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1.
Epilepsy Behav ; 158: 109915, 2024 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-38941952

RESUMEN

It has been determined that quality of life in epilepsy is closely related to the perceived disability experienced by individuals with the diagnosis. However, this measure is seldom considered in healthcare processes. The objective of the present study is to establish the psychometric properties of the Perceived Disability Questionnaire in individuals diagnosed with epilepsy within a Latin American context. A cross-sectional, analytical study was conducted involving 325 participants, aged 12 years and older (M 40.42 years), individuals diagnosed with epilepsy in Colombia. The main psychometric properties of the instrument were explored to account for its factorial validity and reliability. The Perceived Disability Questionnaire exhibits high reliability (α = 0.878) and the three subscales comprising the final version of the questionnaire (Dissatisfaction, Pessimism, and Self-Disdain) explain 45.393 % of the total variance in relation to beliefs of disability associated with the diagnosis of epilepsy; the questionnaire significantly correlates with the Quality of Life in Epilepsy Inventory (QOLIE-10). Adequate psychometric properties of the instrument are found, which allows for its proposal as a tool in epilepsy care processes within the Colombian context.

2.
Int J Health Plann Manage ; 39(1): 36-47, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37796724

RESUMEN

AIMS: To develop and validate an instrument to identify the core components of community strategies for mental health, especially mutual aid groups: The Mutual Aid Scale . METHODS: 135 community strategies leaders participated in the study. The core components are active agency, coping strategies, recognition, and management of emotions, problem-solving strategies, supportive interaction, trust, self-identity construction, and strengthening of social networks. With these components a scale was designed. Content validity was carried out in addition to an exploratory factor analysis. RESULTS: Two dimensions resulted, strengthening of agency capacity and Coping strategies, and the internal consistency of both factors was acceptable, with a Cronbach's alpha of 0.722 and 0.727, respectively. The Kaiser-Meyer-Olkin (KMO) statistic was used with a score of 0.831 and the Barlett Sphericity Test, with a significant value of 265.175. CONCLUSION: This scale identifies the components of community interventions for mental health and can contribute to a better implementation of these strategies. It also articulates autonomous community processes with strategies developed in health services.


Asunto(s)
Salud Mental , Encuestas y Cuestionarios , Reproducibilidad de los Resultados , Análisis Factorial
3.
Rev Panam Salud Publica ; 48: e10, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38410358

RESUMEN

Objectives: To validate the implementation drivers scale among first-level mental health care professionals in Colombia. The scale is designed as a tool to guide the implementation of strategies that effectively reduce gaps in mental health care. Methods: The Active Implementation Framework was adopted, which is a widely used model for measuring implementation. The participants included 380 individuals (55.56% men) - 349 health personnel trained in the Mental Health Gap Action Programme (mhGAP) and 31 territorial personnel in charge of planning mental health strategies at the territorial level in Colombia. To assess the critical dimensions of mhGAP implementation, we developed a scale of 18 items based on the active implementation framework. We conducted content validity assessments and exploratory factor analysis to evaluate the scale. We used the Organizational Readiness for Knowledge Translation scale as a comparative standard. Results: The implementation drivers scale identified four dimensions: system enablers for implementation, accessibility of the strategy, adaptability and acceptability, and strategy training and supervision. These dimensions had Cronbach alpha values of 0.914, 0.868, 0.927, and 0.725, respectively, indicating high internal consistency. In addition, all dimensions demonstrated adequate correlation with the Organizational Readiness for Knowledge Translation scale. Conclusion: The implementation drivers scale effectively determines the adaptability and implementation of various components of mental health programs, particularly those focusing on community-based approaches and primary care settings. As such, this scale can contribute to the more effective implementation of strategies outlined by global and local political frameworks, thus improving mental health care.

4.
Rev Panam Salud Publica ; 48: e49, 2024.
Artículo en Español | MEDLINE | ID: mdl-38779536

RESUMEN

Objectives: Mental, neurological, and substance use (MNS) disorders have a high prevalence in Colombia and there is a treatment gap. The World Health Organization (WHO) Mental Health Gap Action Programme (mhGAP) has various components. The mhGAP 2.0 Intervention Guide, aimed at improving primary health care, is a guide for the assessment and management of MNS disorders based on clinical decision-making protocols. The objective of this study was to determine the barriers that may hinder the program implementation process. Methods: A qualitative study with content analysis was conducted in three phases: i) study preparation, organization, and presentation; ii) open coding, categorization, and abstraction of contents; and iii) information analysis. The study included semi-structured interviews with 21 people involved in the provision of mental health services in Chocó (Colombia): five medical doctors, seven nurses, and three psychologists, as well as six professionals working in the administrative area of the department's health secretariats. The perceptions of these stakeholders were explored. Open-ended questions were asked to explore experiences with the process, as well as the barriers identified in practice. Results: Four different thematic categories were identified: intersectoral action, long-standing challenges, opportunities, and suitability of tools. Conclusions: A theoretical model of barriers to implementation of the mhGAP program was constructed, based on stakeholder perceptions. Controlling barriers is perceived as a possible way to contribute significantly to population health.


Objetivo: Os transtornos mentais, neurológicos e por uso de substâncias psicoativas são muito prevalentes, e há uma lacuna na atenção a esses transtornos na Colômbia. O Programa de Ação para Reduzir as Lacunas em Saúde Mental (mhGAP, na sigla em inglês) da Organização Mundial da Saúde (OMS) consta de vários componentes. Um deles é o Manual de Intervenções mhGAP 2.0, elaborado para aprimorar a atenção primária à saúde. O documento contém orientações para avaliação e manejo de transtornos mentais, neurológicos e por uso de substâncias psicoativas e foi elaborado com base em protocolos para a tomada de decisões clínicas. O objetivo do estudo foi determinar as barreiras que podem surgir no processo de implementação do programa. Métodos: Estudo qualitativo com enfoque de análise de conteúdo desenvolvido em três fases: i) preparação, organização e apresentação do estudo; ii) codificação aberta, categorização e abstração do conteúdo; e iii) análise das informações. O estudo incluiu entrevistas semiestruturadas com 21 pessoas envolvidas na prestação de serviços de saúde mental em Chocó (Colômbia): cinco profissionais da medicina, sete de enfermagem e três de psicologia, bem como seis profissionais que trabalham na área administrativa das secretarias de saúde do departamento. As percepções das partes interessadas, ou seja, do pessoal assistencial e administrativo do setor de saúde no departamento de Chocó, foram exploradas. Foram feitas perguntas abertas a fim de investigar suas experiências com o processo de atenção e as barreiras identificadas na prática. Resultados: Foram identificadas quatro categorias temáticas: intersetorialidade, desafios de longa data, possibilidades e adequação das ferramentas. Conclusões: Elaborou-se um modelo teórico sobre as barreiras de implementação do Programa mhGAP com base nas percepções das partes interessadas. O controle das barreiras é visto como uma possível forma de contribuir significativamente para a saúde da população.

5.
Community Ment Health J ; 60(3): 608-619, 2024 04.
Artículo en Inglés | MEDLINE | ID: mdl-38194119

RESUMEN

The objective of the present study was to evaluate the effectiveness of mutual help groups in continuity of care, loneliness and psychosocial disability in a Colombian context. For this, a quasi-experimental design is used, with pre- and post-intervention assessments due to non-randomized participant allocation. The study involved 131 individuals with mental disorders. The Psychosocial Disability Scale, The Alberta Scale of Continuity of Services in Mental Health, the UCLA Scale and the Zarit Caregiver Burden Scale were employed. The intervention was based on the core components of mutual aid groups. Significant differences (p < 0.001) were observed for the study variables, particularly in Loneliness, Continuity of Care, and various domains of psychosocial disability. A large effect size was found for these variables after the intervention. Most variables exhibited a moderate to large effect. This study demonstrates the effectiveness of mutual groups facilitated by mental health personnel at the primary care level.


Asunto(s)
Soledad , Trastornos Mentales , Pruebas Psicológicas , Humanos , Soledad/psicología , Autoinforme , Trastornos Mentales/terapia , Continuidad de la Atención al Paciente
6.
Catheter Cardiovasc Interv ; 102(2): 233-240, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37300893

RESUMEN

OBJECTIVE: To assess the efficiency of Dyevert™ Power XT compared to the standard clinical practice when used for percutaneous coronary interventions (PCI). METHODS: A Markov model was developed to estimate, over 3-month cycles and a lifetime time horizon, the cumulative costs and health outcomes (life years gained [LYG] and quality-adjusted life years [QALY]) in a hypothetical cohort of 1,000 patients with chronic kidney disease (CKD) 3b-4 and an average age of 72 years. The incidence of contrast-induced acute kidney injury for these patients is 18.89% in routine practice and 7.78% with Dyevert. QALYs were estimated by applying utilities by health state. Transitions between states and utilities were obtained from the literature. Overall all-cause and state-specific mortality were considered. The total cost (€2,022) estimated with the National Health System perspective included cost of the procedure and of CKD management. The parameters were validated by a panel of experts. A discount rate (3% per year) was applied to costs and outcomes. RESULTS: The use of Dyevert yielded more health benefits (34.60 LYG and 5.69 QALYs) compared to the current standard practice (33.11 LYG and 5.38 QALYs). Lifetime cost accumulated at the end of the simulation resulted €30,211/patient with Dyevert and €33,895/patient with current standard clinical practice. CONCLUSIONS: The use of Dyevert™ Power XT resulted dominant option, due to its higher effectiveness and lower cost as compared to standard clinical practice and, therefore, a preferred option in patients with CKD stages 3b-4 undergoing PCI in Spain.


Asunto(s)
Intervención Coronaria Percutánea , Insuficiencia Renal Crónica , Humanos , Anciano , Análisis de Costo-Efectividad , España/epidemiología , Análisis Costo-Beneficio , Resultado del Tratamiento , Insuficiencia Renal Crónica/diagnóstico , Insuficiencia Renal Crónica/epidemiología , Insuficiencia Renal Crónica/terapia , Años de Vida Ajustados por Calidad de Vida
7.
Eur Heart J ; 43(13): 1320-1330, 2022 03 31.
Artículo en Inglés | MEDLINE | ID: mdl-34735004

RESUMEN

AIM: Patients with diabetes mellitus are at high risk of adverse events after percutaneous revascularization, with no differences in outcomes between most contemporary drug-eluting stents. The Cre8 EVO stent releases a formulation of sirolimus with an amphiphilic carrier from laser-dug wells, and has shown clinical benefits in diabetes. We aimed to compare Cre8 EVO stents to Resolute Onyx stents (a contemporary polymer-based zotarolimus-eluting stent) in patients with diabetes. METHODS AND RESULTS: We did an investigator-initiated, randomized, controlled, assessor-blinded trial at 23 sites in Spain. Eligible patients had diabetes and required percutaneous coronary intervention. A total of 1175 patients were randomly assigned (1:1) to receive Cre8 EVO or Resolute Onyx stents. The primary endpoint was target-lesion failure, defined as a composite of cardiac death, target-vessel myocardial infarction, and clinically indicated target-lesion revascularization at 1-year follow-up. The trial had a non-inferiority design with a 4% margin for the primary endpoint. A superiority analysis was planned if non-inferiority was confirmed. There were 106 primary events, 42 (7.2%) in the Cre8 EVO group and 64 (10.9%) in the Resolute Onyx group [hazard ratio (HR): 0.65, 95% confidence interval (CI): 0.44-0.96; Pnon-inferiority < 0.001; Psuperiority = 0.030]. Among the secondary endpoints, Cre8 EVO stents had significantly lower rate than Resolute Onyx stents of target-vessel failure (7.5% vs. 11.1%, HR: 0.67, 95% CI: 0.46-0.99; P = 0.042). Probable or definite stent thrombosis and all-cause death were not significantly different between groups. CONCLUSION: In patients with diabetes, Cre8 EVO stents were non-inferior to Resolute Onyx stents with regard to target-lesion failure composite outcome. An exploratory analysis for superiority at 1 year suggests that the Cre8 EVO stents might be superior to Resolute Onyx stents with regard to the same outcome. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov: NCT03321032.


Asunto(s)
Enfermedad de la Arteria Coronaria , Diabetes Mellitus , Stents Liberadores de Fármacos , Intervención Coronaria Percutánea , Enfermedad de la Arteria Coronaria/etiología , Enfermedad de la Arteria Coronaria/terapia , Humanos , Intervención Coronaria Percutánea/métodos , Diseño de Prótesis , Sirolimus/análogos & derivados , Sirolimus/uso terapéutico , Resultado del Tratamiento
8.
Rev Panam Salud Publica ; 47: e138, 2023.
Artículo en Español | MEDLINE | ID: mdl-37881801

RESUMEN

Objective: Describe barriers and challenges in the implementation of the global Mental Health Gap Action Program (mhGAP), and determine the association between facilitators of implementation, accessibility, acceptability, and supervision, in Chocó, Colombia. Methods: Cross-sectional evaluation study, with mixed and sequential methods. Forty-one people participated: 30 health personnel and 11 administrative workers. Five focus groups were formed within the framework of the mhGAP training. The Likert scale of implementation drivers was used to determine factors affecting the strategy, such as system facilitators, accessibility of the strategy, adaptation and acceptability, and training and supervision. Semi-structured interviews were also conducted, with a subsequent thematic analysis. Results: A statistically significant correlation was found between the components of implementation. This was reaffirmed by the information from the interviews. Notable barriers include dispersion, armed conflict, difficulty in changing one's perspective on the area where they live, and administrative problems in accessing treatment. These factors are addressed in a proposed care pathway. Conclusions: With respect to mhGAP in the department of Chocó, despite adequate acceptability, access, and supervision, there are barriers and challenges at the social, geographical, political, cultural, and health administration levels, which could be overcome through implementation of locally-built intersectoral recovery routes.


Objetivo: Descrever barreiras e desafios na implementação do Programa de Ação para Reduzir as Lacunas em Saúde Mental (mhGAP, na sigla em inglês) e determinar a associação entre facilitadores de implementação, acessibilidade, aceitabilidade e supervisão em Chocó, Colômbia. Métodos: Estudo avaliativo de corte transversal, com métodos mistos e sequenciais, que contou com 41 participantes (30 da equipe de saúde e 11 da equipe administrativa). Um total de cinco grupos focais foram formados como parte do treinamento do mhGAP. Utilizou-se a escala de motivadores de implementação, que determinou fatores como facilitadores do sistema para implementação, acessibilidade da estratégia, adaptação e aceitabilidade, treinamento e supervisão da estratégia. Também foram realizadas entrevistas semiestruturadas, com posterior análise temática. Resultados: Foi encontrada uma correlação estatisticamente significativa entre os componentes da implementação, o que foi reafirmado com as informações das entrevistas. Em termos das barreiras identificadas, destacam-se fatores como dispersão, conflito armado, a dificuldade de mudar a perspectiva da pessoa sobre a área em que vive e problemas administrativos no acesso ao tratamento. Esses fatores são abordados em uma proposta de via de atendimento. Conclusões: Apesar da aceitabilidade, do acesso e da supervisão adequados, há barreiras e desafios sociais, geográficos, políticos, culturais e de administração de saúde no mhGAP do departamento de Chocó que poderiam ser superados com a implementação de rotas de recuperação intersetoriais, construídas a partir do próprio território.

9.
Rural Remote Health ; 23(3): 7851, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37633312

RESUMEN

INTRODUCTION: The aim of this research was to present the process of intercultural creation and validation, in addition to the analysis of the psychometric properties of the Parenting, Behavior, Emotions and Suicide risk scale. METHODS: A cross-sectional study, cultural adaptation and validation with an ethnic approach were carried out by expert judges in mental health; subsequently, the instrument was applied, and a factorial analysis was carried out, and it was established that there was agreement between the instrument results and two expert perspectives regarding spiritual disharmony. The sample consisted of 168 families of children and young people (54.8% women, 45.2% men), with a mean age of 11.2 years, in Colombia. Regarding the geographical location, 44% were from Guajira, 44.6% were from Nariño and 11.3% were from Vaupés, from the Wayuu, Awá and Emberá communities, respectively. RESULTS: The scale showed high reliability (Chronbach's α=0.911), and in the factorial analysis the following parenting domains were formed from the parents: involvement, monitoring and bond, from boys, girls and young people; suicidal risk perceived by caregivers and perceived by children and young people; in addition to a total mental health risk. The questions that inquired about hallucinations and seizures did not show grouping in any factor, and two questions were eliminated. Similarly, a high inter-rater concordance was shown, with a higher Cohen's κ coefficient for all domains. CONCLUSION: There are few intercultural and early detection studies of parenting and mental health problems in children and youth that have an ethnic approach. It is observed that the instrument serves as a means of monitoring mental health issues in children and adolescents, as well as the parenting practices employed in their socialization, from both the perspective of caregivers and the young individuals themselve. This study indicates that the scale is an adequate tool, quick and easy to administer in first-level care settings.


Asunto(s)
Pueblos Indígenas , Trastornos Mentales , Salud Mental , Atención Primaria de Salud , Adolescente , Niño , Femenino , Humanos , Masculino , Colombia , Estudios Transversales , Reproducibilidad de los Resultados , Trastornos Mentales/diagnóstico , Pueblos Indígenas/psicología
10.
J Med Virol ; 94(3): 1167-1174, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-34755352

RESUMEN

Due to the COVID-19 pandemic, many transport kits have been manufactured to preserve and transport nasopharyngeal swab samples (NPSs) from patients. However, there is no information on the performance of the different virus transport media (VTM) used in COVID-19 diagnosis in the population of Santiago de Chile. We compared the RT-qPCR amplification profile of five different viral transport kit mediums, including DNA/RNA Shield™, NAT, VTM-N, Ezmedlab™, and phosphate-buffered saline (PBS), for NPSs from Central Metropolitan Health Service, Santiago, Chile. The DNA/RNA Shield™ medium showed a better performance in terms of Cq and RFU values for the internal reference RNase P and viral ORF1ab probes. By contrast, the PBS transport medium registered higher Cq values for the viral and reference gene, compared to the other VTM. DNA/RNA Shield™ shows higher relative fluorescence units (RFUs) and lower Cq values for the reference gene. Collectively, our results suggest that the PBS medium could compromise the sample diagnosis because of its lower RT-qPCR performance. The NAT, Ezmedlab and VTM-N, and DNA/RNA Shield™ media show acceptable RT-qPCR parameters and, consequently, seem suitable for use in COVID-19 diagnosis.


Asunto(s)
COVID-19 , COVID-19/diagnóstico , Prueba de COVID-19 , Chile , Medios de Cultivo , Humanos , Nasofaringe , Pandemias , ARN , ARN Viral/análisis , ARN Viral/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , SARS-CoV-2/genética , Manejo de Especímenes/métodos
11.
Catheter Cardiovasc Interv ; 99(5): 1619-1625, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-35043543

RESUMEN

BACKGROUND AND OBJECTIVES: Evidence regarding redo percutaneous interventions for recurrent mitral regurgitation is scarce. We ought to evaluate procedural and clinical outcomes of repeated edge-to-edge transcatheter mitral valve repair (TMVR) interventions. METHODS: This multicenter study collected individual data from eight high-volume TMVR Centers in Spain. Between 2012 and 2020, all patients undergoing a second edge-to-edge TMVR intervention (Redo) were included in the study. RESULTS: Among a total of 1028 procedures, 31 patients (3%) with residual MR ≥ 3 at follow-up underwent a second procedure (Redo). Redo intervention was mainly conducted between the first and second year after the first procedure. The most common cause of MR progression was partial detachment (46.7%) followed by LV remodeling (35.5%). Procedural success was achieved in 87% of cases. After a mean follow-up of 1.75 ± 1.54 years, all-cause and cardiovascular mortality were 48.1% and 25%, respectively. Nearly half of the patients (48.1%) required at least one hospital admission for CHF within the follow-up period. However, most of the patients presented symptomatic improvement as depicted by an NYHA class ≤2. Elective mitral surgery was conducted in only one patient at follow-up due to insufficient MR reduction. CONCLUSIONS: According to our findings, redo edge-to-edge TMVR interventions were feasible and safe with a high procedural success rate. Clinical and echocardiographic follow-up showed however modest long-term results in this specific setting.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Implantación de Prótesis de Válvulas Cardíacas , Insuficiencia de la Válvula Mitral , Cateterismo Cardíaco/métodos , Implantación de Prótesis de Válvulas Cardíacas/métodos , Humanos , Válvula Mitral/diagnóstico por imagen , Válvula Mitral/cirugía , Insuficiencia de la Válvula Mitral/diagnóstico por imagen , Insuficiencia de la Válvula Mitral/cirugía , Resultado del Tratamiento
12.
Catheter Cardiovasc Interv ; 99(3): 533-540, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34463427

RESUMEN

OBJECTIVES: To asses mid-term clinical outcomes of bioresorbable vascular scaffolds (BVS) for the treatment of coronary artery disease in a large-scale all-comers population. BACKGROUND: Several clinical settings are underrepresented in randomized studies investigating BVS against drug-eluting stents. Whether their results can be translated into the heterogeny patient population seen during daily routine requires further investigation. METHODS: The European ABSORB Consortium comprises the following European registries: GABI-R, ABSORB UK Registry, ABSORB France, BVS RAI Registry, and REPARA BVS Registry, which all prospectively collected patient-level data regarding outcomes following unrestricted BVS implantation. The primary endpoint of target lesion failure (TLF) includes cardiac death, target-vessel myocardial infarction (TVMI) and target-lesion revascularisation (TLR) at 12 months. The incidence of scaffold thrombosis (ST) according to ARC criteria was also assessed. Multivariable analysis was used to adjust for differences in patient and lesion characteristics. RESULTS: A total of 10,312 patients (mean age 58.4 ± 11.4 y) underwent BVS implantation during routine practice. The 12-month follow-up was complete in 95.5% of patients. At 12 months, the primary endpoint of TLF occurred in 3.6%; its components cardiac death, TVMI and TLR were documented in 1.2%, 1.8%, and 2.6%, respectively. The definite/probable ST rate was 1.7%. Absence of predilatation, discontinuation of DAPT and scaffold diameter below 3 mm were independent predictors of ST. CONCLUSIONS: The EAC demonstrates reasonable real-world clinical outcome data after BVS implantation. However, the rate of scaffold thrombosis remains high.


Asunto(s)
Enfermedad de la Arteria Coronaria , Stents Liberadores de Fármacos , Intervención Coronaria Percutánea , Implantes Absorbibles , Anciano , Enfermedad de la Arteria Coronaria/inducido químicamente , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/terapia , Everolimus/efectos adversos , Humanos , Persona de Mediana Edad , Intervención Coronaria Percutánea/efectos adversos , Diseño de Prótesis , Andamios del Tejido , Resultado del Tratamiento
13.
Brain Cogn ; 156: 105831, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34922210

RESUMEN

Patients with atrophy in motor brain regions exhibit selective deficits in processing action-related meanings, suggesting a link between movement conceptualization and the amount of regional tissue. Here we examine such a relation in a unique opposite model: a rare patient with a double cortex (due to subcortical band heterotopia) in primary/supplementary motor regions, and no double cortex in multimodal semantic regions. We measured behavioral performance in action- and object-concept processing as well and resting-state functional connectivity. Both dimensions involved comparisons with healthy controls. Results revealed preserved accuracy in action and object categories for the patient. However, unlike controls, the patient exhibited faster performance for action than object concepts, a difference that was uninfluenced by general cognitive abilities. Moreover, this pattern was accompanied by heightened functional connectivity between the bilateral primary motor cortices. This suggests that a functionally active double motor cortex may entail action-processing advantages. Our findings offer new constraints for models of action semantics and motor-region function at large.


Asunto(s)
Lisencefalias Clásicas y Heterotopias Subcorticales en Banda , Corteza Motora , Mapeo Encefálico , Humanos , Imagen por Resonancia Magnética/métodos , Semántica
14.
Salud Publica Mex ; 64: S31-S39, 2022 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-36130385

RESUMEN

The continuous development in telecommunication tech-nologies has created opportunities for health professionals to optimise healthcare delivery by adopting digital tools into rehabilitation programs (i.e., telerehabilitation). These tech-nological advances, along with the demographic and social characteristics of each country, have made the implementa-tion of telerehabilitation a disparate process across regions. We have gathered the experience of four countries (Australia, Chile, Brazil, and Colombia) in two different regions (Ocea-nia and South America) to recompile the history pre- and post-Covid-19 outbreak until January of 2021, the barriers to, and facilitators of telerehabilitation, and outline the future challenges for these countries.


Asunto(s)
COVID-19 , Telerrehabilitación , Brasil , Brotes de Enfermedades , Humanos , Modalidades de Fisioterapia
15.
Int J Mol Sci ; 23(10)2022 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-35628103

RESUMEN

Mint (Mentha L., Lamiaceae) is a strongly scented herb of the family Lamiaceae that is grown mostly by clonal propagation, making it a valuable species for the study of somaclonal variation and its phenotypic consequences. The recent introduction of a few species of mint in South America, followed by a presumably rampant propagation, make this region particularly ideal for studying the extent of somaclonal genetic diversity. Hence, the objective of this work was to offer a preliminary characterization of somaclonal genetically coding diversity of the mint in the northern Andes in order to address the question of whether somaclonal variants may have emerged despite relatively recent introductions in a region where mint is not native. A total of 29 clonally propagated specimens, collected in mint export farms in the province of Antioquia, a major region for mint production in the northwest Andes of Colombia, were genotyped using RNA sequencing (RNA-Seq). SNP calling was carried out from the leaves' transcriptome profiles of each plant by combining the GATK4 and TRINITY protocols, obtaining a total of 2033 loci across 912 transcripts with a minimum read depth of 20X and 4% of missing data. Unsupervised machine learning algorithms considered the K-means, AGNES and UPGMA approaches, all of which suggested three genetic clusters for M. spicata and a unique cluster for M. × piperita. The results indicate that at least two different origins of M. spicata reached the eastern region of the Antioquia province, clonally propagated in the locality ever since for local consumption and export. One of these ancestries had more population structure, possibly due to environmental or anthropological pressures that intervened in the fragmentation of this genetic group or to a higher somaclonal mutation rate. This work offers a first step into the study of the accumulation and transmission of presumably quasi-neutral somatic mutations at coding regions in an herbaceous clonally propagated scented species such as mint, likely favored by an expected population expansion after its Andean introduction. These ad hoc hypotheses warrant further study as part of future research.


Asunto(s)
Lamiaceae , Mentha , Genómica , Lamiaceae/genética , Mentha/química , Mentha/genética , Transcriptoma/genética , Secuenciación del Exoma
16.
Can J Infect Dis Med Microbiol ; 2022: 2594564, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35812012

RESUMEN

The early detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using the real-time quantitative polymerase chain reaction (RT-qPCR) as a gold-standard molecular tool has allowed to test and trace the viral spread and the isolation of COVID-19-infected patients. The detection capacity of viral and internal genes is an essential parameter to consider and analyze during the assay. In this study, we analyze the performance of the two commercial RT-qPCR kits used in Chile, TaqMan™ 2019-nCoV Control Kit v1 (Thermo Fisher) and MaxCov19 (TAAG Genetics), for the COVID-19 diagnosis from nasopharyngeal swab samples (NPSs). Our results show a lower sensitivity of the TAAG kit compared to the Thermo Fisher kit, even in the detection of SARS-CoV-2 mutations associated with its variants. This study reinforces the relevance of evaluating the performance of RT-qPCR kits before being used massively since those with lower sensitivity can generate false negatives and produce outbreaks of local infections.

17.
J Sci Food Agric ; 99(13): 6020-6031, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31226216

RESUMEN

BACKGROUND: In contrast to commercial Diospyros species, Mesoamerican fruit-producing species are scarcely known, particularly wild species that might harbor desirable traits suitable for breeding. Thus, metabolomic, chemical, and antioxidant profiles of fruits harvested from cultivated Diospyros digyna and wild Diospyros rekoi trees during consecutive winter seasons were obtained. Fruits were harvested in habitats having marked differences in soil quality, climate, and luminosity. RESULTS: D. digyna fruits were larger and less acid than D. rekoi fruits, whereas antioxidant activity tended to be higher in D. rekoi fruits. Phenolic, flavonoid, and sugar contents also varied significantly between species. Metabolomic analysis allowed the pre-identification of 519 and 1665 metabolites in negative and positive electrospray ionization (ESI) modes, respectively. Principal component analysis of the positive ESI data explained 51.8% of the variance and indicated clear metabolomic differences between D. rekoi and D. digyna fruits that were confirmed by direct-injection ESI mass spectrometry profiles. Twenty-one discriminating metabolites were detected in fruits of both species; D. digyna fruits differentially accumulated lysophospholipids, whereas discriminating metabolites in D. rekoi fruits were chemically more diverse than those in D. digyna fruits. CONCLUSION: Domesticated D. digyna fruits have improved physicochemical fruit traits compared with wild D. rekoi fruits, including larger size and lower acidity. The metabolomic and chemical composition of their respective fruits were also significantly different, which in D. rekoi was manifested as a notable season-dependent increase in antioxidant capacity. Therefore, wild D. rekoi can be considered as an important genetic resource for the improvement of commercial Diospyros fruit quality. © 2019 Society of Chemical Industry.


Asunto(s)
Antioxidantes/análisis , Diospyros/química , Antioxidantes/metabolismo , Clima , Diospyros/metabolismo , Ecosistema , Frutas/química , Frutas/metabolismo , Fenotipo , Estaciones del Año , Suelo/química
18.
Purinergic Signal ; 14(2): 121-139, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29349673

RESUMEN

Endothelial cells participate in extracellular ATP release elicited by mechanosensors. To characterize the dynamic interactions between mechanical and chemical factors that modulate ATP secretion by the endothelium, we assessed and compared the mechanisms participating in the spontaneous (basal) and mechanically stimulated secretion using primary cultures of rat mesentery endothelial cells. ATP/metabolites were determined in the cell media prior to (basal) and after cell media displacement or a picospritzer buffer puff used as mechanical stimuli. Mechanical stimulation increased extracellular ATP that peaked within 1 min, and decayed to basal values in 10 min. Interruption of the vesicular transport route consistently blocked the spontaneous ATP secretion. Cells maintained in media lacking external Ca2+ elicited a spontaneous rise of extracellular ATP and adenosine, but failed to elicit a further extracellular ATP secretion following mechanical stimulation. 2-APB, a TRPV agonist, increased the spontaneous ATP secretion, but reduced the mechanical stimulation-induced nucleotide release. Pannexin1 or connexin blockers and gadolinium, a Piezo1 blocker, reduced the mechanically induced ATP release without altering spontaneous nucleotide levels. Moreover, thrombin or related agonists increased extracellular ATP secretion elicited by mechanical stimulation, without modifying spontaneous release. In sum, present results allow inferring that the spontaneous, extracellular nucleotide secretion is essentially mediated by ATP containing vesicles, while the mechanically induced secretion occurs essentially by connexin or pannexin1 hemichannel ATP transport, a finding fully supported by results from Panx1-/- rodents. Only the latter component is modulated by thrombin and related receptor agonists, highlighting a novel endothelium-smooth muscle signaling role of this anticoagulant.


Asunto(s)
Adenosina Trifosfato/metabolismo , Células Endoteliales/metabolismo , Mecanotransducción Celular/fisiología , Canales Catiónicos TRPV/metabolismo , Trombina/metabolismo , Animales , Células Cultivadas , Masculino , Mesenterio/citología , Mesenterio/metabolismo , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Ratas , Ratas Sprague-Dawley
19.
Opt Express ; 25(11): 12325-12348, 2017 May 29.
Artículo en Inglés | MEDLINE | ID: mdl-28786590

RESUMEN

We present a general theory of spontaneous emission at exceptional points (EPs)-exotic degeneracies in non-Hermitian systems. Our theory extends beyond spontaneous emission to any light-matter interaction described by the local density of states (e.g., absorption, thermal emission, and nonlinear frequency conversion). Whereas traditional spontaneous-emission theories imply infinite enhancement factors at EPs, we derive finite bounds on the enhancement, proving maximum enhancement of 4 in passive systems with second-order EPs and significantly larger enhancements (exceeding 400×) in gain-aided and higher-order EP systems. In contrast to non-degenerate resonances, which are typically associated with Lorentzian emission curves in systems with low losses, EPs are associated with non-Lorentzian lineshapes, leading to enhancements that scale nonlinearly with the resonance quality factor. Our theory can be applied to dispersive media, with proper normalization of the resonant modes.

20.
J Chem Phys ; 147(16): 161725, 2017 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-29096510

RESUMEN

Noncovalent interactions are of fundamental importance across the disciplines of chemistry, materials science, and biology. Quantum chemical calculations on noncovalently bound complexes, which allow for the quantification of properties such as binding energies and geometries, play an essential role in advancing our understanding of, and building models for, a vast array of complex processes involving molecular association or self-assembly. Because of its relatively modest computational cost, second-order Møller-Plesset perturbation (MP2) theory is one of the most widely used methods in quantum chemistry for studying noncovalent interactions. MP2 is, however, plagued by serious errors due to its incomplete treatment of electron correlation, especially when modeling van der Waals interactions and π-stacked complexes. Here we present spin-network-scaled MP2 (SNS-MP2), a new semi-empirical MP2-based method for dimer interaction-energy calculations. To correct for errors in MP2, SNS-MP2 uses quantum chemical features of the complex under study in conjunction with a neural network to reweight terms appearing in the total MP2 interaction energy. The method has been trained on a new data set consisting of over 200 000 complete basis set (CBS)-extrapolated coupled-cluster interaction energies, which are considered the gold standard for chemical accuracy. SNS-MP2 predicts gold-standard binding energies of unseen test compounds with a mean absolute error of 0.04 kcal mol-1 (root-mean-square error 0.09 kcal mol-1), a 6- to 7-fold improvement over MP2. To the best of our knowledge, its accuracy exceeds that of all extant density functional theory- and wavefunction-based methods of similar computational cost, and is very close to the intrinsic accuracy of our benchmark coupled-cluster methodology itself. Furthermore, SNS-MP2 provides reliable per-conformation confidence intervals on the predicted interaction energies, a feature not available from any alternative method.

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