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1.
Hum Psychopharmacol ; : e2895, 2024 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-38367243

RESUMEN

OBJECTIVES: "WKUP GT", a low caffeine beverage consisting of carob, Guarana, Green Tea and Elderberry extracts was studied on attention and cognitive functions post-lunch in a pilot randomized double blind placebo controlled trial. METHODS: Thirty healthy volunteers were included in a crossover design trial, presenting five beverages randomly assigned to the following groups: placebo, "WKUP GT" (single, double or triple doses), or "caffeine" as an active control. Hemodynamic measurements were assessed as safety outcomes. The Cambridge Neuropsychological Test Automated Battery (CANTAB), was used to evaluate the patients when beverages were consumed 30 and 120 min after lunch (respectively Delta30 and Delta120 considering baseline). RESULTS: Drinking "caffeine" or "WKUP GT" after lunch, showed significant improvement (p < 0.05) in rapid visual information processing compared to placebo (Delta120 of "caffeine", "WKUP" single and double). In addition, improvement in Multitasking Test (Delta30 for "WKUP" double, and Delta120 for "caffeine" and "WKUP" triple compared to placebo) was observed. "WKUP" triple also showed significant improvement for "memory" when compared to placebo (Delta120). Compared to "caffeine", WKUP GT did not increase systolic blood pressure. CONCLUSION: "WKUP GT" showed improvements for attention, memory, psychomotor and executive function tasks after lunch without increase in pulse rate.

2.
Actas Dermosifiliogr ; 115(2): 130-136, 2024 Feb.
Artículo en Inglés, Español | MEDLINE | ID: mdl-37689350

RESUMEN

BACKGROUND AND OBJECTIVE: Atypical nevus syndrome has been described as one of the main risk factors for melanoma. The aim of this study was to analyze dermoscopic changes observed in melanocytic lesions over a follow-up period of 5 years in patients with atypical nevus syndrome. MATERIAL AND METHODS: We conducted a retrospective follow-up study of a cohort of patients seen at a specialized skin cancer and digital body mapping clinic in Medellin, Colombia, between January 2017 and December 2022. We analyzed the dermoscopic changes observed during this period and explored their association with newly diagnosed melanoma. RESULTS: A total of 368 patients (187 women) with a median (interquartile range) age of 43 (37-51) years were included. The dermoscopic features observed at 5 years were an atypical network (222 patients, 60.3%), asymmetric globules (163, 44.2%), white-gray regression areas (105, 28.5%), lesion regression (72, 19.5%), a negative pigment network (59, 16%), asymmetric eccentric pigmentation (28, 7.6%), asymmetric projections (21, 5.7%), and asymmetric vascular patterns (8, 2.1%). Melanoma was diagnosed in 12.2% of patients during follow-up. Features significantly associated with a shorter time to melanoma onset were grayish-white areas (P <.001), asymmetric globules (P=.011), asymmetric eccentric pigmentation (P=.047), and a negative pigment network (P=.001). CONCLUSIONS: The main dermoscopic features of melanocytic lesions in patients with atypical nevus syndrome associated with progression to melanoma were grayish-white areas, asymmetric globules, asymmetric spots, and a negative pigment network.


Asunto(s)
Melanoma , Nevo , Neoplasias Cutáneas , Humanos , Femenino , Adulto , Persona de Mediana Edad , Melanoma/complicaciones , Melanoma/epidemiología , Melanoma/diagnóstico , Estudios de Cohortes , Estudios Retrospectivos , Estudios de Seguimiento , Dermoscopía , Neoplasias Cutáneas/complicaciones , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/diagnóstico , Nevo/diagnóstico , Nevo/patología
3.
Actas Dermosifiliogr ; 115(2): T130-T136, 2024 Feb.
Artículo en Inglés, Español | MEDLINE | ID: mdl-38048957

RESUMEN

BACKGROUND AND OBJECTIVE: Atypical nevus syndrome has been described as one of the main risk factors for melanoma. The aim of this study was to analyze dermoscopic changes observed in melanocytic lesions over a follow-up period of 5 years in patients with atypical nevus syndrome. MATERIAL AND METHODS: We conducted a retrospective follow-up study of a cohort of patients seen at a specialized skin cancer and digital body mapping clinic in Medellin, Colombia, between January 2017 and December 2022. We analyzed the dermoscopic changes observed during this period and explored their association with newly diagnosed melanoma. RESULTS: A total of 368 patients (187 women) with a median (interquartile range) age of 43 (37-51) years were included. The dermoscopic features observed at 5 years were an atypical network (222 patients, 60.3%), asymmetric globules (163, 44.2%), white-gray regression areas (105, 28.5%), lesion regression (72, 19.5%), a negative pigment network (59, 16%), asymmetric eccentric pigmentation (28, 7.6%), asymmetric projections (21, 5.7%), and asymmetric vascular patterns (8, 2.1%). Melanoma was diagnosed in 12.2% of patients during follow-up. Features significantly associated with a shorter time to melanoma onset were grayish-white areas (P<.001), asymmetric globules (P=.011), asymmetric eccentric pigmentation (P=.047), and a negative pigment network (P=.001). CONCLUSIONS: The main dermoscopic features of melanocytic lesions in patients with atypical nevus syndrome associated with progression to melanoma were grayish-white areas, asymmetric globules, asymmetric spots, and a negative pigment network.


Asunto(s)
Melanoma , Nevo , Neoplasias Cutáneas , Humanos , Femenino , Adulto , Persona de Mediana Edad , Melanoma/complicaciones , Melanoma/epidemiología , Melanoma/diagnóstico , Estudios de Cohortes , Estudios Retrospectivos , Estudios de Seguimiento , Dermoscopía , Neoplasias Cutáneas/complicaciones , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/diagnóstico , Nevo/diagnóstico , Nevo/patología
4.
Rev Neurol ; 77(s01): S13-S16, 2023 07 28.
Artículo en Español | MEDLINE | ID: mdl-37477029

RESUMEN

INTRODUCTION: Narcolepsy type 1 is a focal degenerative disease of the hypothalamus that selectively affects orexin (hypocretin)-producing neurons. It presents multiple clinical manifestations, both in wakefulness and in sleep. The symptoms are often so disruptive that they cause enormous suffering and impair patients' quality of life. Although a non-pharmacological approach is sometimes sufficient, the vast majority of patients need medication for adequate clinical management. CASE REPORT: A male who, at 43 years of age, began to present acutely with excessive daytime sleepiness and episodes of cataplexy. After a thorough examination, he was diagnosed with narcolepsy type 1. Throughout the course of the disease, he was prescribed antidepressants, neurostimulants and sodium oxybate, in monotherapy or in combination. The response to pharmacological treatment was insufficient and accompanied by numerous side effects. Following the introduction of pitolisant, there was a marked improvement in his symptoms and a reduction in the dose of the other drugs and their adverse effects was achieved. CONCLUSION: A number of measures are now available to address the cardinal symptoms of the disease, although there are still cases that are resistant to anti-narcoleptic treatment. Drugs with mechanisms of action that act upon receptors in the histaminergic system can be very useful in these cases.


TITLE: Narcolepsia multirresistente.Introducción. La narcolepsia de tipo 1 es una enfermedad degenerativa focal del hipotálamo que afecta selectivamente a las neuronas productoras de orexina (hipocretina). Presenta múltiples manifestaciones clínicas, tanto en vigilia como en sueño. Con frecuencia, los síntomas son tan disruptivos que ocasionan enorme sufrimiento y deterioro de la calidad de vida de los pacientes. Aunque en ocasiones es suficiente con un abordaje no farmacológico, la gran mayoría de los enfermos necesita medicación para un adecuado control clínico. Caso clínico. Varón que a los 43 años comenzó a presentar de forma aguda excesiva somnolencia diurna y episodios de cataplejía. Tras un exhaustivo estudio se le diagnosticó narcolepsia de tipo 1. A lo largo de la evolución de la enfermedad se le prescribieron antidepresivos, neuroestimulantes y oxibato sódico, en monoterapia o en combinación. La respuesta al tratamiento farmacológico fue insuficiente y se acompañó de numerosos efectos secundarios. Tras la introducción de pitolisant se objetivó una franca mejoría de los síntomas, y se consiguió reducir la dosis de los otros fármacos y de sus efectos adversos. Conclusión. Son numerosas las medidas disponibles en la actualidad para abordar los síntomas cardinales de la enfermedad, aunque siguen existiendo casos resistentes al tratamiento antinarcoléptico. Los fármacos con mecanismos de acción sobre receptores del sistema histaminérgico pueden resultar de gran utilidad en estos casos.


Asunto(s)
Resistencia a Múltiples Medicamentos , Narcolepsia , Humanos , Masculino , Antidepresivos/uso terapéutico , Cataplejía/complicaciones , Cataplejía/tratamiento farmacológico , Estimulantes del Sistema Nervioso Central/uso terapéutico , Narcolepsia/tratamiento farmacológico , Narcolepsia/complicaciones , Calidad de Vida , Oxibato de Sodio/uso terapéutico , Adulto , Somnolencia
5.
Semergen ; 49(7): 102030, 2023 Oct.
Artículo en Español | MEDLINE | ID: mdl-37487423

RESUMEN

Venous thromboembolic disease (VTE) is a frequent complication in patients diagnosed with cancer and a cause of morbidity and mortality. Approximately 20% of thromboembolic episodes develop in association with active cancer. On the other hand, it is estimated that about 2-12% of cases, the thromboembolic episode is the first manifestation of an occult cancer, diagnosed at that time or subsequently, which offers an opportunity for early diagnosis and treatment. There are multiple factors that contribute to increase the risk of VTE in oncological patients in relation to specific characteristics of the patient, the tumor and the treatments. Knowledge of these risk factors will contribute to early diagnosis when signs of VTE appear, as well as the assessment of thromboprophylaxis if indicated. The diagnosis of VTE in patients with cancer does not differ of those who do not suffer from it. Regarding the treatment of VTE in these patients, low molecular weight heparin (LMWH), direct acting anticoagulants (DACs) and antivitamin K (VKA) are the most commonly used, although the dosing regimen and length are not clear yet. The management of these patients should be interdisciplinary and early, so the primary care physician plays a key role in this process as he/she is liaise with his/her patients. It is also necessary to update knowledge in order to improve the care of these patients. For these reasons, this document has been prepared by the Working Group on Vasculopathies of the Spanish Society of Primary Care Physicians (SEMERGEN) whose objective is to present the available information regarding the management of VTE that may appear in oncological patients, as well as the assessment of thromboprophylaxis and treatment, if appropriate, from an approach focused on a primary care field.


Asunto(s)
Neoplasias , Tromboembolia Venosa , Humanos , Femenino , Masculino , Anticoagulantes/uso terapéutico , Heparina de Bajo-Peso-Molecular/uso terapéutico , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/etiología , Tromboembolia Venosa/prevención & control , Neoplasias/complicaciones , Neoplasias/tratamiento farmacológico , Atención Primaria de Salud
6.
Med Intensiva (Engl Ed) ; 47(5): 257-266, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-36621347

RESUMEN

OBJECTIVE: To describe the sequelae one month after hospital discharge in patients who required admission to Intensive Care for severe COVID 19 pneumonia and to analyze the differences between those who received therapy exclusively with high-flow oxygen therapy compared to those who required invasive mechanical ventilation. DESIGN: Cohort, prospective and observational study. SETTING: Post-intensive care multidisciplinary program. PATIENTS OR PARTICIPANTS: Patients who survived admission to the intensive care unit (ICU) for severe COVID 19 pneumonia from April 2020 to October 2021. INTERVENTIONS: Inclusion in the post-ICU multidisciplinary program. MAIN VARIABLES OF INTEREST: Motor, sensory, psychological/psychiatric, respiratory and nutritional sequelae after hospital admission. RESULTS: 104 patients were included. 48 patients received high-flow nasal oxygen therapy (ONAF) and 56 invasive mechanical ventilation (IMV). The main sequelae found were distal neuropathy (33.9% IMV vs 10.4% ONAF); brachial plexopathy (10.7% IMV vs 0% ONAF); decrease in grip strength: right hand 20.67kg (±8.27) in VMI vs 31.8kg (±11.59) in ONAF and left hand 19.39kg (±8.45) in VMI vs 30.26kg (±12.74) in ONAF; and limited muscle balance in the lower limbs (28.6% VMI vs 8.6% ONAF). The differences observed between both groups did not reach statistical significance in the multivariable study. CONCLUSIONS: The results obtained after the multivariate study suggest that there are no differences in the perceived physical sequelae one month after hospital discharge depending on the respiratory therapy used, whether it was high-flow nasal oxygen therapy or prolonged mechanical ventilation, although more studies are needed to be able to draw conclusions.


Asunto(s)
COVID-19 , Humanos , COVID-19/complicaciones , COVID-19/terapia , Alta del Paciente , SARS-CoV-2 , Estudios Prospectivos , Respiración Artificial , Cuidados Críticos , Oxígeno , Hospitales
7.
Med Intensiva ; 47(5): 257-266, 2023 May.
Artículo en Español | MEDLINE | ID: mdl-36506823

RESUMEN

Objective: To describe the sequelae one month after hospital discharge in patients who required admission to intensive care for severe COVID-19 pneumonia and to analyze the differences between those who received therapy exclusively with high-flow oxygen therapy compared to those who required invasive mechanical ventilation. Design: Cohort, prospective and observational study. Setting: Post-intensive care multidisciplinary program. Patients or participants: Patients who survived admission to the intensive care unit (ICU) for severe COVID-19 pneumonia from April 2020 to October 2021. Interventions: Inclusion in the post-ICU multidisciplinary program. Main variables of interest: Motor, sensory, psychological/psychiatric, respiratory and nutritional sequelae after hospital admission. Results: One hundred and four patients were included. 48 patients received high-flow nasal oxygen therapy (ONAF) and 56 invasive mechanical ventilation (IMV). The main sequelae found were distal neuropathy (33.9% IMV vs. 10.4% ONAF); brachial plexopathy (10.7% IMV vs. 0% ONAF); decrease in grip strength: right hand 20.67 kg (± 8.27) in VMI vs. 31.8 kg (± 11.59) in ONAF and left hand 19.39 kg (± 8.45) in VMI vs. 30.26 kg (± 12.74) in ONAF; and limited muscle balance in the lower limbs (28.6% VMI vs. 8.6% ONAF). The differences observed between both groups did not reach statistical significance in the multivariable study. Conclusions: The results obtained after the multivariate study suggest that there are no differences in the perceived physical sequelae one month after hospital discharge depending on the respiratory therapy used, whether it was high-flow nasal oxygen therapy or prolonged mechanical ventilation, although more studies are needed to be able to draw conclusions.

9.
Ann Diagn Pathol ; 61: 152056, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36371890

RESUMEN

Calcifying aponeurotic fibroma (CAF) is a very rare benign entity that principally affects the volar fascia, tendons, and aponeuroses of the hands and feet with a peak incidence of between 5 and 15 years, although there have been cases found for a wide age range and at various anatomical sites. We present ten CAF cases; consisting of eight children and two adults. CAF occurred in the extremities in nine of the cases and in the chest wall in one case. CAF ultrasound and radiological findings are nonspecific but may help orientate diagnosis. Magnetic resonance imaging should be performed when there are doubtful cases, when occurring in nontypical sites, and when there are cases of nontypical clinical presentation. Histologically, all cases showed two components, a fibromatosis-like component and a nodular component. Chondroid areas were present in five cases. Calcifications were observed in nine cases. ERG immunostaining showed the same patterns in all the cases; diffuse positivity in pericalcified areas, and patchy positivity in areas away from calcifications. CAF has distinctive histopathological features which should aid in the differential diagnoses with other entities.


Asunto(s)
Calcinosis , Fibroma Osificante , Fibroma , Neoplasias de los Tejidos Blandos , Niño , Adulto , Humanos , Neoplasias de los Tejidos Blandos/diagnóstico por imagen , Neoplasias de los Tejidos Blandos/cirugía , Fibroma Osificante/diagnóstico por imagen , Fibroma/diagnóstico por imagen , Fibroma/cirugía , Calcinosis/diagnóstico por imagen , Calcinosis/patología
11.
J Nutr Health Aging ; 26(8): 778-785, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35934822

RESUMEN

OBJECTIVES: To investigate concerns surrounding the benefits of antiresorptive drugs in older adults, a systematic review was carried out to evaluate the efficacy of these treatments in the prevention of osteoporotic hip fractures in older adults. DESIGN: a systematic review and meta-analysis of randomized clinical trials. SETTING AND PARTICIPANTS: older adults ≥65 years with osteoporosis, with or without a previous fragility fracture. Studies with cancer-related and corticosteroid-induced osteoporosis, participants <65 years and no reported hip fracture were not included. METHODS: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ISI Web of Science and Scopus databases were searched. The primary outcome was hip fracture, and subgroup analysis (≥75 years, with different drug types and secondary prevention) and sensitivity analysis was carried out using a GRADE evaluation. Secondary outcomes were any type of fractures, vertebral fracture, bone markers and adverse events. The risk of bias was assessment with the Cochrane risk of bias tool. RESULTS: A total of 12 randomised controlled trials (RCTs) qualified for this meta-analysis, with 36,196 participants. Antiresorptive drugs have a statistically significant effect on the prevention of hip fracture (RR=0.70; 95%CI 0.60 to 0.81), but with a moderate GRADE quality of evidence and a high number needed to treat (NNT) of 186. For other outcomes, there is a statistically significant effect, but with a low to moderate quality of evidence. Antiresorptives showed no reduction in the risk of hip fracture in people ≥75 years. The results for different drug types, secondary prevention and sensitivity analysis are similar to the main analyses and have the same concerns. CONCLUSIONS: Antiresorptive drugs have a statistically significant effect on preventing hip fracture but with a moderate quality (unclear/high risk of bias) and high NNT (186). This small benefit disappears in those ≥75 years, but increases in secondary prevention. More RCTs in very old osteoporotic adults are needed.


Asunto(s)
Conservadores de la Densidad Ósea , Fracturas de Cadera , Osteoporosis , Fracturas Osteoporóticas , Fracturas de la Columna Vertebral , Anciano , Conservadores de la Densidad Ósea/efectos adversos , Fracturas de Cadera/tratamiento farmacológico , Fracturas de Cadera/etiología , Fracturas de Cadera/prevención & control , Humanos , Osteoporosis/complicaciones , Osteoporosis/tratamiento farmacológico , Osteoporosis/prevención & control , Fracturas Osteoporóticas/prevención & control , Ensayos Clínicos Controlados Aleatorios como Asunto , Fracturas de la Columna Vertebral/tratamiento farmacológico
12.
Transpl Int ; 35: 10056, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35734238

RESUMEN

The increasing comorbidity of kidney transplant (KT) donors make it necessary to develop scores to correctly assess the quality of kidney grafts. This study analyzes the usefulness of the preimplantation biopsy and the Kidney Donor Profile Index (KDPI) as indicators of KT survival from expanded criteria donors (ECD). Retrospective study of KT in our center between January 2010 to June 2019 who received a kidney from an ECD and underwent a preimplantation biopsy. 266 KT were included. Graft survival was categorized by KDPI quartiles: Q1 = 86%, Q2 = 95%, Q3 = 99% and Q4 = 100%. KT from KDPI Q1 presented better survival (p = 0.003) and Q4 donors had worse renal function (p = 0.018) and poorer glomerular filtration rate (3rd month; p = 0.017, 1st year; p = 0.010). KT survival was analyzed according to KDPI quartile and preimplantation biopsy score simultaneously: Q1 donors with biopsy score ≤3 had the best survival, especially comparing against Q3 with a biopsy score >3 and Q4 donors (p = 0.014). In multivariable analysis, hyaline arteriopathy, glomerulosclerosis, and KDPI Q4 were predictors for graft survival. High KDPI and a greater histological injury in the preimplantation biopsy, especially glomerular and vascular lesions, were related to a higher rate of KT loss from ECD.


Asunto(s)
Trasplante de Riñón , Biopsia , Supervivencia de Injerto , Humanos , Riñón/patología , Estudios Retrospectivos , Donantes de Tejidos
14.
Semergen ; 48(4): 235-244, 2022.
Artículo en Español | MEDLINE | ID: mdl-35151555

RESUMEN

INTRODUCTION: The prevalence of chronic kidney disease has increased globally (8-16%), mainly due to the incidence of type 2 diabetes mellitus (DM2) and hypertension (HT). Education or training programs for patients with chronic diseases is considered a fundamental tool to prevent their worsening. OBJECTIVES: (1) To determine whether attendance at training for patients with HT and/or diabetes affects the progression of the deterioration of renal function. (2) To assess the association of renal function with HT, DM2 and the occurrence of cardiovascular events, analyzing the influence of the control degree of blood pressure (BP) and glycated hemoglobin (HbA1c). (3) To study the occurrence of cardiovascular events. MATERIAL AND METHODS: Retrospective analytical observational cohort study carried out in a Primary Care Center in Leganés, Madrid, using databases of patients with HT, diabetes and both pathologies simultaneously (n = 200), attending or not to the training of the medical team during the years 2017-2019. RESULTS: 120 of 200 patients received training (60% women). Only in these patients, an improvement of renal function was observed. This was accompanied by a reduction in BP and HbA1c levels, being more prominent in patients with a single pathology, especially hypertensive patients. CONCLUSIONS: Training of patients was beneficial to prevent the deterioration of renal function, by means of the reduction of the BP and HbA1c. It was more evident in those who started from a worse control of both parameters. Association of renal function evolution with HT and DM2 was demonstrated.


Asunto(s)
Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Hipertensión , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/prevención & control , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Femenino , Hemoglobina Glucada , Humanos , Hipertensión/complicaciones , Hipertensión/epidemiología , Hipertensión/terapia , Riñón/fisiología , Masculino , Atención Primaria de Salud , Estudios Retrospectivos
15.
Rehabilitacion (Madr) ; 56(3): 173-181, 2022.
Artículo en Español | MEDLINE | ID: mdl-34511255

RESUMEN

BACKGROUND AND OBJECTIVES: The aim of this study is to present a new virtual reality (VR) low cost application based on Leap Motion Controller (LMC) device for upper extremity motor rehabilitation after neurological pathology and to demonstrate its clinical feasibility by carrying out a pilot experience. MATERIAL AND METHODS: The LMC allows the interaction with virtual applications by capturing the patient's hand movements. A pilot study was carried out with 4 patients with upper limb impairment reflected with Upper Extremity Motor Score (UEMS) greater than 10. They were assessed using the Box and Block (BBT) and the writing task within the Jebsen-Taylor Hand Function (JTHF) before and after the intervention. RESULTS: All patients completed the 9-session, 30-min protocol divided into 3 sessions per week. They went from an average result of 38 (SD 20) blocks in BBT before the intervention to 44 (SD 21.72) after it. They went from 28.25 s (SD 8.61) to 26.75 s (SD 21.72) in the JTHF. Statistically significant differences were no found. The device usability was assessed by the QUEST scale, being the security, effectiveness and ease to use the aspects that patients considered to be a priority. CONCLUSIóN: A new VR development based on the LMC device is presented and the clinical feasibility of its application in neurological patients with upper limb involvement has been proven. A clinical study with a large sample size is needed to assess its potential clinical effectiveness as a treatment element.


Asunto(s)
Rehabilitación de Accidente Cerebrovascular , Realidad Virtual , Terapia por Ejercicio/métodos , Humanos , Proyectos Piloto , Rehabilitación de Accidente Cerebrovascular/métodos , Extremidad Superior
16.
Br J Oral Maxillofac Surg ; 59(10): 1192-1199, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34663526

RESUMEN

The purpose of this paper was to investigate the bone regeneration effect of autologous adipose tissue mesenchymal stem cells (ATMSC) in a small animal model. Twelve Wistar rats were given bilateral critical-size defects in the mandible. The defects were filled with coralline hydroxyapatite alone or combined with autologous undifferentiated ATMSC obtained from the dorsal fat pad. Studies were conducted at three and six weeks. Descriptive histology and histomorphometry revealed a significant (p < 0.05) increased bone regeneration values in the cell-treated defects at both three and six weeks. ATMSC promoted the formation of new bone in the central areas of the defects and in the scaffold micropores, both in a higher state of maturation. Autologous undifferentiated ATMSC enhanced bony healing of mandibular critical-size defects in rats when implanted with a coralline hydroxyapatite scaffold.


Asunto(s)
Implantes Dentales , Células Madre Mesenquimatosas , Animales , Regeneración Ósea , Cerámica , Hidroxiapatitas , Mandíbula , Osteogénesis , Ratas , Ratas Wistar , Andamios del Tejido
17.
Radiologia (Engl Ed) ; 63(5): 425-435, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34625198

RESUMEN

Infections of the central nervous system caused by atypical bacteria are becoming more common. Borrelia burgdorferi and Rickettsia conorii are microorganisms transmitted by ticks; infection with these bacteria result in a wide spectrum of manifestations on imaging. In areas where these tick-borne microorganisms are endemic, including Spain, these infections must be included in the differential diagnosis of patients with a variety of systemic and neurologic symptoms. The clinical presentation of these infections is nonspecific, and CT is normally the initial imaging technique, although MRI is more sensitive to early changes. On MRI, these infections can manifest as small lesions in the deep supratentorial white matter that are hyperintense on T2-weighted/FLAIR sequences. It is fundamental to know the imaging characteristics of the different atypical bacterial infections and their differential diagnoses. Good history taking combined with complementary tests (blood tests and CSF analysis) and the neuroimaging findings can help reach the right diagnosis and enable appropriate treatment, thereby preventing possible neurological sequelae.


Asunto(s)
Infecciones Bacterianas , Borrelia burgdorferi , Garrapatas , Animales , Sistema Nervioso Central , Humanos , Anamnesis
18.
Sci Total Environ ; 791: 148252, 2021 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-34116497

RESUMEN

In the current pandemic context, it is necessary to remember the lessons learned from previous outbreaks in Africa, where the incidence of other diseases could rise if most resources are directed to tackle the emergency. Improving the access to water, sanitation and hygiene (WASH) could be a win-win strategy, because the lack of these services not only hampers the implementation of preventive measures against SARS-CoV-2 (e.g. proper handwashing), but it is also connected to high mortality diseases (for example, diarrhoea and lower respiratory infections (LRI)). This study aims to build on the evidence-based link between other LRI and WASH as a proxy for exploring the potential vulnerability of African countries to COVID-19, as well as the role of other socioeconomic variables such as financial sources or demographic factors. The selected methodology combines several machine learning techniques to single out the most representative variables for the analysis, classify the countries according to their capacity to tackle public health emergencies and identify behavioural patterns for each group. Besides, conditional dependences between variables are inferred through a Bayesian network. Results show a strong relationship between low access to WASH services and high LRI mortality rates, and that migrant remittances could significantly improve the access to healthcare and WASH services. However, the role of Official Development Assistance (ODA) in enhancing WASH facilities in the most vulnerable countries cannot be disregarded, but it is unevenly distributed: for each 50-100 US$ of ODA per capita, the probability of directing more than 3 US$ to WASH ranges between 48% (Western Africa) and 8% (Central Africa).


Asunto(s)
COVID-19 , Saneamiento , África/epidemiología , Teorema de Bayes , Humanos , Higiene , Pandemias , SARS-CoV-2 , Agua , Abastecimiento de Agua
19.
Appl Opt ; 60(12): 3422-3429, 2021 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-33983247

RESUMEN

We propose a Bessel beam optical tweezers setup that can stably trap superparamagnetic beads. The trap stiffness measured is practically independent of the radius of the Bessel beam and of the bead height (distance from the coverlip of the sample chamber), indicating that the beads can be trapped with high accuracy within a wide range of such parameters. On the other hand, the trap stiffness exhibits the expected linear increase with the laser power, despite the non-negligible absorption coefficient of the superparamagnetic beads. A geometrical optics model that considers spherical aberration and light absorption by the beads was used to predict the optical forces and trap stiffness, showing excellent agreement with the experimental data. We believe the results presented here advance the field of optical trapping manipulation of absorbing magnetic particles, and future applications will involve, for example, the design of new hybrid optomagnetic tweezers.

20.
ESMO Open ; 6(2): 100104, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33838532

RESUMEN

BACKGROUND: The COVID-19 pandemic has impacted all aspects of modern-day oncology, including how stakeholders communicate through social media. We surveyed oncology stakeholders in order to assess their attitudes pertaining to social media and how it has been affected during the pandemic. MATERIALS AND METHODS: A 40-item survey was distributed to stakeholders from 8 July to 22 July 2020 and was promoted through the European Society for Medical Oncology (ESMO) and the OncoAlert Network. RESULTS: One thousand and seventy-six physicians and stakeholders took part in the survey. In total, 57.3% of respondents were medical oncologists, 50.6% aged <40 years, 50.8% of female gender and mostly practicing in Europe (51.5%). More than 90% of respondents considered social media a useful tool for distributing scientific information and for education. Most used social media to stay up to date on cancer care in general (62.5%) and cancer care during COVID-19 (61%) given the constant flow of information. Respondents also used social media to interact with other oncologists (78.8%) and with patients (34.4%). Overall, 61.1% of respondents were satisfied with the role that social media was playing during the COVID-19 pandemic. On the other hand, 41.1% of respondents reported trouble in discriminating between credible and less credible information and 30% stated social networks were a source of stress. For this reason, one-third of respondents reduced its use during the COVID-19 pandemic. Regarding meeting attendance, a total of 59.1% of responding physicians preferred in-person meetings to virtual ones, and 51.8% agreed that virtual meetings and social distancing could hamper effective collaboration. CONCLUSION: Social media has a useful role in supporting cancer care and professional engagement in oncology. Although one-third of respondents reported reduced use of social media due to stress during the COVID-19 pandemic, the majority found social media useful to keep up to date and were satisfied with the role social media was playing during the pandemic.


Asunto(s)
COVID-19 , Oncólogos , Medios de Comunicación Sociales , Adulto , Anciano , Actitud del Personal de Salud , Actitud hacia los Computadores , Femenino , Humanos , Difusión de la Información , Masculino , Oncología Médica/educación , Persona de Mediana Edad , Oncólogos/psicología , Red Social , Estrés Psicológico , Encuestas y Cuestionarios , Telemedicina
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