3%) requiring substantial respiratory support. PolyQ alleles distribution did not show significant differences between severity classes in our cohort (Chi2 test p > 0.05). Similar results were observed after adjusting by known risk factors such as age, comorbidities, and ethnicity (multivariate logistic regression analysis). DISCUSSION: Androgen sensitivity may be a critical factor in COVID-19 disease severity. However, we did not find an association between the polyQ polymorphism and the COVID-19 severity. Additional studies are needed to clarify the mechanism underlying the association between androgens and COVID-19 outcome. CONCLUSIONS: The results obtained in our study do not support the role of this polymorphism as biomarker of COVID-19 severity.


Asunto(s)
COVID-19 , Receptores Androgénicos , Humanos , Masculino , Receptores Androgénicos/genética , Alelos , Repeticiones de Trinucleótidos/genética , Estudios Retrospectivos , COVID-19/genética , SARS-CoV-2/genética , Biomarcadores
11.
Plant Cell Environ ; 46(10): 2985-2997, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-36180381

RESUMEN

Plant responses against pathogens are influenced by growth immunity tradeoff, which ensure the best use of limited resources. We study how the immobilization of carbon resources and the induction of defensive responses (glucosinolates, phenolic compounds, stomatal closure) can influence the biomass of two Brassica oleracea lines, differing in their resistance, after infection with Xanthomonas campestris pv. campestris. Potentially, the growth immunity tradeoff can be influenced by the activation of all these processes. However, on the contrary of which is normally stated, our results suggest that the loss of biomass caused by pathogen infection is mainly due to the differential accumulation of starch and the immobilization of sugars rather than the reallocation of resources to synthesize secondary metabolites. Moreover, resistance may be related to the effectiveness of the tradeoff, since the resistant line immobilizes resources more efficiently than the susceptible one. Both inbred lines show a different phytohormones profile, which support the hypothesis that they are employing different strategies to defend themselves against the pathogen. This study emphasizes the key role of the primary metabolism in the defence strategies of plants against pathogens.


Asunto(s)
Brassica , Xanthomonas campestris , Brassica/metabolismo , Enfermedades de las Plantas , Glucosinolatos/metabolismo
12.
Materials (Basel) ; 15(21)2022 Oct 25.
Artículo en Inglés | MEDLINE | ID: mdl-36363077

RESUMEN

Titanium mini-implants are used as anchorage for orthodontic tooth movements. However, these implants present problems due to the infection of surrounding tissues. The aim of this work was to obtain a polyethylene glycol (PEG) layer by plasma in order to achieve a bacteriostatic surface. Titanium surfaces were activated by argon plasma and, after, by PEG plasma with different powers (100, 150 and 200 W) for 30 and 60 min. The roughness was determined by white light interferometer microscopy and the wettability was determined by the contact angle technique. Surface chemical compositions were characterized by X-ray photoelectron spectroscopy (XPS) and cytocompatibility and cell adhesion studies were performed with fibroblast (hFFs) and osteoblast (SAOS-2) cells. Bacterial cultures with Spectrococcus Sanguinis and Lactobacillus Salivarius were performed, and bacterial colonization was determined. The results showed that plasma treatments do not affect the roughness. Plasma makes the surfaces more hydrophilic by decreasing the contact angles from 64.2° for titanium to 5.2° for argon-activated titanium, with values ranging from 12° to 25° for the different PEG treatments. The plasma has two effects: the cleaning of the surface and the formation of the PEG layer. The biocompatibility results were, for all cases, higher than 80%. The polymerization treatment with PEG reduced the adhesion of hFFs from 7000 to 6000 and, for SAOS-2, from 14,000 to 6500, for pure titanium and those treated with PEG, respectively. Bacterial adhesion was also reduced from 600 to 300 CFU/mm2 for Spetrococcuns Sanguinis and from 10,000 to 900 CFU/mm2 for Lactobacillus Salivarius. The best bacteriostatic treatment corresponded to PEG at 100 W and 30 s. As a consequence, the PEG coating would significantly prevent the formation of bacterial biofilm on the surface of titanium mini-implants.

13.
Rev. peru. med. exp. salud publica ; 39(4): 480-488, oct. 2022. tab
Artículo en Español | LILACS, LIPECS | ID: biblio-1424350

RESUMEN

La venta de productos ultraprocesados y el sobrepeso y la obesidad han aumentado en América Latina en los últimos años. En el Perú, se aprobó la Ley N° 30021 en busca de reducir el sobrepeso y la obesidad en niños y adolescentes, sin embargo, el desarrollo de esta Ley se caracterizó por tener continuas modificaciones en los diversos documentos elaborados. El propósito de este artículo es identificar cambios esenciales en los documentos elaborados por el Gobierno y el Congreso en el marco de la Ley N° 30021, específicamente en los temas de regulación de la publicidad de alimentos y bebidas no alcohólicas, advertencias publicitarias y parámetros técnicos de nutrientes críticos. Los cambios identificados en los diferentes documentos muestran el dinamismo en el desarrollo de esta política donde la falta de evidencia científica oportuna, la oposición de la industria alimentaria y la falta de consenso político fueron los principales motivos.


The sale of ultra-processed products has increased in Latin America in recent years, as well as the prevalence of overweight and obesity. In Peru, Law No. 30021 passed in an attempt to reduce overweight and obesity in children and adolescents; however, the development of this law was characterized by constant modifications to the documents prepared in this regard. This article aims to identify essential modifications in the documents elaborated by the Government and the Congress within the timeframe of Law No. 30021, particularly those regarding the regulation of food and non-alcoholic beverage advertising, advertising warnings and technical parameters of critical nutrients. The lack of timely scientific evidence, the opposition by the food industry and the lack of political consensus were the main reasons for the detected modifications, which shows the dynamism during the development of this policy.


Asunto(s)
Control de la Publicidad de Productos , Publicidad de Alimentos , Etiquetado de Alimentos , Legislación Alimentaria , Perú , Política , Alimentos y Bebidas , Comercialización de Productos , Políticas
14.
Lancet Reg Health Am ; 12: 100296, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35791428

RESUMEN

Background: In February 2021, Colombia began mass vaccination against COVID-19 using mainly BNT162b2 and CoronaVac vaccines. We aimed to estimate vaccine effectiveness (VE) to prevent COVID-19 symptomatic cases, hospitalization, critical care admission, and deaths in a cohort of 796,072 insured subjects older than 40 years in northern Colombia, a setting with a high SARS-CoV-2 transmission. Methods: We identified individuals vaccinated between March 1st of 2021 and August 15th of 2021. We included symptomatic cases, hospitalizations, critical care admissions, and deaths in patients with confirmed COVID-19 as main outcomes. We calculated VE for each outcome from the hazard ratio in Cox proportionally hazards regressions (adjusted by age, sex, place of residence, diabetes, human immunodeficiency virus, cancer, hypertension, tuberculosis, neurological diseases, and chronic renal disease), with 95% confidence intervals (CI). Findings: A total of 719,735 insured participants of 40 and more years were followed. We found 21,545 laboratory-confirmed symptomatic COVID-19 among unvaccinated population, along with 2874 hospitalizations, 1061 critical care admissions, and 1329 deaths, for a rate of 207.2 per million person-days, 27.1 per million person-days, 10.0 per million person-days, and 12.5 per million person-days, respectively. We found CoronaVac was not effective for any outcome in subjects above 80 years old; but for people 40-79 years of age, we found two doses of CoronaVac reduced hospitalization (33.1%; 95% CI, 14.5-47.7), critical care admission (47.2%; 95% CI, 18.5-65.8), and death (55.7%; 95% CI, 32.5-70.0). We found BNT162b2 was effective for all outcomes in the entire population of subjects above 40 years of age, significantly declining for subjects ≥80 years. Interpretation: Two doses of either CoronaVac in population between 40 and 79 years of age, or BNT162b2 among vaccinated above 40 years old significantly reduced deaths of confirmed COVID-19 in a cohort of individuals from Colombia. Vaccine effectiveness for CoronaVac and BNT162b2 declined with increasing age. Funding: UK National Institute for Health Research, the European Union's Horizon 2020 research and innovation programme, and the Bill & Melinda Gates Foundation.

15.
Value Health Reg Issues ; 31: 101-110, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35640462

RESUMEN

OBJECTIVES: Our study compares two national COVID-19 vaccination plan strategies-high-risk prioritization and no prioritization-and estimates their cost-effectiveness compared with no vaccination, to generate possible recommendations for future vaccination plans. METHODS: We developed a Markov discrete-time, compartmental, deterministic model stratified by Colombian departments, healthcare workers, comorbidities, and age groups and calibrated to seroprevalence, cases, and deaths. The model simulates three scenarios: no vaccination, no prioritization of vaccination, and prioritization of high-risk population. The study presents the perspective of the health system of Colombia, including the direct health costs financed by the government and the direct health outcomes related to the infection. We measured symptomatic cases, deaths, and costs for each of the three scenarios from the start of the vaccination rollout to February 20, 2023. RESULTS: Both for the base-case and across multiple sensitivity analyses, the high-risk prioritization proves to be the most cost-effective of the considered strategies. An increment of US$255 million results in an incremental cost-effectiveness ratio of US$3339 per disability-adjusted life-year avoided. The simulations show that prioritization of high-risk population reduces symptomatic cases by 3.4% and deaths by 20.1% compared with no vaccination. The no-prioritization strategy is still cost-effective, with an incremental cost-effectiveness ratio of US$5223.66, but the sensitivity analysis the show potential risks of losing cost-effectiveness under the cost-effectiveness threshold (one gross domestic product per averted disability-adjusted life-year). CONCLUSIONS: The high-risk prioritization strategy is consistently more cost-effective than the no-prioritization strategy across multiple scenarios. High-risk prioritization is the recommended strategy in low-resource settings to reduce the burden of disease.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , COVID-19/epidemiología , COVID-19/prevención & control , Colombia/epidemiología , Análisis Costo-Beneficio , Humanos , Estudios Seroepidemiológicos
16.
BMC Cardiovasc Disord ; 22(1): 118, 2022 03 21.
Artículo en Inglés | MEDLINE | ID: mdl-35313809

RESUMEN

BACKGROUND: Endothelial progenitor cells (EPCs) are circulating angiogenic cells with endothelial features associated with risk for stroke. We aimed to delve into their functional characteristics. EPCs were isolated and cultured from Ischemic Stroke (IS) patients and predictors of their variance evaluated. METHODS: This is a single-center observational study evaluating 187 consecutively hospitalized patients with IS. EPCs were isolated from blood samples. The number of circulating angiogenic cells (CACs), colony-forming units (CFU-ECs) and the emergence of late outgrowths endothelial cells (LOECs) were counted. We collected clinical variables and measured the stromal cell-derived factor 1 alpha (SDF1α) serum levels. We also examined the relative telomere length and the expression of osteogenic gene markers in CACs. RESULTS: CACs counts and CFU-ECs colony numbers were positively correlated (rho = 0.41, p < 0.001, n = 187). We found significant differences according to whether thrombolytic treatment was performed in the distribution of CFU-ECs (odds ratio (OR) = 2.5; 95% confidence interval (CI) 1.01-6.35; p = 0.042) and CACs (OR = 4.45; 95% IC 1.2-15.5; p = 0.012). The main determinants of CACs variation were the number of risks factors, thrombolysis treatment, arterial hypertension, LOECs occurrence, and the vascular endothelial growth factor expression, whereas CFU-ECs variations depended on hemoglobin content and the relative reduction in the National Institutes of Health Stroke Scale (NIHSS) criteria. The main predictors of LOECs appearance were thrombolysis and length of hospital stay. CONCLUSIONS: Our study supports the relevance of patient risk factors and treatments in the analysis of the functional properties of EPCs.


Asunto(s)
Células Progenitoras Endoteliales , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Humanos , Células Madre/metabolismo , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/terapia , Factor A de Crecimiento Endotelial Vascular/metabolismo
17.
Intern Emerg Med ; 17(3): 789-797, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-34714486

RESUMEN

Managing patients with multimorbidity and frequent hospital readmissions is a challenge. Integrated care programs that consider their needs and allow for personalized care are necessary for their early identification and management. This work aims to describe these patients' clinical characteristics and evaluate a program designed to reducing readmissions. This prospective study analyzed all patients with ≥ 3 admissions to a medical department in the previous year who were included in the Internal Medicine Department chronic care program at the Lucus Augusti University Hospital (Lugo, Spain) between April 1, 2019 and April 30, 2021. A multidimensional assessment, personalized care plan, and proactive follow-up with a case manager nurse were provided via an advanced hospital system. Clinical and demographic variables and data on healthcare system use were analyzed at 6 and 12 months before and after inclusion. Descriptive and survival analyses were performed. One hundred sixty-one patients were included. Program participants were elderly (mean 81.4 (SD 11) years), had multimorbidity (10.2 (3) chronic diseases) and polypharmacy (10.6 (3.5) drugs), frequently used the healthcare system, and were highly complex. Most were included for heart failure. The program led to significant reductions in admissions and emergency department visits (p = .0001). A total of 44.7% patients died within 1 year. The PROFUND Index showed good predictive ability (p = .013), with high values associated with mortality (RR 1.15, p = .001). Patients with frequent hospital readmissions are highly complex and need special care. A personalized integrated care program reduced admissions and allowed for individualized decision-making.


Asunto(s)
Prestación Integrada de Atención de Salud , Readmisión del Paciente , Anciano , Humanos , Multimorbilidad , Atención Dirigida al Paciente , Estudios Prospectivos
18.
Rev. colomb. ortop. traumatol ; 36(1): 9-15, 2022. ilus.
Artículo en Español | LILACS, COLNAL | ID: biblio-1378758

RESUMEN

Introducción Se pretende definir si la medición de los defectos glenoideos y de Hills-Sachs por resonancia magnética es equivalente a la medición a través de tomografía simple en pacientes con inestabilidad anterior de hombro. Materiales y métodos Estudio observacional descriptivo, tipo transversal de una cohorte de estudios de imagenología de pacientes con antecedente de luxación anterior de hombro, los cuales comprenden resonancia magnética y tomografías simples de hombro, realizadas en un hospital de cuarto nivel. Resultados La cohorte estuvo conformada por 20 casos; se encontró una alta correlación y estadísticamente significativa para la medición del diámetro y defecto glenoideo, con una p<0.05 entre la resonancia y la tomografía simple. Además, se encontró con significancia estadística la medición del intervalo del Hill-Sachs, pero el índice de correlación no fue alto, 60%. Para la concordancia intraobservador, se calculó un índice Kappa para la resonancia magnética de 0.8 comparado con la tomografía con valor de p <0.05 significativo para los defectos enganchantes y no enganchantes. Conclusión La resonancia magnética simple es un método de imagen confiable con alto índice de correlación para la medición del diámetro y los defectos glenoideos con buena concordancia para establecer si los defectos de Hill-Sachs son enganchantes o no.


Introduction The aim is to define whether the measurement of glenoid and Hill­Sachs defects by magnetic resonance imaging is equivalent to the measurement by simple tomography in patients with anterior shoulder instability. Materials and methods Descriptive, observational, cross-sectional study of a cohort of imaging studies of patients with a history of anterior shoulder dislocation, comprising magnetic resonance and simple tomography of the shoulder, performed in a fourth level hospital. Results The cohort consisted of 20 cases; a high and statistically significant correlation was found for the measurement of the glenoid diameter and defect, with a p<0.05 between the MRI and simple tomography. In addition, the Hill­Sachs interval measurement was found to be statistically significant, but the correlation index was not high, 60%. For intraobserver agreement, a Kappa index was calculated for MRI of 0.8 compared to CT with p-value <0.05 significant for engaging and non-engaging defects. Conclusion Simple MRI is a reliable imaging method with high correlation index for the measurement of diameter and glenoid defects with good agreement to establish whether Hill­Sachs defects are engaging or not.


Asunto(s)
Humanos , Tomografía , Luxación del Hombro , Imagen por Resonancia Magnética
19.
Foods ; 10(12)2021 Nov 24.
Artículo en Inglés | MEDLINE | ID: mdl-34945461

RESUMEN

Brassica rapa is grown in northwestern Spain to obtain turnip greens. The tops of the same plants (flower stems with buds) are cut and sell as turnip tops, increasing the value of the crop. This practice could be extended to other brassicas. The objectives of this work are to study the phytochemical potential of tops of coles (Brassica oleracea) and leaf rape (Brassica napus) compared to turnip tops and to compare tops of different coles (cabbage, kale, tronchuda cabbage), which differ in their morphology and use. We evaluated the content of glucosinolates and phenolic compounds and the antioxidant capacity in leaves and tops of the three species. We found that tops had higher amount of glucosinolates than leaves. Phenolic content and antioxidant capacity followed the opposite trend. Therefore, consumption of leaves and tops are complementary, since both type of organs are enriched with different types of compound. Local varieties of kale, curly kale, cabbage and curly leave cabbage are interesting because of their GSLs and phenolic content and antioxidant capacity in both leaves and tops. From the human health perspective, tops of coles and leaf rape are interesting as new crops to include in the diet.

20.
Crit Rev Toxicol ; 51(7): 622-633, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34738508

RESUMEN

Intraoral fixed appliances remain in the potentially corrosive environment of the mouth for an average of two years. Over time, corrosion causes the release of metal ions, such as nickel and chromium. These metals can become allergenic and cytotoxic, causing different conditions in the human body. The aim of this study therefore is to carry out a systematic review of the available scientific evidence on the accumulation of metal ions, and the genotoxic and cytotoxic effects in oral mucosa cells deriving from short- and long-term exposure to them. The systematic review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The primary outcome (quantification of metal ion deposits and assessment of their genotoxic and/or cytotoxic effects) and secondary outcome (complementary analysis of cytotoxic and genotoxic effects) were examined. The Cochrane Collaboration tool and Toxicological data Reliability Assessment Tool (ToxRTool) were used for quality assessment. Once the search was performed, a total of seven articles met the inclusion criteria and were included in this study. Two main techniques were used to assess genotoxic effects: alkaline comet assay (6/7) and micronucleus method (1/7). Cytotoxicity was evaluated (4/7) using the trypan blue dye test. Accumulations of nickel (7/7), chromium (5/7), and other metals (zinc, cobalt, iron, manganese, molybdenum, titanium) were also quantified. The results allowed us to conclude that release of metal ions and acute cell and DNA damage in oral mucosa cells takes place in the early stages of treatment. However, more long-term studies are needed to evaluate chronic exposure to metals and DNA damage, as well as cellular capacity to recover DNA integrity.


Asunto(s)
Mucosa Bucal , Aparatos Ortodóncicos , Cromo , Daño del ADN , Humanos , Iones , Reproducibilidad de los Resultados
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