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1.
Pediatrics ; 154(4)2024 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-39318339

RESUMEN

CONTEXT: There is uncertainty whether acetaminophen and ibuprofen are similar in their effects and safety when used as single or dual (alternating or combined) therapies. OBJECTIVE: To assess the comparative efficacy of acetaminophen, ibuprofen alone, alternating, or combined through a systematic review and network meta-analysis. DATA SOURCES: Medline, Embase, and CENTRAL from inception to September 20, 2023. STUDY SELECTION: Randomized trials comparing acetaminophen, ibuprofen, both alternating, and both combined, for treating children with fever. DATA EXTRACTION: Two reviewers independently screened abstracts and full texts, extracted the data, and assessed the risk of bias. We performed pairwise and network meta-analysis using the random-effects model. RESULTS: We included 31 trials (5009 children). We found that combined (odds ratio [OR], 0.19; confidence interval [CI], 0.09-0.42) and alternating therapies (OR, 0.20; CI, 0.06-0.63) may be superior to acetaminophen, whereas ibuprofen at a high dose may be comparable (OR, 0.98; CI, 0.63-1.59) in terms of proportion of afebrile children at the fourth hour. These results were similar at the sixth hour. There were no differences between ibuprofen (low or high dose), or alternating, or combined with acetaminophen in terms of adverse events. LIMITATIONS: We only evaluated the efficacy and safety during the first 6 hours. CONCLUSIONS: Dual may be superior to single therapies for treating fever in children. Acetaminophen may be inferior to combined or alternating therapies to get children afebrile at 4 and 6 hours. Compared with ibuprofen, acetaminophen was also inferior to ibuprofen alone at 4 hours, but similar at 6 hours. PROSPERO registration: CRD42016035236.


Asunto(s)
Acetaminofén , Antipiréticos , Quimioterapia Combinada , Fiebre , Ibuprofeno , Metaanálisis en Red , Ibuprofeno/uso terapéutico , Ibuprofeno/administración & dosificación , Humanos , Acetaminofén/uso terapéutico , Acetaminofén/administración & dosificación , Fiebre/tratamiento farmacológico , Antipiréticos/uso terapéutico , Antipiréticos/administración & dosificación , Niño , Ensayos Clínicos Controlados Aleatorios como Asunto , Analgésicos no Narcóticos/uso terapéutico , Analgésicos no Narcóticos/administración & dosificación
2.
Artículo en Inglés | MEDLINE | ID: mdl-39338140

RESUMEN

The Phubbing Scale (PS) is an instrument used to measure the frequency and extent of the behavior of ignoring someone you are with and giving attention to your mobile phone instead. However, there is insufficient evidence about the psychometric adequacy of the Spanish version of the instrument. The main goal of this research was to analyze the psychometric properties of PS in a representative sample of Spanish adolescents and young adults. A total of 1351 participants comprised the sample (42.78% females, age range = 12-21). Students were selected from different levels of education such as secondary school, high school, vocational training, or university. A convenient sample was used. The reliability of the scores was calculated by means of McDonald's Omega. The evidence of the internal structure of the questionnaire was analyzed by means of confirmatory factor analysis (CFA). The measurement invariance of the instrument by gender and educational level was also calculated. In addition, Pearson's correlations between phubbing and other indicators of mental health were also calculated. The goodness-of-fit indices for the two-factor model were good. The McDonald's Omega coefficient for the total score was 0.787. Measurement invariance both by gender and educational level was found. The phenomenon of phubbing was found to have statistically significant correlations with emotional well-being, other mental health indicators, and with Problematic Internet Use (PIU), with the sole exception of the hyperactivity subscale of the SDQ. This study provided validity evidence for the Spanish version of the Phubbing Scale (PS), suggesting that PS is a reliable tool for quantifying phubbing in Spanish adolescents.


Asunto(s)
Psicometría , Humanos , Adolescente , Femenino , Masculino , España , Adulto Joven , Encuestas y Cuestionarios , Niño , Reproducibilidad de los Resultados , Teléfono Celular , Acoso Escolar
3.
Healthcare (Basel) ; 12(15)2024 Jul 26.
Artículo en Inglés | MEDLINE | ID: mdl-39120185

RESUMEN

Emotional health represents a significant burden on the mental health of university students. Adapting to a new learning environment and facing increased academic pressure make this period particularly vulnerable for their emotional health and well-being. The objective of the study was to analyse the prevalence of emotional and behavioural problems in university students and their association with lifestyle habits, and mental and physical health indicators. A cross-sectional study was conducted on a sample of 1268 students (23.65 ± 7.84 years) from a university in northern Spain during November 2020 and March 2021. An online questionnaire was administered, comprising the self-report Strengths and Difficulties questionnaire, the Trait Meta-Mood Scale, the Rosenberg Self-Esteem Scale, the Satisfaction with Life Scale, the Perceived Stress Scale, the SENTIA-Brief Scale, the KIDMED questionnaire, the International Physical Activity Questionnaire-Short Form, the Alcohol Use Disorders Identification Test, and the Compulsive Internet Use Scale. 27.60% of students exhibited some form of emotional and behavioural problem. Students who did not present emotional and behavioural problems showed lower perceived stress, reduced suicidal behaviour and emotional intelligence deficits, as well as lower alcohol consumption and compulsive internet use (p < 0.001). Additionally, they reported higher engagement in physical activity and greater adherence to the Mediterranean diet (p < 0.001). The study shows that emotional and behavioural problems are recurring among university students, and given that modifiable psychosocial and lifestyle factors are associated with these issues, it underscores the need to develop multidisciplinary intervention strategies.

4.
Cell Death Dis ; 15(7): 478, 2024 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-38961086

RESUMEN

A recent approach to promote central nervous system (CNS) regeneration after injury or disease is direct conversion of somatic cells to neurons. This is achieved by transduction of viral vectors that express neurogenic transcription factors. In this work we propose adult human mucosal olfactory ensheathing glia (hmOEG) as a candidate for direct reprogramming to neurons due to its accessibility and to its well-characterized neuroregenerative capacity. After induction of hmOEG with the single neurogenic transcription factor NEUROD1, the cells under study exhibited morphological and immunolabeling neuronal features, fired action potentials and expressed glutamatergic and GABAergic markers. In addition, after engraftment of transduced hmOEG cells in the mouse hippocampus, these cells showed specific neuronal labeling. Thereby, if we add to the neuroregenerative capacity of hmOEG cultures the conversion to neurons of a fraction of their population through reprogramming techniques, the engraftment of hmOEG and hmOEG-induced neurons could be a procedure to enhance neural repair after central nervous system injury.


Asunto(s)
Neuroglía , Neuronas , Humanos , Animales , Neuroglía/metabolismo , Neuroglía/citología , Neuronas/metabolismo , Neuronas/citología , Ratones , Adulto , Mucosa Olfatoria/citología , Mucosa Olfatoria/metabolismo , Factores de Transcripción con Motivo Hélice-Asa-Hélice Básico/metabolismo , Factores de Transcripción con Motivo Hélice-Asa-Hélice Básico/genética , Linaje de la Célula , Hipocampo/citología , Hipocampo/metabolismo , Bulbo Olfatorio/citología , Bulbo Olfatorio/metabolismo , Células Cultivadas
5.
Sci Rep ; 14(1): 15464, 2024 07 05.
Artículo en Inglés | MEDLINE | ID: mdl-38965303

RESUMEN

The process of implementation of the UN Sustainable Development Goals (SDGs) which were approved by the UN General Assembly in 2015 has not been simple, being influenced by variety of social, economic, and logistical problems. It has also been negatively affected by the COVID-19 pandemic. There are to date no specific studies aimed at assessing the extent to which higher universities institutions in Europe are active in the SDGs implementation process. Departing from this research need, this paper reports on a study aimed at examining the current degree of engagement of European universities in the implementing the SDGs. By using a multi-methods approach, which entails a review of existing documents, a survey involving participants from 22 countries and case studies, the paper maps, documents and disseminates examples of what European universities are doing to implement the SDGs, the challenges they face, and the solutions being deployed to overcome them.


Asunto(s)
COVID-19 , Desarrollo Sostenible , Universidades , Desarrollo Sostenible/tendencias , Europa (Continente) , Humanos , COVID-19/epidemiología , Objetivos , SARS-CoV-2 , Pandemias , Naciones Unidas
6.
Front Psychol ; 15: 1396863, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38863670

RESUMEN

Objective: This study examined the prevalence of phubbing behavior among school and university students in Spain and analyzed the correlation of phubbing with other indicators of psychological well-being and mental health. Methods: The study sample comprised a total of 1,351 school and university students, with ages ranging from 12 to 21 years. The study used the Phubbing Scale (PS), the Compulsive Internet Use Scale (CIUS), the Rosenberg Self-Esteem Scale (RSE), and the Interpersonal Emotion Regulation Questionnaire (IERQ) for data collection. Results: The results showed evidence of phubbing among approximately half of the students. Statistically significant differences were found based on gender and educational level in the Phone Obsession subscale and the PS total score, with male students and university students scoring higher in their respective parameters. In addition, phubbing was positively correlated with problematic internet use and negatively correlated with self-esteem. Conclusion: Phubbing behavior is highly prevalent among adolescents aged 12-21 years and is positively correlated with low self-esteem and problematic internet use. Developing strategies for addressing this widespread issue at early ages, particularly within the educational context, such as schools, is crucial for implementing preventive measures. The inappropriate use of technological devices, including smartphones, in schools has the potential to negatively affect students' well-being and ability to adapt to school.

7.
Sci Rep ; 14(1): 14147, 2024 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-38898125

RESUMEN

Climate change (CC) will likely significantly impact the world's infrastructure significantly. Rising temperatures, increased precipitation, and rising sea levels are all likely to stress critical infrastructures (CI). Rising temperatures can lead to infrastructure damage from extreme heat events. This can cause roads and bridges to buckle or crack, leading to costly repairs and potential traffic disruptions. In addition, heat waves can damage vital electrical infrastructure, leading to widespread power outages. In light of this context, this article reports on a study which examined the connections and impacts of CC on infrastructure. The study employed a mixed-method approach, combining bibliometric analysis for the period 1997-2022 with a series of relevant case studies from the five continents to offer insight into the impact of CC on infrastructure. The article fills a research gap in respect of assessments of the extent to which climate change (CC) negative influences the infrastructure, with a special focus on developing countries. It also showcases CI projects and adaptation measures being currently deployed, to address CC. The results show that the current infrastructure is vulnerable to CC. The selected case studies on CI adaptation show that in developing and industrialised countries, there is a perceived need to understand better the connections and potential impacts of CC on critical areas such as transport, settlements, and coastal infrastructure. In order to protect infrastructure from CC impacts, governments need to invest in measures such as flood control, early warning systems, and improved building codes. Additionally, they need to work to reduce greenhouse gas emissions more actively, which are the primary cause of CC.

8.
PLoS One ; 19(5): e0304019, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38771748

RESUMEN

Climate change can have direct and indirect effects on human health. Direct effects can include an increase in extreme weather events, such as heatwaves and floods, as well as an increase in the spread of vector-borne and infectious diseases, which may lead to a set of health problems and diseases. Indirect effects can include changes in air quality, water availability, and food production and distribution. These changes can lead to an increase in respiratory problems, malnutrition, and increased food insecurity. There is a perceived need to investigate the extent to which Higher Education Institutions (HEIs) are engaged in efforts to foster a greater understanding of the connections between climate change and health. In this context, this preliminary investigation offers an overview of the relationships between climate change and health. By means of a survey among teaching staff and researchers at HEIs from 42 countries across all continents working on the connection between climate change and health. The study has investigated the extent to which current provisions for education and training on the connection between climate change and health are being considered and how current needs in terms of policy development, research, and training are being met. A series of case studies illustrate how universities worldwide are actively developing strategies and implementing measures to address climate change and health. The study concludes by providing specific recommendations aimed at facilitating the handling of issues related to climate change and health in a higher education context.


Asunto(s)
Cambio Climático , Humanos , Universidades , Encuestas y Cuestionarios
9.
Open Respir Arch ; 6(1): 100290, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38293643

RESUMEN

Introduction: COVID-19 pneumonia results in an impairment of the diaphragmatic musculature that influences the development of respiratory failure during the patient's hospitalization. Diaphragmatic ultrasound is a useful, non-invasive, and accessible tool for measuring the function of this muscle. Objective: Assessing the morphological and functional ultrasound status of the diaphragm in patients admitted within the first 24 h for COVID-related pneumonia and its association with hospital morbidity and mortality (NCT05805579). Material and methods: Observational, prospective cohort study that included 68 patients admitted for COVID-19 pneumonia with respiratory failure. Diaphragmatic ultrasound was performed within the first 24 h of admission to the pulmonology ward. Clinical, analytical, and ultrasound variables were collected: excursion, thickness, and diaphragmatic shortening fraction (DSF). DSF < 20% was used to define diaphragmatic dysfunction (DD). Patients who showed favorable progression and were managed on the ward (HCONV) were compared to those who required admission to the respiratory monitoring unit (RMU). Results: A total of 68 patients were included, of which 22 (32.35%) were admitted to the RMU. Diaphragmatic excursion at maximum volume was higher in the HCONV group compared to the RMU group (58.41 ± 17.83 vs. 50.03 ± 16.23; p = 0.123). Diaphragmatic dysfunction (DD) was observed in 21 (30.88%) patients, with a higher prevalence in the RMU group than in the HCONV group (15 (68.18%) vs. 6 (13.04%); p = 0.0001). In the multivariate analysis, age and DSF at admission were the best predictors of failure to discharge. Conclusions: Performing diaphragmatic ultrasound to assess mobility and DSF within the first 24 h of admission for COVID-19 pneumonia proves valuable in determining short-term progression and the need for admission to a respiratory monitoring unit.


Introducción: La neumonía por COVID-19 provoca un deterioro de la musculatura diafragmática que influye en la aparición de insuficiencia respiratoria durante la hospitalización del paciente. La ecografía diafragmática es una técnica no invasiva accesible y útil para medir la función de este músculo. Objetivo: Evaluar mediante ecografía el estado funcional y morfológico del diafragma en pacientes con neumonía por COVID durante las primeras 24 h de su ingreso y su asociación con la morbimortalidad intrahospitalaria (NCT05805579). Materiales y métodos: Se realizó un estudio prospectivo y observacional de una cohorte compuesta por 68 pacientes ingresados por neumonía por COVID-19 con insuficiencia respiratoria. La ecografía diafragmática se practicó durante las 24 h siguientes al ingreso en la planta de neumología. Se recopilaron variables clínicas, analíticas y ecográficas: desplazamiento, grosor y fracción de acortamiento diafragmático (FAD). Se utilizó una FAD < 20% como definición de disfunción diafragmática. Se comparó a los pacientes que evolucionaron favorablemente y recibieron tratamiento en planta (hospitalización convencional) con los pacientes que tuvieron que ser ingresados en la unidad de monitorización respiratoria (UMR). Resultados: Se incluyó en el estudio a un total de 68 pacientes, de los cuales 22 ingresaron en la UMR (el 32,35%). El desplazamiento diafragmático con el volumen máximo fue más alto en el grupo de hospitalización convencional que en el grupo ingresado en UMR (58,41 ± 17,83 frente a 50,03 ± 16,23; p = 0,123). Presentaron disfunción diafragmática 21 pacientes (30,88%) y la prevalencia fue más alta en el grupo ingresado en UMR que en el de hospitalización convencional: 15 pacientes (68,18%) frente a 6 (13,04%); p = 0,0001. En el análisis multivariable, la edad y la FAD al ingreso son los factores que mejor predicen la imposibilidad del alta. Conclusiones: La ecografía diafragmática para evaluar la movilidad y la FAD en las primeras 24 h del ingreso por neumonía por COVID-19 resulta valiosa para determinar la evolución a corto plazo y la necesidad de ingreso en una unidad de monitorización respiratoria.

10.
Clín. salud ; 34(3): 139 - 144, nov. 2023. tab
Artículo en Inglés | IBECS | ID: ibc-226942

RESUMEN

Background: The present study aims to analyze the prevalence of the problematic Internet use (PIU) among Spanish adolescents using the Compulsive Internet Use Scale (CIUS) and provide normative data. Method: The final sample consisted of a total of 1,977 (M age = 15.70, SD = 1.26, 53.7% female). Results: PIU were relatively common with many items seeing endorsement for between 6.5% and 33.1%. There were statistically significant differences both by gender. Females scored significantly more highly on four CIUS dimensions as well as total scores. With regards to age, we found statistically significant differences in preoccupation. No differences were found for the total score by age. Conclusions: Early detection strategies should be implemented in order to prevent PIU during adolescence, a critical developmental stage. (AU)


Antecedentes: El presente estudio tiene por objeto analizar la prevalencia del uso problemático de Internet (UPI) entre adolescentes españoles mediante la Escala de Uso Compulsivo de Internet (CIUS) y estudiar las puntuaciones típicas de la escala. Método: La muestra final estuvo compuesta por un total de 1,977 adolescentes (edad, M = 15.7, DT = 1.26, 53.7% chicas). Resultados: El UPI fue relativamente frecuente, con muchos ítems en los cuales la prevalencia se situó entre el 6.5% y el 22.1%. Se encontraron diferencias estadísticamente significativas para el género y la edad. Atendiendo al género, se obtuvieron diferencias estadísticamente significativas en 4 dimensiones de la CIUS y en la puntuación total. Con respecto a la edad, se observaron diferencias estadísticamente en la dimensión preocupación. No se encontraron diferencias para la puntuación total con respecto a la edad. Conclusiones: Se deberían utilizar estrategias de detección temprana con el objetivo de prevenir el UPI durante la adolescencia, una etapa crítica del desarrollo. (AU)


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , /epidemiología , /estadística & datos numéricos , España/epidemiología , Prevalencia , Encuestas y Cuestionarios , /prevención & control
11.
Sci Rep ; 13(1): 19030, 2023 Nov 03.
Artículo en Inglés | MEDLINE | ID: mdl-37923772

RESUMEN

Many higher education institutions around the world are engaged in efforts to tackle climate change. This takes place by not only reducing their own carbon footprint but also by educating future leaders and contributing valuable research and expertise to the global effort to combat climate change. However, there is a need for studies that identify the nature of their engagement on the topic, and the extent to which they are contributing towards addressing the many problems associated with climate change. Against this background, this paper describes a study that consisted of a review of the literature and the use of case studies, which outline the importance of university engagement in climate change and describe its main features. The study identified the fact that even though climate change is a matter of great relevance to universities, its coverage in university programmes is not as wide as one could expect. Based on the findings, the paper also lists the challenges associated with the inclusion of climate change in university programmes. Finally, it describes some of the measures which may be deployed in order to maximise the contribution of higher education towards handling the challenges associated with a changing climate.

12.
Brain Behav ; 13(9): e3133, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37533174

RESUMEN

OBJECTIVES: Problematic Internet Use (PIU) has become a worldwide problem in recent years. Among screening instruments for PIU, the Compulsive Internet Use Scale (CIUS) is perhaps the most widely used. Psychometric properties of the full CIUS are not convincing, however, and the short form (CIUS-S) has shown promising results, albeit limited to the English version, with little evidence in Spanish. Therefore, the aim of the present work was to study the psychometric properties of the CIUS-S scores in a large sample of Spanish adolescents. METHOD: The sample consisted of 1790 participants, 816 male (45.6%), 961 female (53.7%), and 13 other (0.7%) . Mean age was 15.70 years (SD = 1.26). RESULTS: The five-items one-dimensional model displayed appropriate goodness-of-fit indices. Strong measurement invariance model across age and partial across gender was found. Furthermore, the CIUS-S was positively associated with several indicators of poor well-being and mental health, and negatively associated with prosocial behavior, self-esteem, and feeling of belonging. CONCLUSION: Overall, the CIUS-S scores appear reliable and valid in its Spanish version for adolescent populations, supporting its aim to detect and prevent a problem that has become a major worldwide issue in the last years.


Asunto(s)
Conducta Adictiva , Uso de Internet , Humanos , Masculino , Adolescente , Femenino , Psicometría , Salud Mental , Emociones , Conducta Compulsiva/diagnóstico , Conducta Adictiva/diagnóstico , Conducta Adictiva/psicología
13.
Crit Rev Oncol Hematol ; 189: 104067, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37454703

RESUMEN

Colorectal cancer (CRC) is the third most common malignant tumor and one of the deadliest cancers. At molecular level, CRC is a heterogeneous disease that could be divided in four Consensus Molecular Subtypes. Given the differences in the disease due to its anatomical location (proximal and distal colon), another classification should be considered. Here, we review the current knowledge on CRC dichotomic´s behaviour based on two different entities; right and left-sided tumors, their impact on clinical trial data, microbiota spatial composition and the interaction with the nervous system. We discuss recent advances in understanding how the spatial tumor heterogeneity influences the tumor growth, progression, and responses to current therapies.


Asunto(s)
Neoplasias del Colon , Neoplasias Colorrectales , Humanos , Neoplasias Colorrectales/terapia , Neoplasias Colorrectales/tratamiento farmacológico , Neoplasias del Colon/patología
14.
Travel Med Infect Dis ; 53: 102594, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37211342

RESUMEN

INTRODUCTION: Colombia is the fifth most affected country by the global monkeypox outbreak and the second in LAC after Brazil. We describe the clinical and epidemiological characteristics of 521 patients with mpox in the country. METHODS: We conducted an observational analysis of laboratory-confirmed Mpox cases between June 29 and November 16, 2022. RESULTS: Most cases were young men living with HIV. The clinical evolution was primarily benign, with two deaths reported. We found some differences between women and men regarding their BMI, presence of lymphadenopathies, localization of lesions, and the antecedent of HIV infection. CONCLUSION: Although it seems that the epidemic curve for this outbreak of Mpox is decreasing not only in Colombia but globally, it could remain endemic. Therefore, it is necessary to maintain very close surveillance.


Asunto(s)
Infecciones por VIH , Mpox , Masculino , Humanos , Femenino , Colombia/epidemiología , Infecciones por VIH/epidemiología , Brasil , Brotes de Enfermedades
15.
Cochrane Database Syst Rev ; 5: CD013640, 2023 05 17.
Artículo en Inglés | MEDLINE | ID: mdl-37196992

RESUMEN

BACKGROUND: Although acute diarrhoea is a self-limiting disease, dehydration may occur in some children. Dehydration is the consequence of an increased loss of water and electrolytes (sodium, chloride, potassium, and bicarbonate) in liquid stools. When these losses are high and not replaced adequately, severe dehydration appears. Severe dehydration is corrected with intravenous solutions. The most frequently used solution for this purpose is 0.9% saline. Balanced solutions (e.g. Ringer's lactate) are alternatives to 0.9% saline and have been associated with fewer days of hospitalization and better biochemical outcomes. Available guidelines provide conflicting recommendations. It is unclear whether 0.9% saline or balanced intravenous fluids are most effective for rehydrating children with severe dehydration due to diarrhoea. OBJECTIVES: To evaluate the benefits and harms of balanced solutions for the rapid rehydration of children with severe dehydration due to acute diarrhoea, in terms of time in hospital and mortality compared to 0.9% saline. SEARCH METHODS: We used standard, extensive Cochrane search methods. The latest search date was 4 May 2022. SELECTION CRITERIA: We included randomized controlled trials in children with severe dehydration due to acute diarrhoea comparing balanced solutions, such as Ringer's lactate or Plasma-Lyte with 0.9% saline solution, for rapid rehydration. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. Our primary outcomes were 1. time in hospital and 2. MORTALITY: Our secondary outcomes were 3. need for additional fluids, 4. total amount of fluids received, 5. time to resolution of metabolic acidosis, 6. change in and the final values of biochemical measures (pH, bicarbonate, sodium, chloride, potassium, and creatinine), 7. incidence of acute kidney injury, and 8. ADVERSE EVENTS: We used GRADE to assess the certainty of the evidence. MAIN RESULTS: Characteristics of the included studies We included five studies with 465 children. Data for meta-analysis were available from 441 children. Four studies were conducted in low- and middle-income countries and one study in two high-income countries. Four studies evaluated Ringer's lactate, and one study evaluated Plasma-Lyte. Two studies reported the time in hospital, and only one study reported mortality as an outcome. Four studies reported final pH and five studies reported bicarbonate levels. Adverse events reported were hyponatremia and hypokalaemia in two studies each. Risk of bias All studies had at least one domain at high or unclear risk of bias. The risk of bias assessment informed the GRADE assessments. Primary outcomes Compared to 0.9% saline, the balanced solutions likely result in a slight reduction of the time in hospital (mean difference (MD) -0.35 days, 95% confidence interval (CI) -0.60 to -0.10; 2 studies; moderate-certainty evidence). However, the evidence is very uncertain about the effect of the balanced solutions on mortality during hospitalization in severely dehydrated children (risk ratio (RR) 0.33, 95% CI 0.02 to 7.39; 1 study, 22 children; very low-certainty evidence). Secondary outcomes Balanced solutions probably produce a higher increase in blood pH (MD 0.06, 95% CI 0.03 to 0.09; 4 studies, 366 children; low-certainty evidence) and bicarbonate levels (MD 2.44 mEq/L, 95% CI 0.92 to 3.97; 443 children, four studies; low-certainty evidence). Furthermore, balanced solutions likely reduces the risk of hypokalaemia after the intravenous correction (RR 0.54, 95% CI 0.31 to 0.96; 2 studies, 147 children; moderate-certainty evidence). Nonetheless, the evidence suggests that balanced solutions may result in no difference in the need for additional intravenous fluids after the initial correction; in the amount of fluids administered; or in the mean change of sodium, chloride, potassium, and creatinine levels. AUTHORS' CONCLUSIONS: The evidence is very uncertain about the effect of balanced solutions on mortality during hospitalization in severely dehydrated children. However, balanced solutions likely result in a slight reduction of the time in the hospital compared to 0.9% saline. Also, balanced solutions likely reduce the risk of hypokalaemia after intravenous correction. Furthermore, the evidence suggests that balanced solutions compared to 0.9% saline probably produce no changes in the need for additional intravenous fluids or in other biochemical measures such as sodium, chloride, potassium, and creatinine levels. Last, there may be no difference between balanced solutions and 0.9% saline in the incidence of hyponatraemia.


Asunto(s)
Deshidratación , Hipopotasemia , Niño , Humanos , Bicarbonatos/uso terapéutico , Creatinina , Deshidratación/etiología , Deshidratación/terapia , Diarrea/terapia , Potasio , Cloruro de Potasio/uso terapéutico , Lactato de Ringer , Solución Salina , Sodio
16.
Clín. salud ; 34(1): 15-22, mar. 2023. tab
Artículo en Inglés | IBECS | ID: ibc-217515

RESUMEN

Background: The aim of the PSICE (Evidence-based Psychology in Educational Contexts) Project is to examine the effectiveness of the Unified Protocol for Transdiagnostic Treatment of Adolescents (UP-A) with symptoms of anxiety and depression in school settings. The goal is to prevent emotional problems and to improve adolescents’ socioemotional adjustment, learning processes, and academic performance. Method: A randomized controlled trial with two groups will be performed: active control (progressive relaxation training) and experimental (UP-A). After screening, participants with subclinical emotional symptomatology will be selected for pre- and post-test evaluation and follow-up at 6, 12, and 18 months. Results: The impact of different indicators at behavioral, cognitive, affective, social and academic functioning levels will be analyzed, as well as their effects in the short, medium and long term. Conclusions: Examining the effectiveness of the UP-A in the Spanish educational context will, among other things, provide data for informed decision-making in the field of educational psychology. In addition, it will ensure that such interventions, using standardized protocols, are accessible to a large population at such an important stage of human development as adolescence. The PSICE project will provide leadership and guidance on the importance of psychology in schools. (AU)


Antecedentes: El objetivo del Proyecto PSICE (Psicología basada en la evidencia en contextos educativos) es examinar la efectividad del protocolo unificado para el tratamiento transdiagnóstico de síntomas de ansiedad y depresión en adolescentes (UP-A) en contextos educativos. El objetivo es prevenir los problemas emocionales, así como mejorar el ajuste socioemocional, los procesos de aprendizaje y el rendimiento académico de los adolescentes. Método: Se implementa mediante un ensayo controlado aleatorizado con dos grupos: control activo (entrenamiento en relajación progresiva) y experimental (UP-A). Tras un cribado, se seleccionarán participantes con síntomas emocionales subclínicos a los que se realizará evaluación pretest, postest y seguimiento a los 6, 12 y 18 meses. Resultados: Se analizará el impacto de diferentes indicadores a nivel comportamental, cognitivo, afectivo y de funcionamiento social y académico, así como sus efectos a corto, medio y largo plazo. Conclusiones: Examinar la efectividad del UP-A en el contexto educativo español permitirá, entre otras cuestiones, disponer de datos en el campo de la psicología educativa de cara a la toma de decisiones informadas, además de garantizar que dichas intervenciones sean accesibles, empleando protocolos estandarizados, para un gran conjunto de la población y en una etapa del desarrollo humano tan relevante como es la adolescencia. El proyecto PSICE proporcionará liderazgo y orientación sobre la importancia de la Psicología en el contexto educativo. (AU)


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Educación , Salud Mental , Emociones , Ansiedad/tratamiento farmacológico , Ansiedad/prevención & control , Depresión/tratamiento farmacológico , Depresión/prevención & control , España
17.
Front Mol Neurosci ; 16: 1110356, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36910262

RESUMEN

An approach to generate new neurons after central nervous system injury or disease is direct reprogramming of the individual's own somatic cells into differentiated neurons. This can be achieved either by transduction of viral vectors that express neurogenic transcription factors and/or through induction with small molecules, avoiding introducing foreign genetic material in target cells. In this work, we propose olfactory ensheathing glia (OEG) as a candidate for direct reprogramming to neurons with small molecules due to its well-characterized neuro-regenerative capacity. After screening different combinations of small molecules in different culture conditions, only partial reprogramming was achieved: induced cells expressed neuronal markers but lacked the ability of firing action potentials. Our work demonstrates that direct conversion of adult olfactory ensheathing glia to mature, functional neurons cannot be induced only with pharmacological tools.

18.
Children (Basel) ; 10(2)2023 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-36832426

RESUMEN

The main purpose of the present study was to analyze the psychometric properties of the Spanish version of the Modified Conflict Tactics Scale (M-CTS) in adolescents. The M-CTS is a questionnaire that screens for intimate partner violence. Additionally, we studied the association between the M-CTS and attitudes towards violence. The study included a sample of 1248 students in a cross-sectional survey. The M-CTS and the Attitudes Towards Violence (EAV) scale were used. The analysis of the internal structure of the M-CTS revealed that a four-factor structure was the best fitting solution. The M-CTS scores revealed evidence of structural equivalence by gender and age. The McDonald's Omega indices were adequate for both victims and perpetrators models. Moreover, attitudes towards violence were positively correlated with measures of violence manifestations. Results found in the present study confirm the psychometric adequacy of the M-CTS scores and gather new evidence about its internal structure and measurement equivalence for its use in samples of adolescent and young students. The assessment of intimate partner violence may contribute to detect adolescents at risk for different forms of violence in the future.

19.
J Clin Res Pediatr Endocrinol ; 15(1): 16-24, 2023 02 27.
Artículo en Inglés | MEDLINE | ID: mdl-35984227

RESUMEN

Objective: Several endocrine manifestations have been described in patients with 22q11 deletion syndrome, including growth retardation, hypoparathyroidism, and thyroid disorders. This study aimed to characterize these abnormalities in a Colombian retrospective cohort of children with this condition. Methods: A retrospective study comprising a cohort of children with 22q11 deletion syndrome in Medellín, Colombia followed up between 2011 and 2017 was conducted. Results: Thirty-seven patients with a confirmed diagnosis of 22q11 deletion syndrome were included. 37.8% had some endocrinopathy, the most frequent being hypoparathyroidism (21.6%), followed by hypothyroidism (13.5%), hyperthyroidism (2.7%) and growth hormone deficiency (2.7%). There was wide heterogeneity in the clinical presentation, with late onset of severe hypocalcemia associated with seizure or precipitated in postoperative cardiac surgery, which highlights the importance of continuous follow-up as indicated by the guidelines. Short stature was mainly related to nutritional factors. Growth monitoring is required with the use of syndrome-specific charts and careful monitoring of the growth rate. Conclusion: As previously reported, a significant proportion of patients with endocrine abnormalities were found in this cohort. This highlights that it is essential to carry out an adequate multidisciplinary follow-up, based on the specific clinical guidelines, in order to avoid serious complications such as convulsions due to hypocalcemia. It is important to track size with curves specific to the syndrome and analyze the growth rate.


Asunto(s)
Síndrome de Deleción 22q11 , Enanismo Hipofisario , Enfermedades del Sistema Endocrino , Hipocalcemia , Hipoparatiroidismo , Humanos , Niño , Estudios Retrospectivos , Colombia , Hipocalcemia/etiología , Hipocalcemia/diagnóstico , Síndrome de Deleción 22q11/genética , Síndrome de Deleción 22q11/complicaciones , Síndrome de Deleción 22q11/diagnóstico , Deleción Cromosómica
20.
Front Cell Dev Biol ; 11: 1328261, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38188022

RESUMEN

In the last decades, mesenchymal stem cells (MSCs) have become the cornerstone of cellular therapy due to their unique characteristics. Specifically human placenta-derived mesenchymal stem cells (hPMSCs) are highlighted for their unique features, including ease to isolate, non-invasive techniques for large scale cell production, significant immunomodulatory capacity, and a high ability to migrate to injuries. Researchers are exploring innovative techniques to overcome the low regenerative capacity of Central Nervous System (CNS) neurons, with one promising avenue being the development of tailored mesenchymal stem cell therapies capable of promoting neural repair and recovery. In this context, we have evaluated hPMSCs as candidates for CNS lesion regeneration using a skillful co-culture model system. Indeed, we have demonstrated the hPMSCs ability to stimulate damaged rat-retina neurons regeneration by promoting axon growth and restoring neuronal activity both under normoxia and hypoxia conditions. With our model we have obtained neuronal regeneration values of 10%-14% and axonal length per neuron rates of 19-26, µm/neuron. To assess whether the regenerative capabilities of hPMSCs are contact-dependent effects or it is mediated through paracrine mechanisms, we carried out transwell co-culture and conditioned medium experiments confirming the role of secreted factors in axonal regeneration. It was found that hPMSCs produce brain derived, neurotrophic factor (BDNF), nerve-growth factor (NGF) and Neurotrophin-3 (NT-3), involved in the process of neuronal regeneration and restoration of the physiological activity of neurons. In effect, we confirmed the success of our treatment using the patch clamp technique to study ionic currents in individual isolated living cells demonstrating that in our model the regenerated neurons are electrophysiologically active, firing action potentials. The outcomes of our neuronal regeneration studies, combined with the axon-regenerating capabilities exhibited by mesenchymal stem cells derived from the placenta, present a hopeful outlook for the potential therapeutic application of hPMSCs in the treatment of neurological disorders.

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