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1.
Eur J Pediatr ; 2024 Aug 07.
Artículo en Inglés | MEDLINE | ID: mdl-39110215

RESUMEN

Preterm birth represents a public health problem, with prematurity being the leading cause of infant mortality. An objective brain maturation and oxygenation measurement are necessary. The objective has been To test the feasibility of EEG and NIRS combination in the assessment of physiological brain maturation and oxygenation in preterm and non-preterm babies. A systematic review in Pubmed, Web of Science, MEDLINE, Cochrane, Dialnet, CINAHL, Scopus, Lilacs and PEDro databases until December 2022 was developed. 598 registers were found, finally 5 of them reached the inclusion criteria. Two independent reviewers analyzed data and a third reviewer were available for discrepancies. All articles combined EEG and NIRS to assess brain oxygenation and maturation in healthy new-born babies. There is an agreement on the electrode's placement for EEG at P3 and P4; besides, these regions have been shown to be a development predictive area, as well as the frontoparietal region for the NIRS region and comparison between regions. There is little evidence about the physiological brain electrical activity and oxygenation without stimuli.Conclusion: EEG and NIRS have been useful to assess brain electrical activity and oxygenation in preterm and non-preterm. The combined measurement of these instruments could be essential in neurological disorders diagnosis or their sequels. Unfortunately, the heterogeneity of the results found prevents a consensus on which variables are the most appropriate for the assessment of this population. What is Known • Brain assessment could help clinicians to prevent sequels. • There is an agreement for EEG electrodes placement at P3 and P4 region. What is New • EEG and NIRS assessment are effective measurements for preterm babies. • P3 and P4 regions have shown to be a predictive area of development, as well as the frontoparietal region for NIRS assessment.

2.
Public Health ; 234: 187-190, 2024 Jul 18.
Artículo en Inglés | MEDLINE | ID: mdl-39029268

RESUMEN

OBJECTIVES: To evaluate the association of ultra-processed food (UPF) consumption with depression among Brazilian adults (≥18 years). STUDY DESIGN: Cross-sectional study. METHODS: Data were obtained from a population-based survey conducted in 2023 (n = 21,690). UPF consumption was investigated using a questionnaire regarding the consumption on the previous day of 13 subgroups of UPF selected from those most consumed in Brazil according to a previous national survey (cutoff score ≥5 subgroups). The medical diagnosis of depression was self-reported. Logistic regression models were used to estimate the adjusted (by sex, age, education, presence of partner/spouse, and overweight) Odds Ratio (aOR) of UPF consumption according to the presence of depression. Analyses were conducted for the total population and stratified by sex. RESULTS: Medical diagnosis of depression was reported by 12.3%. The prevalence of high UPF consumption (≥5 subgroups) was 17.7%, being higher in men (22.0%) and those with depression (19.3%). Depression increased the chance of presenting a high UPF consumption among the total population (aOR 1.35; CI 95% 1.08-1.68) and women (aOR 1.35; CI 95% 1.03-1.77), with no association among men. CONCLUSION: The presence of depression was associated with greater consumption of UPF among Brazilian adults, especially among the female population. Public health actions to reduce UPF consumption could benefit from targeting this population group.

3.
Anaesthesia ; 77(3): 326-338, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34855986

RESUMEN

Videolaryngoscopes are thought to improve glottic view and facilitate tracheal intubation compared with the Macintosh direct laryngoscope. However, we currently do not know which one would be the best choice in most patients undergoing anaesthesia. We designed this systematic review with network meta-analyses to rank the different videolaryngoscopes and the Macintosh direct laryngoscope. We conducted searches in PubMed and a further five databases on 11 January 2021. We included randomised clinical trials with patients aged ≥16 years, comparing different videolaryngoscopes, or videolaryngoscopes with the Macintosh direct laryngoscope for the outcomes: failed intubation; failed first intubation attempt; failed intubation within two attempts; difficult intubation; percentage of glottic opening seen; difficult laryngoscopy; and time needed for intubation. We assessed the quality of evidence according to GRADE recommendations and included 179 studies in the meta-analyses. The C-MAC and C-MAC D-Blade were top ranked for avoiding failed intubation, but we did not find statistically significant differences between any two distinct videolaryngoscopes for this outcome. Further, the C-MAC D-Blade performed significantly better than the C-MAC Macintosh blade for difficult laryngoscopy. We found statistically significant differences between the laryngoscopes for time to intubation, but these differences were not considered clinically relevant. The evidence was judged as of low or very low quality overall. In conclusion, different videolaryngoscopes have differential intubation performance and some may be currently preferred among the available devices. Furthermore, videolaryngoscopes and the Macintosh direct laryngoscope may be considered clinically equivalent for the time taken for tracheal intubation. However, despite the rankings from our analyses, the current available evidence is not sufficient to ensure significant superiority of one device or a small set of them over the others for our intubation-related outcomes.


Asunto(s)
Intubación Intratraqueal/métodos , Laringoscopía/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Procedimientos y Técnicas Asistidas por Video , Adulto , Humanos , Intubación Intratraqueal/normas , Laringoscopía/normas , Metaanálisis en Red , Ensayos Clínicos Controlados Aleatorios como Asunto/normas
4.
Ann Oncol ; 30(2): 290-296, 2019 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-30535340

RESUMEN

BACKGROUND: Approximately 30% of tumor biopsies from patients with advanced-stage lung adenocarcinomas yield insufficient tissue for successful molecular subtyping. We have analyzed the clinical utility of next-generation sequencing (NGS) of cell-free circulating tumor DNA (ctDNA) in patients with inadequate tumor samples for tissue genotyping. PATIENTS AND METHODS: We conducted the study in a multi-institutional prospective cohort of clinically unselected patients with advanced-stage lung adenocarcinomas with insufficient tissue for EGFR, ALK or ROS1 genotyping across 12 Spanish institutions (n = 93). ctDNA NGS was carried out by Guardant Health (Guardant360, Redwood City, CA), using a hybrid-capture-based 73-gene panel. Variants were deemed actionable if they were part of the OncoKB precision oncology knowledge database and classified in four levels of actionability based on their clinical or preclinical evidence for drug response. RESULTS: Eighty-three out of 93 patients (89%) had detectable levels of ctDNA. Potentially actionable level 1-4 genomic alterations were detected in 53 cases (57%), of which 13 (14%) had level 1-2A alterations (Food and Drug Administration-approved and standard-care biomarkers according to lung cancer guidelines). Frequencies of each genomic alteration in ctDNA were consistent with those observed in unselected pulmonary adenocarcinomas. The majority of the patients (62%), particularly those with actionable alterations (87%), had more than one pathogenic variant in ctDNA. The median turnaround time to genomic results was 13 days. Twelve patients (13%) received genotype-matched therapies based on ctDNA results, deriving the expected clinical benefit. Patients with co-occurring pathogenic alterations had a significantly shorter median overall survival as compared with patients without co-occurring pathogenic alteration (multivariate hazard ratio = 5.35, P = 0.01). CONCLUSION: Digital NGS of ctDNA in lung cancers with insufficient tumor samples for tissue sequencing detects actionable variants that frequently co-occur with other potentially clinically relevant genomic alterations, allowing timely initiation of genotype-matched therapies.


Asunto(s)
Adenocarcinoma del Pulmón/secundario , Biomarcadores de Tumor/sangre , ADN Tumoral Circulante/sangre , ADN de Neoplasias/sangre , Secuenciación de Nucleótidos de Alto Rendimiento/métodos , Neoplasias Pulmonares/patología , Proteínas Proto-Oncogénicas/genética , Adenocarcinoma del Pulmón/sangre , Adenocarcinoma del Pulmón/genética , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/genética , ADN Tumoral Circulante/genética , ADN de Neoplasias/genética , Femenino , Estudios de Seguimiento , Genoma Humano , Genómica , Humanos , Neoplasias Pulmonares/sangre , Neoplasias Pulmonares/genética , Masculino , Persona de Mediana Edad , Mutación , Metástasis de la Neoplasia , Medicina de Precisión , Pronóstico , Estudios Prospectivos , Tasa de Supervivencia
5.
Clin Genet ; 93(6): 1229-1233, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29437235

RESUMEN

Splicing-related gene mutations might affect the expression of a single gene or multiple genes and cause clinically heterogeneous diseases. With the advent of next-generation sequencing, several splicing gene mutations have been exposed, yet most major spliceosome genes have no reports of germline mutations and therefore, their effects are largely unknown. We describe the previously unreported concurrence of intellectual disability, short stature, poor speech, and minor craniofacial and hand anomalies in 2 female siblings with 3 homozygous missense variants in SNRPA (a component of the U1 small nuclear ribonucleoprotein complex) characterized by homozygosity mapping and whole exome sequencing. Combined, c.97A>G, c.98T>C, and c.100T>A, in exon 2 of SNRPA lead to p.Ile33Ala and p.Phe34Ile exchanges, which were predicted in silico to be deleterious. Although both patients exhibited some clinical features seen in other spliceosomal disorders, their complete clinical phenotype appears to be rather uncommon, a finding that may further support the notion that mutations in components of the major spliceosome do not strictly lead to the same syndromes/phenotypes.


Asunto(s)
Secuenciación del Exoma , Discapacidad Intelectual/genética , Mutación Missense/genética , Ribonucleoproteína Nuclear Pequeña U1/genética , Hermanos , Adulto , Niño , Preescolar , Exoma/genética , Femenino , Homocigoto , Humanos , Recién Nacido , Síndrome , Adulto Joven
6.
Osteoporos Int ; 29(10): 2355-2368, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30019084

RESUMEN

Rheumatoid arthritis (RA) is characterized by increased bone resorption and impaired bone formation. Osteoblast function is regulated by the canonical LRP5/Wnt/ß-catenin pathway. Bone mineral density and RA joint destruction are partially inherited. In line with this, we found significant associations between LRP5 SNPs (p.A1330V, p.N740N, p.V667M) and RA radiographic damage severity. INTRODUCTION: Increased bone resorption and impaired bone formation characterize rheumatoid arthritis (RA). Canonical Wnt/ß-catenin pathway, signalled by lipoprotein receptor-related protein-5 (LRP5), regulates osteoblast function. Since bone mineral density (BMD) and RA joint destruction are partially inherited, we studied their association with LRP5 single nucleotide polymorphisms (SNPs). METHODS: Clinical data and peripheral blood for biomarkers assessment and LRP5 genotyping were collected from 208 RA patients. Hands and feet X-rays were scored [modified Sharp/van der Heijde Score (SHS), joint space narrowing (JSN), and erosion scores]. Lumbar spine, total left proximal femur, and left hand BMD were assessed by dual-energy X-ray absorptiometry (DXA). RESULTS: TT genotypes for p.A1330V and p.N740N LRP5 SNPs associated with total SHS, erosion score, and hands erosion score; the same for p.A1330V with feet JSN score and p.N740N with hands total score. AG genotype for p.V667M associated with sclerostin and hands JSN score. Femoral BMD associated with TC genotype for p.N740N. Multiple test correction precluded a few of these associations. Among V667M-N740N-A1330V haplotypes: GTT associated with higher feet JSN score (OR = 3.80; p = 0.016) and ATT with higher JSN score (OR = 4.60; p = 0.032), hands total score (OR = 5.65; p = 0.022), and total SHS (OR = 6.74; p = 0.024). CONCLUSION: Significant associations between LRP5 SNPs (p.A1330V, p.N740N, and p.V667M) and the severity of radiographic damage reinforce the evidence of bone destruction heritability in RA.


Asunto(s)
Artritis Reumatoide/genética , Resorción Ósea/genética , Proteína-5 Relacionada con Receptor de Lipoproteína de Baja Densidad/genética , Polimorfismo de Nucleótido Simple , Absorciometría de Fotón , Anciano , Artritis Reumatoide/complicaciones , Artritis Reumatoide/diagnóstico por imagen , Artritis Reumatoide/fisiopatología , Densidad Ósea/genética , Resorción Ósea/diagnóstico por imagen , Resorción Ósea/etiología , Resorción Ósea/fisiopatología , Femenino , Fémur/fisiopatología , Huesos de la Mano/diagnóstico por imagen , Huesos de la Mano/fisiopatología , Humanos , Vértebras Lumbares/fisiopatología , Masculino , Persona de Mediana Edad , Radiografía
7.
Faraday Discuss ; 187: 187-98, 2016 06 23.
Artículo en Inglés | MEDLINE | ID: mdl-27032537

RESUMEN

Cervical cancer is the fourth most common cancer affecting women worldwide but mortality can be decreased by early detection of pre-malignant lesions. The Pap smear test is the most commonly used method in cervical cancer screening programmes. Although specificity is high for this test, it is widely acknowledged that sensitivity can be poor mainly due to the subjective nature of the test. There is a need for new objective tests for the early detection of pre-malignant cervical lesions. Over the past two decades, Raman spectroscopy has emerged as a promising new technology for cancer screening and diagnosis. The aim of this study was to evaluate the potential of Raman spectroscopy for cervical cancer screening using both Cervical Intraepithelial Neoplasia (CIN) and Squamous Intraepithelial Lesion (SIL) classification terminology. ThinPrep® Pap samples were recruited from a cervical screening population. Raman spectra were recorded from single cell nuclei and subjected to multivariate statistical analysis. Normal and abnormal ThinPrep® samples were discriminated based on the biochemical fingerprint of the cells using Principal Component Analysis (PCA). Principal Component Analysis - Linear Discriminant Analysis (PCA-LDA) was employed to build classification models based on either CIN or SIL terminology. This study has shown that Raman spectroscopy can be successfully applied to the study of routine cervical cytology samples from a cervical screening programme and that the use of CIN terminology resulted in improved sensitivity for high grade cases.


Asunto(s)
Prueba de Papanicolaou , Espectrometría Raman , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/patología , Frotis Vaginal , Femenino , Humanos , Análisis de Componente Principal , Lesiones Intraepiteliales Escamosas de Cuello Uterino/clasificación , Lesiones Intraepiteliales Escamosas de Cuello Uterino/diagnóstico , Lesiones Intraepiteliales Escamosas de Cuello Uterino/patología , Neoplasias del Cuello Uterino/clasificación , Displasia del Cuello del Útero/clasificación , Displasia del Cuello del Útero/diagnóstico , Displasia del Cuello del Útero/patología
8.
Actas Dermosifiliogr ; 107(8): 666-73, 2016 Oct.
Artículo en Inglés, Español | MEDLINE | ID: mdl-27238743

RESUMEN

BACKGROUND AND OBJECTIVE: Dermatology in-house call is uncommon in the Spanish national health system. The objective of the present study was to define the groups of dermatologic diseases and conditions most frequently seen in the emergency department and to evaluate the need for dermatology in-house call in the training of medical residents. MATERIAL AND METHODS: We performed a descriptive study of all patients who attended the emergency department with a skin complaint during a 1-year period (June 2013 to May 2014) and were assessed by 9 dermatology residents. The study variables were date/day, sex, age, diagnosis, special surgical procedures, additional laboratory tests, and need for hospitalization and/or follow-up. We also evaluated patients attending their first scheduled visit to the dermatologist between January and June 2014 in order to compare the most frequent conditions in both groups. RESULTS: A total of 3084 patients attended the emergency room with a skin complaint (5.6% of all visits to the emergency department), and 152 different diagnoses were made. The most frequent groups of diseases were infectious diseases (23%) and eczema (15.1%). The specific conditions seen were acute urticaria (7.6%), contact dermatitis (6.1%), and drug-induced reactions (4.6%). By contrast, the most frequent conditions seen in the 1288 patients who attended a scheduled dermatology appointment were seborrheic keratosis (11.9%), melanocytic nevus (11.5%), and actinic keratosis (8%). A follow-up visit was required in 42% of patients seen in the emergency department. Fourth-year residents generated the lowest number of follow-up visits. CONCLUSIONS: We found that infectious diseases and eczema accounted for almost 40% of all emergency dermatology visits. Our results seem to indicate that the system of in-house call for dermatology residents is very useful for the hospital system and an essential component of the dermatology resident's training program.


Asunto(s)
Dermatología/educación , Urgencias Médicas/epidemiología , Internado y Residencia , Enfermedades de la Piel/epidemiología , Centros de Atención Terciaria/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Grupos Diagnósticos Relacionados , Eccema/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Enfermedades de la Piel/cirugía , Enfermedades Cutáneas Infecciosas/epidemiología , España/epidemiología , Adulto Joven
9.
Ecol Lett ; 18(12): 1406-19, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26415616

RESUMEN

Recent studies have shown that accounting for intraspecific trait variation (ITV) may better address major questions in community ecology. However, a general picture of the relative extent of ITV compared to interspecific trait variation in plant communities is still missing. Here, we conducted a meta-analysis of the relative extent of ITV within and among plant communities worldwide, using a data set encompassing 629 communities (plots) and 36 functional traits. Overall, ITV accounted for 25% of the total trait variation within communities and 32% of the total trait variation among communities on average. The relative extent of ITV tended to be greater for whole-plant (e.g. plant height) vs. organ-level traits and for leaf chemical (e.g. leaf N and P concentration) vs. leaf morphological (e.g. leaf area and thickness) traits. The relative amount of ITV decreased with increasing species richness and spatial extent, but did not vary with plant growth form or climate. These results highlight global patterns in the relative importance of ITV in plant communities, providing practical guidelines for when researchers should include ITV in trait-based community and ecosystem studies.


Asunto(s)
Biodiversidad , Fenotipo , Fenómenos Fisiológicos de las Plantas , Especificidad de la Especie
10.
Pulm Pharmacol Ther ; 34: 37-45, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26271598

RESUMEN

Neutrophil infiltration and activation in the lung are important pathophysiological features in COPD, severe asthma and bronchiectasis mostly mediated by CXCL8 and CXCL1 via CXCR1 and CXCR2. No thorough study to date has been performed to compare the anti-inflammatory effect profile of dual CXCR1/2 vs. selective CXCR2 antagonists in relevant human neutrophil assays and pulmonary inflammation models. Dual CXCR1/2 (SCH527123, diaminocyclobutandione-1) and selective CXCR2 (SB265610, thiopyrimidine-1) antagonist activity and receptor residence time were determined by [(35)S]GTPγS binding in human (h)- and guinea pig (gp)-CXCR1 and CXCR2 overexpressing membranes. h-neutrophil chemotaxis, degranulation and ROS production were established using CXCL8 or CXCL1 to evaluate dual CXCR1/2- or selective CXCR2-dependent activities. LPS-induced lung inflammation in gp was selected to assess in vivo potency. Dual CXCR1/2 antagonists blocked both CXCL8 and CXCL1-induced h-neutrophil functions and [(35)S]GTPγS binding. In contrary, selective CXCR2 antagonists displayed significantly reduced potency in CXCL8 -mediated h-neutrophil responses despite being active in CXCR2 assays. Upon LPS challenge in gp, administration of SCH527123 inhibited the increase of neutrophils in BALF, modestly reduced blood neutrophils and induced minor neutrophil accumulation in bone marrow. Differentiation of CXCR1/2 vs. CXCR2 antagonists could not be extended to in vivo due to differences in CXCR1 receptor homology between h and gp. Dual CXCR1/2 therapy may represent a promising anti-inflammatory treatment for respiratory diseases reducing more effectively neutrophil migration and activation in the lung than a CXCR2 selective treatment. However, the in vivo confirmation of this claim is still missing due to species differences in CXCR1.


Asunto(s)
Benzamidas/farmacología , Ciclobutanos/farmacología , Neutrófilos/metabolismo , Compuestos de Fenilurea/farmacología , Receptores de Interleucina-8A/antagonistas & inhibidores , Receptores de Interleucina-8B/antagonistas & inhibidores , Triazoles/farmacología , Animales , Línea Celular , Cricetinae , Cobayas , Humanos , Inflamación/inmunología , Interleucina-8/metabolismo , Lipopolisacáridos/farmacología , Pulmón/metabolismo , Masculino , Especies Reactivas de Oxígeno/inmunología , Transducción de Señal
11.
Orthod Craniofac Res ; 18(4): 212-20, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26012631

RESUMEN

OBJECTIVES: To define the morphometry of the hard palate in Down's syndrome (DS) on cone beam computed tomography (CBCT) images. SETTING AND SAMPLE POPULATION: Santiago de Compostela University (Spain). The study group included 40 white DS individuals aged 10 to 40 years (mean = 18.8 ± 7.3 years), 25 males and 15 females. The control group consisted of 40 individuals matched for age and sex were selected. MATERIAL & METHODS: Nine measurements were taken on the CBCT images. Axial plane: anteroposterior length (aAPL) and arch length (aARL); sagittal plane: anteroposterior length (sAPL), maximum height (sMH) and sagittal arch (sAR); coronal plane: interdental width (cIDW), height (cHE), skeletal width (cSW) and coronal arch (cAR). RESULTS: aAPL, aARL, sAPL, sMH, sAR, cMH and cAR were comparable in the two groups. cIDW and cSW were greater in controls than in DS. We found no statistically significant differences between males and females with DS. In the controls, sAPL and sAR were greater in males than females. In DS, age only had a statistically significantly increasing effect on aAPL and sAPL. In the controls, age significantly affected sAR and cHE. CONCLUSION: The hard palate is narrower in DS than in controls, but the anteroposterior measurements and the height of the vault are comparable in both groups.


Asunto(s)
Tomografía Computarizada de Haz Cónico/métodos , Síndrome de Down/patología , Procesamiento de Imagen Asistido por Computador/métodos , Paladar Duro/patología , Adolescente , Adulto , Estudios de Casos y Controles , Cefalometría/métodos , Niño , Arco Dental/diagnóstico por imagen , Arco Dental/patología , Síndrome de Down/diagnóstico por imagen , Femenino , Humanos , Masculino , Maxilar/diagnóstico por imagen , Maxilar/patología , Paladar Duro/diagnóstico por imagen , Adulto Joven
12.
J Bacteriol ; 196(12): 2166-77, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24682329

RESUMEN

NADH oxidase (Nox, encoded by nox) is a flavin-containing enzyme used by the oral pathogen Streptococcus mutans to reduce diatomic oxygen to water while oxidizing NADH to NAD(+). The critical nature of Nox is 2-fold: it serves to regenerate NAD(+), a carbon cycle metabolite, and to reduce intracellular oxygen, preventing formation of destructive reactive oxygen species (ROS). As oxygen and NAD(+) have been shown to modulate the activity of the global transcription factors Spx and Rex, respectively, Nox is potentially poised at a critical junction of two stress regulons. In this study, microarray data showed that either addition of oxygen or loss of nox resulted in altered expression of genes involved in energy metabolism and transport and the upregulation of genes encoding ROS-metabolizing enzymes. Loss of nox also resulted in upregulation of several genes encoding transcription factors and signaling molecules, including the redox-sensing regulator gene rex. Characterization of the nox promoter revealed that nox was regulated by oxygen, through SpxA, and by Rex. These data suggest a regulatory loop in which the roles of nox in reduction of oxygen and regeneration of NAD(+) affect the activity levels of Spx and Rex, respectively, and their regulons, which control several genes, including nox, crucial to growth of S. mutans under conditions of oxidative stress.


Asunto(s)
Regulación Bacteriana de la Expresión Génica/efectos de los fármacos , Regulación Enzimológica de la Expresión Génica/efectos de los fármacos , Complejos Multienzimáticos/metabolismo , NADH NADPH Oxidorreductasas/metabolismo , NAD/metabolismo , Oxígeno/farmacología , Streptococcus mutans/enzimología , Eliminación de Gen , Regulación Bacteriana de la Expresión Génica/fisiología , Regulación Enzimológica de la Expresión Génica/fisiología , Complejos Multienzimáticos/genética , NADH NADPH Oxidorreductasas/genética , Regiones Promotoras Genéticas , Streptococcus mutans/genética , Streptococcus mutans/metabolismo
13.
Eur J Clin Microbiol Infect Dis ; 33(12): 2241-7, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25012821

RESUMEN

This is the first Portuguese multicenter observational and descriptive study that provides insights on the species distribution and susceptibility profiles of yeast isolates from fungemia episodes. Ten district hospitals across Portugal contributed by collecting yeast isolates from blood cultures and answering questionnaires concerning patients' data during a 12-month period. Molecular identification of cryptic species of Candida parapsilosis and C. glabrata complex was performed. The susceptibility profile of each isolate, considering eight of the most often used antifungals, was determined. Both Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) protocols were applied. The incidence of 240 episodes of fungemia was 0.88/1,000 admissions. Fifteen different species were found, with C. albicans (40 %) being the most prevalent, followed by C. parapsilosis (23 %) and C. glabrata (13 %). Most isolates were recovered from patients admitted to surgical wards or intensive care units, with 57 % being males and 32 % aged between 41 and 60 years. For both the CLSI and EUCAST protocols, the overall susceptibility rates ranged from 74 to 97 % for echinocandins and from 84 to 98 % for azoles. Important resistance rate discrepancies between protocols were observed in C. albicans and C. glabrata for echinocandins and in C. parapsilosis and C. tropicalis for azoles. Death associated with fungemia occurred in 25 % of the cases, with more than half of C. glabrata infections being fatal. The great number of Candida non-albicans is noteworthy despite a relatively low antifungal resistance rate. Studies like this are essential in order to improve empirical treatment guidelines.


Asunto(s)
Antifúngicos/farmacología , Candida/efectos de los fármacos , Candida/aislamiento & purificación , Candidemia/microbiología , Adolescente , Adulto , Anciano , Candidemia/epidemiología , Niño , Preescolar , Farmacorresistencia Fúngica , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Portugal/epidemiología , Adulto Joven
14.
Clin Radiol ; 69(4): 378-84, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24360516

RESUMEN

AIM: To evaluate the performance of diffusion-weighted imaging (DWI) at 3 T for the detection and characterization of breast lesions. MATERIALS AND METHODS: Magnetic resonance imaging (MRI) of the breast, including DWI single-shot spin-echo echo planar images (SS-SE-EPI; eight b-values, 50-3000 s/mm(2)), were acquired in women with a clinical indication for breast MRI. The exclusion criteria were as follows: (1) previous breast surgery, radiotherapy and/or chemotherapy within the prior 48 months (14 women); (2) only cystic lesions (one woman); (3) no detectable enhancing lesion at dynamic contrast-enhanced (DCE)-MRI (15 women); and (4) breast implants (four women). MRI results were corroborated by histopathology or imaging follow-up. Apparent diffusion coefficients (ADCs) were estimated for lesions and normal glandular tissue. Differences in the ADC between tissue types were evaluated and the sensitivity and specificity of the method calculated by receiver operating characteristics (ROC) curves. RESULTS: The final cohort comprised 53 patients with 59 lesions. Histopathology was obtained for 58 lesions. One lesion was validated as benign on imaging follow-up. Mean ADCs of 1.99 ± 0.27 × 10(-3) mm(2)/s, 1.08 ± 0.25 × 10(-3) mm(2)/s, and 1.74 ± 0.35 × 10(-3) mm(2)/s were obtained for normal tissue, malignant, and benign lesions, respectively. Mean ADCs of malignancies were significantly lower than those of benign lesions (p < 0.001) and normal tissue (p < 0.0001). The sensitivity and specificity for stratifying lesions, considering an ADC threshold of 1.41 × 10(-3) mm(2)/s, were 94.3% and 87.5%, respectively; accuracy was 91.5%. CONCLUSION: DWI proved useful for the detection and characterization of breast lesions in the present sample. ADC values provide a high diagnostic performance for differentiation between benign and malignant lesions.


Asunto(s)
Neoplasias de la Mama/diagnóstico , Mama/patología , Medios de Contraste , Imagen de Difusión por Resonancia Magnética , Detección Precoz del Cáncer , Gadolinio DTPA , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/patología , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Curva ROC , Sensibilidad y Especificidad
15.
Clin Oral Implants Res ; 25(8): 919-25, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23795973

RESUMEN

OBJECTIVES: To study early soft tissue healing of immediately placed implants with or without immediate loading in the dog. MATERIAL AND METHODS: Forty-eight implants were placed in the distal sockets of Pm3 and Pm4 in the lower jaw of 12 beagle dogs immediately after tooth extraction. In the control group, no loading was applied. In the test group, an immediate loading restoration with occlusal contacts was performed. Dogs were sacrificed at 2, 4, and 8 weeks for histological analysis. RESULTS: At the end of the study, there was a 100% implant and prosthesis survival. The biological width dimension was similar in both groups at all the studied healing periods. This dimension tended to decrease from week 2 to 8 in both groups, on both the buccal and lingual side. The barrier epithelium tended to stop at the implant-abutment interface in both groups and also decreased in length from week 2 to 8, on the buccal and the lingual side. Soft tissue recession remained low and occurred mainly in the test group. CONCLUSIONS: The characteristics, dimension, and healing pattern of the peri-implant soft tissues were similar around immediate implants with or without immediate loading.


Asunto(s)
Encía/cirugía , Carga Inmediata del Implante Dental , Alveolo Dental/cirugía , Cicatrización de Heridas/fisiología , Proceso Alveolar/cirugía , Animales , Implantes Dentales , Perros , Inserción Epitelial , Femenino , Mandíbula/cirugía , Oseointegración
16.
Oral Dis ; 20(3): 313-8, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23607445

RESUMEN

OBJECTIVE: To determine hepatitis C virus (HCV) RNA clearance from blood and saliva of HIV-HCV-coinfected patients undergoing combined therapy with pegylated interferon plus ribavirin (PEG-IFN-RIB). SUBJECTS AND METHODS: Study group was formed of 60 HIV-infected patients with chronic hepatitis C who were starting treatment with PEG-IFN-RIB. Blood and saliva samples were taken at baseline, at the end of treatment and 24 and 48 weeks later. A nested RT-PCR technique was used to detect HCV-RNA in saliva. RESULTS: HCV-RNA was detected in saliva at baseline in 64.7% of patients. Thirty-four patients completed follow-up. The response rate (undetectable HCV-RNA) in blood was 79.4% at the end of treatment; 55.8% at 24 weeks after the end of treatment and 50% at 48 weeks. HCV was detected in saliva of 13 (38.2%) patients at the end of treatment and in 18 (52.9%) patients at 24 and 48 weeks later. Concordance of HCV clearance from blood and saliva reached its maximum value at 48 weeks after the end of treatment (odds ratio, 112.51). CONCLUSION: In HIV-HCV-coinfected patients responders to PEG-IFN-RIB, the salivary glands do not appear to be a sanctuary site for HCV, although viral clearance from saliva may be slower than from blood.


Asunto(s)
Antivirales/uso terapéutico , Infecciones por VIH/sangre , Infecciones por VIH/tratamiento farmacológico , Hepacivirus/genética , Hepatitis C Crónica/sangre , Hepatitis C Crónica/tratamiento farmacológico , Interferón-alfa/uso terapéutico , Polietilenglicoles/uso terapéutico , ARN Viral/análisis , Ribavirina/uso terapéutico , Saliva/química , Adulto , Anciano , Coinfección , Quimioterapia Combinada , Femenino , Infecciones por VIH/complicaciones , Hepatitis C Crónica/complicaciones , Hepatitis C Crónica/virología , Humanos , Masculino , Persona de Mediana Edad , Proteínas Recombinantes/uso terapéutico , Carga Viral
17.
J Helminthol ; 88(3): 342-8, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23628163

RESUMEN

The development of cage fish farms has been associated with an increase in parasitic diseases. Organic matter resulting from feed waste and faeces attracts animals such as birds and invertebrates that can act as hosts for parasites. The aim of this study was to evaluate the influence of cage farming on Austrodiplostomum compactum metacercariae infections of Plagioscion squamosissimus collected close to a cage farm in the Chavantes reservoir (Paranapanema River). Thirty-seven fish were collected in an area close to cages (CF), and 28 in an area not influenced by cages (CT). All specimens were weighed, measured and the eyes removed for morphological analyses of metacercariae. The prevalence, mean intensity of infection, mean abundance and condition factor were calculated. The prevalence (CF = 86.4%, CT = 57.1%), mean infection intensity (CF = 20.31 ± 1.13, CT = 4.29 ± 7.14) and mean abundance (CF = 17.70 ± 6.27, CT = 2.35 ± 0.77) were higher in the CF (P< 0.05) group. There were no significant correlations (P> 0.05) between the mean abundance and standard length or the total weight and condition factor in either group (P> 0.05). Fish farms may interfere with the life cycle of A. compactum, leading to more infections with P. squamosissimus. This could be due to an increase in the number of host animals that are attracted by the availability of food resources derived from fish farms.


Asunto(s)
Acuicultura/métodos , Enfermedades de los Peces/epidemiología , Metacercarias/aislamiento & purificación , Perciformes , Trematodos/aislamiento & purificación , Infecciones por Trematodos/veterinaria , Animales , Brasil , Enfermedades de los Peces/parasitología , Carga de Parásitos , Prevalencia , Infecciones por Trematodos/epidemiología , Infecciones por Trematodos/parasitología
18.
Int J Dent Hyg ; 12(2): 121-6, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-23730898

RESUMEN

OBJECTIVE: To investigate whether there is a relationship between the oral hygiene habits of individuals with severe disability the carer's personal appearance and interest in oral health. PATIENTS AND METHODS: The study group was formed of 60 disabled persons and their respective carers who came for the first time to consultation in the Special-Needs Dentistry Unit of the University of Santiago de Compostela, Spain. All the carers answered a standardised questionnaire of 28 questions divided into four sections: disabled individual's demographic data, disabled individual's general medical details, social aspects of the carer (personal appearance of the carer and interest in oral health), and disabled individual's oral hygiene habits. The personal appearance of the carers and their interest in the disabled individual's oral health were evaluated using independent scales designed specifically for the study, with five binary items in each scale. RESULTS: The carer's personal appearance and interest in the disabled individual's oral health showed a statistically significant relationship with the individual's oral hygiene habits, particularly with respect to the frequency and duration of toothbrushing, need for physical restraint during toothbrushing, use of a manual toothbrush and use of toothpaste. CONCLUSIONS: The carer's personal appearance and interest in the disabled individual's oral health are good indicators of the oral hygiene habits of an individual with severe disability. Consideration should be given to the inclusion of these aspects as a complementary element of the dental record.


Asunto(s)
Actitud Frente a la Salud , Cuidadores/psicología , Personas con Discapacidad , Conductas Relacionadas con la Salud , Salud Bucal , Higiene Bucal , Autoimagen , Adolescente , Adulto , Imagen Corporal , Niño , Preescolar , Índice CPO , Femenino , Halitosis/clasificación , Humanos , Higiene , Relaciones Interpersonales , Masculino , Persona de Mediana Edad , Antisépticos Bucales/uso terapéutico , Higiene Bucal/educación , Índice Periodontal , Restricción Física , Cepillado Dental/instrumentación , Cepillado Dental/métodos , Pastas de Dientes/uso terapéutico , Adulto Joven
19.
Sci Total Environ ; 946: 174317, 2024 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-38960189

RESUMEN

Lignin is an abundant and recalcitrant biopolymer of major relevance as soil organic matter (SOM) component playing a significant role in its stabilization. In this work, a factorial field experiment was established, where three climatic treatments (W, warming; D, drought; W + D, warming + drought), mimicking future climate change scenarios were installed over five years in a Mediterranean savannah "dehesa", accounting for its landscape diversity (under the tree canopy and in open grassland). A combination of analytical pyrolysis (Py-GC/MS) and the study of biogeochemical proxies based on lignin monomers is used for the direct detection of lignin-derived phenols and to infer possible shifts in lignin dynamics in soil. A total of 27 main lignin-derived methoxyphenols were identified, exhibiting different patterns and proportions, mainly driven by the effect of habitat, hence biomass inputs to SOM. An accelerated decomposition of lignin moieties -(exhibited by higher LG/LS and Al/K + Ac ratios)- is particularly exacerbated by the effect of all climatic treatments. There is also an overall effect on increasing lignin oxidation of side chain in syringyl units, especially under the tree canopy due to the alteration in biomass degradation and potential stimulation of enzyme activities. Conversely, in open grassland these effects are slower since the microbial community is expected to be already adapted to harsher conditions. Our findings suggests that climate change-related temperature and soil moisture deviations impact soil lignin decomposition in dehesas threatening this productive Mediterranean agroecosystem and affecting the mechanism of soil carbon storage.

20.
Rev Neurol ; 78(1): 1-7, 2024 Jan 01.
Artículo en Español | MEDLINE | ID: mdl-38112651

RESUMEN

INTRODUCTION: Autism spectrum disorder (ASD) often presents related medical disorders that require specialised healthcare. Professionals in the health sector therefore face difficulties that require specific training in the healthcare needs of this population. AIM: The aim of this study is to quantify paediatric healthcare professionals' knowledge about ASD and to assess the impact of online training. SUBJECTS AND METHODS: It is a quasi-experimental, longitudinal, prospective before-and-after study; study subjects: health professionals; independent variable: online training in ASD; dependent variable: knowledge about ASD. An online training course was held for paediatric professionals to address the core characteristics of diagnosis, as well as the needs they present in the hospital context and the adaptations it is recommended that should be carried out. Fifty-eight healthcare professionals took part. RESULTS: An increase in knowledge about ASD was observed at the end of the intervention (from 73.9% to 85% according to the ASD background knowledge questionnaire), which showed that more than 90% of the participants had the highest level of knowledge about ASD. CONCLUSIONS: Online training courses are a useful and effective way to increase knowledge about ASD and the adaptations that are recommended in the hospital setting. More training in ASD should be made available in these settings.


TITLE: Trastorno del espectro autista: impacto de una estrategia de formación en línea en los conocimientos del personal sanitario de un hospital de tercer nivel.Introducción. El trastorno del espectro autista (TEA) frecuentemente presenta trastornos médicos relacionados que requieren una atención sanitaria especializada. En este sentido, los profesionales del ámbito sanitario se enfrentan a dificultades que precisan una formación específica en las necesidades sanitarias que presenta esta población. Objetivo. Cuantificar los conocimientos sobre el TEA de los profesionales sanitarios del área pediátrica y valorar el impacto de una formación en línea. Sujetos y métodos. Estudio cuasi experimental del antes y después, longitudinal y prospectivo; sujetos a estudio: profesionales sanitarios; variable independiente: formación en línea en TEA; variable dependiente: conocimiento sobre el TEA. Se llevó a cabo una formación en línea para profesionales del área de pediatría en la que se abordaron las características nucleares del diagnóstico, así como las necesidades que presentan en el contexto hospitalario y las adaptaciones que se recomiendan llevar a cabo. Participaron 58 profesionales sanitarios. Resultados. Se observó un aumento en el conocimiento sobre el TEA al finalizar la intervención (del 73,9 al 85% según el cuestionario de conocimientos previos del TEA), que mostró que más del 90% de los participantes tenía el grado máximo de conocimiento sobre el TEA. Conclusiones. Las formaciones en línea son un método para ampliar conocimiento útil y eficaz para aumentar el conocimiento sobre el TEA y las adaptaciones que se recomiendan en el ámbito hospitalario. Se recomienda aumentar la disponibilidad de formación sobre TEA en estos entornos.


Asunto(s)
Trastorno del Espectro Autista , Humanos , Niño , Trastorno del Espectro Autista/terapia , Trastorno del Espectro Autista/diagnóstico , Estudios Prospectivos , Centros de Atención Terciaria , Personal de Salud , Conocimientos, Actitudes y Práctica en Salud
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