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1.
Artículo en Inglés | MEDLINE | ID: mdl-38632016

RESUMEN

BACKGROUND: The calculation of body height in the intensive care unit is essential for obtaining the ideal body weight, which is used to program the tidal volume and establish objective and effective pulmonary ventilation. The objective of the study was to determine the interrater reliability of a tool for measuring body height in adult patients in an intensive care unit (ICU) in southwestern Colombia. METHODS: This cross-sectional observational study was conducted between January and May 2021, following the recommendations of the COSMIN protocol. Two physiotherapists in the roles of observer/evaluator measured the heights of 106 patients upon admission to the ICU with a previously designed. The sample size was calculated based on Pearson's correlation coefficient. For interrater reliability, the intraclass correlation coefficient (ICC) was used, and Bland-Altman analysis was used to assess concordance. The 95% confidence interval was established, and a P value <0.05 indicated statistical significance. RESULTS: A total of 106 individuals with a mean age of 59.3 years were included; the mean body height was 158.5 cm for women. The interrater reliability of the measurement of height was excellent (global ICC of 0.99, P = 0.000), and an almost perfect positive correlation was obtained between the raters for both women and men (R = 0.99). CONCLUSIONS: Excellent interrater/interobserver reliability was obtained for the measurement of body height in the ICU. This research highlights the importance of protocolizing the measurement of height in critical patients with valid and reliable instruments.

2.
Neurologia (Engl Ed) ; 38(9): 617-624, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37996212

RESUMEN

INTRODUCTION: Despite the highly favorable prognosis, mortality occurs in nearly 2% of patients with cerebral venous thrombosis (CVT), in which decompressive craniectomy (DC) may be the only way to save the patient's life. The aim of this report is to describe the risk factors, neuroimaging features, in-hospital complications and functional outcome of severe CVT in patients treated with DC. MATERIALS AND METHODS: Consecutive malignant CVT cases treated with DC from a retrospective third-level hospital database were analyzed. Demographic, clinical, and functional outcomes were analyzed. RESULTS: Twenty-six patients were included (20 female, age 35.4±12.1 years); 53.8% of the patients had acute CVT, with neurological focalization as the most common symptom in 92.3% of the patients. Superior sagittal sinus thromboses were found in 84.6% of cases. Bilateral lesions were present in 10 patients (38.5%). Imaging on admission showed a parenchymal lesion (venous infarction±hemorrhagic lesion)>6cm measured along the longest diameter in 25 patients (96.2%). Mean duration of clinical neurological deterioration was 3.5 days; eleven patients (42.3%) died during hospitalization. CONCLUSION: In patients with severe forms of CVT, we found higher mortality than previously reported. DC is an effective life-saving treatment with acceptable functional prognosis for survivors.


Asunto(s)
Craniectomía Descompresiva , Trombosis de la Vena , Humanos , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Craniectomía Descompresiva/métodos , Estudios Retrospectivos , Pronóstico , Resultado del Tratamiento , Trombosis de la Vena/cirugía , Trombosis de la Vena/complicaciones , Trombosis de la Vena/diagnóstico
3.
Eur Rev Med Pharmacol Sci ; 27(16): 7738-7748, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37667952

RESUMEN

OBJECTIVE: The aim of this study was to develop an initial valid tool to measure attitudes toward cancer-related cognitive changes. SUBJECTS AND METHODS: After revising the literature, three main dimensions were hypothesized. Eight judges were contacted to obtain content validity evidence. A robust Exploratory Factor Analysis (EFA) was performed via a parallel analysis with an Unweighted Least Squares (ULS) estimator and polychoric correlations. The results were crossed with sociodemographic variables to find possible statistical differences and estimate the size effect. Analysis was performed in the software Factor and the statistical package R. RESULTS: A sample of 374 participants was obtained, involving oncology patients, their caregivers, and people from the general community. A statistical fit was found in two dimensions: Awareness and Judgments [root mean squared error of approximation (RMSEA) = 0.042, standardized root mean square residual (SRMR) = 0.02, comparative fit index (CFI) = 0.99, Tucker-Lewis index (TLI) = 0.98] with a moderate correlation between them (r = 0.612). Optimal reliability indices were obtained for the total scale and its dimensions. No real statistical difference was found between sociodemographic variables; the interpretation norms were established via the quartiles. CONCLUSIONS: The first attempt to measure the construct of interest was developed with two primary validity evidence based on the content and its internal structure. This instrument could help strengthen the prevention of cancer-related cognitive changes. More research is needed to adhere more valid evidence to the scale.


Asunto(s)
Oncología Médica , Neoplasias , Humanos , Colombia , Reproducibilidad de los Resultados , Programas Informáticos , Cognición
4.
Hipertens Riesgo Vasc ; 40(3): 132-136, 2023.
Artículo en Español | MEDLINE | ID: mdl-37302940

RESUMEN

Hypertension (HT) is a frequent pathology in patients with active or surviving onco-haematological malignancies. It is estimated that the prevalence of HT in this population ranges between 30 and 70%. The relationship between cancer and HT is multifactorial: common risk factors, neoplasia that cause HT through hormonal secretion, and, especially, chemotherapy drugs that cause HT. Ambulatory blood pressure monitoring (ABPM) is a fundamental tool in the diagnosis and adequate control of blood pressure, avoiding having to suspend or reduce the dose of chemotherapy treatment. In addition, it can help in the diagnosis of autonomic dysfunction related to certain neoplastic pathologies.


Asunto(s)
Enfermedades Hematológicas , Hipertensión , Humanos , Monitoreo Ambulatorio de la Presión Arterial , Hipertensión/tratamiento farmacológico , Presión Sanguínea , Factores de Riesgo
5.
Hipertens Riesgo Vasc ; 40(3): 145-149, 2023.
Artículo en Español | MEDLINE | ID: mdl-35718693

RESUMEN

Tyrosine kinase inhibitors are a family of chemotherapy drugs used in first and second line for many solid and hematological neoplasms. Its toxicity is relatively low, since the mechanism of action is based on the inhibition of some tyrosine kinases involved in the explosion of neoplastic cells. However, this blockade is not selective, so it can produce secondary effects. Sorafenib can produce arterial hypertension, thyroid disorders, abdominal pain or hyperamylasemia, among others. We must monitor these patients during treatment to avoid side effects.

6.
Hipertens Riesgo Vasc ; 39(1): 46-48, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34400099

RESUMEN

Secondary arterial hypertension (HTN) can be caused by primary hyperaldosteronism, renovascular disease, sleep apnea syndrome, chronic kidney disease, drug use, etc. In addition, some urological disorders such as hydronephrosis can cause hypertension due to an increase in intraglomerular pressure that activates the renin angiotensin system.


Asunto(s)
Hiperaldosteronismo , Hipertensión , Enfermedades Renales , Femenino , Humanos , Hiperaldosteronismo/complicaciones , Hipertensión/complicaciones , Persona de Mediana Edad , Renina , Sistema Renina-Angiotensina
7.
Neurologia (Engl Ed) ; 2021 Jul 09.
Artículo en Inglés, Español | MEDLINE | ID: mdl-34253412

RESUMEN

INTRODUCTION: Despite the highly favorable prognosis, mortality occurs in nearly 2% of patients with cerebral venous thrombosis (CVT), in which decompressive craniectomy (DC) may be the only way to save the patient's life. The aim of this report is to describe the risk factors, neuroimaging features, in-hospital complications and functional outcome of severe CVT in patients treated with DC. MATERIALS AND METHODS: Consecutive malignant CVT cases treated with DC from a retrospective third-level hospital database were analyzed. Demographic, clinical, and functional outcomes were analyzed. RESULTS: Twenty-six patients were included (20 female, age 35.4±12.1 years); 53.8% of the patients had acute CVT, with neurological focalization as the most common symptom in 92.3% of the patients. Superior sagittal sinus thromboses were found in 84.6% of cases. Bilateral lesions were present in 10 patients (38.5%). Imaging on admission showed a parenchymal lesion (venous infarction±hemorrhagic lesion)>6cm measured along the longest diameter in 25 patients (96.2%). Mean duration of clinical neurological deterioration was 3.5 days; eleven patients (42.3%) died during hospitalization. CONCLUSION: In patients with severe forms of CVT, we found higher mortality than previously reported. DC is an effective life-saving treatment with acceptable functional prognosis for survivors.

8.
Hipertens Riesgo Vasc ; 38(3): 151-155, 2021.
Artículo en Español | MEDLINE | ID: mdl-33706996

RESUMEN

Survival of neoplasms has improved significantly in recent years. An increase in the incidence of cardiovascular disease has been observed. This is due to increasing age of patients and the side effects of chemotherapy. Anti-angiogenic drugs frequently cause hypertension. This may force the reduction or suspension of chemotherapy treatment. We present the cases of three patients treated with different anti-angiogenic drugs. All three developed secondary arterial hypertension.


Asunto(s)
Inhibidores de la Angiogénesis , Enfermedades Cardiovasculares , Hipertensión , Neoplasias , Inhibidores de la Angiogénesis/efectos adversos , Humanos , Hipertensión/inducido químicamente , Hipertensión/tratamiento farmacológico , Neoplasias/complicaciones , Neoplasias/tratamiento farmacológico
9.
Tech Coloproctol ; 25(4): 481-482, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33387101
10.
Rev Colomb Enferm ; 20(1): e031, 2021.
Artículo en Español | LILACS, BDENF, COLNAL | ID: biblio-1253268

RESUMEN

Introducción: el proceso de parto representa una de las experiencias más importantes para la mujer, puede ser una de las mejores vivencias o el evento más traumático y doloroso que podría tener durante la vida; implica una experiencia psicosocial profunda que pone a prueba su feminidad y competencias personales. Objetivo: describir la percepción de la gestante acerca del cuidado brindado por el profesional en enfermería durante el trabajo de parto en un hospital de nivel III-IV de la ciudad de Neiva, Colombia desde las cinco dimensiones propuestas en la teoría de los cuidados de Kristen Swanson. Métodos: se utilizó la fenomenología interpretativa, y como técnica de recolección de datos la entrevista en profundidad. La muestra se determinó por saturación de la información. Se entrevistaron seis mujeres que tuvieron trabajo de parto, a cada una se le realizaron tres entrevistas, transcritas por las investigadoras. Resultados: se identificaron cinco categorías: 1) El acompañamiento marca la diferencia en el cuidado de enfermería; 2) Lo que necesita la parturienta: confianza, seguridad y tranquilidad; 3) Encontrar un ángel; 4) La enfermera me animaba para seguir adelante; 5) El conocimiento de la enfermera produce seguridad en la gestante. Fue posible determinar que cuando la gestante se sintió acompañada, estableció empatía con la enfermera y, logró sentir confianza, tranquilidad y seguridad. Esto permitió tener una relación de reciprocidad. Además las participantes destacaron que la enfermera se esforzó para otorgar un cuidado más cercano y centrado en la persona. Conclusiones: el cuidado que brinda la enfermera significa algo más que intervenciones asistenciales competentes; implica crear empatía, generar confianza, tranquilidad, seguridad, todo lo cual es propiciado por el acompañamiento que se da a la gestante. (AU)


Introduction: The childbirth process represents one of the most important experiences for a woman. It can be one of the best experiences or the most traumatic and painful event a woman could undergo during her life; it is a deep psychosocial experience that tests her femininity and personal competencies. Objective: To describe pregnant women's perception of the care provided during labor by professional nurses in a Level III-IV hospital in the city of Neiva, Colombia, based on the five processes proposed in Kristen Swanson's theory of caring. Methods: An interpretative phenomenological analysis was used. In-depth interviews were employed as the method of data collection. The sample was determined by data saturation. Six women who were in labor were interviewed; three interviews were conducted with each woman and transcribed by the researchers. Results: Five categories were identified: 1) assistance makes the difference in nursing care, 2) what a woman in labor needs: confidence, security, and peace of mind, 3) finding an angel, 4) the nurse encouraged me to keep going, and 5) nurse's knowledge provides pregnant women with security. It was possible to determine that when the pregnant woman felt assisted, she empathized with the nurse and was able to feel confidence, peace of mind, and security; this allowed for a reciprocal relationship. In addition, the participants highlighted that the nurse made an effort to provide closer and more person-centered care. Conclusions: Nurse-delivered care means something more than competent assistance interventions; it implies developing empathy and building confidence, peace of mind, security, all of which are propitiated by the assistance given to pregnant women. (AU)


Introdução: O processo de parto representa uma das experiências mais importantes nas mulheres e pode ser uma das melhores experiências ou o evento mais traumático e doloroso que poderia ter durante a vida; implicando uma profunda experiência psicossocial que testa sua feminilidade e habilidades pessoais. Esta pesquisa é guiada pela teoria de médio alcance proposta por Kristen Swanson, com seus cinco processos que se sobrepõem e são melhor compreendidos como dimensões de um fenômeno que não são excluídos um do outro, mas podem ser organizados hierarquicamente, conservando a Ideia de uma totalidade. Objetivo: Descrever a percepção da gestante sobre os cuidados prestados pelo profissional de enfermagem durante o trabalho de parto em um hospital do nível III-IV da cidade de Neiva, a partir das cinco dimensões propostas na Teoria do Cuidado de Kristen Swanson. Métodos: Fo i utilizada a fenomenologia interpretativa e, como técnica de coleta de dados em profundidade, a amostra foi determinada pela saturação das informações, foram entrevistadas 6 mulheres que tiveram trabalho de parto, cada uma com três entrevistas, que foram transcritas pela pesquisadora. Resultados: fo r a m identificadas cinco categorias: 1. O acompanhamento faz a diferença na assistência de enfermagem, 2. O que a parturiente precisa: confiança, segurança e tranquilidade, 3. Encontrar um anjo, 4. A enfermeira me incentivou a seguir em frente, 5. O conhecimento do enfermeiro produz segurança na gestante. Foi possível determinar que, quando a gestante se sentia acompanhada, estabeleceu empatia com a enfermeira, conseguindo sentir confiança, tranquilidade e segurança, isso permitiu ter um relacionamento recíproco; Eles também enfatizam que a enfermeira fez um esforço para oferecer um cuidado mais próximo e centrado na pessoa. Conclusões: O cuidado prestado pelo enfermeiro significa mais do que intervenções assistenciais competentes, implica criar empatia, criar confiança, tranquilidade, segurança, fomentada pelo apoio prestado à gestante. (AU)


Asunto(s)
Parto Humanizado , Confianza , Relaciones Enfermero-Paciente , Atención de Enfermería
11.
J Assist Reprod Genet ; 37(6): 1379-1385, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32363563

RESUMEN

PURPOSE: To investigate the clinical efficacy of a "Universal Warming" protocol, based on subsequent steps with 1 M and 0.5 M concentration of extracellular cryoprotectant (ECCP), on shipped oocytes. Oocytes are vitrified using different brands of ready-to-use kits which recommend that the use of their own warming kit and combining different vitrification/warming kits may have legal consequences for assisted reproductive (AR) centers, until this practice has been validated with clinical studies. METHODS: Retrospective multi-center transnational observational study. Number of oocytes warmed 1.898. Vitrification performed with vitrification kit (Kitazato, Japan); warming carried out randomly with two different kits: Kitazato warming kit and Vit Kit®-Thaw (FujiFilm Irvine, USA). Warmed oocytes were assigned to 2 groups: KK (Kitazato/Kitazato) 939, and KI (Kitazato/Irvine) 959. Primary endpoint: survival rate. Secondary endpoints: fertilization rate; blastulation rate; implantation rate; live birth rate. RESULTS: Survival was comparable between the groups: 84.6% (795/939) in group KK vs 82.1% (787/959) in group KI. Fertilization rate was lower (P = 0.027) in group KK (75.7%-602/795) than in group KI (80.4%-633/787). Blastulation and implantation and live birth rates were all statistically comparable between the study groups: blastulation rate was 58.5% (352/602) vs 57.8% (366/633); implantation rate was 41.5% (80/193) vs 45.9% (84/183); live birth rate was 52.5% (62/118) in KK and 45.0% (54/120) in KI. CONCLUSION: The use of this "Universal Warming" protocol simplifies vitrified oocyte exchange between AR centers in different countries, and overcomes potential regulatory/commercial/availability differences affecting clinical practice.


Asunto(s)
Tasa de Natalidad , Implantación del Embrión/fisiología , Transferencia de Embrión , Oocitos/crecimiento & desarrollo , Adulto , Criopreservación , Femenino , Fertilización In Vitro , Humanos , Japón , Nacimiento Vivo/epidemiología , Donación de Oocito , Recuperación del Oocito/métodos , Embarazo , Índice de Embarazo , Vitrificación
12.
Hipertens Riesgo Vasc ; 37(3): 133-136, 2020.
Artículo en Español | MEDLINE | ID: mdl-32224047

RESUMEN

Autonomic dysfunction is a common condition in the alpha-synucleinopathies (Parkinson's disease, dementia with Lewy bodies, multiple system atrophy). Cardiovascular symptoms may include orthostatic hypotension, supine hypertension or decreased heart rate response. A clinical suspicion and physical examination are essential for diagnosis, taking blood pressure in supine and standing positions. The electrocardiogram may show a prolongation of the PR and QT intervals, while 24-hour ambulatory blood pressure monitoring provides information on blood pressure patterns. Cardiac sympathetic dysfunction can be confirmed by an innervation myocardial scintigraphy with 123-I-methylbenzylguanidine (123-I-MIBG). This can reflect specific neuronal noradrenergic uptake. We present the case of a man with Parkinson's disease who was diagnosed with cardiovascular autonomic dysfunction after a complete study.


Asunto(s)
Enfermedades del Sistema Nervioso Autónomo/diagnóstico , Enfermedades Cardiovasculares/diagnóstico , Enfermedad de Parkinson/complicaciones , Anciano de 80 o más Años , Enfermedades del Sistema Nervioso Autónomo/etiología , Enfermedades del Sistema Nervioso Autónomo/fisiopatología , Presión Sanguínea , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/fisiopatología , Electrocardiografía , Humanos , Masculino
14.
Rehabilitacion (Madr) ; 54(1): 31-40, 2020.
Artículo en Español | MEDLINE | ID: mdl-32007181

RESUMEN

OBJECTIVE: To describe the characteristics of motor behaviour in premature infants during the first months of postnatal life, according to the available evidence. MATERIALS AND METHODS: A systematic literature review was carried out; this method forms part of secondary studies under investigation and describes a phenomenon in detail based on primary sources of information. RESULTS: The literature search in the databases consulted yielded 7,228 articles; of these, 15 more were identified through "snowball" search strategies. At the start of the screening process, 63 eligible records were chosen based on their title and summary, and 14 were excluded because they were duplicates. A total of 49 articles were selected for a full text revision and, of these, 37 were excluded because they did not meet all the inclusion criteria. Finally, 12 articles were selected to prepare the qualitative synthesis of the present research work. CONCLUSIONS: In comparison with neonates born at term, premature infants demonstrate a particular motor repertoire, due to the immaturity of their systems; their motor behaviour follows a line of development mainly characterised by deficits in muscle tone, postural control, muscle balance, and antigravity muscle activation.


Asunto(s)
Recien Nacido Prematuro/fisiología , Actividad Motora/fisiología , Humanos , Lactante , Recién Nacido , Tono Muscular/fisiología , Músculo Esquelético/fisiología , Equilibrio Postural/fisiología
15.
Hum Reprod ; 34(10): 2027-2035, 2019 10 02.
Artículo en Inglés | MEDLINE | ID: mdl-31560740

RESUMEN

STUDY QUESTION: Are the LH levels at the start of ovarian stimulation predictive of suboptimal oocyte yield from GnRH agonist triggering in GnRH antagonist down-regulated cycles? SUMMARY ANSWER: LH levels at the start of ovarian stimulation are an independent predictor of suboptimal oocyte yield following a GnRH agonist trigger. WHAT IS KNOWN ALREADY: A GnRH agonist ovulation trigger may result in an inadequate oocyte yield in a small subset of patients. This failure can range from empty follicle syndrome to the retrieval of much fewer oocytes than expected. Suboptimal response to a GnRH agonist trigger has been defined as the presence of circulating LH levels <15 IU/l 12 h after triggering. It has been shown that patients with immeasurable LH levels on trigger day have an up to 25% risk of suboptimal response. STUDY DESIGN, SIZE, DURATION: In this retrospective cohort study, all patients (n = 3334) who received GnRH agonist triggering (using Triptoreline 0.2 mg) for final oocyte maturation undergoing a GnRH antagonist cycle in our centre from 2011 to 2017 were included. The primary outcome of the study was oocyte yield, defined as the ratio between the total number of collected oocytes and the number of follicles with a mean diameter >10 mm prior to GnRH agonist trigger. PARTICIPANTS/MATERIALS, SETTING, METHODS: The endocrine profile of all patients was studied at initiation as well as at the end of ovarian stimulation. In order to evaluate whether LH levels, not only at the end but also at the start, of ovarian stimulation predicted oocyte yield, we performed multivariable regression analysis adjusting for the following confounding factors: female age, body mass index, oral contraceptives before treatment, basal and trigger day estradiol levels, starting FSH levels, use of highly purified human menopausal gonadotrophin and total gonadotropin dose. Suboptimal response to GnRH agonist trigger was defined as <10th percentile of oocyte yield. MAIN RESULTS AND THE ROLE OF CHANCE: The average age was 31.9 years, and the mean oocyte yield was 89%. The suboptimal response to GnRH agonist trigger cut-off (<10th percentile) was 45%, which was exhibited by 340 patients. Following confounder adjustment, multivariable regression analysis showed that LH levels at the initiation of ovarian stimulation remained an independent predictor of suboptimal response even in the multivariable model (adjusted OR 0.920, 95% CI 0.871-0.971). Patients with immeasurable LH levels at the start of stimulation (<0.1 IU/l) had a 45.2% risk of suboptimal response, while the risk decreased with increasing basal LH levels; baseline circulating LH <0.5 IU/L, <2 IU/L and <5 IU/L were associated with a 39.1%, 25.2% and 13.6% risk, respectively. LIMITATIONS, REASONS FOR CAUTION: The main limitation of the study is its retrospective design. WIDER IMPLICATIONS OF THE FINDINGS: This is the largest study of GnRH agonist trigger cycles only, since most of the previous research on the predictive value of basal LH levels was performed in dual trigger cycles. LH values should be measured prior to start of ovarian stimulation. In cases where they are immeasurable, suboptimal response to GnRH agonist trigger can be anticipated, and an individualized approach is warranted. STUDY FUNDING/COMPETING INTEREST(S): There was no funding and no competing interests. TRIAL REGISTRATION NUMBER: Not applicable.


Asunto(s)
Hormona Liberadora de Gonadotropina/agonistas , Hormona Luteinizante/sangre , Recuperación del Oocito/métodos , Inducción de la Ovulación/métodos , Pamoato de Triptorelina/administración & dosificación , Adulto , Femenino , Hormona Liberadora de Gonadotropina/metabolismo , Humanos , Infertilidad/etiología , Infertilidad/terapia , Donación de Oocito/métodos , Donación de Oocito/estadística & datos numéricos , Recuperación del Oocito/estadística & datos numéricos , Oocitos/efectos de los fármacos , Oocitos/fisiología , Oogénesis/efectos de los fármacos , Estudios Retrospectivos , Resultado del Tratamiento
16.
Rev Sci Instrum ; 88(8): 084705, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28863641

RESUMEN

A scanning system for specific absorption rate of ferrofluids with superparamagnetic nanoparticles is presented in this study. The system contains an induction heating device designed and built with a resonant inverter in order to generate magnetic field amplitudes up to 38 mT, over the frequency band 180-525 kHz. Its resonant circuit involves a variable capacitor with 1 nF of capacitance steps to easily select the desired frequency, reaching from 0.3 kHz/nF up to 5 kHz/nF of resolution. The device performance is characterized in order to compare with the theoretical predictions of frequency and amplitude, showing a good agreement with the resonant inverters theory. Additionally, the setup is tested using a synthetic iron oxide with 10 ± 1 nm diameter suspended in liquid glycerol, with concentrations at 1%. Meanwhile, the temperature rise is measured to determine the specific absorption rate and calculate the dissipated power density for each f. This device is a suitable alternative to studying ferrofluids and analyzes the dependence of the power absorption density with the magnetic field intensity and frequency.

17.
TH Open ; 1(2): e106-e112, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31249916

RESUMEN

Introduction Individualized risk assessment for venous thromboembolism (VTE) using the Caprini risk score (CRS), coupled with targeted prophylaxis based on the score, is effective in reducing postoperative VTE. Critics contend that using this tool is time consuming for health care providers. We decided to create a patient-completed CRS and conducted a prospective study to compare the scores calculated by a patient with those calculated by a blinded physician for the same patient. Methods In phase 1, we interviewed patients in our deep vein thrombosis (DVT) support group who had a history of thrombosis and included their family members to determine areas of misunderstanding in the original CRS. We created a patient-completed form based on these interviews. In phase 2, we further optimized the questions after a CRS-trained, blinded physician scored 20 hospitalized patients during the pilot study. In the final (third) phase, we measured the agreement level between the new form filled out by the trained physicians and those filled out by the patients. The study was approved by our local institutional review board. Using PASS version 11, we determined that a sample size of 37 individuals achieves a power of 80%, to detect a 0.1 difference between the null hypothesis correlation of 0.5 and the alternative hypothesis correlation of 0.7 using a two-sided hypothesis test with a significance level of 0.05. We tabulated the individuals' answers and categorized the scores by using SPSS version 23 to estimate the kappa value, linear correlation, and the Bland-Altman test. A kappa value greater than 0.8 indicated an "almost perfect agreement." Results We tested the first patient-completed CRS version (phase 2) in a 20-patient pilot study. A poor agreement was observed with the body mass index (BMI) responses in multiple iterations, and so we excluded the BMI calculation from the final patient-completed CRS form. We recruited 42 patients with an average age of 55, mostly female (45%), who completed less than college education (62%) to fill out the updated CRS form (phase 3). An almost perfect agreement was found for both the individual questions and the overall score comparing physician and patient answers, resulting in a high correlation ( r = 0.95). In Bland-Altman, we did not find any trend for extreme values. Conclusion We created and validated a patient-completed CRS form that has an excellent agreement level with the physician-completed form. From the results, the physician only needs to calculate the BMI. The average time for a patient to complete the form was 5 minutes. The average time for the physician to finalize the score was approximately 6 minutes. Implementation studies are needed to assess the correlation of the aggregated score, derived from this form, with the occurrence of perioperative VTE.

19.
Rev. chil. nutr ; 42(4): 351-356, dic. 2015. tab
Artículo en Español | LILACS | ID: lil-775505

RESUMEN

Objective: to assess the potential association between non-syndromic cleft lip and/or palate (CLP) and weight and height gain. Subjects and methods: An analytic cross sectional study was donei n a sample conformed by 83 CLP children and 96 children without clefts. Sociodemographic and clinical variables were included as the presence of LPH, weight, height and nutritional status. For bivariate analyzes, Chi2 or Fisher exact test and Student t test or Wilcoxon Rank test were applied as appropriate. Logistic regression and the respective OR correction was performed. Results: the presence of lip and palate was associated with height (p=0.015), weight (p=0.030) and nutritional status (p=0.043); however, in the final adjusted model, the nutritional status was only statistically associated with the variable gender (p=0.031). Conclusions: the nutritional condition between cleft lip and palate and non-cleft children did not show a statistically significant difference, nor did the type of cleft.


Objetivo: determinar la posible asociación entre el labio y/o el paladar hendido no sindrómico (LPH) con el estado nutricional de los niños que lo padecen. Sujetos y Método: se realizó un estudio observacional analítico de corte transversal que comparó el estado nutricional de 83 niños con LPH y 96 que no lo presentaban. Se incluyeron variables sociodemográficas, clínicas y antropométricas que fueron analizadas mediante un análisis bivariado y una regresión logística con su respectiva corrección de los OR. Resultados: la presencia de labio y paladar hendido se asoció con la talla (p=0,015), el peso (p=0,030) y el estado nutricional (p=0,043); sin embargo, en el modelo final ajustado el estado nutricional solo se asoció estadísticamente con la variable sexo (p=0,031). Conclusiones: no se presentó una diferencia estadísticamente significativa entre el estado nutricional de los infantes con labio y/o paladar hendido comparado con el de los niños que no presentaban hendiduras.


Asunto(s)
Niño , Estado Nutricional , Fisura del Paladar , Peso por Estatura
20.
Biochem Biophys Res Commun ; 468(4): 713-8, 2015 Dec 25.
Artículo en Inglés | MEDLINE | ID: mdl-26551457

RESUMEN

Fertilization is a key reproductive event in which sperm and egg fuse to generate a new individual. Proper regulation of certain parameters (such as intracellular pH) is crucial for this process. Carbonic anhydrases (CAs) are among the molecular entities that control intracellular pH dynamics in most cells. Unfortunately, little is known about the function of CAs in mammalian sperm physiology. For this reason, we re-explored the expression of CAI, II, IV and XIII in human and mouse sperm. We also measured the level of CA activity, determined by mass spectrometry, and found that it is similar in non-capacitated and capacitated mouse sperm. Importantly, we found that CAII activity accounts for half of the total CA activity in capacitated mouse sperm. Using the general CA inhibitor ethoxyzolamide, we studied how CAs participate in fundamental sperm physiological processes such as motility and acrosome reaction in both species. We found that capacitated human sperm depend strongly on CA activity to support normal motility, while capacitated mouse sperm do not. Finally, we found that CA inhibition increases the acrosome reaction in capacitated human sperm, but not in capacitated mouse sperm.


Asunto(s)
Acrosoma/enzimología , Anhidrasas Carbónicas/metabolismo , Motilidad Espermática/fisiología , Espermatozoides/fisiología , Animales , Células Cultivadas , Activación Enzimática , Humanos , Masculino , Ratones , Ratones Endogámicos C57BL , Especificidad de la Especie
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