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1.
Indian J Med Microbiol ; : 100654, 2024 Jun 24.
Artículo en Inglés | MEDLINE | ID: mdl-38925277

RESUMEN

PURPOSE: Patients with hematologic malignancies (HM) are at high risk of invasive lung fungal infections (ILFI). To describe the main characteristics, treatment, and outcomes for five years in adult patients with HM and fungal pneumonia. METHODS: We conducted a retrospective study at Instituto Nacional de Cancerología (INCan), a referral tertiary care oncology hospital with 135 beds in Mexico City, Mexico. We included all cases of fungal pneumonia in patients with HM from January 1, 2017, to December 31, 2022. Cases were classified as proven, probable, and possible according to EORTC/MSG criteria 2021. RESULTS: Two hundred ten patients were included; the mean age was 40 years. The most frequent HM was acute lymphoblastic leukemia (n=74) and acute myeloid leukemia (n=68). One hundred forty patients (66.7%) had severe neutropenia for a median of 16 days. All patients had a CT thorax scan; in 132 (62.9%), multiple nodules were documented. Serum galactomannan (GM) was positive in 21/192 (10.9%) and bronchoalveolar lavage in 9/36 (25%). Fifty-three patients (25.2%) died in the first month. In the multivariate analysis for mortality in the first 30 days, hypoalbuminemia, shock, possible ILFI, and inappropriate antifungal treatment were statistically associated. CONCLUSIONS: In high-risk HM patients, CT thorax scan and GM help diagnose ILFI. An appropriate antifungal improves mortality.

2.
Rev Gaucha Enferm ; 45: e20230161, 2024.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-38922234

RESUMEN

OBJECTIVE: To understand the experiences and vulnerabilities for cross-cultural nursing care for immigrant women during pregnancy and delivery. METHOD: Exploratory, qualitative research, in the light of the Theory of Diversity and Universality of Cultural Care, in Foz do Iguaçu, Brazil, through interviews with eight postpartum woman and 18 nurses, between February and September 2022. The interpretation of meanings was adopted for analysis. RESULTS: The categories of analysis emerged: Experiences, vulnerabilities and acculturation of immigrant women during pregnancy and delivery; Cross-cultural care and vulnerabilities experienced by immigrants in Brazilian health services. Vulnerabilities were identified in Cultural and Social Structure Dimensions expressed in access to work, low socioeconomic conditions, lack of family and social support and specific services for this population. The potentialities experienced included good care provided by health services, quality of the multidisciplinary team and appreciation of professional knowledge, however, the understanding of expectations and cultural aspects needs to be deepened. FINAL CONSIDERATIONS: Understand that immigrant women experience situations of vulnerability in pregnancy and childbirth, in the Brazilian context, mainly related to social and programmatic dimensions. However, potentialities were also experienced, evidenced by positive aspects in cross-cultural nursing care in Brazil.


Asunto(s)
Emigrantes e Inmigrantes , Investigación Cualitativa , Humanos , Femenino , Embarazo , Emigrantes e Inmigrantes/psicología , Brasil , Adulto , Parto/psicología , Asistencia Sanitaria Culturalmente Competente , Enfermería Transcultural , Aculturación , Enfermería Obstétrica
3.
Molecules ; 29(11)2024 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-38893365

RESUMEN

The use of z-drugs has increased worldwide since its introduction. Although the prescribing patterns of hypnotics differ among countries, zolpidem is the most widely used z-drug in the world. Zolpidem may be involved in poisoning and deaths. A simple and fast HPLC-PDA method was developed and validated. Zolpidem and the internal standard chloramphenicol were extracted from plasma using a sonication-assisted dispersive liquid-liquid microextraction procedure. The method was validated including selectivity, linearity, precision, accuracy, and recovery. The calibration range (0.15-0.6 µg/mL) covers therapeutic and toxic levels of zolpidem in plasma. The limit of quantification was set at 0.15 µg/mL. Intra- and interday accuracy and precision values were lower than 15% at the concentration levels studied. Excellent recovery results were obtained for all concentrations. The proposed method was successfully applied to ten real postmortem plasma samples. In our series, multiple substances (alcohol and/or other drugs) were detected in most cases of death involving zolpidem. Our analytical method is suitable for routine toxicological analysis.


Asunto(s)
Microextracción en Fase Líquida , Zolpidem , Zolpidem/sangre , Humanos , Microextracción en Fase Líquida/métodos , Cromatografía Líquida de Alta Presión/métodos , Sonicación/métodos , Reproducibilidad de los Resultados , Hipnóticos y Sedantes/sangre , Límite de Detección , Piridinas/sangre
4.
Sci Total Environ ; 945: 174006, 2024 Jun 16.
Artículo en Inglés | MEDLINE | ID: mdl-38889822

RESUMEN

Seaweeds are important components of coastal benthic ecosystems along the Western Antarctic Peninsula (WAP), providing refuge, food, and habitat for numerous associated species. Despite their crucial role, the WAP is among the regions most affected by global climate change, potentially impacting the ecology and physiology of seaweeds. Elevated atmospheric CO2 concentrations have led to increased dissolved inorganic carbon (Ci) with consequent declines in oceanic pH and alterations in seawater carbonate chemistry, known as Ocean Acidification (OA). Seaweeds possess diverse strategies for Ci uptake, including CO2 concentrating mechanisms (CCMs), which may distinctly respond to changes in Ci concentrations. Conversely, some seaweeds do not operate CCMs (non-CCM species) and rely solely on CO2. Nevertheless, our understanding of the status and functionality of Ci uptake strategies in Antarctic seaweeds remains limited. Here, we investigated the Ci uptake strategies of seaweeds along a depth gradient in the WAP. Carbon isotope signatures (δ13C) and pH drift assays were used as indicators of the presence or absence of CCMs. Our results reveal variability in CCM occurrence among algal phyla and depths ranging from 0 to 20 m. However, this response was species specific. Among red seaweeds, the majority relied solely on CO2 as an exogenous Ci source, with a high percentage of non-CCM species. Green seaweeds exhibited depth-dependent variations in CCM status, with the proportion of non-CCM species increasing at greater depths. Conversely, brown seaweeds exhibited a higher prevalence of CCM species, even in deep waters, indicating the use of CO2 and HCO3-. Our results are similar to those observed in temperate and tropical regions, indicating that the potential impacts of OA on Antarctic seaweeds will be species specific. Additionally, OA may potentially increase the abundance of non-CCM species relative to those with CCMs.

5.
Artículo en Inglés | MEDLINE | ID: mdl-38598081

RESUMEN

PURPOSE: Therapeutic drug monitoring of plasma lamotrigine (LTG) has customarily been carried out in order to prevent some its adverse effects. For forensic purposes, determination of LTG in plasma is an useful tool in cases of accidental overdose or suicidal attempts. Currently, there are several analytical methods available including some based on LC tandem mass spectrometry techniques, but simple and accessible LC-UV methods still can be useful for the purpose. Here we report on a new high-performance liquid chromatography method for the determination of lamotrigine in human plasma which has been developed and validated including selectivity, sensitivity, accuracy, precision and recovery studies. METHODS: Lamotrigine and the internal standard chloramphenicol were extracted from plasma using liquid-liquid extraction using small volumes of buffer and ethylacetate. Detection was monitored at 305.7 and 276.0 nm for lamotrigine and chloramphenicol, respectively. RESULTS: The method was linear concentration dependence within the range of 0.1-10 µg/ml, with a mean coefficient of correlation r = 0.993. The limit of detection (LOD) was 0.04 µg/ml and the limit of quantification (LOQ) was 0.1 µg/ml. Intra and interday precision values were lower than 9.0% at all concentrations studied. The intra and interday accuracy values ranged from - 7.6 to 10.1%. Recovery was found to be 98.9% or higher. The method here described was successfully applied to 11 postmortem blood samples received at the Forensic Sciences Institute of Santiago de Compostela (Spain). CONCLUSION: A new HPLC method for the determination of lamotrigine in human plasma was developed and validated. A liquid-liquid extraction using small volumes of buffer and ethylacetate was optimized. The proposed method is suitable for forensic toxicological analysis.

6.
Transpl Infect Dis ; : e14274, 2024 Apr 04.
Artículo en Inglés | MEDLINE | ID: mdl-38576133

RESUMEN

BACKGROUND: Hematopoietic stem cell transplant (HSCT) recipients are among patients with highest risk of adverse coronavirus disease 2019 (COVID-19) outcomes. OBJECTIVE: We compared clinical outcomes in post-HSCT patients with COVID-19 before and during the Omicron period. STUDY DESIGN: This was a retrospective study including patients post-HSCT with severe acute respiratory syndrome coronavirus 2 infection from April 2020 to March 2023 at Instituto Nacional de Cancerología, Mexico City. We describe their clinical characteristics and report the variables associated with severe clinical disease, hospitalization, and death. RESULTS: Fifty-three patients were included; 31 (58.5%) from the pre-Omicron period and 22 (41.5%) from the Omicron period. Median age was 42-years old (interquartile range 26-53), and 31 patients (59%) were men. Only four patients (16%) had received a vaccine prior to COVID-19 diagnosis in the pre-Omicron period versus 20 (91%) in the Omicron period (p < 0.001). COVID-19 severe cases were more common before Omicron: seven patients (23%) versus two patients (9%). Only one patient (3%) received an antiviral in the pre-Omicron period compared to 11 patients (50%) during the Omicron period (p < 0.01). COVID-19-associated mortality was almost double in the pre-Omicron period (16% vs. 9%, p = 0.6). CONCLUSIONS: This study reports patients with a high proportion of severe outcomes during the first 2 years of the pandemic. Outcomes improved during Omicron with better access to vaccines and antivirals and no in-hospital cases. Variables associated with worse outcomes were similar to other reports. Strengthening infection control measures in the hospital and better access to preventive strategies and therapeutic options are mandatory in these high-risk patients.

7.
Molecules ; 29(3)2024 Jan 25.
Artículo en Inglés | MEDLINE | ID: mdl-38338336

RESUMEN

Some South American countries have ancient traditions that may pose legal problems, such as the consumption of coca leaves, as this can provide positive results for cocaine use after the analysis of biological samples. For this reason, it is necessary to find specific markers that help differentiate legal from illegal consumption, such as tropacocaine, cinnamoylcocaine, and especially hygrine and cuscohygrine. In this work, two techniques for collecting biological samples are compared: the Quantisal® Oral Fluid collection device and passive drooling. Once the samples were collected, they were subjected to solid-phase extraction for subsequent injection into GC-MS. Different validation parameters included in international guides have been studied to evaluate whether the proposed method is valid for the defined purpose, placing special emphasis on the study of the matrix effect and little value on GC-MS analyses. With respect to this parameter, an increase in the signal was found for CUS and t-CIN, but it was not significant for the rest of the substances studied. The recoveries have varied significantly depending on the way of working, being higher when working with standardized areas. After carrying out work with the oral fluid samples collected from laboratory volunteers, the method was applied to two real samples. The results obtained support the need for further research to overcome certain limitations presented by the device.


Asunto(s)
Alcaloides , Coca , Cocaína , Humanos , Coca/química , Cromatografía de Gases y Espectrometría de Masas , Alcaloides/análisis , Hojas de la Planta/química
8.
Andes Pediatr ; 94(5): 616-627, 2023 Oct.
Artículo en Español | MEDLINE | ID: mdl-37975695

RESUMEN

OBJECTIVES: To characterize the COVID-19 disease profile in Chilean children hospitalized in pediatric intensive care units (PICU) and to evaluate risk factors associated with severe COVID-19. PATIENTS AND METHOD: A multicenter prospective cohort study with patients 0-18 years of age with confirmed SARS-CoV-2 hospitalized in PICU. Clinical, laboratory, imaging, and therapeutic variables were recorded. We compared "mild/moderate COVID-19" with ''severe COVID-19" using median with interquartile range (IQR), Mann-Whitney U test, two-tailed Fisher's test, and forward binary multivariate analysis to adjust variables for "severe COVID-19". A p < 0.05 was considered significant. RESULTS: From 16 PICUs, 219 patients were recruited, 55.3% were male, with a median age of 86 months (IQR: 13.5-156). The most frequent comorbidities were obesity and respiratory diseases. Overall mortality was 3.6%. "Severe COVID-19" (26.5%) showed more leukopenia, lymphopenia, increased inflammatory parameters, and altered organ function (p < 0.05). It also developed more sepsis/shock, ARDS, and organ dysfunction, requiring more hemodynamic, anti-inflammatory, anticoagulation, and antibiotic therapy, with a longer stay in the PICU/hospital (p < 0.05), and 13.8% of mortality. Risk factors associated with "severe COVID-19" were shock on admission to the PICU [aOR 28.44 (95%CI 10.45-77.4)], obesity [aOR 3.55 (95%CI 1.3-9.6)], consolidation [aOR 3.1 (95%CI 1.1 -8.7)], atelectasis [aOR: 8.7 (95%CI 1.17-64.3)], stress dose of corticosteroids [aOR 7.7 (95%CI 1.9-30.6)], early antibiotic therapy [aOR: 12.02 (95%CI 1.11-130.02)], acquired/congenital immunodeficiency [aOR: 19.2 (95%CI: 1.19-321)], and oncological pathology [aOR 10.7 (95%CI 2.14-47.8)]. CONCLUSION: In this Chilean pediatric cohort, most patients with COVID-19 admitted to de PICU were male, of school age, with associated comorbidity. Risk factors for developing severe COVID-19 were the presence of comorbidities such as acquired/congenital immunodeficiency, oncological pathology, and obesity, in addition to shock on admission and consolidations on X-rays.


Asunto(s)
COVID-19 , Trombocitopenia , Humanos , Niño , Masculino , Femenino , COVID-19/epidemiología , SARS-CoV-2 , Pandemias , Estudios Prospectivos , Obesidad , Antibacterianos/uso terapéutico
9.
Front Neurol ; 14: 1165155, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37681010

RESUMEN

Hemorrhage secondary to rupture of a brain arteriovenous malformations (AVM) is one of the initial manifestations, and the main cause of, morbidity and mortality in patients with this condition. Current treatment strategies include endovascular embolization with the goal of AVM obliteration and neurological preservation. In the transvenous endovascular embolization procedure, adenosine is the preferred agent to induce temporary hypotension and allow adequate AVM embolization. We describe the intraoperative management of an adenosine-resistant 38 year-old male who underwent a successful intracranial AVM embolization after concomitant administration of gradually increasing doses of nitroglycerin. This report suggests that nitroglycerin infusion can be combined with adenosine boluses to create a pronounced and dose-dependent hypotension in patients partially unresponsive to adenosine alone.

10.
J Nutr Biochem ; 122: 109451, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37748623

RESUMEN

Mesolimbic dopaminergic circuit is essential for food reward and motivational behaviors and can contribute to weight gain and obesity. Litter reduction is a classical model for studying the effects of neonatal overfeeding and overweight. Litters of Wistar rats were reduced to 4 pups/dam for small litter (SL) and 10 pups/dam for normal litter at postnatal day (PND) 4. Immediately after performing the feeding behavior tests, the animals were sacrificed in PND21 and PND90. The ventral tegmental area (VTA), Nucleus Accumbens Core (NAcC) and Shell (NAcSh) were isolated from frozen brain sections using the Palkovits micropunch technique. RNA and DNA were extracted from these areas, gene expression was measured by RT-qPCR and DNA methylation levels were measured by MSRM-qPCR technique. SL-PND21 animals presented increased expression levels of Tyrosine Hydroxylase and Dopamine Receptor D2 in VTA, decreased expression levels of dopamine active transporter (DAT) in VTA, and higher expression levels of DAT in NAcC. On the other hand, SL-PND90 animals showed decreased expression levels of Dopamine Receptor D1 and higher expression of DAT in NAcSh. These animals also evidenced impaired sensory-specific satiety. In addition, altered promoter methylation was observed at weaning, and remained in adulthood. This work demonstrates that neonatal overfeeding induces disruptions in the mesolimbic dopaminergic circuitry and causes alterations in feeding behavior from weaning to adulthood, suggesting that the neonatal period is critical for the normal development of dopaminergic circuit that impact on feeding behavior.


Asunto(s)
Metilación de ADN , Dopamina , Ratas , Animales , Dopamina/metabolismo , Ratas Wistar , Conducta Alimentaria , Núcleo Accumbens/metabolismo
11.
Scand J Psychol ; 64(6): 794-801, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37345358

RESUMEN

Aggressive behavior is a growing problem across many contexts. Thus, searching for its predictors is important. The aim of the current study was to analyze the moderator effect of mentalization in the relationship between impulsiveness and both verbal and physical aggressive behavior, using a sample of 583 participants gathered from the general Spanish population (MAge = 34.60, SDAge = 12.99). In our sample, 182 were male and 401 were female. The results showed significant bivariate relationships among aggression, impulsiveness, and mentalization. Moderation structural equation modeling (MSEM) showed a significant moderation effect, so whereas the value of mentalization is not relevant in cases of people with low impulsiveness, high mentalization abilities allow those people with high impulsiveness to behave less aggressively than people with high impulsiveness and low mentalization abilities. Practical implications and limitations of the study are discussed.


Asunto(s)
Agresión , Mentalización , Humanos , Masculino , Femenino , Adulto , Niño , Adolescente
12.
Molecules ; 28(8)2023 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-37110820

RESUMEN

A simple and sensitive analytical method was developed for qualitative and quantitative analysis of Δ9-tetrahydrocannabinol (Δ9-THC) and its metabolite 11-nor-Δ9-tetrahydrocannabinol-carboxylic acid (Δ9-THC-COOH) in human postmortem blood using gas chromatography/mass spectrometry (GC-MS) in selected ion monitoring (SIM) mode. The method involved a liquid-liquid extraction in two steps, one for Δ9-THC and a second one for Δ9-THC-COOH. The first extract was analyzed using Δ9-THC-D3 as internal standard. The second extract was derivatized and analyzed using Δ9-THC-COOH-D3 as internal standard. The method was shown to be very simple, rapid, and sensitive. The method was validated for the two compounds, including linearity (range 0.05-1.5 µg/mL for Δ9-THC and 0.08-1.5 µg/mL for Δ9-THC-COOH), and the main precision parameters. It was linear for both analytes, with quadratic regression of calibration curves always higher than 0.99. The coefficients of variation were less than 15%. Extraction recoveries were superior to 80% for both compounds. The developed method was used to analyze 41 real plasma samples obtained from the Forensic Toxicology Service of the Institute of Forensic Sciences of Santiago de Compostela (Spain) from cases in which the use of cannabis was involved, demonstrating the usefulness of the proposed method.


Asunto(s)
Dronabinol , Alucinógenos , Humanos , Cromatografía de Gases y Espectrometría de Masas/métodos , Alucinógenos/análisis , Espectrometría de Masas , Extractos Vegetales , Detección de Abuso de Sustancias/métodos
13.
Actual. SIDA. infectol ; 31(111): 49-53, 20230000. fig
Artículo en Español | LILACS, BINACIS | ID: biblio-1427113

RESUMEN

El sarcoma de Kaposi (SK) es una neoplasia maligna angioproliferativa de bajo grado, causada por la infección por virus herpes humano tipo 8 (HHV-8). El tracto gastrointestinal está involucrado en el 40% de los casos y constituye la neoplasia maligna gastrointestinal más común en pacientes con sida. Se presenta el caso de un paciente 32 años con antecedente de VIH de larga data, sin tratamiento, que relató episodios de proctorragia intermitente y pérdida de peso en los últimos dos meses. Presentaba lesiones cutáneas elevadas en forma de placas violáceas que predominaban en tronco y miembros superiores. Se realizó videocolonoscopía, la que evidenció en el área próxima a la válvula ileocecal y en el colon ascendente, lesiones sobreelevadas, eritematosas, friables y sangrantes, las cuales se biopsiaron. El estudio anatomopatológico reportó un perfil inmunohistoquímico compatible con SK. Al momento de la escritura de este artículo el paciente se encontraba bajo tratamiento quimioterápico (doxorrubicina liposomal, seis ciclos) e iniciando tratamiento antirretroviral (lamivudina ­ tenofovir ­ dolutegravir). Se presenta el siguiente caso para destacar la importancia del enfoque multidisciplinario del paciente con VIH/sida y fundamentalmente el rol de la endoscopía digestiva tanto alta como baja en pacientes con dolor abdominal, sangrado digestivo u otros síntomas abdominales, con el fin de descartar patologías del tracto gastrointestinal y, particularmente, el SK


Kaposi's sarcoma (KS) is a low-grade angioproliferative malignancy caused by infection with human herpes virus -8. The gastrointestinal tract is involved in 40% of cases, being the most common gastrointestinal malignancy in patients with AIDS. We present the case of a 32-year-old patient with a long-standing history of HIV without treatment, who reported episodes of intermittent proctorrhagia and weight loss in the last two months. He presented raised skin lesions in the form of violaceous plaques that predominate on the trunk and upper limbs. A videocolonoscopy was performed, revealing raised, erythematous, friable, bleeding lesions near the ileocecal valve and in the ascending colon, which were biopsied. The anatomopathological study shows an immunohistochemical profile compatible with KS. At the time of writing this article, the patient was under chemotherapy treatment (liposomal doxorubicin, 6 cycles) and starting antiretroviral treatment (lamivudine - tenofovir - dolutegravir). The following case is presented to highlight the importance of the multidisciplinary approach of the patient with HIV / AIDS and fundamentally the role of both upper and lower digestive endoscopy in those cases that present with abdominal pain, digestive bleeding and other abdominal symptoms, in order to rule out gastrointestinal tract pathologies and particularly KS


Asunto(s)
Humanos , Femenino , Adulto , Sarcoma de Kaposi/diagnóstico , Endoscopía Gastrointestinal , Síndrome de Inmunodeficiencia Adquirida/inmunología , VIH/inmunología , Tracto Gastrointestinal/patología
14.
Prev Sci ; 24(4): 765-773, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-36757660

RESUMEN

Driving under the influence of alcohol or drugs is a very common behavior in our environment and a serious problem for public health. On the one hand, in 2016, 400,000 people died in the world in traffic accidents in which ethanol was involved. On the other hand, traffic accidents in which the use of drugs of abuse other than ethyl alcohol accounted for more than 160,000 deaths worldwide in 2017. The objective of this work is to carry out a review of the 710 cases of people who died in traffic accidents received at the forensic toxicology service of the Institute of Forensic Sciences of the University of Santiago de Compostela (Galicia-Spain) over a period of 10 years (2009-2019). We performed an observational study of period prevalence, in which the following data were collected: age, sex, year, and analytical results in plasma, in the case of being positive. The data collected was subjected to statistical treatment. Of the 710 cases analyzed, 123 correspond to pedestrians and 587 to occupants of vehicles or motorcycles. A total of 77.6% of the deceased were men. At least one psychotropic substance was found in the blood of almost 40% of the victims. The most frequently found substance was ethyl alcohol, which appeared in 231 cases, more frequently in males. The second place is occupied by benzodiazepines, which appeared in 43 cases, followed by cocaine, which was detected in 25 cases. Polydrug use was found in only 44 cases, with the association of ethanol and cocaine being the most commonly found, followed by that of ethanol and benzodiazepines. Only in 5 of the cases analyzed there were 3 or more substances present. With the data obtained in this study, it is shown that in traffic accidents, the finding of different toxic or medicinal substances is frequent. Ethyl alcohol continues to be very present in road accidents (most detected substance), with the great impact that this implies. Secondly, the presence of benzodiazepines stands out, and cocaine is the third most detected toxic in this study. These results allow to obtain a profile of the substances most frequently involved in traffic accidents. Despite the surveillance, control, and information campaigns that the Spanish Government regularly carries out, the results are far from satisfactory.


Asunto(s)
Accidentes de Tránsito , Cocaína , Masculino , Humanos , Femenino , España/epidemiología , Etanol , Benzodiazepinas , Estudios Observacionales como Asunto
15.
Clin Exp Med ; 23(6): 2231-2238, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36508048

RESUMEN

PURPOSES: Patients with hematologic malignancies (HM) are among the individuals with highest risk of COVID-19 complications. We report the impact of remdesivir in patients with hematologic malignancies (HM) during Omicron in Mexico City. METHODS: All patients with HM and COVID-19 during December 2021-March 2022 were included. Socio-demographic and clinical data were collected. The primary outcome was COVID-19 progression. Variables associated with progression were analyzed. RESULTS: 115 patients were included. Median age was 50 years (IQR 35-63); 36% (N = 41) had at least one comorbidity. Fifty-two percent had non-Hodgkin lymphoma. Fifty patients (44%) had at least two doses of SARS-CoV-2 vaccine. COVID-19 was classified as mild (52.6%), moderate (9.7%), and severe/critical (28%). Twenty-eight patients (24%) received remdesivir. Nine patients received remdesivir at the ambulatory clinic (33%), the rest during hospital admission. Overall, 22(19%) patients progressed to severe/critical COVID-19; nine died due to COVID-19(8%). Hospital admission for non-COVID-19 causes was associated with higher odds of progression. Remdesivir did not reduce the risk of progression in hospitalized patients; none of the patients who received remdesivir in the ambulatory clinic progressed to severe COVID-19 or died. CONCLUSIONS: Patients with HM and COVID-19 continue to present with high risk of complications. More prospective studies are needed to define the impact of antivirals in this high-risk group, including the best duration of treatment. Also, better vaccine coverage and access to treatment are mandatory.


Asunto(s)
Antivirales , Tratamiento Farmacológico de COVID-19 , COVID-19 , Neoplasias Hematológicas , Humanos , Persona de Mediana Edad , Antivirales/uso terapéutico , Antivirales/efectos adversos , Vacunas contra la COVID-19 , Neoplasias Hematológicas/complicaciones , SARS-CoV-2
16.
Int J STD AIDS ; 34(3): 159-167, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36527188

RESUMEN

BACKGROUND: People living with HIV(PLWH) and cancer are among the most vulnerable patients and require constant access to medical services. We compared the characteristics of PLWH and cancer in Mexico, before and during the COVID-19 pandemic. METHODS: Patients admitted 1 year before (pre-pandemic) and 1 year after the start of the pandemic (pandemic) were included. Clinical characteristics, HIV-related variables, and 90-day mortality were compared. Data are described a proportions (N,%) and central tendency measures. A multiple regression model for variables associated with 90-day mortality was performed. RESULTS: Seventy-nine patients were seen in the pre-pandemic period; 92 during the pandemic. Main diagnoses were Kaposi Sarcoma and lymphoma. CD4+ cell count at diagnosis was lower during the pandemic: 81 cells/mm3 vs. 128 cells/mm3, p = .035. CD4+<100 cells/mm3 at first consultation increased from 41% to 58% during the pandemic (p = .041). Only BMI <20 kg/m2 was associated to death (aOR 8.27, 95%CI 1.74-39.25) (p = .008). The pandemic period was not associated with a higher 90-day mortality. CONCLUSIONS: PLWH and cancer presented to care with advanced disease overall. This was more pronounced during the pandemic period. Mortality was associated with AIDS-related variables regardless of study period. This underscores the need for strategies to maintain in-person access to health-care services for PLWH.


Asunto(s)
COVID-19 , Infecciones por VIH , Sarcoma de Kaposi , Humanos , COVID-19/epidemiología , Infecciones por VIH/complicaciones , Pandemias , México/epidemiología , Sarcoma de Kaposi/complicaciones
17.
Pers Individ Dif ; 184: 111195, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36540665

RESUMEN

The current global pandemic situation due to the Covid-19 has implied several consequences at all psychological levels. One of the main differences with respect to the pre-pandemic life in most of countries around the world is the obligation to wear a mask for citizens. This new habit could have several issues for human relationships. The current research aimed to explore the effect of wearing a mask on both emotion recognition and perception of attractiveness. Two hundred and two participants completed a task consisting of 24 face images presented twice, with and without mask. Of them, there were six images for emotion: anger, sadness, fear, and happiness. The results showed that emotion recognition was worse when wearing a face mask except for surprise: happiness, η2 = 0.84; anger, η2 = 0.74; anger, η2 = 52. Moreover, wearing a mask enhanced the perception of attractiveness both in male and female in all emotions except for happiness: sadness, η2 = 0.22; surprise, η2 = 0.05, and anger, η2 = 0.03. Finally, social implications and limitations of the study are discussed.

18.
Actual. nutr ; 23(4): 179-187, dic.2022.
Artículo en Español | LILACS | ID: biblio-1418279

RESUMEN

Introducción: Las emociones son reacciones automáticas ante diversos estímulos ambientales que tienen como finalidad adaptar al individuo a su entorno1,2. Son parte integral de la vida diaria de las personas e influyen en la alimentación y, por ende, afectan los estilos de ingesta. El estilo de vida actual ha generado que las emociones tengan mayor influencia en la alimentación y es por ello que este estudio tuvo como propósito analizar la alimentación emocional y el patrón de ingesta del personal administrativo de la Universidad Nacional de Entre Ríos (UNER), de la ciudad de Paraná en 2021. Materiales y Métodos: estudio cuantitativo, observacional, descriptivo y correlacional de corte transversal en 58 personas adultas. Para evaluar la alimentación emocional y el patrón de ingesta se aplicó una encuesta virtual autoadministrada, previamente validada. Resultados: 40% de la muestra categorizó como comedor "emocional" (puntaje 9,36 ± 4,77), observándose en las mujeres puntajes más altos (10,87 ± 5,30) que en los hombres (7,75 ± 3,56). Respecto del patrón de ingesta, las categorías "salteo de comidas" (53%) e "hiperfagia" (52%) fueron las más prevalentes. En cuanto a los alimentos, los más elegidos fueron los incluidos dentro de "dulces y grasos", tanto para emociones negativas (62%) como positivas (47%). Al estudiar la relación entre comedor emocional y estado nutricional (IMC), se encontró asociación estadísticamente significativa entre comedor "emocional" y exceso de peso (p=0,0461). Conclusiones: La mayor parte de la muestra presentó alimentación emocional, siendo las mujeres las más influenciadas por las emociones al momento de la ingesta. El comer emocional se asoció a la elección de alimentos "dulces y grasos" y, además, se correlacionó con la presencia de "hiperfagia", "atracón" y exceso de peso


Introduction: Emotions are automatic reactions to various environmental stimuli whose purpose is to adapt the individual to his environment 1,2. They are an integral part of people's daily lives and influence their diet and, therefore, eating styles disappear. The current lifestyle has generated that emotions have a greater influence on eating and that is why this study aimed to analyze the emotional eating and intake pattern of the administrative staff of the National University of Entre Ríos (UNER) of the city of Parana in 2021. Materials and Methods: quantitative, observational, descriptive and correlational cross-sectional study in 58 adults. To evaluate emotional eating and intake pattern, a previously validated self-administered virtual survey was applied.Results: 40% of the sample categorized as "emotional" eater (score 9.36 ± 4.77), observing higher scores in women (10.87 ± 5.30) than in men (7.75 ± 3.56). Regarding the eating pattern, the categories "skipping meals" (53%) and "hyperphagia" (52%) were the most prevalent. As for foods, the most chosen were those included within "sweet and fatty", both for negative (62%) and positive (47%) emotions. When studying the relationship between emotional eating and nutritional status (BMI), a statistically significant association was found between "emotional" eating and excess weight (p=0.0461). Conclusions: Most of the sample presented emotional eating, with women being the most influenced by emotions at the time of eating. Emotional eating was associated with the choice of "sweet and fatty" foods and, in addition, was correlated with presenting "hyperphagia", "binge eating" and excess weight


Asunto(s)
Humanos , Adulto , Conducta Alimentaria , Dieta , Emociones
19.
Cancer Med ; 11(8): 1827-1836, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-35166033

RESUMEN

BACKGROUND: Literature on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in cancer patients is scarce in Latin America. This population seems to have a higher risk for adverse outcomes. This study aims to correlate clinical characteristics with outcomes in patients with cancer. METHODS: We included all patients with cancer and confirmed SARS-CoV-2 infection from April 19 to December 31, 2020, at the Instituto Nacional de Cancerologia, Mexico. Clinical information was obtained from medical and epidemiological records. For the association between variables and hospitalization, invasive mechanical ventilation (IMV), and mortality, univariate and multivariate logistic regression were performed; odds ratios and 95% confidence intervals were calculated. RESULTS: Four hundred thirty-three patients were included; 268 (62%) were female, the median age was 55 years. One hundred thirty-five (31%), 131 (30%), and 93 (21%) patients had obesity, hypertension, and diabetes mellitus (DM), respectively. Three hundred forty-one (79%) had solid cancer. One hundred seventy (39%) had advanced cancer. Two hundred (46%) patients were hospitalized. Age (p < 0.01), male gender (p = 0.03), hematological malignancies (HM) (p = 0.04) and advanced cancer (p = 0.03) increased the risk for hospital admission. Forty-five (10%) patients required IMV. Age (p = 0.02); DM (p = 0.04); high C-reactive protein (p < 0.01), and lactate dehydrogenase (p = 0.03) were associated with IMV. Mortality within 30 days after diagnosis was 18% (76 cases). Associated characteristics were age (p = 0.04) and low albumin (p < 0.01). CONCLUSIONS: In this study, patients with cancer showed higher mortality, need for hospitalization, and IMV compared with other non-cancer cohorts. We did not find an increased risk in mortality for HM. Although our cohort was younger than others previously reported, age was a strong predictor of adverse outcomes. Variables associated with IMV and death were similar to those previously described in cancer patients with COVID-19.


Asunto(s)
COVID-19 , COVID-19/epidemiología , Femenino , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Pandemias , Respiración Artificial , SARS-CoV-2
20.
Int J STD AIDS ; 33(3): 296-303, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-34965797

RESUMEN

OBJECTIVE: Chronic Lower Limb Lymphedema (CL-LL) secondary to Kaposi sarcoma (KS) has not been recognized as a risk factor for cellulitis. The aim was to describe the clinical spectrum and use of antimicrobial prophylaxis in patients with cellulitis and CL-LL due to KS. METHODS: HIV patients with KS, CL-LL, and at least one episode of cellulitis seen at the AIDS Cancer Clinic at INCan in Mexico from 2004 to 2019 were included. Demographic and clinical data were obtained from medical records. RESULTS: Thirty-nine men all with CL-LL were included. Clinical factors associated with cellulitis were groin and/or lymph-node KS infiltration (69.2%), onychomycosis and/or tinea pedis (44.7%), ulcerated lesions (38.4%), and obesity (2.5%). Eighteen (46.1%) were hospitalized in the first episode and eight (20.5%) in recurrence. Six (25.3%) died, two of toxic shock syndrome (TSS), and one of septic shock. Fourteen (35.8%) had at least one recurrent episode of cellulitis. Twenty-five (64.1%) received prophylaxis. Patients without prophylaxis had significantly more unfavorable outcomes (hospitalization and recurrences) than those with prophylaxis. CONCLUSIONS: CL-LL due to KS is a risk factor for cellulitis and severe complications in patients with a long life expectancy. Antimicrobial prophylaxis needs to be explored as it could prevent complications.


Asunto(s)
Infecciones por VIH , Linfedema , Sarcoma de Kaposi , Antibacterianos/uso terapéutico , Celulitis (Flemón)/etiología , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Humanos , Linfedema/complicaciones , Linfedema/tratamiento farmacológico , Masculino , Sarcoma de Kaposi/complicaciones , Sarcoma de Kaposi/tratamiento farmacológico , Sarcoma de Kaposi/epidemiología
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