Methodological considerations in cross-sectional studies validating the International Classification of Functioning, Disability and Health (ICF) Core-Sets: a systematic review.

PURPOSE: To describe and analyze the methodological characteristics and quality of cross-sectional studies that have validated an ICF-CS. MATERIALS AND METHODS: A systematic review was conducted to identify empirical studies published in English that validated any ICF-CS using a cross-sectional design. Databases searched included Web of Science, Scopus, CINAHL, PubMed, Embase, and PsycINFO. The search was conducted in November 2022 with an update in October 2023. Two independent reviewers coded studies that met the inclusion criteria and assessed their methodological quality and risk of bias using the AXIS tool. Synthesis was performed by calculating frequencies and percentages. RESULTS: 87 articles validating 24 ICF-CSs were analyzed. Most articles showed strengths in consistency between study objectives and the outcome variables measured. However, a large majority did not report sample size calculation (up to 94.2% in Delphi studies), and few validation studies were conducted in the WHO regions of Africa and the Eastern Mediterranean. CONCLUSIONS: The quality of cross-sectional studies validating ICF-CSs was satisfactory, although several articles did not describe aspects such as sample size calculation. Validity evidence for ICF-CS studies could be improved by conducting more multicenter studies, replicating ICF-CS validation studies in different WHO regions, and through synthesis of existing research.

Cross-sectional validation studies of ICF-CSs have satisfactory quality, supporting the use of the CSs in clinical rehabilitation settings similar to those evaluated here.Additional validation studies are required for ICF-CSs that have not yet been validated or for which validity evidence is limited.The methodological findings of this review constitute a roadmap that could guide the development and improve the quality of future ICF-CS validation studies.Knowing which ICF-CSs are validated through cross-sectional designs is useful for planning and designing interventions and instrument development.

Incorporation of age into patient early warning scores significantly improves mortality prediction.

BACKGROUND: Age is a critical factor for the assessment of patients attended by emergency medical services (EMSs). However, how age modifies early warning scores' (EWSs) predictive ability should be unveiled. AIM: To determine how age influences the performance of EWS [National Early Warning Score 2 (NEWS2), VitalPAC-Early Warning Score (ViEWS), Rapid Acute Physiology Score (RAPS) and modified Rapid Emergency Medicine Score (mREMS)] to predict 2-day mortality. The secondary objective was to determine the performance of EWSs at different age ranges. DESIGN: A prospective, observational study performed between November 2019 and July 2023. METHODS: A multicenter, ambulance-based study, considering 38 basic life support units and six advanced life support units referring to four tertiary care hospitals. Eligible patients were adults recruited from among all phone requests for emergency assistance who were later evacuated to emergency departments. The primary outcome was 2-day in-hospital mortality (includes all-cause mortality). The main measures were demographical and vital signs needed for EWS calculation. RESULTS AND DISCUSSION: A total of 8028 participants fulfilled the inclusion criteria, with 7654 survivors and 374 non-survivors. Among age ranges, the 2-day mortality was 2.8% for the ≤44 years, 3.3% for the 45-64 years, 4.1% for the 65-74 years and 6.7% for the ≥75-year age group. The inclusion of age significantly improved the Area Under the Curve (AUC) in all the scores (P = 0.006 for non-age-adjusted mREMS, P = 0.001 for NEWS2, P = 0.002 for ViEWS, P = 0.028 for RAPS, all compared with their counterparts with age). CONCLUSION: Our results demonstrated that the incorporation of age into the EWS improved the performance of the scores. These results will allow the EMS to improve patient management and resource optimization by including an easy-to-obtain variable.

Acute myocardial infarction in a young patient by coronary embolism / Infarto agudo de miocardio en un paciente joven causado por embolia coronaria

Abstract: Coronary artery disease continues to be the leading cause of death in modern society; the most frequent cause is atherosclerosis. There are other causes such as coronary embolism and coronary dissection, among others. This article presents the case of a young patient with acute myocardial infarction in whom a coronary embolism was documented as the cause of infarction.

Resumen: La enfermedad arterial coronaria continúa siendo una causa de mortalidad en nuestro medio; la causa más frecuente es la aterosclerosis. Existen otras causas como embolia coronaria, disección coronaria. En este artículo se describe el caso de un paciente joven, quien presentó un infarto agudo de miocardio y se documentó un embolia conoraria como causa.

Análisis discursivo de la pandemia COVID-19 desde la oftalmología / Discourse analysis of the COVID-19 pandemic from ophthalmology

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Reumataxi: una experiencia solidaria en tiempos de COVID-19 / Reumataxi: an experience of solidarity in times of COVID-19

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La asistencia oftalmológica en la sanidad pública y en la sanidad privada ¿confrontación o colaboración? / Ophthalmological assistance in private health care and public health, collaboration or confrontation?

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Adecuación del esfuerzo terapéutico. Un reto en camino / Adequacy of therapeutic effort. A challenge on the way

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Método imunomagnético associado ao meio MesenCult® na obtenção de células mononucleares da medula óssea de coelhos negativas para o anticorpo monoclonal CD45 / Immunomagnetic method associated with MesenCult® medium to obtain bone marrow mononuclear cells from rabbits negative for CD45 monoclonal antibody

O objetivo detse artigo é de descrever um protocolo de isolamento das células mononucleares da medula óssea de coelhos, seguido de purificação celular por depleção negativa com o anticorpo monoclonal CD45 e posterior expansão em meio de cultura MesenCult®. Dez coelhos machos adultos, da raça Nova Zelândia, com idade média de 1,0±0,2 anos e peso médio 3,5±0,24kg, foram utilizados para padronização da metodologia. O isolamento das células mononuclares da medula óssea foi realizado pelo gradiente de densidade Ficoll-paque® e a purificação e obtenção das células- pela depleção negativa com o anticorpo monoclonal CD45 em base imunomagnética. A população celular obtida foi expandida posteriormente em meio de cultura MesenCult®. No isolamento pelo gradiente de icoll-Paque® foi obtido um rendimento médio de 7,31x106 células/mL. Após purificação e obtenção das possíveis células-tronco mesenquimais pela base imunomagnética, houve um decréscimo do rendimento para 2,28x106 células/mL, mas o processo de expansão foi incrementado pelo cultivo celular. Os resultados indicaram que as células obtidas da fração mononuclear da medula óssea, cultivadas in vitro foram capazes de gerar células aderentes 24 horas após o cultivo, com predominância de células fibroblastóides sugestivas de células-tronco mesenquimais. Concluiu-se que a obtenção de células-tronco mesenquimais pode ser alcançada após purificação das células mononucleares da medula óssea de coelhos pelo método imunomagético, o meio de cultura MesenCult® proporciona um ambiente adequado para a rápida expansão in vitro e o número de passagens exerce influência negativa sobre as características morfológicas das células.

The objective of this study was to describe guidelines for the isolation of bone marrow mononuclear cells from rabbits, followed by cell purification by negative depletion with CD45 monoclonal antibody, and further expansion in MesenCult® medium. Ten adult male New Zealand White rabbits, age average of 1.0±0.2 years and weighting 3.5±0.24kg, were used to obtain a standardized method. The mononuclear cells of the bone marrow were isolated with Ficoll-paque® density gradient centrifugation, and the cell purification and acquisition was completed by negative depletion with CD45 monoclonal antibody in immunomagnetic base. The cell population obtained was expanded in MesenCult® medium. Through isolation with Ficoll-paque® density gradient was possible to obtain an average yield of 7.31x106 cells/mL. After purification and acquisiton of potential mesenchymal stem cells by the immunomagnetic base, there was a yield decrease to 2.28x106 cells/mL; however the expansion process was increased in cell culture. The results indicated that cells obtained from the mononuclear fraction of bone marrow and cultivated in vitro were capable to generate adherent cells 24 hours after culture, with predominance of fibroblastoid cells suggestive of mesenchymal stem cells. It can be concluded that mesenchymal stem cells can be achieved with purified rabbit bone marrow mononuclear cells through the immunomagnetic method, as the MesenCult® medium provides a suitable environment for a quick in vitro expansion, and the number of passages exerts negative influence on the morphological characteristics.

La formación continuada en oftalmología, un derecho, un deber y una responsabilidad / Continuing education in ophthalmology, a right, a duty and a responsibility

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Reivindicando la validez del oftalmólogo general. Homenaje al Dr. Li Wenliang (1986-2020) / Vindicating the general ophthalmologist. Tribute to Dr. Li Wenliang (1986-2020)

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Repensando el sobrediagnóstico y el sobretratamiento en oftalmología. Introducción al concepto de futilidad / Re-thinking overdiagnosis and over-treatment in ophthalmology. Introduction to the concept of futility

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¿Para qué sirven los jefes de servicio y los jefes de sección en un servicio de oftalmología de la sanidad pública? / What are the duties of Opthalmology Dept. heads in the public health system?

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¿Qué sucede con la docencia en Oftalmología? / What happens with teaching in Ophthalmology?

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Linfoma no Hodgkin del tejido linfoide asociado a mucosa extraganglionar con presentación clínica de apendicitis aguda en una paciente nonagenaria / Extra-ganglionar non-Hodgkin mucosa-associated lymphoid tissue lymphoma presenting as acute appendicitis in a nonagenarian patient

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Meditaciones de la técnica / A meditation on technique

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Ensayos clínicos en oftalmología, ¿hacemos lo que debemos? / Clinical trials in ophthalmology, do we do what we must?

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