RESUMEN
BACKGROUND: Severe imported P. falciparum malaria is a source of morbi-mortality in non-endemic regions. WHO criteria don't accurately classify patients at risk of complications. There is a need to evaluate new tools such as biomarkers to better identify patients with severe imported malaria. METHODS: A case-control study was conducted in Barcelona, from January 2011-January 2021. Adult patients with microbiologically confirmed P. falciparum malaria were classified according to WHO criteria. Patients with imported non-malarial fevers were included as controls. In each group, angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), soluble triggering receptor expressed on myeloid cells (sTREM-1), C-reactive protein (CRP) and platelets were measured and their concentrations were compared between groups. New groups were made with a modified WHO severity classification and biomarkers' performance was evaluated using multiple imputation models. RESULTS: 131 participants were included: 52 severe malaria, 30 uncomplicated malaria and 49 non-malarial fever cases. All biomarkers except sTREM-1 showed significant differences between groups. Using the modified WHO severity classification, Ang-2 and CRP presented the best AUROC; 0.79 (95%CI 0.64-0.94) and 0.80(95%CI 0.67-0.93). A model combining CRP and Ang-2 showed the best AUROC, of 0.84(95%CI 0.68-0.99), with the highest sensitivity and specificity: 84.6%(95%CI 58.9-98.1) and 77.4% (95%CI 65.9-87.7), respectively. CONCLUSIONS: The combination of Ang-2 and CRP may be a reliable tool for the early identification of severe imported malaria. The use of a rapid prognostic test including the mentioned biomarkers could optimize imported malaria management, with the potential to decrease the rate of complications and hospitalizations in patients with imported malaria.
Asunto(s)
Malaria Falciparum , Malaria , Adulto , Humanos , Estudios de Casos y Controles , Malaria Falciparum/diagnóstico , Biomarcadores , Pronóstico , Proteína C-Reactiva , Plasmodium falciparumAsunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Medición de Riesgo , Retratamiento , Intubación Intratraqueal , Curva ROCRESUMEN
No disponible
Asunto(s)
Humanos , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Cuidados Críticos/normas , Unidades de Cuidados Intensivos/normas , Enfermedad Catastrófica/epidemiología , Estudios Retrospectivos , 28599Asunto(s)
Enfermedades Transmisibles Importadas/diagnóstico , Epidemias , Servicio Ambulatorio en Hospital/estadística & datos numéricos , Viaje , Infección por el Virus Zika/diagnóstico , Enfermedades Transmisibles Importadas/virología , Cuba/epidemiología , Europa (Continente) , Humanos , Estudios Prospectivos , España , Infección por el Virus Zika/epidemiologíaRESUMEN
El artículo pretende hacer un análisis de las posibilidades terapéuticas que ofrecen los hospitales de día para adolescentes, atendiendo a una dimensión cualitativa inherente a su estructura. En este sentido, veremos cómo se abren grandes posibilidades de trabajo frente a los tratamientos tradicionales, ya sean de tipo cognitivo-conductual, psicodinámico o sistémico. La terapéutica institucional no solo supone la posibilidad de trabajar de manera interdisciplinar e intensiva, sino que también permite vivenciar una experiencia emocional correctora diferenciada de lo que el adolescente repite en su familia y en sus relaciones de objeto interno. Además, si tenemos presente una posible focalización terapéutica institucional articulada con los objetivos terapéuticos individuales y familiares, veremos cómo se amplían todavía más estas posibilidades (AU)
This paper reflects on the therapeutic potential of adolescent day hospitals by focusing on the qualitative features of its particular structure. In a facility of this sort, new opportunities and possibilities of treatment are opened compared to traditional methods such as behavioural, cognitive, psychoanalytical or systemic therapy. Institutional therapeutics. In addition to working in an interdisciplinary and intensive manner, enables the teenager to experience a corrective emotional experience which differs from what he/she repeats in his/her family and internal object relations. A focalized institutional therapeutic intervention, articulated together with individual and family therapeutic objectives, can enhance the therapeutic possibilities of adolescent day hospitals even more (AU)
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Centros de Día/organización & administración , Trastornos Mentales/terapia , Psicoterapia/métodos , Cooperación del Paciente , Adhesión a Directriz , Cumplimiento de la MedicaciónRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Adulto , Endocarditis Bacteriana/complicaciones , /complicaciones , Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Endocarditis Bacteriana/microbiología , Endocarditis Bacteriana , Resultado Fatal , Huésped Inmunocomprometido , Abuso de Sustancias por Vía Intravenosa/complicaciones , SíndromeAsunto(s)
Endocarditis Bacteriana/complicaciones , Meningitis Neumocócica/complicaciones , Neumonía Neumocócica/complicaciones , Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Adulto , Insuficiencia de la Válvula Aórtica/complicaciones , Insuficiencia de la Válvula Aórtica/diagnóstico por imagen , Bacteriemia/complicaciones , Bacteriemia/microbiología , Endocarditis Bacteriana/diagnóstico por imagen , Endocarditis Bacteriana/microbiología , Resultado Fatal , Humanos , Huésped Inmunocomprometido , Masculino , Abuso de Sustancias por Vía Intravenosa/complicaciones , Síndrome , UltrasonografíaRESUMEN
OBJECTIVES: This study examines whether oral health-related quality of life (OHRQoL) is associated with malnutrition risk in the elderly. METHODS: A cross-sectional study was designed using a representative sample of Spaniards over 65 years old. Data on sociodemographics and oral health status were gathered by interview and examination. Oral health-related quality of life was evaluated using the Geriatric Oral Health Assessment Index (GOHAI), and malnutrition risk using the Mini Nutritional Assessment (MNA). RESULTS: The final sample included 2,860 elderly, 41.7 percent males and 58.3 percent females, with a mean age of 73.7 +/- 6.8 years. Mean GOHAI score was 52.1 +/- 7.2, with 70.7 percent of the sample needing oral health care according to this index. The mean MNA score was 24.0 +/- 3.31; 3.5 percent of the elderly were malnourished, 31.5 percent were at risk of malnutrition, and 65.0 percent were considered adequately nourished. A strong association was found between mean GOHAI and MNA scores.
Asunto(s)
Estado Nutricional , Salud Bucal , Calidad de Vida , Anciano , Anciano de 80 o más Años , Estudios Transversales , Índice CPO , Trastornos de Deglución/epidemiología , Cuidado Dental para Ancianos/estadística & datos numéricos , Trastornos de Alimentación y de la Ingestión de Alimentos/epidemiología , Femenino , Evaluación Geriátrica , Humanos , Institucionalización , Arcada Edéntula/epidemiología , Masculino , Desnutrición/epidemiología , Masticación/fisiología , Persona de Mediana Edad , Evaluación de Necesidades/estadística & datos numéricos , Evaluación Nutricional , Factores de Riesgo , España/epidemiología , Xerostomía/epidemiologíaRESUMEN
BACKGROUND: Malnutrition in elderly has become an important problem of health, and is associated with an increase of morbidity and mortality in this age group. The aim of this study was to determine the prevalence of malnutrition in the Spanish institutionalized and living home elderly people. SUBJECTS AND METHOD: A sample of 3,460 representative Spanish subjects older than 65 years old were studied (response rate of 96%). Nutritional status was gathered by Mini Nutritional Assessment questionnaire. RESULTS: The prevalence of malnutrition was 3,3% among elderly living at home and 7,7% among institutionalized people. Malnutrition was more prevalent in women and people with a lower income. Increase of malnutrition with age was observed. CONCLUSIONS: The observed prevalence of malnutrition in Spanish non-institutionalized elderly people was similar to observed in another populations. Sex, age and income were associated with a risk of malnutrition